The Impact of Debt on Young Family Physicians: Unanswered Questions with Critical Implications

Phillips, Julie

doi:10.3122/jabfm.2016.02.160034

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…Fifty-eight percent of graduating family medicine residents already have more than $150,000 of debt and 26% have more than $250,000 of debt on completing their program ( 33 ). Even in the National Health Service Corps, young physicians often have to use extended repayment plans to balance their finances ( 5 ). Family medicine practices also suffer from unbalanced Medicare reimbursement policies, which tend to overwhelmingly favor specialists ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

“…Designated primary care positions in internal medicine and pediatrics actually saw a decrease in available positions offered. Although 99.3% of those seats were filled by the NRMP, only 60.0% were filled by USMGs ( 4 ).Unfortunately, a paradox results: primary care and family medicine become the specialties that create the greatest health value for the nation but ultimately are viewed as the specialties that offer the least personal financial security ( 5 ).…”

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confidence: 99%

“…Only 45.3% of PGY-1 family medicine positions in 2016 were filled by USMGs (excluding osteopathic match) ( 5 , 9 ). The growth in international medical graduates (IMGs) has led to their increased employment in family medicine programs ( 9 ).…”

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Bolstering the pipeline for primary care: a proposal from stakeholders in medical education

Shi

Lee

2016

Medical Education Online

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The Association of American Medical Colleges reports an impending shortage of over 90,000 primary care physicians by the year 2025. An aging and increasingly insured population demands a larger provider workforce. Unfortunately, the supply of US-trained medical students entering primary care residencies is also dwindling, and without a redesign in this country's undergraduate and graduate medical education structure, there will be significant problems in the coming decades. As an institution producing fewer and fewer trainees in primary care for one of the poorest states in the United States, we propose this curriculum to tackle the issue of the national primary care physician shortage. The aim is to promote more recruitment of medical students into family medicine through an integrated 3-year medical school education and a direct entry into a local or state primary care residency without compromising clinical experience. Using the national primary care deficit figures, we calculated that each state medical school should reserve 20–30 primary care (family medicine) residency spots, allowing students to bypass the traditional match after successfully completing a series of rigorous externships, pre-internships, core clerkships, and board exams. Robust support, advising, and personal mentoring are also incorporated to ensure adequate preparation of students. The nation's health is at risk. With full implementation in allopathic medical schools in 50 states, we propose a long-term solution that will serve to provide more than 1,000–2,700 new primary care providers annually. Ultimately, we will produce happy, experienced, and empathetic doctors to advance our nation's primary care system.

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Section: Discussionmentioning

confidence: 99%

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Bolstering the pipeline for primary care: a proposal from stakeholders in medical education

Shi

Lee

2016

Medical Education Online

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“…Elements that contribute to career regret among physicians include declining incomes, excessive paperwork, electronic health records and working too many hours ( Adams, 2012 ; Peckham, 2015 ). Other factors considered in the literature that may lead to career regret include student loan debt, marital status and gender ( Peckham, 2015 ; Phillips, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Career regret: an analysis of physician assistants

Sierra¹,

Rodríguez²,

Forbes³

2019

MedEdPublish

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The purpose of this study was to identify life and career variables that differ between physician assistants (PAs) with and without career regret. The information in this article may be useful to PAs and PA students in their search for a professional environment that is associated with a lower risk of career regret. Methods: A survey was emailed to 5,000 PAs nationally. Aspects of their life and careers were compared between those with career regret and those without. Results: 26.9% of respondents indicated career regret. Differences were found between PAs with and without regret on the degree of schedule control, hours worked per week, salary, work-life balance, perceived burnout, career satisfaction, advice to others considering the career, and work stability. Other elements that were analyzed were not statistically significant between groups. Conclusion: Differences in work and life aspects were found when comparing PAs with and without regret. Current and future PAs may use the information from this study to help create or seek professional environments that will be less likely to lead to burnout and career regret. Employers can also utilize the information from this research study to develop or maintain work environments that protect against burnout.

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“…19 In fact, a recent study of the impact of debt load found high debt was correlated with callousness, stress, suicidal thoughts, failing medical licensing exams, and leaving or being dismissed from medical school. 20 It is therefore important to understand whether residents view the opportunity cost of a fourth year of training as worth a year of lost practice income.…”

mentioning

confidence: 99%

Financial Considerations Associated With a Fourth Year of Residency Training in Family Medicine: Findings From the Length of Training Pilot Study

Carney

Ericson

Conry

et al. 2021

Fam Med

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Background and Objectives: The feasibility of funding an additional year of residency training is unknown, as are perspectives of residents regarding related financial considerations. We examined these issues in the Family Medicine Length of Training Pilot. Methods: Between 2013 and 2019, we collected data on matched 3-year and 4-year programs using annual surveys, focus groups, and in-person and telephone interviews. We analyzed survey quantitative data using descriptive statistics, independent samples t test, Fisher’s Exact Test and χ2. Qualitative analyses involved identifying emergent themes, defining them and presenting exemplars. Results: Postgraduate year (PGY)-4 residents in 4-year programs were more likely to moonlight to supplement their resident salaries compared to PGY-3 residents in three-year programs (41.6% vs 23.0%; P=.002), though their student debt load was similar. We found no differences in enrollment in loan repayment programs or pretax income. Programs’ descriptions of financing a fourth year as reported by the program director were limited and budget numbers could not be obtained. However, programs that required a fourth year typically reported extensive planning to determine how to fund the additional year. Programs with an optional fourth year were budget neutral because few residents chose to undertake an additional year of training. Resources needed for a required fourth year included resident salaries for the fourth year, one additional faculty, and one staff member to assist with more complex scheduling. Residents’ concerns about financial issues varied widely. Conclusions: Adding a fourth year of training was financially feasible but details are local and programs could not be compared directly. For programs that had a required rather than optional fourth year much more financial planning was needed.

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The Impact of Debt on Young Family Physicians: Unanswered Questions with Critical Implications

Cited by 7 publications

References 19 publications

Bolstering the pipeline for primary care: a proposal from stakeholders in medical education

Bolstering the pipeline for primary care: a proposal from stakeholders in medical education

Career regret: an analysis of physician assistants

Financial Considerations Associated With a Fourth Year of Residency Training in Family Medicine: Findings From the Length of Training Pilot Study

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