High debt load anticipated by majority of medical students; African-Americans most affected

September 16, 2013

The cost of a medical school education in the United States has been on the rise over the past 10 years. However, given racial and ethnic inequalities in access to financial resources, increases in the student debt burden may not be assumed equally. To evaluate the issue, researchers at Columbia University's Mailman School of Public Health analyzed data from a sample of over 2% of the U.S. medical students enrolled at 111 accredited American medical schools.

In the sample of 2,355 medical in 2010-2011, 62.1% of the medical students overall and 65% of White students anticipated above the $150,000 threshold. A greater portion of Black students—77.3%—anticipated owing more than $150,000. Asian students, at 50.2%, expected the lowest levels of debt, and a slightly higher rate of Hispanics/Latinos—57.2%—predicted having debt in excess of $150,000. Results were weighted by race and class year.

The study is published online in the journal PLOS One.

"The finding that Black medical students had significantly higher anticipated debt than Asian students has implications for understanding differential enrollment among in U.S. medical schools," according to senior author Sandro Galea, MD, DrPH, Gelman Professor and chair of the Department of Epidemiology at the Mailman School of Public Health.

Since 2004, the percentage of Black enrollment in medical schools has fallen, particularly in osteopathic schools. Meanwhile, enrollment of Hispanic and Asian students continues to rise. For 2010-2011, 60% of medical school students were White compared with 21% Asian, 7% Hispanic/Latin, and 6% Black. Compared to the overall U.S. population, Asian students are overrepresented in the medical student population by over 75%, while Black students are underrepresented by over 100%.

Unique to this analysis, the researchers included data from both allopathic—or mainstream medical practice—and osteopathic institutions. "This is uncommon in studies about medical but better reflects the total population of students entering the physician workforce," according to Robert A. Dugger, MD, MPH, study author and a former research associate at the Mailman School of Public Health who is currently a psychiatry resident at North Shore-Long Island Jewish Hospital. "As concern over the physician supply grows, more investigation into the influence of medical education cost on the physician supply is needed," noted Dr. Dugger.

Less Debt Anticipated By Hispanic and Asian Students

Disparities in medical student debt burden generally correlated with racial and ethnic disparities in income, although there was a significant exception. Hispanic medical students experienced comparatively low anticipated educational debt yet they have among the lowest median incomes in the U.S. Asian , like their Hispanic counterparts, also had low anticipated educational debt, yet both groups of students are likely to come from immigrant households.

"It is plausible that immigrant families may be less comfortable with the American norm of educational loan utilization than nonimmigrant families," said co-author Dr. Abdulrahman El-Sayed, a fellow in the Mailman School Department of Epidemiology and medical student at Columbia's College Physicians and Surgeons. "At the same time, they may be more willing to offset the costs of their children's graduate education."

The paper underscores that experts have been tracking the high cost of medical education for some time and, in particular, its effect on qualified Black and Hispanic applicants. The higher anticipated debt among Black compared to Hispanic students that this research revealed may explain, in part, why matriculation among Blacks is decreasing in the setting of increasing matriculation among Hispanics.

High medical student debt is known to frustrate efforts to create a diverse and representative physician workforce. "Our work suggests that the burden of medical student debt is substantial, and that the distribution of debt across race and ethnicity is disproportionate. With Black students reporting higher debt burdens than their counterparts from other racial and ethnic backgrounds, it is plausible that this disproportionate may play a role in the relative decline in medical school attendance among Black students," noted Dr. Galea.

Explore further: Debt and income concerns deter medical students from primary care careers

Related Stories

Debt and income concerns deter medical students from primary care careers

September 21, 2012
(Medical Xpress)—Primary care physicians—America's front line healthcare practitioners—are usually the first to diagnose illness, refer patients to specialists and coordinate care. Yet, despite that critical role, primary ...

Proportion of black males in US medical schools dropping

March 5, 2013
(HealthDay)—The proportion of black males in medical school is decreasing, according to a report published by the Association of American Medical Colleges (AAMC).

Med school enrollment on rise in 2012

October 26, 2012
(HealthDay)—The number and diversity of students applying to and enrolling in medical schools in the United States increased this year, new data shows.

Study finds heavily indebted med students choosing primary care face greater financial challenges

November 27, 2012
Researchers at Boston University and the Association of American Medical Colleges (AAMC) have determined that heavily indebted medical students choosing primary care careers will experience difficulty paying their student ...

Recommended for you

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

Best of Last Year – The top Medical Xpress articles of 2016

December 23, 2016
(Medical Xpress)—It was a big year for research involving overall health issues, starting with a team led by researchers at the UNC School of Medicine and the National Institutes of Health who unearthed more evidence that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.