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EM Resident Career Path Often Influenced by Crippling Student Debt

LOMA LINDA, CA – Back in the day, emergency medicine physicians were just overwhelmed with work. Now, according to a new study, residents are likely to be buried in educational debt, as well.

A presentation at the recent Society for Academic Emergency Medicine annual meeting in San Diego notes that, in 2001, less than 20% of emergency medicine residents had more than $150,000 of educational debt.

Now, however, emergency medicine residents anecdotally report much larger debt loads, which affect their career and life choices, according to the Loma Linda University Medical Center and Children’s Hospital-led research.

Background information in the report notes that debt can limit medical school graduates’ ability or desire to pursue the career of their choosing. That, in turn, decreases the number of physicians pursuing lower-paying specialties or willing to extend their training by obtaining specialized training.

The study team sought to gain a better understanding of how emergency medicine residents experience debt by conducting individual semi-structured interviews at the healthcare system. Collecting self-reported data related to educational debt, researchers conducted 48 interviews with 98% of the residents in a single program, asking open-ended questions about how the amount of money owed influences career choices, personal life, future plans, and financial decisions.

Results indicate that median educational debt was $212,000. Study authors listed six themes they said emerged from the analysis:

  • Debt influenced career and life decisions by altering priorities.
  • Residents experienced debt as a persistent source of background stress and felt powerless to change it.
  • Residents made use of various techniques to negotiate debt to focus on day-to-day work.
  • Personal debt philosophy, based on individual values and obtained from family, shaped how debt affected each individual.
  • Debt had a normative effect and was acculturated in residency.
  • Residents reported a wide range of financial knowledge, but recognized its importance to career success.

Study authors explain that emergency medicine is a young and growing specialty with increasing subspecialty options and is near the middle of the compensation spectrum for physicians.

“Our emergency medicine residents’ debt experience is complex and involves multiple dimensions,” the researchers write. “Given our current understanding, simple solutions are unlikely to be effective in adequately addressing this issue.”