BACKGROUND:Physicians often enter the workplace with substantial debt. The relationship between debt and reported career plans among internal medicine residents is unknown. OBJECTIVE:To determine distributions of educational debt among internal medicine residents and associations of debt with reported career plans. DESIGN:Cross-sectional survey using data from the annual Internal Medicine In-Training Examination Residents Questionnaire completed by U.S. categorical internal medicine residents. SETTING:Categorical internal medicine residencies in the United States. PARTICIPANTS:22,563 residents in their third (final) year of residency, representing 74.1% of all eligible U.S. categorical internal medicine residents from 2003 through 2007. MEASUREMENTS:Distributions of educational debt were tabulated. Proportions of residents choosing career plans were calculated for various levels of debt. RESULTS:International medical graduates represented 48.7% of the cross section and had considerably less debt than U.S. medical graduates: 53.8% of U.S. medical graduates had debt of 100,000 dollars or greater and 60.2% of international medical graduates had none. U.S. medical graduates with debt of 100,000 dollars to 150,000 dollars were less likely than those with no debt to choose a subspecialty career (57.5% vs. 63.5%). U.S. medical graduates with debt of 50,000 dollars to 99,999 dollars were more likely than those with no debt to choose a hospitalist career (8.5% vs. 6.2%), and this preference increased with increasing debt level (10.0% for those with >150,000 dollars debt). These associations are more pronounced for U.S. medical graduates than for international medical graduates. LIMITATION:The study addressed total educational debt, but not when it was incurred, and did not allow inferences related to causality. CONCLUSION:Educational debt is associated with differences in reported career plans among internal medicine residents.

译文

背景:医师经常带着沉重的债务进入工作场所。内科医师的债务与已报告的职业计划之间的关系尚不清楚。
目的:确定内科医学居民中教育债务的分布以及已报告职业计划的债务协会。
设计:横断面调查使用的是美国分类内科住院医师完成的年度内科培训期居民问卷调查的数据。
地点:美国的分类内科住院医师。
参与者:在第三(最后)年居住的22,563居民,占2003年至2007年所有合格的美国分类内科合格居民的74.1%。
测量:将教育债务的分配表化。针对各种债务水平,计算了选择职业计划的居民比例。
结果:国际医学毕业生占横截面的48.7%,债务比美国医学毕业生少得多:53.8%的美国医学毕业生的负债为100,000美元或更高,而60.2%的国际医学毕业生则没有。负债在100,000美元至150,000美元之间的美国医学毕业生比没有债务的美国大学毕业生选择亚专业的可能性要小(57.5%vs. 63.5%)。负债在50,000美元至99,999美元之间的美国医学毕业生比没有债务的毕业生更倾向于选择住院医生职业(8.5%对6.2%),并且这种偏好随着债务水平的提高而增加(负债超过150,000美元的人为10.0%)债务)。这些协会对于美国医学毕业生比国际医学毕业生更为明显。
局限性:该研究针对的是教育债务总额,但不是针对债务总额,而是针对因果关系的推论。
结论:教育债务与内科医师之间报告的职业计划差异有关。

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