Many anesthesia residents are carrying high educational debt—$150,000 or higher—that may constrain their employment decisions after graduation, according to a survey study in the July issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).
New anesthesiologists with high debt may face limited options during and after residency—including being less likely to pursue an academic career, according to the survey report by Dr Jeffrey W. Steiner of UT Southwestern Medical Center, Dallas, and colleagues. They write, "The medical school experience may be shaping our future anesthesiologists in ways that may be difficult to undo."
High Debt May Limit Job Choices for New Anesthesiologists
The researchers performed an Internet survey to assess levels of medical educational debt among anesthesia residents and other trainees (interns and fellows). Residents were also asked how debt would affect their work schedule during training, particularly "moonlighting"; and their career choices after graduation. A total of 237 residents completed the questionnaire (response rate 22.5 percent).
As expected, the residents reported high levels of indebtedness. Most owed at least $120,000, and more than 40 percent had debt of $150,000 or higher.
Debt load significantly affected the residents' occupational choices. Those with higher debt were more likely to say they were interested in "moonlighting"—working a second job to earn extra money—during their residency. For every additional $30,000 in indebtedness, the odds of expressing an interest in moonlighting increased by seven percent.
Debt also affected the residents' thoughts about career choices after graduation. In particular, residents with high indebtedness were less likely to say they'd consider a career as an academic faculty member. Such academic positions—teaching and working in a university setting—typically pay less than working in private practice. For each $30,000 increase in debt, the odds of choosing an academic career decreased by thirteen percent.
High-Debt Graduates Express Interest in Repayment Aid
Not surprisingly, residents with higher debt said they'd be interested in taking a job with a group practice that offered an education debt repayment program. Those with debt of more than $150,000 were about four times more likely to say they'd be interested in a job that offered help paying back loans.
Amid mounting concern about the financial burden of student loans, high debt incurred by medical students has been identified as a growing problem. Indebtedness is increasing faster than the rate of inflation—average medical school debt has risen to $158,000. One respondent to the new survey reported loans of $350,000, and suggested that some anesthesia residents have debt in the $400,000 range.
To limit the impact of debt on career choices, Dr Steiner and coauthors suggest that anesthesia residency programs should promote moonlighting opportunities that are within current work-hour limits, as well as develop financial education programs for trainees. They also suggest debt repayment programs as an incentive for new graduates to consider academic careers.
An accompanying editorial by Dr David Alan Lubarsky echoes the call for university anesthesia programs to develop debt repayment plans, as a way of making academic careers more competitive with private practice. Aid with paying back loans could help university anesthesia departments to "attract the best and brightest, while lifting a load of worry from the minds of many newly graduating physicians."
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