A Retrospective Analysis of the Relationship Between Medical Student Debt and Primary Care Practice in the United States

Julie P. Phillips; Stephen M. Petterson; Andrew W. Bazemore; Robert L. Phillips

doi:10.1370/afm.1697

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Re:Let's Move Beyond the Debt Issue
William Pevsner

Published on: 17 November 2014
Author response: Debt and Income are Not Separate Issues
Julie P. Phillips

Published on: 12 November 2014
Let's Move Beyond the Debt Issue
Richard A Young

Published on: 12 November 2014

Published on: (17 November 2014)
Page navigation anchor for Re:Let's Move Beyond the Debt Issue
Re:Let's Move Beyond the Debt Issue
William Pevsner, Family Physician
Let's face it, the massive debt any student who doesn't have help from family or otherwise faces is a huge psychological burden! One has to remember if they have medical school loans, likely they also have a significant debt from their undergrad education(accruing interest all the while, btw). But what does a student do once he has traveled down the educational juggernaut? He really has few choices but to persevere and...
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Let's face it, the massive debt any student who doesn't have help from family or otherwise faces is a huge psychological burden! One has to remember if they have medical school loans, likely they also have a significant debt from their undergrad education(accruing interest all the while, btw). But what does a student do once he has traveled down the educational juggernaut? He really has few choices but to persevere and hope he will be able to pay off the debt some day, especially with the stranglehold the loan processing/holding firms have on the individual under current law. Sallie Mae is no one's friend. The area of specialty chosen has less to do with debt repayment advantage or disadvantage than just pure survival. And let's not forget how helpful our own fraternity is by offering these kids great high-paying jobs when they get out. Many are taken advantage of because groups looking for new grads know the predicament they are in. I am not sure what reform looks like for the new generation of physicians, but it needs to be looked at seriously for the health of our profession, or we will lose the best and brightest to What's App interns who cash in while still in school.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (12 November 2014)
Page navigation anchor for Author response: Debt and Income are Not Separate Issues
Author response: Debt and Income are Not Separate Issues
Julie P. Phillips, Associate Professor
I agree with Dr. Young's perspective that the impact of debt on students' career choices is relatively small, compared to other factors. I also agree that payment reform has the potential to fundamentally change the way our students make specialty choices.
However, isolating debt from students' perceptions of their income oversimplifies the problem. Students are interested in higher income specialties, in part,...
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I agree with Dr. Young's perspective that the impact of debt on students' career choices is relatively small, compared to other factors. I also agree that payment reform has the potential to fundamentally change the way our students make specialty choices.
However, isolating debt from students' perceptions of their income oversimplifies the problem. Students are interested in higher income specialties, in part, because their debt is high. High debt contributes to a culture within medical education that encourages students to value financial renumeration above other considerations.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (12 November 2014)
Page navigation anchor for Let's Move Beyond the Debt Issue
Let's Move Beyond the Debt Issue
Richard A Young, Director of Research
Phillips, et al have convincingly shown that medical student debt is a minor contributor to the massive disinterest in family medicine among U.S. medical students. There is a statistically significant impact among public school students, but the magnitude is small, making no more than about a 5% difference.
Therefore, let's stop putting our efforts as family medicine advocates into loan repayment programs at th...
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Phillips, et al have convincingly shown that medical student debt is a minor contributor to the massive disinterest in family medicine among U.S. medical students. There is a statistically significant impact among public school students, but the magnitude is small, making no more than about a 5% difference.
Therefore, let's stop putting our efforts as family medicine advocates into loan repayment programs at the state or federal level as a viable solution to the chronic undersupply of family physicians. Payment reform, and only payment reform, will be required to create the massive shift of medical student interest in family medicine to right our sinking health professional ship.
Competing interests: I was paid a stipend to participate in the CMS Innovation Advisors Program.
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Competing Interests: None declared.