Medical student debt may be driving physicians to practise in higher paying specialty areas rather than primary care, suggest the authors of a new systematic review in BMJ Open.
For the review, researchers reviewed 59 studies, which looked at the effect of student debt on mental health, academic performance and specialty choice. The majority of the research was conducted in the USA with some from Canada, New Zealand, Scotland and Australia.
Of the studies which looked at the association between student debt and specialty choice, the majority (n=21) found the presence of debt was associated with the choice of higher paying specialties, while nine articles found that the presence of debt was associated with lower paying specialty choice. Ten articles said there was no or minimal effect, and 13 articles found there was an association but did not further explore the nature of this relationship.
The study also found medical student debt levels were negatively associated with academic outcomes and mental well-being.
“Additional prospective studies may be warranted, to better understand how educational debt loads are affecting the well-being, career preparation and career choices of physicians-in-training, which may in turn impact the quality of care provided to their current and future patients,” the authors concluded.