The authors used results from questions on the
Association of American Medical Colleges' 2002 Medical
School Graduation Questionnaire that focused on students'
debt and career choices to examine the hypothesis that
medical students' rising total educational debt is one of
the factors that explains the recent decline in students'
interest in family medicine and primary care. Students
reported that higher levels of debt influenced their
future career choices, and there was an inverse
relationship between the level of total educational debt
and the intention to enter primary care, with the most
marked effect noted for students owing more than $150,000
at graduation. Total debt was associated with a lower
likelihood of choosing a primary care career, but factors
such as gender and race appeared to have more explanatory
power. Female students were much more interested in
primary care-and especially pediatrics-than were male
students; African American students were more interested
in inner-city practice than was any other identified
racial or ethnic group.