How Doctors Choose Specialities (Sometimes for Money, Sometimes Not)
National data on medical student debt find that those with a high debt burden are actually more likely to go into the less lucrative primary care fields than doctors who hold no loans at all.
“For private schools, odds of choosing primary care increases as debt increases, with those having no debt (and no scholarships) less likely to choose primary care,” researchers at the Robert Graham Center concluded in a 2009 report.
—Med students graduate with an average of $161,290 in student loan debt. Logic would say: The more debt you have, the higher-paying job you’re probably going to go after! But data says: Not the case! Turns out that med school grads with higher debtloads are more likely to become primary care physicians, which pays nothing compared to cardio.(Please note that “nothing” is a relative term—primary care docs earn $178,00 per year, on average, which is the lowest amount of any doctors—except pediatricians. Cardiologists make $532,000, on average.)
What’s going on? The Washington Post suggests that doctors without debt are probably without debt because they are independently wealthy or have wealthy parents, in which case: They want to continue being wealthy, and so, cardio. On the flip side, regular folks with high debtloads may be resigned to their fate of never being “rich.” Also a thing: The cardio payday is not imminent or immediate after graduation. Med school grads receive intern stipends (median: $46K tot start) for five years after graduation. Five years is a long time to wait for a payday. Might as well be doing what you love. (Though, for people who love cardio: LUCKY.)
Also, many more complex specialties (specialized surgery, etc) require a longer residency, or multiple residencies (general surgery, then specialty) delaying the “payday.” If you have a lot of debt, you aren’t going to want to wait another 8-10 years before you can pay yo’ shit off.
@liznieve Whaaa? There are no specialties that requires multiple residencies, unless you’re speaking of fellowships, which are generally 1-2 years. There are combined residency programs, but they require an additional residency year at most. I work for the organization that regulates these matters on a national level.
@Jake Reinhardt
Yes, fellowships. But those are essentially second residencies, and with some fields, and if you want to work in a competitive market, it might require a few. I.e. my plastic surgeon friend who had both a general and plastics residency and then a fellowship in microsurgery.
Primary care physicians complete the shortest residencies at 2-3 years. It’s really not so mysterious as to why students with high debt loads are more likely to choose primary care. Especially when you add in other mitigating factors like having a family and completion of prior degrees. 4 years bachelors + 4 years med school + 2-5+ years for residency which is very low paying for what it is = a very long time to be poor and in debt.
@staircases makes me wonder how common it is for physicians who go into primary care to later on go back to school for a specialty.
I’m not a doctor, but I know many hospitals and practice groups offer loan repayment assistance plans for doctors who go into high demand + low pay fields like primary care. These arrangements are very attractive to med students I’ve known who had high debt burdens.