Medical education indebtedness: Does it affect physician specialty choice?

Abstract

Prior studies have found no relationship between debt and specialty choice. One shortcoming of these studies is that debt from a variety of sources including, the Guaranteed Student Loan (GSL), the National Direct Student Loan (NDSL), the Health Professionals Student Loan (HPSL), and the Health Education Assistance Loan (HEAL) is combined into one variable. This paper, on the other hand, disaggregates debt by source, allowing the influence of debt from different sources on specialty choice to be examined. This distinction proves to be very important. Specifically, the analysis quite clearly shows that indebtedness has a statistically significant effect on specialty choice, but the nature of this effect varies to a large extent with the source of the loan. This paper will do two things. First, the research results will be used to examine how changes in the composition of medical school indebtedness influence the number of new physicians selecting primary and nonprimary care. And second, the policy implications of these results will be explored.