Friday, February 11, 2005

Medical School Debt: Part 2 (Why should You Care)

In Part 1 of this series I discussed the average financial outlook for today's Medical School Graduate. In this segment I would like to discuss how these numbers translate to real life problems, not just for the physician

The Brain Drain:

The total number of applications in 2004 for medical school were 35,000 while in 1996 that number was 47,000.

With the average salary of physicians slowly trending downwards less students are willing to invest in such costly education and time before seeing profit. Although there is no hard evidence to support this, it is likely that less top students now choose medicine as a career, Thus, a brain drain of sorts is created. What once was the ultimate of professional goals is slowly losing its appeal.


The high costs of tuition have created inequality among the classes and races. Currently, nearly two thirds of students applying for medical school come from families in the top 25% of income. This statistic is raising concerns that the current cost of medical education may be out of the reach of even middle class families. In addition, a recent survey of these under-represented students indicated that cost was the number one concern and reason for not applying.

Recently, an Institute of Medicine report found that though Hispanics constituted 12 percent of the population, they accounted for only 3.5 percent of all physicians, and though 1 in 8 Americans is black, fewer than 1 in 20 physicians is black. The trend has far-reaching consequences for the national health care workforce, which needs diverse physicians in order to address the needs of an increasingly heterogeneous patient population.

Primary Care:

The latest match conducted by the National Resident Matching Program shows a continuing decrease in the number of medical students pursuing careers in primary care (37 percent in 2003, as compared with 49 percent in 1997) and an increase in the number gravitating toward "the ROAD" to happiness (careers in Radiology, orthopedics, Ophthalmology,and Dermatology, which offer higher discretionary income and easier lifestyle, ortho excluded).

"Pick your specialist, pick your disease"

The primary care physician is the central coordinator of multiple medical problems. Integrating these into the care of a human being as a whole. It is an underappreciated artform. In medicine the Primary Physician, or PMD, is the quarterback running the team, better yet, the maestro orchestrating the symphony.

The shortage of Primary Physician will lead to greater dissatisfaction with the medical profession as many patients will find themselves coordinating medical matters of which they have no understanding. The resulting unnecessary workups and tests will only add to the costs of medicine and put more patients in harm's way.

In conclusion, the current medical school debt burden influence not only the student's future career goals but will also influence the level of care the average patient can look forward to and will likely cause more frustration with medical care as a whole. The decreasing desire to pursue medicine as a career will likely only decelerate the advancement of new treatments and a better future.

The new emerging class are alarming since the current cost of medical education is only trending upwards. With the already established class and race divide the gap will continue to widen. In many parts of the world medical education is wholy subsidized by the government, eliminating this gap.

In a country which prides itself on allowing migration of class thorugh hard work can we allow this to continue?

In the next Part of the Series we'll discuss how to stop this alarming trend.In the final piece, I will try to do some research on creative solutions to pay off medical school debt. Until then, try to win the lottery.

( Reference: Morrison)