By Julie Fresne
I read with interest the recent Wing of Zock posting, “It’s Time for Innovation in How We Pay for Medical School.” While I’m encouraged that this post addressed the important topic of medical education cost and debt, it’s unfortunate that it reinforces misperceptions that exist about education debt and repayment.
While many claim that debt leads medical students to choose more lucrative specialties, AAMC research indicates that debt does not play a determining role in specialty choice for most students. The report, “Physician Education Debt and the Cost to Attend Medical School,” includes a section outlining evidence on the “minor role of debt in specialty choice.” Studies show that specialty choice is a complex and personal decision involving many factors. Some students with high debt do in fact choose primary care and AAMC data suggests that there is no systematic bias away from primary care specialties by graduates with higher debt levels. In addition, an Academic Medicine article co-authored by AAMC staff concluded, “A primary care career remains financially viable for medical school graduates with median levels of education debt,” after rigorously analyzing the household finances of a typical physician repaying education debt.
Finally, the post fails to mention that the new income-driven repayment plans for federal loans make repayment affordable for all indebted medical students, regardless of their specialty or debt level. These plans, such as “Pay As You Earn,” link payments to income, not debt levels, providing all indebted students, not just those seeking a public service career, with a manageable monthly payment and potential forgiveness options.
I appreciate discussion of this important topic on Wing of Zock and hope that these posts stimulate useful conversation. I also hope that some of the evidence cited here offers encouragement for those considering a career in medicine who may be deterred by misperceptions about medical student debt. The AAMC has a wealth of useful resources for those aspiring to a medical career, including Aspiring Docs for inspiration, FIRST for financial information, Careers in Medicine for specialty choice help, and the Fee Assistance Program for financial support in taking the MCAT and applying to medical school.
Julie Fresne is director of student financial services for the Association of American Medical Colleges in Washington, DC. She can be reached at firstname.lastname@example.org.