Ron Southwick

For doctors and prospective physicians paying off their heavy student debt, President Biden’s loan forgiveness move will offer almost all medical residents and students at least some relief.

 on millions of Americans. The Biden administration said last week it will forgive up to $10,000 in federal student loan debt for borrowers who earn less than $125,000 annually, or $250,000 for married couples. Those with Pell Grants could see up to $20,000 in loan forgiveness.

The White House estimates the loan forgiveness plan will wipe out the debt for 20 million borrowers, and provide at least some relief for 43 million borrowers.

Recent medical school graduates will still be looking at some hefty debt, but the Biden administration’s assistance is welcome, said Matthew Shick, senior director of government relations and regulatory affairs for the Association of American Medical Colleges.

“This news is a positive step to ensuring that medical education remains affordable and accessible for students from all backgrounds,” Shick said in an email.

“We are supportive of this effort and encourage Congress, the administration, and medical schools to continue working together on this issue to simplify federal loan repayment. Given the parameters the Biden administration has laid out, almost all medical residents and most current medical students should qualify for the student debt cancellation,” Shick said. “While the amount may only be a fraction of a student’s debt, every bit helps, and receiving this financial relief early in a student’s career will save them significantly more in interest over the course of repayment.”

To be sure, doctors will be paying off plenty of medical school debt, even with the help from the Biden administration. The average debt for medical students in the class of 2021 was $203,062, according to the 

Many carry substantial debt from their education before medical school. Nearly a third (30%) of medical school graduates in 2021 had premedical education debt, with the median debt of $27,000, the AAMC said.

The average medical resident earns about $64,000 annually, according to the 

Medscape Residents Salary and Debt Report

, released in July. So as AAMC notes, medical residents should be able to secure some debt relief.

Healthcare leaders have said the heavy debt burden is a barrier for many pursuing careers in healthcare, especially those from underrepresented groups. The AAMC and others have pointed to a national shortage of doctors and said the nation needs 

a larger and more diverse physician workforce

The National Consumer Law Center, which has pushed for student debt relief, hailed the Biden administration’s effort but said more must be done, particularly for borrowers from minority groups.

“This relief is huge for the roughly 20 million people whose student loan debt may be wiped out completely, but we also know that many borrowers, including Black women who carry the heaviest student debt burdens, will continue to struggle with their remaining debt until the student loan system is fixed,” Alpha Taylor, staff attorney at the National Consumer Law Center, said in a statement.

“We will continue to lift borrowers’ voices and to work with the Administration to reform the student loan system—and particularly the broken income-driven repayment plans and punishing default policies—so that all borrowers can make meaningful progress toward being debt free.”

The Biden administration took another step to help those with medical debt. The federal Office of Management and Budget issued a 

 to federal lending agencies to stop factoring medical debt in the loan decision process.

“The Administration is committed to taking actions to mitigate the burden of medical debt on American families and in particular preventing medical debt from unfairly limiting Americans’ access to Federal loans and loan guarantee programs,” Shalanda Young, director of the Office of Management and Budget, wrote in the directive.

Berneta Haynes, an attorney with the National Consumer Loan Center, said the step will help people obtain loans.

“Medical debt is a crisis that takes an even greater toll on Black families, Latine families, and people with disabilities,” Haynes said in a 

. “Medical debt is not predictive of creditworthiness, and we appreciate the Administration’s efforts around eliminating medical debt as a barrier to credit.”

The AAMC remains concerned about the difficulty students from underrepresented communities face in paying for medical school, Shick said. He pointed to the 

 to offer guidance for students to pay for medical school and repay debt.

This article was published by our sister publication Medical Economics.

Articles

The president’s student loan initiative only covers a portion of the average debt of medical school, but the Association of American Medical Colleges says it still does some good.

What Biden's student debt forgiveness plan means for physicians

Over the course of a career, the gender gap in earnings among doctors reaches seven figures, a new study has found.

Women doctors earn $2 million less than male physicians over a 40-year career, according to a 

Other studies have documented the disparity in earnings between men and women doctors. However, this new study is the first to capture the impact over the length of a career, said Christopher Whaley, a policy researcher at the RAND Corporation and lead author of the study.

