Educational Debt Among US Medical Graduates Entering Radiology.

Objective: The aim of this study was to identify trends in medical educational debt for U.S. medical school graduates pursuing radiology and examine associations with socioeconomic factors.

Materials and methods: Data was obtained from the Association of American Medical Colleges (AAMC) Graduation (GQ) and Matriculating Student Questionnaires (MSQ) to identify self-reported medical educational debt for graduates pursuing radiology training. The proportion of medical graduates with debt in radiology were compared to those in other medical specialties. Trends in medical educational debt (inflation adjusted to 2024 USD) were calculated from 2015 to 2024. Descriptive statistics were used to assess characteristics associated with debt. Debt-to-income ratios were calculated using compensation data from AAMC and Medical Group Management Association (MGMA) data.

Results: There were 162081 responses from US medical graduates recorded from 2015 to 2024, of which 6477 planned on radiology training. The percentage of students pursuing radiology with medical educational debt decreased from 76.5% in 2015 to 64.6% in 2024. The median medical educational debt increased from $237,600 in 2015 to $248,000 in 2018, and has been decreasing since, to $200,000 in 2024. Higher likelihood of debt was reported by graduates from self-identified race and ethnicity groups who are underrepresented in medicine (URiM) (OR 1.74, 95% CI 1.48-2.06), but with a lower total debt among indebted (median $208,530 [IQR $133,915 - $280,810]) when compared with graduates not self-identifying as URiM ($226,600 [IQR $153,400 - $298,388]; P = 0.004). In 2015, 25.8% of indebted radiology-bound graduates indicated plans to use Public Service Loan Forgiveness (PSLF), which increased to 44.9% in 2024 (P < 0.001). In 2023, the median debt for radiology graduates represented between 35% and 45% of total annual compensation.

Discussion: Although the debt burden and the proportion of radiology-bound graduates with medical educational debt declined from 2015 to 2024, interest in PSLF nearly doubled. Graduates from lower-income families and those of URiM racial/ethnic groups had a higher likelihood of debt burden.

Summary sentence: From 2015 to 2024, medical educational debt among radiology-bound US medical graduates declined overall, but debt remained disproportionately more likely among students from underrepresented and lower-income backgrounds, with interest in Public Service Loan Forgiveness nearly doubling. TAKE HOME POINTS (3-6): •Prevalence of medical educational debt among radiology-bound medical graduates has declined, from 76.5% in 2015 to 64.6% in 2024. •Median educational debt for indebted radiology-bound graduates rose by 4.4% from $237,600 in 2015 to $248,000 in 2018, then fell by 19.4% to $200,000 in 2024 (inflation adjusted 2024 USD). •Graduates pursuing radiology had a lower proportion and lower median debt in 2024 compared to those pursuing anesthesia, emergency medicine, and family medicine; but higher than dermatology and ophthalmology. •Sociodemographic debt disparities persist with older, male, and URiM being more likely to have debt compared to their counterparts. However, among indebted individuals, median debt amounts were lower for URiM graduates compared to their non-URiM peers. •Interest in Public Service Loan Forgiveness (PSLF) has increased substantially among indebted radiology-bound graduates, rising from 25.8% in 2015 to 44.9% in 2024. •Parental income and program type strongly influenced debt burden with radiology-bound graduates from higher-income families and those in many dual-degree or accelerated programs having significantly lower odds and amounts of debt.