Understand how we got here — and how to move forward.


September 11, 2017

The debt dichotomy: Fewer med grads have debt—but they have more of it, research finds

Daily Briefing

While fewer medical school students graduated with debt in 2016 than did in 2010, the amount of debt students graduate with has increased substantially during the same time period, according to a research letter published in JAMA.

How physician pay is evolving in an age of consumerism and burnout

Study details

For the study, researchers assessed data from the 2010-2016 Association of American Medical Colleges Graduation Questionnaire on respondents' medical education debt, adjusting for inflation. The researchers then sorted the results into four categories:

  • Graduates with no debt;
  • Graduates with debt less than $100,000;
  • Graduates with debt between $100,001 and $200,000; and
  • Graduates with debt greater than $200,000.

The researchers also assessed respondents' reported scholarship funding.

Key findings

According to the researchers, the percentage of medical students who said they graduated with no debt increased by 67 percent, from 16.1 percent in 2010 to 26.9 percent in 2016. There was also a fairly noticeable drop in the percentage of students reporting debt between $100,001 to $200,000, dropping from 41.5 percent in 2010 to 33.2 percent in 2016. Meanwhile, the percentage of students graduating with less than $100,000 of debt and those with between $100,001 and $200,000 in debt—stayed relatively static with minor changes, the researchers said.

The researchers also sorted the results by specialization, with graduates planning to practice ophthalmology seeing the lowest rates of debt, and those looking to practice family medicine seeing the highest rates of debt.

Overall, the researchers found, the percentage of graduates with debt decreased for every specialty from 2010 to 2016.

However, among graduates who did report debt, the average increased from $161,739 in 2010 to $179,000 in 2016—and it increased for every specialty. For instance, those hoping to practice emergency medicine reported the highest average debt, $195,432, while those planning to practice dermatology reported the lowest average, $153,827. According to the researchers, students seeking careers in pathology reported the largest increase in average debt, from $148,440 in 2010 to $178,146 in 2016.

The researchers also cited data showing a sharp decrease in scholarship funding for students who reported graduating with no debt, indicating that these students might come from high-income backgrounds. If so, the researchers said the findings suggest that students from lower-income households are likely bearing a disproportionate burden of the increases in medical school debt.

David Asch—executive director of the Penn Medicine Center for Health Care Innovation, and one of the study authors—said, "The costs of becoming a physician are incredibly high." He added that such costs could put "upward mobility out of reach of people at a time when we want to reverse that trend by having a more representative workforce."

According to Asch, "If we reduce those costs, everyone wins" (Blau/Bronshtein, STAT News, 9/5; Vartorella, Becker's Hospital Review, 9/5).

New report from the frontier of physician compensation

This research report examines the emergence of this trend and profiles organizations that have recently redesigned physician pay around a salary-based model.

It also considers key questions about the longer-term future of compensation—including the potential conflict looming as physician pay continues to climb while health systems focus on controlling costs.

Download the Report

Have a Question?


Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.