Impact of Service-Based Student Loan Repayment Program on the Primary Care Workforce

Article Figures & Data

Table 1.

Demographics of Early Career Family Physicians, Overall and by Loan Repayment Program

Demographic	Value (P Value)
Demographic	Overall (N = 10,677)	PSLF (n = 1,653)	NHSC (n = 504)	IHS (n = 32)	Military (n = 525)	Other (n = 2,360)
Age, mean, y	35.8	35.2 (<.001)	35.8 (.88)	36.4 (.40)	36.0 (.37)	35.3 (<.001)
Gender, %
Female	56.3	57.4 (.34)	62.7 (.003)	78.2 (.01)	35.1 (<.001)	55.3 (.30)
Male	43.7	42.7	37.3	21.9	65.0	44.7
Medical degree, %
MD	81.8	71.0 (<.001)	80.8 (.55)	96.9 (.03)	61.3 (<.001)	82.2 (.49)
DO	18.2	29.0	19.3	3.1	38.7	17.8
International medical graduate, %
Yes	32.8	18.1 (<.001)	12.3 (<.001)	0 (<.002)	4.4 (<.001)	29.6 (<.001)
No	67.2	81.9	87.7	100.0	95.6	40.5
Race, %^{^a}
Asian	17.1	9.3 (<.001)	7.7 (<.001)	3.1 (.04)	6.9 (<.001)	12.8 (<.001)
Black or African American	5.6	5.6 (.93)	9.5 (<.002)	0 (.17)	4.8 (.40)	5.0 (.20)
White	51.9	70.3 (<.001)	57.5 (.009)	18.8 (<.002)	68.6 (<.001)	66.7 (<.002)
Other	2.3	1.6 (.051)	2.8 (.46)	53.1 (<.001)	1.5 (.23)	1.5 (.005)
Ethnicity, %^{^a}
Hispanic	8.4	5.9 (<.002)	9.7 (.33)	4.2 (.46)	8.2 (.86)	6.5 (<.002)
Non-Hispanic	91.6	94.1	90.3	95.8	91.8	93.5

DO = doctor of osteopathy; IHS = Indian Health Service; MD = doctor of medicine; NHSC = National Health Service Corps; PSLF = Public Service Loan Forgiveness.
Notes: Data are from the American Board of Family Medicine National Graduate Survey, 2016-2020. A total of 5,603 family physicians reported using no loan repayment program. P values are for comparison of the program group vs the overall sample.
↵a Available for the 2017-2020 cohorts only.

Table 2.

Practice Scope and Setting of Early Career Family Physicians, Overall and by Loan Repayment Program

Practice Attribute	Value (P Value)
Practice Attribute	Overall	PSLF	NHSC	IHS	Military	Other
iSOP score, mean^{^a}	16.1	16.4 (<.001)	17.2 (<.001)	18.6 (<.001)	17.3 (<.001)	16.8 (<.001)
Rural area (RUCC ≥4), %	12.0	10.8 (.11)	23.3 (<.001)	43.8 (<.001)	8.2 (.009)	28.9 (<.001)
Primary care HPSA in 2020
Whole county or partial, %	89.7	90.7 (.43)	96.6 (.03)	100.0 (.41)	88.9 (.82)	91.0 (.32)
Whole county only, %	4.5	3.7 (.42)	12.5 (<.002)	0 (.60)	4.9 (.83)	8.2 (<.001)
Medically underserved practice setting, %	19.5	24.2 (<.001)	82.2 (<.001)	100.0 (<.001)	2.6 (<.001)	30.4 (<.001)
Annual income, mean, $	208,646	203,995 (.02)	191,344 (<.001)	203,726 (.74)	148,711 (<.001)	223,757 (<.001)

HPSA = Health Professional Shortage Area; IHS = Indian Health Service; iSOP = individual scope of practice; NHSC = National Health Service Corps; PSLF = Public Service Loan Forgiveness; RUCC = Rural-Urban Continuum Code.
Notes: Data are from the American Board of Family Medicine National Graduate Survey, 2016-2020. A total of 5,603 family physicians reported using no loan repayment program. P values are for comparison of the program group vs the overall sample.
↵a Reflects the number of clinical services provided; possible range is 0 to 30, with a higher score indicating a broader scope.