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Home Research Research Library Debt and the emerging physician workforce: the relationship between educational debt and family medicine residents’ practice and fellowship intentions Debt and the emerging physician workforce: the relationship between educational debt and family medicine residents’ practice and fellowship intentions 2019 Author(s) Phillips, Julie P, Peterson, Lars E, Fang, Bo, Kovar-Gough, I, and Phillips, Robert L Topic(s) Education & Training, Role of Primary Care, and What Family Physicians Do Keyword(s) Practice Organization / Ownership, Shortage Areas, Imprinting Of Training, and Graduate Medical Education Volume 94(2):267-273 Source Academic Medicine Purpose: Educational debt is increasing and may affect physicians’ career choices. High debt may influence family medicine residents’ initial practice setting and fellowship training decisions, adversely affecting the distribution of primary care physicians. The purpose of this study was to determine whether debt was associated with graduating family medicine residents’ practice and fellowship intentions. Method: The authors completed a cross-sectional secondary analysis of 2014 and 2015 American Board of Family Medicine (ABFM) examination registration questionnaire data and ABFM administrative data. They used multivariate logistic regression to determine whether educational debt was associated with graduating residents’ practice (ownership and type) and fellowship intentions. Results: Most residents (89.7%; 3,368) intended to pursue an employed position, but this intention was not associated with their debt. Residents with high debt ($150,000-$249,999) had lower odds of intending to work for a government organization (odds ratio [OR] 0.57; confidence interval [CI] 0.41-0.79). Those with high or very high debt (> $250,000) had lower odds of choosing academic practice (OR 0.55, CI 0.36-0.85 and OR 0.62, CI 0.40-0.96, respectively) or a geriatrics fellowship (OR 0.36, CI 0.20-0.67 and OR 0.29, CI 0.15-0.55, respectively). Conclusions: High educational debt may contribute to national shortages of academic primary care physicians and geriatricians. Existing National Health Service Corps loan repayment opportunities may not offer adequate incentives to primary care physicians with high debt. The medical community should advocate for policies that better align financial incentives with workforce needs. Read More ABFM Research Read all 2014 One in Fifteen Family Physicians Principally provide Emergency or Urgent Care. Go to One in Fifteen Family Physicians Principally provide Emergency or Urgent Care. 2015 A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care Go to A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care 2018 Slow Progress and Persistent Challenges for the Underrepresented Minority Family Physician Go to Slow Progress and Persistent Challenges for the Underrepresented Minority Family Physician 2016 Supporting Health Reform in Mexico: Experiences and Suggestions from an International Primary Health Care Conference Go to Supporting Health Reform in Mexico: Experiences and Suggestions from an International Primary Health Care Conference
Author(s) Phillips, Julie P, Peterson, Lars E, Fang, Bo, Kovar-Gough, I, and Phillips, Robert L Topic(s) Education & Training, Role of Primary Care, and What Family Physicians Do Keyword(s) Practice Organization / Ownership, Shortage Areas, Imprinting Of Training, and Graduate Medical Education Volume 94(2):267-273 Source Academic Medicine
ABFM Research Read all 2014 One in Fifteen Family Physicians Principally provide Emergency or Urgent Care. Go to One in Fifteen Family Physicians Principally provide Emergency or Urgent Care. 2015 A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care Go to A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care 2018 Slow Progress and Persistent Challenges for the Underrepresented Minority Family Physician Go to Slow Progress and Persistent Challenges for the Underrepresented Minority Family Physician 2016 Supporting Health Reform in Mexico: Experiences and Suggestions from an International Primary Health Care Conference Go to Supporting Health Reform in Mexico: Experiences and Suggestions from an International Primary Health Care Conference
2014 One in Fifteen Family Physicians Principally provide Emergency or Urgent Care. Go to One in Fifteen Family Physicians Principally provide Emergency or Urgent Care.
2015 A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care Go to A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care
2018 Slow Progress and Persistent Challenges for the Underrepresented Minority Family Physician Go to Slow Progress and Persistent Challenges for the Underrepresented Minority Family Physician
2016 Supporting Health Reform in Mexico: Experiences and Suggestions from an International Primary Health Care Conference Go to Supporting Health Reform in Mexico: Experiences and Suggestions from an International Primary Health Care Conference