title: Increasing educational indebtedness influences medical students to pursue specialization: a military recruitment potential?
abstract: BACKGROUND
  Cost of medical education and student indebtedness has increased dramatically. This study surveyed medical students on educational debt, educational costs, and whether indebtedness influenced career choice. Responses should impact (1) Department of Defense (DoD) recruitment of physicians and (2) future of primary care.
  
  
  METHODS
  The authors surveyed 188 incoming medical students (University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Class of 2012) concerning educational indebtedness, perceptions about educational costs, and plans regarding loan repayment. Data were analyzed and expressed as mean +/- standard error.
  
  
  RESULTS
  Students with loans anticipated their medical educational costs to be $155,993. 62% felt costs were "exorbitant," and 28% "appropriate." 64% planned to specialize, whereas only 9% chose primary care. 28% of students planning specialization said income potential influenced their decision. 70% of students said cost was a factor in choosing New Jersey Medical School over a more expensive school. Students anticipated taking about 10 years to repay loans.
  
  
  CONCLUSIONS
  As medical educational costs and student indebtedness rise, students are choosing less costly education and career paths with higher potential future earnings. These trends will negatively impact health care availability, accessibility, and cost. DoD programs to provide financial assistance in exchange for military service are not well publicized. These findings should increase DoD recruitment opportunities.
authors.affiliation: Department of Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 140 Bergen Street, Suite 1625, Newark, NJ 07103, USA.
authors.forename: Asha G
authors.initials: AG
authors.lastname: Bale
authors.forename: Karl
authors.initials: K
authors.lastname: Coutinho
authors.forename: Kenneth G
authors.initials: KG
authors.lastname: Swan
authors.forename: George F
authors.initials: GF
authors.lastname: Heinrich
mesh_terms: D000328:Adult; D002321:Career Choice; D003365:Costs and Cost Analysis; D004470:Economics, Medical / Q000639:trends*; D004504:Education, Medical, Undergraduate / Q000191:economics*; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine; D013337:Students, Medical; D055815:Young Adult