Should Docs Cash In Unused Paid Time Off to Repay Student Loan Debt?

Alok S. Patel, MD


October 30, 2019

This transcript has been edited for clarity.

The median medical school debt in this country is about $200,000 for those of us who took out loans. I fit into this category, unfortunately, so if there are any headlines addressing this, I'm all in.

I recently saw a story about a hospital offering doctors a chance to trade in vacation time for debt payments. Here's how it goes. Montefiore St. Luke's Cornwall (MSLC), a nonprofit hospital in New York State, is offering employees a chance to trade in unused paid time off (PTO) to make some debt payments—up to $5000 a year. It's an interesting concept because hospitals do report a lot of unused PTO. Is this a good thing? I have a couple of thoughts.

MSLC Hospital has set up this novel program to help their employees bank their unused PTO. Awesome. But I have a question: Why is there so much unused PTO to begin with? I mean, PTO is for maternity/paternity leave, sick days, vacation, whatever we want. And we should use it because time away from the hospital or clinic is really important when it comes to fighting burnout. A senior director at, the company that's helping to launch this program, straight up said that PTO often goes unused because patient care positions can be short-staffed.

Now, if you're a doctor or nurse and you want to moonlight, not use your vacation, make some extra cash, good for you. But I do worry that we have a culture in medicine that encourages people to not use their PTO and work when they don't want to or when they shouldn't.

On one hand, MSLC's student loan repayment program is a novel idea and at least they're talking about debt. But their solution illuminates another large problem. Debt does contribute to burnout, but so does being overworked and not taking time off. So I ask you this:

Do you think MSLC is on the right track with this program? Do you think $5000 a year toward debt is a fair consolation for unused PTO? Or do you think this is all going to fail? Either way, share your thoughts.

Dr Alok S. Patel is a pediatric hospitalist, television producer, media contributor, and a digital health enthusiast. He splits his time between New York City and San Francisco as he is on faculty at both Columbia University/Morgan Stanley Children's Hospital and the University of California San Francisco, Benioff Children's Hospital. Alok hosts The Hospitalist Retort video blog on Medscape and is a medical producer at CNN.

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