Residents: Will They Ever Pay Off Medical School Debt?

Carol Peckham


August 05, 2014

In This Article

Is There a Decline in Idealism?

The Commonwealth Fund Task Force, which was commissioned by the AAMC, states that academic health centers "should ensure that medical students and residents have appropriate training and experience in providing care to the poor, uninsured, and racial and ethnic minorities. The goal of these activities should be to reduce the disparities in health care use and improve outcomes for these populations."[30] However, a number of studies have found a decline in idealism among medical students, beginning as early as the second year of school.[31] The Medscape survey suggests that idealism declines further during residency. In comparing responses by residents in post-med school years one through four with years five through eight, a shift occurred, with fewer residents finding patient gratitude rewarding in the later years (61%) than in the early years (67%), and more residents in later years looking to make "good money" compared with during their earlier years (43% versus 36%). Authors of a 2014 study commented that as "students make choices in their medical careers, such as specialty choice or consideration of primary care, the influences of job security, student debt and social status increasingly outweigh idealistic motivations."

Female residents tend to cite more idealistic factors as rewards of their job, with 72% of women noting patient relationships compared with 62% of men, and with only 28% viewing money as a reward compared with 43% of men. Such biases are supported by a study of surgical residents, which found that single female residents or those without children identified lifestyle rather than income as their motivator for going into a specialty.[32]

Although many physicians who have been in practice for years have become discontent with the industry, residents are still positive and optimistic about their careers. Eighty-three percent of residents look forward to practicing as physicians. (This percentage did not vary significantly when looked at by years after medical school or by gender.) Only 5% were not happy about their future and 13% were undecided.


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