$360,000 and Counting: The Burden of Student Loans

What do a vintage Ferrari, a one-bedroom home in Boston, and Paul’s student debt all have in common? All three are worth about $360,000. But unlike the car and home, Paul’s investment in his education is not an asset, but rather a burden that continues to grow.

Like many children, Paul wanted to be a doctor when he grew up. When his classmates began to explore other career opportunities or firmly place themselves in the “undecided” category, Paul never wavered from his desire to pursue a career in medicine.

During his senior year of high school, Paul applied and was accepted into a prestigious combined undergraduate and medical school program at a private university. He was also offered a generous scholarship to the local state university but chose to forgo this offer in exchange for guaranteed early acceptance into medical school. Paul’s parents could not afford steep tuition at the private school leading him to apply for financial aid. He viewed these loans as an investment in his future that he would be able to pay off once his training was complete. However, like many pre-med and medical students, Paul did not realize just how long the road to becoming a full-fledged doctor would be.

Following medical school, Paul chose to pursue a career in radiology and began in earnest the required five-year training tract. Like so many residents today, Paul added a sixth year of training to pursue a fellowship in abdominal imaging. During this time, he opted to defer his loan payments to free up resources to care for his family on a modest trainee income. His loans have continued to accrue interest during this six-year period and his debt burden has spiraled.

Unfortunately, Paul’s story is not unique. Below are a few sobering figures from the Association of Medical Colleges regarding student debt:

• $157,944 - Average educational debt of indebted graduates of the class of 2010.
• 78 percent of graduates have debt of at least $100,000.
• 42 percent of graduates have debt of at least $150,000.
• 85 percent of graduating medical students carry outstanding loans.

How does this affect radiology? Paul has excelled both academically and professionally as a medical student, resident, and fellow. He has developed an interest in research and would like to pursue an academic career.

However, Paul has discovered that financial offers from academic medical centers pale in comparison to those in the private practice world. While it is generally known that salaries in the academic sector are not at the level of private practice, the increasing gap between the two is staggering. Some of the offers Paul received barely exceeded what he currently earns as a fellow and most would not allow him to financially provide for his family while paying down his student loans.

As a result, Paul is now considering a career in private practice, and academic radiology may have lost a talented professional. As more and more talented radiology trainees choose private practice rather than academics, radiology’s ability to produce cutting edge research in imaging will be threatened by other specialties in medicine. If more of the research that drives the imaging sciences originates from outside radiology, non-radiologists could ultimately take over the clinical domain of imaging¹. More important, Paul’s debt burden is affecting his ability to pursue his passion for a research career.

Sadly, it does not appear this problem is going away any time soon. Here are more sobering numbers:

Estimated four-year cost of tuition, room and board starting in 2020²:
• Public in-state university: $152,185
• Private university: $310,499

If the burden that education loans place on our best and brightest is not addressed our profession and our nation will surely face the consequences in the future.

1 Rao VM, Levin DC. Turf wars in radiology: what must academic radiology do? J Am Coll Radiol. 2007 Sep;4(9):622-5.

2 The College Board, a not-for-profit education services organization. Estimated costs assume a 6 percent average yearly increase.