One of the universal 4-letter words in medicine = debt. By the time you've finished a 4 year undergraduate degree, 4 years of medical school and between 2 to 7 (or more) years of residency/fellowship training, you are easily looking at a 6 figure debt load. For us, as with many physicians who end up life partnering with another physician, multiply that amount times two. It is difficult to compare the cost of medical education across countries, but looking at where we live here in Canada, most numbers you will see now average around $200,000 in debt after 4 years of medical school. That means even before residency begins!
So it’s not hard to figure out why debt correlates with so many other aspects of career choice and ultimately physician well-being. Mounting debt may steer many medical students away from Family Medicine, leading to problems in the match system - given it's expected that half of medical students will end up in Family Medicine. We all know, including us personally, an inequality exists among specialties in terms of remuneration, and in particular, Family Medicine compared to other specialties. But that's for another day…
This debt fiasco also may determine where a newly minted physician will work, even if it isn't their first choice. Sounds like the starting point of potential burnout? Certainly can be. Now you have a physician potentially working in both a specialty and location not of their choosing with hundreds of thousands of dollars in debt to pay off. Quite a "piano" on their back to start out.
At this point in time, other factors come into play such as the desire to spend after delayed gratification, having a family, starting a practice, and oh yeah, don’t forget to start saving for retirement since you don’t have a pension. You get the picture.
We don’t bring up this gloomy topic to point out the obvious, but rather to spark awareness and conversation around the gravity debt plays in choosing a career in medicine. Don’t be afraid to talk to someone, professional or otherwise, to work towards individual solutions. It's easy to get into debt, much harder to get out of it, but it can be done.