Does educational indebtedness affect physician specialty choice?

Abstract

There has been much debate over the effect of educational indebtedness on the specialty choices of new physicians, especially in light of the perceived shortage of primary care physicians. This paper explores the theoretical foundations on which this debate is based. In addition, the paper estimates the effects of various types of debt on specialty choice. The results suggest that an increase in debt from subsidized loan sources (i.e., Guaranteed Student Loans, National Direct Student Loans, or Health Professions Student Loans) has mixed effects while an increase in debt from Health Education Assistance Loans reduces the likelihood of becoming a primary care physician. Though these effects are significant, they are very small in magnitude. Economic returns to certain specialties and personal background appear to play a more important role in specialty choice.