Is medical student choice of a primary care residency influenced by debt?
BACKGROUND
The average medical student accumulates more than $120,000 in debt upon graduation.


OBJECTIVE
The purpose of this study was to investigate whether medical student debt affects residency choice.


METHODS
This was a cross-sectional research study.


METHODS
This study was a 5-year analysis of student debt and residency choice for 2001-2005 graduates from 3 US medical schools (n = 2022): Tulane University School of Medicine, New Orleans, Louisiana; University of South Florida College of Medicine, Tampa, Florida; and Louisiana State University School of Medicine in New Orleans.


METHODS
Individual student data were collected from offices of financial aid for debt prior to and during medical school to determine total debt at graduation. Total debt (adjusted for inflation) was compared with residency match results coded according to specialties listed in the Graduate Medical Education Directory 2005-2006. Graduates were coded into either primary care (PC) or nonprimary care (NPC) specialty categories. Logistic regression for the choice of a PC residency was used with 4 predictors: (1) total debt, (2) medical school, (3) year of graduation, and (4) number of years of training required for a residency program.


RESULTS
Mean total debt for the study population was $89,807 (SD = 54,925). Graduates entering PC did not have significantly less total debt than those entering NPC ($87,206 vs $91,430; P = .09). Further, total debt was not a predictor of a PC residency after adjusting for medical school, year of graduation, and years of training in residency (P = .64).


CONCLUSIONS
There is no association between PC residency choice and debt. We conclude that medical students make residency decisions on the basis of a complex set of factors.
Kahn
Marc J
MJ
Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA. mkahn@tulane.edu
Markert
Ronald J
RJ
Lopez
Fred A
FA
Specter
Steven
S
Randall
Howard
H
Krane
N Kevin
NK
D002321:Career Choice; D003430:Cross-Sectional Studies; D004470:Economics, Medical; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000191:economics*; D008019:Life Style; D008297:Male; D011320:Primary Health Care / Q000191:economics*; D013038:Specialization; D013337:Students, Medical; D014146:Training Support; D014481:United States