title: What is the financial state of medical students from rural backgrounds during tuition fee deregulation?
abstract: BACKGROUND
  We sought to examine the financial state of medical students from rural backgrounds during a time of tuition fee deregulation.
  
  
  METHODS
  We surveyed incoming classes from 2007 to 2011 at the University of Calgary. Community background, expected educational debt at graduation, educational debt at entry to medical school and parental income were collected for analysis. Data were analyzed using the Χ² test, analysis of variance and the Newman-Keuls multiple comparison test.
  
  
  RESULTS
  The overall response rate was 95.3%. Of the 571 (93.5%) respondents who supplied data on their background and debt, 94.4% expected to have educational debt at graduation. The mean projected educational debt at graduation by medical students from both rural ($107 226 [95% confidence interval (CI) $98 030-$116 423]) and regional ($99 456 [95% CI $91 905-$107 006]) backgrounds was significantly greater than the debt projected by students from metropolitan ($88 565 [95% CI $83 607-$93 524]) backgrounds. Medical students who came from rural backgrounds had the highest mean debt at entry to medical school ($33 053 [95% CI $25 715-$40 391]) compared with their peers from regional ($23 253 [95% CI $16 621-$29 885]) and metropolitan ($22 053 [95% CI $17 344-$26 762]) backgrounds. Students of rural origin also had parents whose mean income ($104 024 [95% CI $75 976-$132 173]) was significantly lower than the mean parental income of their peers who originated from regional ($143 167 [95% CI $119 898-$166 435]) and metropolitan ($150 339 [95% CI $135 241-165 438]) centres.
  
  
  CONCLUSIONS
  Rising tuition and subsequent debt may be affecting the diversity of medical students' backgrounds. Financial programs dedicated to rural-background students and their interest in medicine may become necessary.
authors.affiliation: University of Calgary, Alta. woloschu@ucalgary.ca
authors.forename: Wayne
authors.initials: W
authors.lastname: Woloschuk
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Lemay
authors.forename: Bruce
authors.initials: B
authors.lastname: Wright
mesh_terms: D000328:Adult; D000416:Alberta; D004501:Education, Medical / Q000191:economics*; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D009313:National Health Programs; D011365:Professional Practice Location / Q000191:economics*; D019035:Rural Health Services; D012424:Rural Population / Q000706:statistics & numerical data*; D012577:Schools, Medical / Q000191:economics* / Q000458:organization & administration; D013337:Students, Medical / Q000706:statistics & numerical data*; D014146:Training Support / Q000191:economics* / Q000458:organization & administration; D019037:Urban Health Services; D014505:Urban Population / Q000706:statistics & numerical data; D000078329:Workforce; D055815:Young Adult