Influence of Student Loan Debt on General Surgery Resident Career and Lifestyle Decision-Making.

BACKGROUND: The average medical school debt in 2011 was $170,000, and by 2017 it increased to $190,000. High debt burden has been shown to affect career choices for residents in primary care specialties; however, it has not been well studied among surgical residents. The purpose of this multi-institutional study was to assess the amount of debt among general surgery residents and its effects on their career and lifestyle decisions.

STUDY DESIGN: Surveys were distributed to 607 categorical general surgery residents at 19 different residency programs. Degree of debt was assessed and responses compared.

RESULTS: Overall, 427 (70.3%) residents completed the survey, 317 (74.2%) of whom reported having student loan debt. Of those with debt, 262 (82.6%) believed that repaying debt was a significant financial burden in residency, 248 (78.3%) thought it would remain a burden after residency, 210 (66.2%) believed their debt would influence their future job choice, and 225 (71%) thought their debt would delay their ability to buy a home. Debt did not affect decisions to get married or have children. There were 109 (25.6%) residents with no debt, 131 (30.8%) with <$200,000, 103 (24.2%) with $200,000 to $300,000, and 83 (19.5%) with >$300,000. Residents with high debt were less likely to feel financially secure now (p < 0.0001) and when thinking about their future (p < 0.0001). They also had higher minimum starting salary goals (p = 0.002) and were less likely to have had assistance paying for their education (p = 0.0001).

CONCLUSIONS: Surgical residents believe their debt is a significant financial burden. Furthermore, high debt significantly influences their financial security, practice location, and salary goals.