Report: Medical School Debt Should Not Preclude Primary Care Career


Medical school debt can be daunting: The latest data shows the average med school graduate owes over $166,000.

But according to a new report published in The Journal of the Association of American Medical Colleges, that debt alone should not steer young doctors away from primary care, where their services are now desperately needed.

WBUR’s Sacha Pfeiffer spoke with the senior author of that report, John Wiecha, assistant dean for academic affairs and an associate professor of family medicine at the Boston University School of Medicine. Here are some interview highlights:

SP: So you wanted to try to figure out if various levels of med school debt actually are manageable on a primary care salary. What did you find?

JW: By and large, except for the highest levels of debt, with careful financial planning, they actually should be able to pay off their debt, purchase a house at a median house price, and even save some money for eventual retirement.

SP: So even making about $145,000, but owing about $160,000 to $170,000, you can pay for your kids to go to college, have money in retirement, and still pay off your loans?

JW: It looks that way. I will say, though, that about 27 percent of students in private medical schools had debts of $250,000 or more. At that level or above that, we’re really seeing that students need to be very careful about financial planning, and they may have to make some compromises in terms of the practice environment that they’re in…

SP: But can we conclude from your study that if a med school grad is avoiding primary care because he or she is afraid they’ll struggle too much to pay back their student loans, that could be a false alarm, depending on the debt level?

JW: Yeah, I think that’s a fair characterization. But I think we also need to realize that students’ choice of career direction really is responsive to many other factors — not so much education debt or even income expectation. Those are really fairly low down on the list of influences that students report regarding their career choice.

SP: What would you say is the overall message of your study?

JW: I would say to a student that’s graduating from medical school, who’s interested in primary care, I would say it’s very possible. They should look carefully at loan repayment options. There are a number of federal programs that can help them. And I think they should follow their heart.

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  • DVM

    And what do you suggest for veterinarians. Those who don’t specialize carry the same medical school debt load for an average salary that is not much more than half of the average primary care physician. The general practitioner veterinarian is seeing this erosion now.

  • Evan Pankey

    Most people don’t feel particularly sorry for medical students in these economic times.
    It seems their drive to specialize is based on potential income gain as much as fear of loss. If you do internal medicine and specialize in cardiology, you make hundreds of dollars more per year for 2 or 3 years more of training.

    My concern for upcoming doctors is that the price increases of health care migh drive very low cost disruptive innovations in health care that will erode physician salaries

    Right now we’re seeing more and more doctors go into large group practices or organizations instead of private practice.

    The average pilot in the 1970′s used to make a lot more per year than they do now.
    Journalists made more before the internet and blogs become popular.
    Health care is moving in a similar direction, but I think the average med student understands this.