21st July 2017, Volume 130 Number 1459

Craig S Webster, Christopher Ling, Mark Barrow, Phillippa Poole, Marcus Henning

A student’s career choices may be influenced by many factors, including personal interest, financial compensation, the cost and perceived level of difficulty of the training programme and lifestyle preferences.1–3 A…

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Summary

We explored relationships between student loans debt, financial support and career preferences upon graduation in 2,405 students across all healthcare disciplines offered at the Faculty of Medical and Health Sciences, University of Auckland. Students in health sciences, nursing and pharmacy typically accrue levels of student loans debt of around $15,000 to $29,999, while optometry students accrue debt around $15,000 higher. Medical students show debt distributed around both ends of the scale at $0 and $90,000 or more. All students typically access three sources of financial support during study. Career preferences at graduation were found to reduce to four categories for all health disciplines, and five significant effects were found, involving students in health sciences, medicine and pharmacy, relating the number of sources of financial support to a category of career preference. No significant effects were found related to level of student loans debt. Our results suggest that financial support is a more strongly determining factor in career choices than the level of student loans debt.

Abstract

Aim

To explore relationships between student loans debt, financial support and career preferences upon graduation for all healthcare disciplines offered at the Faculty of Medical and Health Sciences, University of Auckland.

Method

The Faculty Tracking Project is a longitudinal study which invites students to complete a questionnaire at the beginning and end of their educational programmes, including questions on debt, financial support and career preference. Our analysis comprised three phases: (1) a descriptive analysis of data related to debt and financial support; (2) a principal component analysis in order to find related categories of career choice; and (3) logistic regression models to determine how career preference categories could be explained by either levels of student loans debt or financial support.

Results

Data from 2,405 participating students were included. Students in health sciences, nursing and pharmacy typically accrue levels of student loans debt of around $15,000 to $29,999, while optometry students accrue debt around $15,000 higher. Medical students show debt distributed around modes of $0 and $90,000 or more. All students typically access three sources of financial support during study. Career preferences at graduation reduced to four categories for all health disciplines. We found five significant effects, involving students in health sciences, medicine and pharmacy, relating the number of sources of financial support to the four categories of career preference. No significant effects were found related to level of student loans debt.

Conclusion

Our results suggest that financial support is a more strongly determining factor in career choices than the level of student loans debt. The four-category framework for student career preferences appears to be a useful model for further research.

Author Information

Craig S Webster, Senior Lecturer, Centre for Medical and Health Sciences Education, University of Auckland, Auckland; Christopher Ling, House Officer, Counties Manukau District Health Board; Mark Barrow, Associate Dean – Academic, Faculty of Medical and Health Sciences, University of Auckland, Auckland; Phillippa Poole, Head of Department of Medicine, University of Auckland, Auckland; Marcus Henning, Senior Lecturer, Centre for Medical and Health Sciences Education, University of Auckland, Auckland.

Acknowledgements

This research was supported by a summer studentship stipend from the Faculty of Medical and Health Sciences, University of Auckland, New Zealand. We thank Antonia Verstappen of the Faculty Tracking Project, University of Auckland for assistance with data extraction. The Faculty Tracking Project, University of Auckland, is supported by a grant from Health Workforce New Zealand.

Correspondence

Dr Craig Webster, Centre for Medical and Health Sciences Education, University of Auckland, Private Bag 92-019, Auckland 1142.

Correspondence Email

c.webster@auckland.ac.nz

Competing Interests

Nil.

