McMichael Brennan, Lee Iv Anderson, Fallon Brian, Matusko Niki, Sandhu Gurjit
Department of Surgery, University of Michigan, Ann Arbor, MI, 48109, USA.
Department of Anesthesia, University of Michigan, Ann Arbor, MI, 48109, USA.
MedEdPublish (2016). 2022 Jun 13;12:3. doi: 10.12688/mep.17544.2. eCollection 2022.
The authors analyzed the distribution of medical student debt and identified demographic features that placed students at high risk for increased debt and financial stress. From April to May 2019, a cross-sectional, anonymous, web-based survey was administered to first-year (M1) to fourth-year (M4) medical students at the University of Michigan to assess financial literacy, debt burden, financial stress, and demographic factors. A total of 216 of 680 (32%) students completed the survey. Respondents voluntarily answered 15 multiple-choice questions on personal finance and 30 questions on their demographics, current financial situation, and debt burden. To quantify debt burden, students estimated anticipated education-related debt in one of four categories: no debt, $1-99,999; $100,000-$199,999; and $200,000 or more. A chi-square test was used to identify associations between categorical variables and logistic regression was used to identify risk factors for debt and worry. Fifty-four respondents (25%) reported $0 in education related debt, while 44 (16%) had $200,000 or more. Race (p=0.006), first-generation college student status (p=0.004), first-generation medical student status (p<0.001), household income (p<0.001), and parental education (p=0.008) were associated with higher levels of debt. Students who were underrepresented in medicine (URiM) had higher odds of higher debt compared to Arab and Asian students (p=0.02). URiM students (p=0.02), first-generation college students (p=0.009), and parental education (p=0.01) were associated with increased financial stress. Additionally, female students had higher odds of increased financial stress (OR=1.85, p=0.045) on logistic regression. URiM and socioeconomically disadvantaged students feel the burden of the high cost of medical school disproportionately more, suggesting that our current systems are not adequately supporting these students. Reducing this burden may serve to further promote diversity in medicine.
作者分析了医学生债务的分布情况，并确定了使学生面临债务增加和经济压力风险较高的人口统计学特征。2019年4月至5月，对密歇根大学一年级（M1）至四年级（M4）的医学生进行了一项横断面、匿名的网络调查，以评估金融知识、债务负担、经济压力和人口统计学因素。680名学生中有216名（32%）完成了调查。受访者自愿回答了15道关于个人财务的多项选择题以及30道关于他们的人口统计学、当前财务状况和债务负担的问题。为了量化债务负担，学生们将预期的教育相关债务估计为以下四类之一：无债务、1万至99999美元；10万至199999美元；以及20万美元或更多。采用卡方检验来确定分类变量之间的关联，并使用逻辑回归来确定债务和担忧的风险因素。54名受访者（25%）报告教育相关债务为0美元，而44名（16%）的债务为20万美元或更多。种族（p=0.006）、第一代大学生身份（p=0.004）、第一代医学生身份（p<0.001）、家庭收入（p<0.001）和父母教育程度（p=0.008）与更高水平的债务相关。与阿拉伯和亚洲学生相比，医学领域代表性不足的学生（URiM）债务较高的几率更高（p=0.02）。URiM学生（p=0.02）、第一代大学生（p=0.009）和父母教育程度（p=0.01）与经济压力增加相关。此外，在逻辑回归中，女生经济压力增加的几率更高（OR=1.85，p=0.045）。URiM学生和社会经济弱势学生感受到医学院高昂成本负担的比例过高，这表明我们目前的体系没有充分支持这些学生。减轻这一负担可能有助于进一步促进医学领域的多样性。
