More New Doctors Shunning Private Practice

Report shows medical students are choosing higher-paid specialties because of heavy postgraduation debt

By Diana Tith
Contributing Writer

As many UCSD premed students prepare to graduate and enter medical school, a realm of new experiences and challenges awaits them. Yet these students’ medical school experiences come at a price­­ — almost $130,000 in educational bills, according to a report by the Association of American Medical Colleges.

Studies suggest that medical schools’ escalating tuition fees and the subsequent debt that students accumulate influence the specialty they choose upon graduation. The cost of tuition fees and health insurance has risen from last year at UCSD’s School of Medicine: The fees for 2007-08 are $22,959 for residents and $35,204 for non residents.

The nationwide increase in tuition fees is sparking concerns due to the adverse effects on students and patients, according to recent data released by the American Medical Association. The AMA suggests that there have been correlations between debt and students’ choices, and how those decisions in turn have come to harm the health-care system. Such correlations include unsafe physician behavior and a decrease in primary-care physicians and in diversity of the physician workforce.

The AMA said that residents who carry the high debt burdens are more likely to assume an additional job. This can lead to fatigue, which in turn can breed medical errors. Also, high debt becomes a barrier for many low-income and minority students. Furthermore, the increase in debt among students can pressure them to pursue higher-paid specialties.

“Students with high debt are less likely to pursue family practice and primary care specialties and instead seek specialties with higher income or more leisure time,� the report said.

On average, a family practice doctor earns about $160,000, as suggested by a 2007 report by physician-staffing firm Merritt, Hawkins & Associates. Such a salary is far less than what other medical practitioners are earning. According to the report, radiologists earn an average salary of $380,000, neurosurgeons make roughly $530,000 and urologists can earn up to $400,000 per year.

Despite the increase of tuition fees at UCSD’s School of Medicine, the average debt is less than what the national data suggests, according to Maria Savoia, the school’s vice dean of medical education.

“There are national data that suggest that higher debt — over $100,000 — makes students think about choosing higher-paying specialties,� Savoia said. “Thankfully, we at UCSD aren’t at an average debt greater than $100,000, but this certainly is a concern for us as tuition and fees go higher.�

However, Assistant Director of UCSD Career Services Center Nicole O’Neil said that postgraduation debt is nothing new to medical students.

O’Neil said that premed students at UCSD are advised about the financial burdens that they will face if they are serious about choosing a medical career, which helps to lessen the shock related to salary disparities in different fields.

“We tell all the students who come in here and who are interested in premed, ‘Be prepared to take a debt,’� she said.

According to the data compiled by the Career Services Center, the number of UCSD students applying to medical school has steadily increased. There were 410 applicants in 2006, compared to 362 in 2004 and 383 in 2005.

O’Neil suggests that there are other factors that play into a student’s specialty choice, such as lifestyle and location. There are also personal reasons that drive students toward one particular medical field over another, she said.

Such is the case for Revelle College junior Elizabeth McDevitt, who hopes to practice pediatric medicine and specialize in autoimmune diseases because of her own battle with juvenile rheumatoid arthritis. McDevitt said the idea of accumulating debt was never a point of concern for her.

“It’s just money, and this is something I really want to do,� she said. “I’m sure it is something that will work itself out, and instead of worrying about it now, I’m just focusing on doing the best I can to get what I want, and for me, that’s never been money.�
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