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M e d i c a l R e c o R d F e at u R e

Behind the Curtain

of Medical School Debt
by Lucy J. Cairns, MD, and T.J. Huckleberry, MPA


he debt incurred by students in the process of completing
medical school in the U.S. has certainly ballooned to levels
likely to give aspiring medical students (and their parents!)
pause. But the implications for current and future students are not
entirely clear, since physicians are a relatively highly compensated
group. In this feature we will examine the question of whether we
should be concerned about the rising debt burden of the average
medical student. What are the consequences for the individual
students? What are the implications for the wider community?
As a starting point, we reached out to some recent medical
school graduates - resident physicians in training at our local health
systems. The following are answers we received to a questionnaire
we created to ask for some insight. Keep in mind that these
physicians have all chosen a career in a primary care specialty.
1. Did the cost of medical education make you hesitate
before deciding to become a physician?
- No, I always wanted to be a doctor and I knew I would
eventually pay back loans.
- Yes. I was not going to have any financial help from my parents
and I knew I was going to have to bear the financial burden of
medical education on my own. I knew I would graduate with
loans of about $300,000. For someone who had basically no
money starting medical school, that did make me worry. It's a
staggering amount of money. That amount of money could buy
a very nice house. I knew other students in the same situation I
was in, however, so I figured the debt could not be so crippling
that it was deterring other students from attending medical
2. Was the financial aid offered a deciding factor when you
chose your school?
- I was not offered very much financial aid because they take
your parents' salary and assets into account on the FAFSA, as
institutions assume your parents will help you pay for medical




school. This was not the case for me. I did not receive very much
financial aid from my institution.
- Yes and no. It helped, but I don't think I would have made it
be the determining factor.
- No, but tuition did play a role.
3. How well informed were you regarding your eventual
student debt load?
- Not well at all!
- Very. They don't shut up about it for Pre-Med in college.
- Before attending school I was able to calculate out what I
thought the amount of my debt would be. I was shocked.
About the same time, I received a flyer from the Army and
Navy offering scholarships. They would pay for my medical
education if I worked for them for as many years as they
paid for my medical education. I seriously considered this.
I interviewed with a recruiter, I had lab work and physicals
completed. The only thing left was for me to sign on the dotted
line. I had a heart to heart conversation with my mother, who
eventually convinced me not to sign.
- Not well. I'm still surprised at the cost and interest on the
4. Did the cost of your education influence your choice of
- Note: all responses were "No."
- No. I always wanted to be a family physician and work in
primary care. I value my happiness and job satisfaction higher
than the pay scale. I don't believe I will regret my decision.
- No, I always wanted family medicine - which is the lowest
paying - because it was interesting to me.
5. Did or will student debt play a role in your choice of
practice location and/or practice type (i.e. independent vs.
employed, large vs. small group, etc.)?


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