He didn’t expect the career earnings gap to reach $2 million.

“That was a surprising number to see,” Whaley said in a phone interview. “That really is a stark difference in pay.”

Over the course of a simulated 40-year career, male physicians earned $8.31 million, while female doctors earned $6.26 million, the study found.

The disparities in compensation varied among different types of doctors.

The gender gap in earnings was largest among surgical specialists, with women typically earning $2.5 million less over their careers. Among non-surgical specialists, women earned $1.6 million less. Female primary care physicians earned about $900,000 less over their careers, the study found.

The study also examined the 10 most common specialties and found substantial pay disparities in each one. The smallest gap was seen in emergency medicine physicians, but the difference was still $621,952. The largest disparity among those 10 specialties was found in orthopedic surgery ($1,530,006).

It’s worth noting the study focused on full-time clinicians who typically aren’t in academic practice, Whaley said. The study may not fully capture the difficulties women have in choosing higher paying specialties.

“Our study probably understates the true differences in pay,” Whaley said.

The annual income differences appeared and accelerated at the beginning of physicians’ careers, the researchers found. He said it undercuts arguments that male doctors are earning more over time because they are treating more patients or securing more accomplishments.

“We found that those differences are apparent in year one,” Whaley said.

Even as women doctors gained more experience and were able to shed some nonclinical responsibilities, they didn’t close the pay gap.

“It’s not a story that male physicians are just more productive,” Whaley said.

The reasons for the pay disparities vary, the researchers found.

Gender bias and pay structures that put women at a disadvantage could be suppressing the pay for female doctors. It’s also possible that women physicians are less willing or able to change jobs and are less aggressive in negotiating compensation, the researchers said.

One study last year showed a possible explanation for the gap in earnings among women who are primary care physicians: they're spending more time with their patients.

 last year found women primary care physicians spend, on average, an additional 2.4 minutes with their patients. The study showed women generated 11% less in annual revenue because they were offering more direct patient care.

Women account for one-third of the physician workforce nationwide. About half of all medical school students are women, according to the Association of American Medical Colleges. Healthcare policy leaders have said it’s critical to get more women to pursue careers in medicine to address the physician shortage.

As more women become doctors, Whaley said it could help narrow the gender gap in compensation. The study found that pay disparities were particularly pronounced in practices heavily dominated by men. In practices where there were a fairly equal balance in the number of male and female physicians, the disparities didn’t tend to be as stark.

“If the practice is more gender diverse, we’re less likely to see these more egregious career outcomes,” Whaley said.

The study is garnering considerable media attention, including coverage in 

. Whaley said there are reasons the study is resonating with people.

“What’s driving a lot of the attention is many women professionals know these factors exist,” Whaley said. “There isn’t good data to estimate the net impacts of these incremental disparities. Having these career numbers adds to the starkness of disparities in work-life balance and pay.”

Some are concerned women could be facing new career obstacles.

The COVID-19 pandemic appears to be having a 

disproportionate impact on the career of women physicians

. That study found women physicians were more likely to reduce their hours, work from home or assume child care responsibilities. The disparities were even more pronounced among couples where both parents were full-time physicians.

Healthcare leaders are hearing more calls to support women physicians. The AAMC found 40% of women physicians shift to part-time hours or leave medicine within six years of finishing their residency.

Paid family leave policies and better child care coverage have been shown to reduce the gender gap in pay and other sectors and healthcare leaders should embrace those approaches, researchers said. Such policies could reduce pay differences earlier in the early years of practice, when women physicians are having children, and also could reduce disparities over careers. Those policies also could reduce burnout among women doctors.

 study, the authors suggested another possible remedy is adjusting compensation models to reflect health outcomes and patient satisfaction.

Whaley endorsed those ideas and also suggested more transparency in pay could help close the pay disparity for women doctors.

“If women are providing better care and patients have better outcomes, it seems that’s something we should financially reward,” Whaley said.

This article was originally published by sister publication Chief Healthcare Executive.

A new study on the gender pay gap in medicine examined earnings data from more than 80,000 doctors.



Ron Southwick

Articles

What Biden's student debt forgiveness plan means for physicians

Study finds female clinicians earn millions less than male colleagues