• Kelsey Gray, Amy H Kaji, Mary Wolfe, Kristine Calhoun, Farin Amersi, Timothy Donahue, Brian R Smith, Edgardo S Salcedo, Kenric Murayama, Christian de Virgilio, and Surgery Educators Workgroup.
• Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA.
• J. Am. Coll. Surg. 2020 Feb 1; 230 (2): 173-181.

BackgroundThe average medical school debt in 2011 was $170,000, and by 2017 it increased to $190,000. High debt burden has been shown to affect career choices for residents in primary care specialties; however, it has not been well studied among surgical residents. The purpose of this multi-institutional study was to assess the amount of debt among general surgery residents and its effects on their career and lifestyle decisions.Study DesignSurveys were distributed to 607 categorical general surgery residents at 19 different residency programs. Degree of debt was assessed and responses compared.ResultsOverall, 427 (70.3%) residents completed the survey, 317 (74.2%) of whom reported having student loan debt. Of those with debt, 262 (82.6%) believed that repaying debt was a significant financial burden in residency, 248 (78.3%) thought it would remain a burden after residency, 210 (66.2%) believed their debt would influence their future job choice, and 225 (71%) thought their debt would delay their ability to buy a home. Debt did not affect decisions to get married or have children. There were 109 (25.6%) residents with no debt, 131 (30.8%) with <$200,000, 103 (24.2%) with $200,000 to $300,000, and 83 (19.5%) with >$300,000. Residents with high debt were less likely to feel financially secure now (p < 0.0001) and when thinking about their future (p < 0.0001). They also had higher minimum starting salary goals (p = 0.002) and were less likely to have had assistance paying for their education (p = 0.0001).ConclusionsSurgical residents believe their debt is a significant financial burden. Furthermore, high debt significantly influences their financial security, practice location, and salary goals.Copyright © 2019 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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