Increasing educational indebtedness influences medical students to pursue specialization: a military recruitment potential?

BACKGROUND: Cost of medical education and student indebtedness has increased dramatically. This study surveyed medical students on educational debt, educational costs, and whether indebtedness influenced career choice. Responses should impact (1) Department of Defense (DoD) recruitment of physicians and (2) future of primary care. METHOD: The authors surveyed 188 incoming medical students (University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Class of 2012) concerning educational indebtedness, perceptions about educational costs, and plans regarding loan repayment. Data were analyzed and expressed as mean +/- standard error. RESULTS: Students with loans anticipated their medical educational costs to be $155,993. 62% felt costs were "exorbitant," and 28% "appropriate." 64% planned to specialize, whereas only 9% chose primary care. 28% of students planning specialization said income potential influenced their decision. 70% of students said cost was a factor in choosing New Jersey Medical School over a more expensive school. Students anticipated taking about 10 years to repay loans. CONCLUSIONS: As medical educational costs and student indebtedness rise, students are choosing less costly education and career paths with higher potential future earnings. These trends will negatively impact health care availability, accessibility, and cost. DoD programs to provide financial assistance in exchange for military service are not well publicized. These findings should increase DoD recruitment opportunities.

Commentary: criminal background checks for entering medical students: history, current issues, and future considerations.

In this commentary, the authors aim to contextualize the history and rationale for what has become the Association of American Medical Colleges-facilitated criminal background check process for entering medical students. As the process was being considered, many issues with a standardized process were identified. There were concerns that demographic or socioeconomic factors might unfairly burden certain applicants or discourage them from applying to medical school. On the other hand, a unified, national program would minimize cost and enhance quality assurance. The authors discuss these issues. Lessons learned in the first three years of the program are also addressed, including some unexpected and favorable consequences such as the identification of accepted applicants with at-risk behaviors (e.g., substance abuse), who would have otherwise gone undetected. Several challenges remain, including the fact that the criminal background check process creates an enhanced role for prehealth advisors and encourages undergraduate institutions to establish standards and processes relating to professionalism. While this is, no doubt, an evolving program which needs continued oversight and ongoing reevaluation, the authors support the continued advancement of the criminal background check process for entering medical students.

Don't know, don't care: revisited.

OBJECTIVES: This study re-evaluates the awareness and attitudes of medical students concerning military programs, which can provide financial support for medical student education. An original study, 10 years ago, demonstrated a minimal awareness of these programs. With medical school tuitions rising dramatically in the intervening years, as well as the resultant student indebtedness increasing significantly, it is appropriate to readdress this knowledge of attitude toward financial options through military programs for medical students. Reassessment was undertaken using the same evaluation instrument. In the decade in which these four assessments were made, attitudes toward amelioration of medical student tuitional indebtedness, through programs sponsored by the Department of Defense, have worsened. This phenomenon jeopardizes military medicine and, in so doing, negatively impacts readiness of our Armed Forces.