References

  1. Gill D, Palmer C, Mulder R, et al. Medical student career intentions at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results Part II. N Z Med J 2001; 114:465–7.
  2. Lent RW, Brown SD, Talleyrand R, et al. Career choice barriers, supports, and coping Strategies: college students’ experiences. J Vocational Behav 2002; 60:61–72.
  3. O’Grady G, Fitzjohn J. Debt on graduation, expected place of practice, and career aspirations of Auckland Medical School students. N Z Med J 2001; 114:468–70.
  4. West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA 2011; 306(9):952–60. doi: 10.1001/jama.2011.1247
  5. Henning M, Krägeloh C, Moir F, et al. Quality of life: international and domestic students studying medicine in New Zealand. Perspect Med Educ 2012; 1:129–42.
  6. Kahn MJ, Markert RJ, Lopez FA, et al. Is medical student choice of a primary care residency influenced by debt? Medscape Gen Med 2006;8:18. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1868367/ accessed 6 May 2017.
  7. Bale AG, Coutinho K, Swan KG, et al. Increasing educational indebtedness influences medical students to pursue specialization: a military recruitment potential? Mil Med 2013; 178(2):202–6.
  8. Phillips JP, Weismantel DP, Gold KJ, et al. Medical student debt and primary care specialty intentions. Fam Med 2010; 42(9):616–22.
  9. King HA. The Primary Healthcare Strategy New Zealand: Ministry of Health; 2001. Available from: http://www.hauora.co.nz/assets/files/PHO%20Info/Primary%20Health%20Care%20Strategy%20-%202001.pdf accessed 6 May 2017.
  10. Pole R. Medical student debt and evidence-based politics. N Z Med J 2001; 114:459–60.
  11. Anderson DM, Whitler ET, Johnson AO, et al. Increasing the medical school applicant pool: a key to training more rural physicians. J Ky Med Assoc 2009; 107(9):355–60.
  12. Phillips JP, Petterson SM, Bazemore AW, et al. A retrospective analysis of the relationship between medical student debt and primary care practice in the United States. Ann Fam Med 2014; 12(6):542–9. doi: 10.1370/afm.1697
  13. Gill D, Palmer C, Mulder R, et al. Medical student debt at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results Part I. N Z Med J 2001; 114:461–4.
  14. Tonkin P. Effect of rising medical student debt on residency specialty selection at the University of Minnesota. Minn Med 2006; 89(6):46–7, 49.
  15. Youngclaus JA, Koehler PA, Kotlikoff LJ, et al. Can medical students afford to choose primary care? An economic analysis of physician education debt repayment. Acad Med 2013; 88(1):16–25. doi: 10.1097/ACM.0b013e318277a7df
  16. Rosenblatt RA, Andrilla CH. The impact of U.S. medical students’ debt on their choice of primary care careers: an analysis of data from the 2002 medical school graduation questionnaire. Acad Med 2005; 80(9):815–9.
  17. Rosenthal MP, Marquette PA, Diamond JJ. Trends along the debt-income axis: implications for medical students’ selections of family practice careers. Acad Med 1996; 71(6):675–7.
  18. Walton JN, Matthew IR, Dumaresq C, et al. The burden of debt for Canadian dental students: Part 4. The influence of debt on program and career decisions. J Can Dent Assoc 2006; 72:913. Available from: www.cda-adc.ca/jcda accessed 6 May 2017.
  19. Boddington L, Kemp S. Student debt, attitudes towards debt, impulsive buying, and financial management. N Z J Psych 1999; 28:89–93.
  20. The MSOD Project - A Tool for Medical Workforce Planning and Medical Education Evaluation. Australia: Medical Deans Australia and New Zealand Inc. Available from: http://www.medicaldeans.org.au/projects-activities/msodproject/ accessed 6 May 2017.
  21. Bender R, Lange S. Adjusting for multiple testing - when and how? J Clin Epidemiol 2001; 54:343–49.
  22. Rothman KJ. No adjustments are needed for multiple comparisons. Epidemiology 1990; 1:43–46.
  23. Field A. Discovering Statistics Using IBM SPSS Statistics (4th Ed.). London: SAGE Publications 2013.
  24. Leech NL, Barrett KC, Morgan GA. IBM SPSS for Intermediate Statistics - Use and Interpretation (5th Ed.). New York: Routledge 2015.
  25. Haultain S, Kemp S, Chernyshenko OS. The structure of attitudes to student debt. J Econ Psych 2010; 31:322–30.
  26. Tuition fees 2014 for undergraduate students (domestic) New Zealand: University of Auckland. Available from: http://www.auckland.ac.nz/en/for/current-students/cs-fees-and-money-matters/cs-fees/cs-tuition-fees-ug-domestic.html accessed 6 May 2017.
  27. 2014 Optometry and Vision Science Handbook New Zealand: University of Auckland. Available from: http://www.optometry.auckland.ac.nz/webdav/site/optometry/shared/for/future-undergraduates/documents/OPTOM_UG_PGhandbook_2014_20LoRes.pdf accessed 6 May 2017.
  28. Baruch Y, Holtom BC. Survey response rate levels and trends in organizational research. Human Relations 2008; 61(8):1139–60.
  29. Fincham JE. Response rates and responsiveness for surveys, standards, and the Journal. Am J Pharm Educ 2008; 72(2):43.

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