School Debt, Income Gap Push Med Students Away From Primary Care09/27/12
THURSDAY, Sept. 27 (HealthDay News) -- School debt and income
expectations are two main reasons many medical students decide to
enter a high-paying specialty instead of becoming primary care
doctors, according to a new long-term study.
The United States has a shortage of primary care doctors, who
are among the lowest paid of all physicians. Primary care doctors
are front-line health providers and usually are the first to
diagnose illnesses. They also refer patients to specialists and
Primary care includes internal medicine, family practice and
In this study, researchers surveyed more than 2,500 medical
students attending either New York Medical College or the Brody
School of Medicine at East Carolina University between 1992 and
2010. The students were surveyed in their first and fourth years
about the area of medicine they planned to enter, their expected
debt upon graduation, their anticipated annual income five years
after completing residency and the importance they placed on
Medical students who anticipated high levels of debt and placed
a premium on high income were more likely to enter a high-paying
medical specialty -- such as dermatology, radiology or
anesthesiology -- than to enter primary care.
By graduation, 30 percent of the students who entered medical
school with the intention of becoming a primary care doctor
switched their preference to a high-paying specialty.
Those who changed their minds about becoming primary care
doctors placed a higher value on income and had an 11 percent
higher expected debt load than those who followed through on their
goal of become primary care doctors.
The study was published online Sept. 19 in the journal
In 2010, 86 percent of medical students graduated with some
education debt, according to the Association of American Medical
Colleges. The average debt was $158,000, but 30 percent of
graduates were more than $200,000 in debt.
"While the amount of debt medical students take on is well known, there hasn't been much research to assess how students respond to this pressure," study lead author Dr. Martha Grayson, senior associate dean of medical education at Albert Einstein College of Medicine at Yeshiva University in New York City, said in a university news release.
These findings suggests that measures such as incentive pay,
debt forgiveness, additional scholarships and higher reimbursement
for primary care services should be considered in order to meet the
growing need for primary care doctors, the researchers said.
The American Medical Association has more about
health care careers.
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