Money isn’t everything, but it certainly is a factor. It’s safe to say that most people don’t want to be extravagantly rich. They just want to have enough money to fulfill their needs and demands. Just because someone doesn’t want to be a millionaire that doesn’t mean they’re okay with living on the street. So, yes people look to reach a certain target of money that will enable them to live satisfying lives. This makes a lot of sense because you can’t be happy if you’re always worried about paying rent or needing a new phone but being unable to afford it. Happiness is required for a better life which will result in a more productive person. Debt, however; make money a priority. Imagine being about 25 years old just graduated medical school yesterday and you’re now ready to face the world as a doctor, but instead you realize you have over two hundred thousand dollars in debt in addition to interest.
Having a lot of debt that you need to repay makes life more complicated. You’re not just looking ahead and thinking about moving to a new place and getting a car, but you’re also stuck in the past where there’s a huge amount of debt chasing you. That’s why a lot of medical students choose more financially rewarding specialties at the expense of things they actually like. Something like family medicine becomes a specialty to avoid because it’ll result in taking longer to pay off debt. There are consequences for that as well because if you’re not working in a field you love and your main concern is money then you won’t be feeling too good.
Over the last 30 years medical school fees have risen 165% in private schools and over 300% in public schools. If you graduated in 1984 your debt would be an average of 25 thousand, but if you’re graduating these days it’ll be over 125 thousand dollars. It costs over two hundred thousand dollars to go to medical school and these are tuition fees alone. We’re not even talking about books and living expenses. These are high numbers for anyone let alone a bunch of 25 year olds who still haven’t even started working in medicine.
This is one of the reasons we have highly competitive specialties such as surgery, dermatology, and radiology. They are some of the highest paying specialties so it makes sense for students with a lot of debt to seek residencies in them. The faster the debt is paid off the sooner they can focus on the future and what they want to do with the money they earn rather than having to direct most of it towards repaying the debt.
Medical school is very competitive. You have the top high school students in the country going at each other. There are lots of egos involved and each one of them wants to prove himself or herself. They want to prove that being the top of their high school or premed classes wasn’t a fluke and that they really do deserve to be doctors. It’s important to relax and remember that if you made it this far then you do deserve and will become a physician. Unfortunately that’s harder to do when you’re busy worrying about loans. So you’ve gotten past the stress of getting into med school now you’re under the stress of med school as well as the stress of what you’re going to do after it. So things get more competitive because you need the highest grades and the most experience in order to guarantee getting a good residency and even a competitive specialty. This is one of the things international medical graduates think about when they apply for residencies in the U.S. They know Americans have loans and need the more competitive specialties and that residency directors are more likely to choose Americans so IMGs go for less competitive specialties such as family medicine for better matching chances.
Some people choose to not go to med school at all even though it’s what they really want. If you’re going to have almost the entire amount of tuition in debt not to mention your living expenses then it’s understandable if you choose to not go that way. It’s too much stress and some people don’t want that in their lives. They will find other ways to help people. Some will keep working until they have the money for it then get back to medical school which isn’t unheard of. There are old junior residents around. They’re people who chose to not give up on their dream and to do it when they had the means for it so they could do it right.
It’s expected that within a decade there’s going to be a serious shortage of doctors in America. There will be a deficiency of about 90,000 doctors. A third of this deficit will consist of family doctors. There’s no doubt that the high medical school fees are a factor and that seeking higher paying specialties contributes to the lack of family doctors.
There are consequences to this lifestyle of constant worrying. Burnout and depression are the major ones. A lot of medical students are depressed and some of them even attempt suicide. Depression is generally very common among doctors due to the constant stress and heavy workload. It could be said that some of the physicians suffering from depression aren’t working in the specialty they originally wanted which played a role in them being depressed. Burnout is another serious condition where physicians stop caring about their patients and start to antagonize them. This is something they suffer from; it’s not done on purpose. This also makes sense in medical students because they’re constantly worrying and working themselves to the ground which will eventually push them to their breaking point. Physicians who don’t love what they do will also eventually suffer from this.
Constantly thinking and worrying about money also affects the mindset of young doctors. They become obsessed with making more money even after their debt is paid off. This makes them forget why they originally become doctors: to help people. They become callous and lose interest in patients or really caring about them.
There are a few ways to solve this problem such as medical students lowering their tuition fees. Perhaps it would be possible for them to cut back on a few things without affecting the quality of education in order to make medical school more affordable. There are also organizations that exempt very few students each year from their debt. There’s also a 10-year plan that takes a certain amount of money out of a student’s bank account each month according to how much they make. Most of these programs require young doctors to work for nonprofit organizations or for certain places, but unfortunately the spots are limited.
If debt wasn’t involved I think we’d see a lot more students heading in the direction of family medicine. Being a family doctor is great and what lots of students want, but it doesn’t pay as much as other specialties. Still, the average family doctor makes over 150 thousand dollars per year which is pretty good. Having medical students specialize in fields they like is wonderful because they’ll be happier which will make them more productive and less prone to depression and burnout. These are things that will result in more money coming into their workplace as well as more innovations.
It’s important to find a way to make education more affordable to all. At this rate of rise of tuition fees medicine is going to end up becoming a career choice for the rich who can afford it or a very stressful experience for those who can’t.