In an ideal world where money grew on trees, perhaps our professional choices wouldn't depend upon potential income vs indebtedness. Sadly, such is not the case, at least not with respect to the medical profession. Back in the day when I graduated with my MD from a private school, it was very rare for a newly minted physician to leave school with debt greater than $100,000. Of course, this figure dates me as
the average medical student graduated in 2009 with over $141,000 in debt - one school booted its graduates out the door owing close to a quarter million dollars on average!
Given the vast differential in potential lifetime earnings, it's not difficult to see how our current payment system, which favors the proceduralist over the primary care physician, might influence one's choice of residency training. And let's not even consider that for the next 3-7 years or more of residency and possible fellowship training, these physicians will receive a mere pittance (granted $48,460 is more than average income in the US in 2010) after factoring in hours worked (now currently
limited to just 80 hours/week!) while their debt increases geometrically.
How can I make this statement? It turns out that few of the most expensive medical schools are ranked or considered supportive of primary care. So if we agree that we need more primary care physicians, one place to
start is the cost of graduate medical education.
In fact,
the NY Times published earlier this week some thoughts from physicians who've left private practice for policy making on how we might actually make medical school free. I thought I'd mention additional commentary from both a
subspecialist (cardiac electrophysiologist) and
someone in primary care (internist).
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