Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners

Just Accepted

This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.

Influence of student debt on health career location and specialty

Steven Ling , Robert Jacobs , Rhys Ponton , Julia Slark , Antonia Verstappen , Craig S. Webster , Phillippa Poole


Introduction In New Zealand (NZ), there are shortages of health professionals in rural areas and in primary care. Aim This study aims to examine the association of student debt levels of medical, nursing, pharmacy and optometry students with: (1) Preferred geographical location of practice, specifically preference to work in urban vs. rural areas; and (2) Preferred career specialties, specifically interest in primary health care. Methods Medical, nursing, pharmacy and optometry students from one NZ institution completed a questionnaire at graduation which includes questions on levels of New Zealand Government Student Loan debt and preferences regarding location of practice and career specialty. In an additional survey, medical students were asked to self-rate the impact of financial factors on their career choices. Results Debt patterns varied across programmes. Medical and pharmacy students with high debt were significantly more likely than those with low debt to prefer rural practice over urban practice (P = 0.003 and < 0.0001). There was no difference in level of interest in a primary care specialty by debt level for any of the programmes. Medical students reported little influence of debt on career choice, although those with high debt levels were less concerned regarding career financial prospects than those with lower levels of debt. Discussion Current levels of student debt do not deter students from rural or primary care. Perhaps surprisingly, higher levels of debt are associated with greater rural practice intentions for medical and pharmacy students, although the underlying reasons are uncertain.

HC17052  Accepted 09 November 2017

© CSIRO 2017