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More New Doctors Shunning Private Practice

California residents attending UCSD’s School of Medicine paid $22,959 in tuition last year, but do not have an average debt higher than $100,000, according to the vice dean of medical education. (Will Parson/Guardian)

As many UCSD premed students
prepare to graduate and enter medical school, a realm of new experiences
and challenges awaits them. Yet these students’ medical school experiences come
at a price­­ — almost $130,000 in educational bills, according to a report by
the Association of American Medical Colleges.

Studies suggest that medical schools’ escalating tuition
fees and the subsequent debt that students accumulate influence the specialty
they choose upon graduation. The cost of tuition fees and health insurance has
risen from last year at UCSD’s School
of Medicine
: The fees for 2007-08
are $22,959 for residents and $35,204 for non residents.

The nationwide increase in tuition fees is sparking concerns
due to the adverse effects on students and patients, according to recent data
released by the American Medical Association. The AMA suggests that there have
been correlations between debt and students’ choices, and how those decisions
in turn have come to harm the health-care system. Such correlations include unsafe
physician behavior and a decrease in primary-care physicians and in diversity
of the physician workforce.

The AMA said that residents who carry the high debt burdens
are more likely to assume an additional job. This can lead to fatigue, which in
turn can breed medical errors. Also, high debt becomes a barrier for many
low-income and minority students. Furthermore, the increase in debt among
students can pressure them to pursue higher-paid specialties.

“Students with high debt are less likely to pursue family
practice and primary care specialties and instead seek specialties with higher
income or more leisure time,” the report said.

On average, a family practice doctor earns about $160,000,
as suggested by a 2007 report by physician-staffing firm Merritt, Hawkins &
Associates. Such a salary is far less than what other medical practitioners are
earning. According to the report, radiologists earn an average salary of
$380,000, neurosurgeons make roughly $530,000 and urologists can earn up to
$400,000 per year.

Despite the increase of tuition fees at UCSD’s School of
Medicine, the average debt is less than what the national data suggests,
according to Maria Savoia, the school’s vice dean of medical education.

“There are national data that suggest that higher debt —
over $100,000 — makes students think about choosing higher-paying specialties,”
Savoia said. “Thankfully, we at UCSD aren’t at an average debt greater than
$100,000, but this certainly is a concern for us as tuition and fees go
higher.”

However, Assistant Director of UCSD Career Services Center
Nicole O’Neil said that postgraduation debt is nothing new to medical students.

O’Neil said that premed students at UCSD are advised about
the financial burdens that they will face if they are serious about choosing a
medical career, which helps to lessen the shock related to salary disparities
in different fields.

“We tell all the students who come in here and who are
interested in premed, ‘Be prepared to take a debt,’” she said.

According to the data compiled by the Career
Services Center
,
the number of UCSD students applying to medical school has steadily increased.
There were 410 applicants in 2006, compared to 362 in 2004 and 383 in 2005.

O’Neil suggests that there are other factors that play into
a student’s specialty choice, such as lifestyle and location. There are also
personal reasons that drive students toward one particular medical field over
another, she said.

Such is the case for Revelle
College
junior Elizabeth McDevitt,
who hopes to practice pediatric medicine and specialize in autoimmune diseases
because of her own battle with juvenile rheumatoid arthritis. McDevitt said the
idea of accumulating debt was never a point of concern for her.

“It’s just money, and this is something I really want to
do,” she said. “I’m sure it is something that will work itself out, and instead
of worrying about it now, I’m just focusing on doing the best I can to get what
I want, and for me, that’s never been money.”

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