Yes, Virginia, You Can Enter Primary Care and Afford to Raise a Family and Live in a City, Study Finds

Last week, one of my blog posts explored the financial decisions that face the future physicians of our country. The post was in response to a CBS News article that called becoming a physician a potential “million dollar mistake.”
I argued then that the math in the article wasn’t exactly accurate. Debt and lost income during medical training are significant, and often in the hundreds of thousands of dollars, but I wasn’t sold on it reaching a million dollars.
That said, I did bring up the fact that regardless of the exact dollar amount, education debt for physicians is significant and most concerning for primary care physicians who will have similar debt levels but lower incomes than their surgical and specialist counterparts.
Earlier this week, in response, I received an email from a spokesperson for the Association of American Medical Colleges. She shared with me the findings of a study funded by the AAMC, “Physician education debt and the Cost to Attend Medical School,” which found that many other factors drive specialty choice, and debt and income actually have little influence on this decision. According to the report:
“Many claim few physicians choose primary care because of prohibitive debt levels, but surprisingly little evidence supports this assertation. In fact, a thorough review of the academic literature shows little to no connection between the economic facts such as debt/income and potential specialty choice.

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By: Staff

Additionally, in an article in the January 2013 issue of Academic Medicine, researchers used financial planning software to model the annual finances of a physician and his or her family at various debt and income levels. According to the analysis:

“A primary care career remains financially viable for medical school graduates with median levels of education debt. Graduates pursuing primary care with higher debt levels need to consider additional strategies to support repayment such as extended repayment terms, use of a federal loan forgiveness/repayment program, or not living in the highest-cost areas.”

Thus, according to the findings, physicians with median debt levels ($160,000-$170,000) can afford to pursue primary care while living in an urban area and raising a family. Physicians with higher debt ($250,000 or more) will need to think carefully about repayment choices during residency and beyond.

So, I suppose I need to admit that my initial thinking about debt and income influencing a decision not to pursue primary care was wrong. However, I still think medical education is incredibly expensive, and while analysis shows that entering the lowest paying specialty at a median debt level is doable, monthly loan repayments could reach into the several thousand dollars for some students, a sizeable chunk of a monthly budget.

Perhaps the most important decision physicians will make then, at least financially, is not whether to go to med school, but where to go to med school, considering the cost of attendance (tuition + cost of living – financial aid) as key factor in their decision.

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