Health Professions Educational Debt: Personal, Professional, and Psychological Impacts 5 Years Post-graduation

Abstract

IntroductionCost burden in health professions education is rising. To bridge the gap between growing tuition and stagnating wages, student loans are increasingly obtained to cover educational costs. The spiraling after-effects are a source of acute concern, raising alarms across institutions and occupations. There is little dissemination to date of feasible data collection strategies and outcomes beyond 1 year post-graduation. Research is needed in evaluating the impacts of healthcare educational debt on career and personal choices following transition to practice.Materials and MethodsThis study utilized a cross-sectional, mixed methods design. Doctor of Physical Therapy (DPT) Program graduates 5 years following degree completion completed a quantitative online survey, with topics including debt-to-income ratio, educational debt repayment strategies, impact on personal factors, non-education debt, and perceived value of their health professions education. Subsequent phone interviews were conducted by student researchers to gain insights into alumni perceptions of the impacts of educational debt on personal and professional decision-making. Data analysis involved descriptive and correlational quantitative statistics and open and axial coding of interview constructs.ResultsThe mixed methods format was successful in obtaining desired depth of response data. Quantitative findings demonstrated primary factors impacted by educational debt as savings, housing, leisure, discretionary spending, and family planning. Qualitative findings revealed impacts on themes of “personal factors” (81%), “professional factors” (62.5%), and “psychological factors” (56%) 5 years after graduation. Most negatively impacted were housing decisions, hours worked, initial job selection, and ability to save for the future, contributing to decreased mental health wellbeing with anxiety, frustration, and guilt. The majority (75%) of respondents perceived a high degree of value during and following their DPT education, though many expressed discordance between expectations and realities of practice.DiscussionFindings demonstrate that impacts of health professional educational debt in professional, personal, and psychological factors continue 5 years following degree completion, regardless of debt load. Successful implementation of this pilot methodology indicates potential for use of such extended data collection strategies. Further research is needed at the programs, profession, and/or interprofessional level to garner depth of understanding to guide interventions designed to mitigate or prevent these long-term repercussions.

Excellence in Academic Physical Therapy: Promoting a Culture of Data Sharing

“…2,3 e ACAPT priorities include transforming clinical education, building diversity, controlling student debt, increasing the value of education for PTcareers, and addressing a shortage of qualified faculty. 1 Educational researchers are actively exploring these challenges and have shared studies related to PT student debt, [4][5][6] quality in clinical education, 7 readiness for full-time clinical education, 8 integrated clinical education, 9 and a culture of diversity in the PT profession. 10,11 Although these studies have expanded the understanding of important challenges in academic PT, the profession has not yet explored and operationalized profession-wide data analytics to facilitate program-level and profession-level educational excellence.…”

Daily association of stressors with perceived cognitive performance: Moderating role of age

“…When providing care both at work and at home, there is greater risk for stressor exposure. Moreover, younger nurses are more likely to be paying off student loan debt (Laschinger & Read, 2016; Meyer et al., 2021; Webster & North, 2022). Loan debt may serve as an additional demand that younger nurses have to face on top of job demands.…”