Volume 46, Issue 10 p. 983-991

career choice

Payback time: the associations of debt and income with medical student career choice

Martha S Grayson,

Martha S Grayson

Office of Medical Education, Albert Einstein College of Medicine, New York, New York, USA

Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA

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Dale A Newton,

Dale A Newton

Department of Paediatrics, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA

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Lori F Thompson,

Lori F Thompson

Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA

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Martha S Grayson,

Martha S Grayson

Office of Medical Education, Albert Einstein College of Medicine, New York, New York, USA

Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA

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Dale A Newton,

Dale A Newton

Department of Paediatrics, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA

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Lori F Thompson,

Lori F Thompson

Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA

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First published: 19 September 2012

https://doi.org/10.1111/j.1365-2923.2012.04340.x

Citations: 75

Martha S Grayson, Department of Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, New York 10461, USA. Tel: 00 1 718 430 3371; Fax: 00 1 718 430 8825; E-mail: [email protected]

MSG was employed in the Department of Medicine, New York Medical College, Valhalla, New York, USA, at the time this study was conducted.

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Abstract

Medical Education 2012: 46: 983–991

Context With impending health care reform in the USA, there is an imperative to increase the number of students choosing primary care (PC) careers. Research is needed to better understand the roles of economic factors in medical student career choice. The objective of this study was to examine the relationships among debt, income and career choice by comparing students planning PC careers with those aspiring to one of the 12 non-PC fields in which median income exceeds US$300 000 (‘high-paying non-primary care’ [HPNPC]).

Methods Surveys (response rate = 81%) were administered to Year 1 students scheduled to graduate between 1996 and 2012, and Year 4 students graduating between 1993 and 2010. Respondents were students at New York Medical College and East Carolina University’s Brody School of Medicine. Analyses focused on the 2674 Year 1 respondents choosing a PC (n = 1437, 54%) or HPNPC (n = 1237, 46%) career, and the 2307 Year 4 respondents intending to pursue PC (n = 992, 43%) or HPNPC (n = 1315, 57%). Longitudinal analyses examining changes in career goals during medical school were based on students who completed surveys in both Years 1 and 4. The outcome measures studied were self-reported debt, anticipated income and self-rated value placed on income.

Results Relative to their PC counterparts, students intending to pursue HPNPC careers anticipated an average of US$24 904 (Year 4 students) or US$29 237 (Year 1 students) greater debt, placed a higher importance value on income, and anticipated earning an average of US$58 463 (Year 1 students) and US$89 909 (Year 4 students) more in annual income after graduation. Debt was associated with the value placed on income in the choice of career and the amount of future income anticipated. Students who valued income highly were especially inclined to switch from PC during medical school. The switch away from PC was associated with debt, as well as with a marked increase in anticipated income.

Conclusions Debt and anticipated income are important concerns which may shape future supplies of PC doctors.

Supporting Information

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Volume46, Issue10

October 2012

Pages 983-991

Payback time: the associations of debt and income with medical student career choice

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Payback time: the associations of debt and income with medical student career choice

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