Help ease the financial burden of medical education

Lately, there has been a lot of talk on Capitol Hill about student loans, with each political party proposing different ways to prevent student loan interest rates from doubling, as they are set to do this summer. As a pediatrician going into a pediatric subspecialty, I am painfully aware of the financial burden of medical education: I owe more than $350,000 in education loans, including college and a Masters in Public Health graduate degree, and  only part of that sum includes medical school. For me and so many others like me across the country, loan repayment has become an additional 30 year mortgage, and its staggering debt makes it nearly impossible to contemplate new investments like a home or college savings for my own child’s future.
 
I take on this burden because I love what I do: caring for children in some of the scariest moments of their young lives, when they visit the emergency room. I am currently pursuing a fellowship in emergency medicine here in DC. In this field, I can help pediatric patients in nearly every aspect of their health in the moment when they need me the most. It is exhausting, rewarding work, and I can’t imagine doing anything else.

Yet, currently, one-third of American children must travel greater than 40 miles to receive care from many types of pediatric specialists, including those who do what I do in pediatric emergency medicine. In some parts of the country, children have to wait more than three months to get an appointment to see the right pediatric specialist to treat them. The nation’s current supply of pediatric specialists is simply inadequate to take care of the growing needs of children, and the staggering loan repayment burden these physicians face disheartens rather than incentivizes more providers from entering the field.
 

For many going into medicine, medical education translates to an immense financial burden that looms over their entire medical career. In 2009, according to the American Medical Association, the average medical school debt was $156,456, with some medical students topping $200,000 in debt for medical school alone.
 
The next phase of medical training, which includes residency and fellowships for those going into subspecialties, does not make it any easier to pay off this substantial debt. Residency salary averages in 2010 were $48,460, and fellowship salaries are not much more than that—far less than our adult counterparts. This combined training may add up to an additional 4-7 years post medical school graduation.
 
But pediatricians like me, who choose careers in a subspecialty, do not do so for the salary: we pursue pediatric medicine because we love children. We recognize their resiliency, their potential, their vulnerability and their reliance on our care to grow and thrive. Still, these numbers are hard to swallow, and make it difficult to encourage medical students to pursue the subspecialties we so desperately need to adequately care for our children.
 
President Obama recognizes the role pediatric subspecialists play in caring for some of our nation’s most vulnerable children: in his Fiscal Year 2013 budget proposal, the president requested $5 million for a loan repayment program contained in Section 5203 of the Affordable Care Act. If fully funded, the program would forgive up to $35,000 in loan forgiveness up to three years for pediatric specialists and surgical specialists who choose to practice in underserved areas.
 
We need this type of investment if we are to provide the best possible care for our children. I urge Congress to honor the president’s request for this critical program as they consider ways to fund the federal government through the next fiscal year.

Sylvia Owusu-Ansah, MD, MPH, pediatric emergency medicine fellow, Washington, DC. She is also a member of the American Academy of Pediatrics

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