PRP026: Association of Average Institutional Educational Debt Load and Graduate Choice of Family Medicine

Ada Pariser; Shelby Walker; Julie Phillips, MD, MPH; Andrea Wendling, MD


Context: There is a pervasive shortage of family physicians in the United States, and current workforce projections are not on track to meet demands. While there are many reasons that medical students may choose not to go into family medicine, educational debt combined with lower salary expectations may contribute. Current studies have only examined this problem at the individual level rather than exploring the impact at an institutional level of graduates’ education debt loads on the proportion of graduates entering family medicine. Objective: To determine the relationship between average indebtedness and percent of students entering family medicine on a school-by-school basis. Study Design: Secondary analysis of merged dataset using logistic regression to compare odds ratios for graduates entering family medicine from each school based on debt, when controlling for other institutional factors associated with family medicine production including private/public designation, presence of FM department, regional campuses, underserved or rural training tracks...
Dataset: A dataset was constructed describing all accredited medical schools within the United States (both allopathic and osteopathic) that have graduated at least two medical student classes. Data were gathered from the American Academy of Family Physicians’, Association of American Medical Colleges, American Association of Colleges of Osteopathic Medicine, US News and World Report and individual medical school and residency program websites.
Population Studied: All 2016-2019 allopathic and osteopathic medical schools. Outcome measures: Average debt and tuition costs by school compared with percentage of graduates entering family medicine. Results: Study is ongoing. We anticipate that medical schools at which students graduate with higher average indebtedness will have lower numbers of students entering family medicine residencies. Outcomes to be reported: Results could inform strategies to bolster the primary care workforce by decreasing or ameliorating medical student debt, supporting debt relief for primary care physicians, or adjusting family physician or primary care reimbursement to better address future debt load of graduates.

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