Who should pay for medical education?

Residency Program Insider, November 6, 2012

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It’s no surprise that debt is one of the largest issues facing medical school students after graduation. It’s even less surprising that with an average debt of $162,000, these grads seek some sort of loan repayment program as part of their recruitment package. 

World-renowned Princeton University economics professor Uwe Reinhart evaluates the subject in a recent post with the New York Times Economix blog and references a Cejka Search survey. In Dr. Reinhart’s article, he discusses the range of physician compensation and whether or not medical education should be government subsidized as a public good. 

According to our annual Resident and Fellow Survey, recent graduates are looking for loan repayment in their starting compensation packages. In fact, 48% of respondents ranked educational loan repayment as important or very important when deciding upon a practice opportunity.

According to the 2011 Cejka Search and AMGA Physician Retention Survey, about 60% of medical groups offer loan repayment, a majority of who believe this incentive acts as a differentiator. 
But size matters. For many medical groups, this is not a practical incentive to offer. Midsize groups were much more likely to offer this incentive as a part of their compensation package. Half of respondents from both small groups and large groups reported that loan payment isn’t applicable within their organization.

This mirrors the trends our search consultants are seeing in the field. We’ve found that small group clients often don’t have the resources to offer loan repayment. Large groups, on the other hand, don’t have to offer loan repayment because they are either in a desirable location or they are the primary employer in the area, so their job openings aren’t as difficult to fill. 

Medical education debt load can thus be seen as a contributing factor to the demise of the small, independent medical practice. It’s apparent that the cost of medical education deters students and exacerbates the growing physician shortage.  

Part of the current debate in the medical community revolves around the size of the role the government should play in subsidizing medical education. This debate will surely continue as the industry and government formulate solutions to offset the high cost of medical care. 

Should America continue to let the private sector address the high cost of medical education in this way or follow the lead of other countries that make medical education affordable or free? In essence, who should pay for medical training?

Lori Schutte, MBA, is president of Cejka Search, a nationally recognized physician, allied health and healthcare executive search firm providing services exclusively to the healthcare industry for more than 30 years. She is a member of the management team of Cross Country Healthcare, the parent corporation of Cejka Search.

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