Navigation Links
Debt and income concerns deter medical students from primary care careers

September 21, 2012 (BRONX, NY) Primary care physicians America's front line healthcare practitioners are usually the first to diagnose illness, refer patients to specialists and coordinate care. Yet, despite that critical role, primary care physicians remain among the lowest paid of all doctors at a time when there's an acute primary care shortage.

A unique longitudinal study of medical students by researchers at Albert Einstein College of Medicine of Yeshiva University, the Brody School of Medicine at East Carolina University, and North Carolina State University shows how significantly both student debt and income expectations impact the decision of medical students to enter a high-paying specialty rather than primary care.

The study, published online on September 19 in Medical Education, surveyed more than 2,500 medical students attending either New York Medical College or the Brody School of Medicine. Over an 18-year period from 1992 to 2010, students were surveyed in their first and fourth years about the area of medicine they planned to enter, their anticipated debt upon graduation, the annual income they anticipated five years after completing residency, and the importance they placed on income in general.

The study indicates that medical students who anticipated high levels of debt upon graduation and placed a premium on high income were more likely to enter a high-paying medical specialty such as radiology, anesthesiology or dermatology than to enter primary care, which consists of internal medicine, pediatrics and family practice.

According to a 2010 Medical Group Management Association income survey, primary care physicians earned nearly $200,000 per year and those in 12 high-paying specialties selected by the researchers earned double that, with an average of just under $400,000 per year.

"The income gap between primary care and specialty physicians started growing in earnest in 1979, and now we're seeing the consequences of that ongoing trend," noted Martha Grayson, M.D., senior associate dean of medical education at Einstein and the study's lead author. (Dr. Grayson was at New York Medical College at the time of the study.)

Among those surveyed in the study, 30 percent of students who entered medical school intending to become a primary care physician switched their preference to a high-paying specialty by the time they graduated. Compared to classmates who didn't change their minds about entering primary care, the switching group placed a significantly higher value on income and expected a debt load that was 11 percent greater than those who ultimately chose a primary care career.

Based on an Association of American Medical Colleges survey of residents and fellows taken in 2010, 86 percent of medical students graduated with some education debt in 2010. The average debt was $158,000. Thirty percent of graduates had debt exceeding $200,000. "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," said Dr. Grayson.

The study suggests that measures should be explored to encourage primary care careers such as incentive pay, debt forgiveness, additional scholarships and higher reimbursement for primary care services, in order to meet the growing need.

The study's findings come as the Association of American Medical Colleges (AAMC) projects a shortage of 63,000 physicians by 2015, the vast majority of those in primary care.

The paper is titled "Payback Time: The Association of Debt and Income with Medical Student Career Choice." In addition to Dr. Grayson, the other authors are Dale Newton, M.D., at East Carolina University, and Lori Foster Thompson, Ph.D., at North Carolina State University. The authors report no conflicts of interest.


Contact: Deirdre Branley
Albert Einstein College of Medicine

Related medicine news :

1. Seeing fewer older people in the street may lead low-income adults to fast-track their lives
2. Income, screen time affect soda, junk food consumption
3. Expanding Medicaid to low-income adults leads to improved health, fewer deaths
4. Federally funded clinics for low-income patients as effective as private practices
5. DotComSecrets Invites Professionals to Learn Great Tips On How to Make a Handsome Income By Working As Local Internet Marketing Consultants
6. Study: Willingness to be screened for dementia varies by age but not by sex, race or income
7. Low-Income Mothers May Overfeed Their Infants
8. Social ties have mixed impact on encouraging healthy behaviors in low-income areas
9. Wellesley study shows income inequality a key factor in high US teen births
10. Climate concerns
11. New survey shows patient concerns and misinformation impede treatment of menopausal women
Post Your Comments:
(Date:10/13/2017)... ... October 13, 2017 , ... Ellevate Network, the leading network ... advocate for action towards gender equality at their inaugural Summit in New York City ... and reached a social audience of over 3 million. To watch the Mobilize Women ...
(Date:10/13/2017)... ... ... Journey: From the Mountains to the Mission Field”: the story of a missionary couple ... From the Mountains to the Mission Field” is the creation of published author, Carole ... and currently teaches a class of ladies at her church, which she has taught ...
(Date:10/12/2017)... ... October 12, 2017 , ... The company has developed ... consumer and regulatory authorities worldwide. From Children’s to Adults 50+, every formula has ... highest standard. , These products are also: Gluten Free, Non-GMO, Vegan, Soy ...
(Date:10/12/2017)... ... 12, 2017 , ... Dr. Parsa Mohebi, the Los Angeles ... to the newly revamped Cosmetic Town journal section, featuring articles written ... known as Follicular Unit Extraction (FUE). , Dr. Mohebi says “I ...
(Date:10/12/2017)... ... October 12, 2017 , ... Health Literacy ... health literacy software tool, and the Cancer Patient Education Network (CPEN), an independent ... today announce a new strategic alliance. , As CPEN’s strategic partner, HLI ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... Oct. 11, 2017  Caris Life Sciences ® , ... the promise of precision medicine, today announced that St. ... Precision Oncology Alliance™ (POA) as its 17 th ... St. Jude Crosson Cancer Institute will help develop standards ... of tumor profiling, making cancer treatment more precise and ...
(Date:10/10/2017)... EXTON, Pa. , Oct. 10, 2017   ... leader in innovative solutions for injectable drug administration, today ... of West,s ID Adapter for improving the intradermal administration ... the Fourth Skin Vaccination Summit in May 2017 by ... Team Lead, Polio Department, World Health Organization (WHO), and ...
(Date:10/4/2017)... Mass. , Oct. 4, 2017  According to the Centers for ... the end of October . PhysicianOne Urgent Care is helping communities across ... Westchester, NY , by offering no-cost* flu shots through the ... as mandated by certain health insurance regulations. ... The best time to get a flu shot is by the ...
Breaking Medicine Technology: