Wednesday, October 25, 2017

Medical Students Assume Huge Debt to Become Physicians

Student Debt Shapes the Future of Medicine




The thought of amassing a half-million dollars in medical school debt, in some cases, is steering some of the best and brightest aspiring physicians to choose certain specialties over others, altering their life plans, or discouraging them from going into medicine altogether. An October Texas Medicine magazine article covering the cost of medical education reports staggering student debt is shaping how new physicians approach medicine.

Nicole Hernandez, DDS, MD, an oral and maxillofacial surgery resident at UT Health San Antonio, said she will have to start paying back her $450,000 in student loans in 2020. Assuming everything goes according to plan, she plans to pay them off within eight to 10 years. However, it is not uncommon for physicians to pay off their medical school debts decades after they began practicing medicine.

Michael Metzner, MD, a second-year general surgery resident at the Joe R. and Teresa Lozano Long University of Texas School of Medicine in San Antonio, said his medical school tried to brace him for the financial impact of his school loans before graduation. “In med school, it’s very easy to think of it as Monopoly money,” Dr. Metzner said. “You see these huge figures, and it’s, like, ‘I’m already $100,000 in debt, and my medical school tuition’s $40,000 [a year].’ It's easy to say, ‘Sign the dotted line.’ But I don’t think it’s until you’re out there working that you realize what that means.”

The “Monopoly money” reference is common among medical students. Christina Thorngren, MD, a third-year emergency medicine resident at the Dell Seton Medical Center at The University of Texas, used the term in discussing her $485,000 in medical school debt from the out-of-state private school she attended. While she has no regrets about her career choice, she knows people who shied away from medicine over the price tag. She suspects a potentially huge debt load affects whether talented students will consider medicine as a career. “I’ve known people who thought about going into medicine and who would’ve been really good doctors, who chose not to go into it and chose to do something else…because they were afraid of the debt,” she said.

Texas Medicine cites a study by the Association of American Medical Colleges, showing three-quarters (76 percent) of all medical school, graduates have education debt averaging $190,000 per person. That is up from an inflation-adjusted $125,372 in 2000. As a result, medical school debt hangs over every aspect of a new physician’s life.

Debt is reshaping the field of medicine, as more students choose certain medical specialties over others to pay off their debts. Gary Ventolini, MD, regional dean of the medical school at the Texas Tech University Health Sciences Center’s Permian Basin campus, said some students are considering more lucrative specialties, instead of traditional primary care. He said the choice of career and debt concerns often spill over into personal life choices. “[Debt] influences their decisions about whether to marry or not, or to have a family,” Dr. Ventolini said. “Many are afraid of losing a girlfriend or boyfriend [if they wait].”

James Dahle, MD, a Utah emergency physician who also runs the financial website WhiteCoatInvestor.com, said medical students’ best strategy for coping with debt is to learn the basics of personal finance, live frugally, and do everything possible to cut expenses and avoid adding more debt ― both during school and while they’re paying back their student loans. “It’s the basics of personal finance ― it’s just math,” he said. “You don’t get a pass on math because you’re a doctor and you decided to do something good with your life.”

Dr. Thorngren anticipates paying off her medical school loans in her 40s or 50s. And despite the cost, Dr. Hernandez said she has no regrets about her dual-degree career choice. “I've always said, ‘Do what you want because you’re passionate about what you want to do,’ ” she said. “Consider the amount it will cost you, but don’t choose something just because of how many dollar signs there are.”

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