Borrow or Serve? An Economic Analysis of Options for Financing a Medical School Education

Marcu, Mircea; Kellermann, Arthur L.; Hunter, Christine; Curtis, Jerri; Rice, Charles; Wilensky, Gail R.

doi:10.1097/acm.0000000000001572

Cited by 32 publications

(24 citation statements)

References 13 publications

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“…Compared with age-matched peers, IM and MP residents are less likely to know if they regularly contribute to a retirement account or to figure out how much savings is needed for retirement. 17 Residents with high debt loads may be less financially fit compared with peers and may need personal finance education.…”

Section: Discussionmentioning

confidence: 99%

“…Twelve questions were developed by the study investigators to collect information about type of medical school education, level of training, student loan amount, importance of financial education during residency, role of debt in career choice, disability and life insurance, and sources of prior financial advice (provided as online supplemental material). 17 The modified survey was not tested prior to use.…”

Section: Methodsmentioning

confidence: 99%

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Financial Attitudes and Behaviors of Internal Medicine and Internal Medicine–Pediatrics Residents

Wong

Bonino

et al. 2018

Journal of Graduate Medical Education

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Background Residents graduate from medical school with increasing levels of debt and also may possess poor financial knowledge and practices. Prior studies have assessed resident financial knowledge and interest in financial education, yet additional information regarding their attitudes about personal finance and financial planning could be essential for the development of relevant curricula.Objective We assessed baseline financial attitudes and planning behaviors of internal medicine and internal medicine-pediatrics residents in 3 geographically diverse academic programs.Methods A modified version of the Financial Industry Regulatory Authority National Financial Capability survey was administered anonymously to residents in 3 programs in spring 2017. Outcomes included levels of educational debt, positive financial planning behaviors, perception of finances and debt, and education about personal finance.Results Response rate was 62% (184 of 298). Rates of educational debt were high, with 81% (149 of 184) of respondents reporting educational debt, and the majority owing more than $100,000. Residents' financial practices were variable, and residents could be grouped into 1 of 3 categories-concerned-engaged, concerned-unengaged, and unconcerned-unengaged-based on their engagement with debt and financial management. Residents with high debt (. $250,000) had a bimodal distribution of respondents who strongly agreed and those who strongly disagreed they were concerned about debt.Conclusions Resident financial attitudes and practices are variable, ranging from highly engaged residents actively managing their financial wellness to unengaged residents who have low concern, despite high educational debt.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Financial Attitudes and Behaviors of Internal Medicine and Internal Medicine–Pediatrics Residents

Wong

Bonino

et al. 2018

Journal of Graduate Medical Education

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“…We would like to call attention to a recently published analysis of the costs and financial benefits of medical education over a lifetime of practice using net present value methodology. 2 This study compares alternatives for funding one's medical education through personal loans, and through service-related public financing, such as the Health Professions Scholarship Program and the USU.…”

Section: Concerning a Service Commitment To Fund Your Medical Educationmentioning

confidence: 99%

Concerning A Service Commitment to Fund Your Medical Education

Pangaro

Gilliland

Moores

et al. 2018

The American Journal of Medicine

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“…Secondly, researchers have conducted economic analyses that have demonstrated that choosing a primary care career (rather than a specialist career) has negative long‐term financial consequences . For example, an analysis conducted by the Robert Graham Center in 2009 determined that, over a lifetime, primary care physicians earn approximately US$3 000 000 less than specialists .…”

Section: Introductionmentioning

confidence: 99%

“…13,15 Secondly, researchers have conducted economic analyses that have demonstrated that choosing a primary care career (rather than a specialist career) has negative long-term financial consequences. 16,17 For example, an analysis conducted by the Robert Graham Center in 2009 determined that, over a lifetime, primary care physicians earn approximately US$3 000 000 less than specialists. 18 Another economic analysis found that primary care career choices are economically feasible, but only if tradeoffs are made; for example, primary care physicians may need to rely on partner income or live in lower-cost communities.…”

mentioning

confidence: 99%

Specialty income and career decision making: a qualitative study of medical student perceptions

et al. 2019

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Context Medical educators in the USA are interested in the ways medical students make career choices because shortages in key specialties, particularly primary care specialties, limit access to care. Although anticipated specialty income is a strong predictor of student interest, no studies have qualitatively explored the reasons why income is important to students. By better understanding students’ perspectives on income and specialty choice, educators can help students make choices that fit their goals and better educate students about the specialties in which the need for expansion is greatest. Methods In 2012, Year‐2 students at one USA medical school were invited to write an essay about how debt and anticipated income levels influence their career choices. A total of 132 essays (response rate: 67%) were qualitatively analysed using a hermeneutic phenomenology approach to conventional content analysis, in which themes emerge inductively from the data. Researchers employed peer debriefing, modified member checking, thick description, code–recode strategies, audit trails and reflexivity to ensure quality and rigour. Although this analysis initially focused on student perceptions of specialty income, prestige also emerged as an important related theme. Results Three major findings emerged. Income is of varying importance to different students. Students value income because it provides freedom and flexibility, and power and security. Students recognise that high income confers social prestige. Students also define specialty prestige in other ways, including match competitiveness, perceived expertise, opportunities for advancement through fellowships, and power and autonomy. Conclusions Medical students’ perspectives of specialty income, specialty choice and prestige are more complex than previously reported. Medical educators should frame conversations about specialty choices in ways that incorporate varied perspectives on income and prestige. Health policymakers should recognise that income and prestige influence medical students’ decisions in complex ways. These insights may inform strategies to counteract shortages in key specialties, including primary care specialties.

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Borrow or Serve? An Economic Analysis of Options for Financing a Medical School Education

Abstract: Supplemental Digital Content is available in the text.

Cited by 32 publications

References 13 publications

Financial Attitudes and Behaviors of Internal Medicine and Internal Medicine–Pediatrics Residents

Financial Attitudes and Behaviors of Internal Medicine and Internal Medicine–Pediatrics Residents

Concerning A Service Commitment to Fund Your Medical Education

Specialty income and career decision making: a qualitative study of medical student perceptions

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