Jan 8 Pediatricians-in-training are more likely
to plan to go into primary care, rather than a speciality field,
if they have lots of debt from college and medical school,
according to a U.S. study.
Researchers publishing in Pediatrics also found that the
average pediatric resident doctor's debt increased 34 percent
between 2006 and 2010.
That suggests financial considerations may keep young
doctors out of medical specialities, they said, especially those
fields that aren't known for paying well but still require extra
"(The debt) keeps climbing, and it doesn't seem like there's
an end," said Mary Pat Frintner, the study's lead author, from
the American Academy of Pediatrics (AAP).
"There are multiple factors that (affect) a pediatrician's
career decisions, and debt is just one part of that," she told
Reuters Health. "Since there's no end in sight to the rise in
debt, that relationship may become more important in the
The findings also hint that rising debt, due to increases in
medical school tuition, is not what's driving young doctors away
from primary care, as many people have suggested, according to
one health economist.
The new data collected by the AAP are based on five years of
surveys of young doctors finishing their residencies, the
training that follows medical school. The study included about
2,700 pediatric residents.
Close to three-quarters of the responders had debt from
school. The average graduating resident's debt increased from
$104,000 in 2006 to $139,000 in 2010.
Forty-three percent of residents had career plans requiring
further subspeciality training, such as in pediatric cardiology
or adolescent medicine. The rest planned to go straight into
primary care or hospital medicine.
Frintner and her colleagues found residents with at least
$51,000 in debt were about 50 percent more likely to be planning
a primary care or hospitalist career than those who owed less or
Women and residents with children were also less apt to be
seeking further speciality training before entering the
workforce, the research team said.
Peter Bach, at Memorial Sloan-Kettering Cancer Center in New
York, said that residents with more debt may come from more
disadvantaged backgrounds, which might influence the type of
medicine they want to practice. So the link between debt and
career plans might not be cause-and-effect, he told Reuters
So far, there hasn't been a spike in the number of pediatric
residents pursuing primary care careers rather than becoming
specialists, Frintner said. In fact, there's still concern there
may be too few primary care doctors, at least in some parts of
the United States.
Increasing debt may create or worsen other shortages by
discouraging young doctors from pursuing speciality training in
fields that aren't particularly lucrative, such as adolescent
medicine, the researchers said.
Amitabh Chandra, an economist and health policy researcher
from Harvard University, said the findings go against
conventional wisdom that debt is one concern driving medical
students to specialities and away from lower-paying primary care
jobs - and that raising salaries for fields that need more
doctors may be a more effective strategy than focusing on debt.
(Reporting from New York by Genevra Pittman at Reuters Health;
editing by Elaine Lies)