Don’t Let Debt Drive Your Medical Specialty Choice

Think back to the very first moment when you knew you wanted to be a doctor. When did it happen? What did you picture for your future?

Odds are that your youthful dreams did not include crushing medical school debt or the stress that so often accompanies it. And yet, recent research indicates that 40% of residents have over $200,000 in debt, with family medicine residents being hit particularly hard by debt that seems immense compared to their annual salaries. With the prospect of debt stretching decades into the future, it’s only natural that more and more students find themselves choosing a medical specialty associated with higher salaries. Unfortunately, these specialties often have nothing to do with the reason they got into medicine in the first place.

It’s difficult to shake the pressure to change your medical specialty to boost your income. After all, what of the pediatrician with $250,000 in debt when, according to Medscape’s 2016 Physician Compensation report, the average pediatric physician earns $204,000 in salary before taxes, the lowest of any of the specialties surveyed? It’s no wonder that a medical student, anticipating being a slave to medical school debt, might find general surgery or cardiology to be a more lucrative medical specialty choice. So why is this a problem? Well, chances are that you didn’t decide to go into medicine for the money, so don’t let dollar signs drive your career path now. Here are a few things to remember as you jump back in the driver’s seat, push your debt into the rearview mirror, and still allow your practical side to be a passenger.

Doing what you love will help you be the best at what you do

Let’s think back to those medical dreams you had when you first knew you wanted to be a doctor. Not only did those specifics in specialty provide you with a sense of purpose, but they likely also cultivated in you a sense of empathy for a particular audience you anticipated serving. In other words, you cared deeply, and when you switch to a specialty in which you are invested for purely financial reasons, it’s all too easy for that empathy to be replaced by cynicism. If you lack passion for your specialty, it may become all too easy for you to “phone it in” instead of doing your best work.

A fulfilling medical career is so much more than a paycheck

When choosing a medical specialty, overall quality of life cannot be ignored, and different medical specialties often compensate for higher salaries with long hours or increased paperwork. The residents surveyed by Medscape in their 2015 Residents Salary & Debt Report based their answers not just on compensation and debt but on the hours they work, professional relationships, quality of education, and ability to maintain a healthy work-life balance. If you dreamt of psychiatry or family medicine, you may not be prepared for the lifestyle accompanying a general surgery medical specialty. In fact, despite the great difference in salary, far more family medicine physicians than general surgery physicians professed overall career satisfaction.

Long-term financial gain is based on more than starting salary

While there are no easy solutions to your problem of medical school debt, take comfort in the fact that medical specialty salaries may not be as set in stone as many previously believed. Salaries for family physicians are actually increasing at a faster rate than other specialties, and family medicine is the most highly recruited medical specialty. In the long run, the greater demand and job security of some medical specialties may balance out with the short-term salary boost of others. And while it may not be clear to you in your time as a student or resident that your debt is indeed manageable, the income of the average doctor over time is enough to cover the debt of the average doctor.

There are solutions

Rather than pursuing an ill-fitting specialty and abandoning your passion, a little research can reveal many options. Solutions exist, from relocating to a rural area where money goes further, to moving to a state with a loan repayment program, to joining National Health Service Corps (NHSC), to refinancing your student loans at a lower interest rate. Increasing your salary through a change in medical specialty is only one solution. There are other solutions that can preserve your bank account as well as your ideals.