Education is expensive and the costs of college tuition and fees are rising faster than the cost of living in the United States. The problem for medical students is even worse. The median indebtedness of students in the class of 2004 was more than $100,000 ( ). Shortly after beginning a residency training program, there are additional educational expenses, including books and fees for enrollment in the American Board of Radiology (ABR) examination process. Drs. Tilak and Baker point out how our training programs contribute to further resident indebtedness and urge department leaders to consider new approaches to address these issues ( ).
It may be difficult to feel sympathy for the debts some radiology residents carry when we consider their expected career incomes. Radiologists have passed surgeons and now rank as the highest paid specialty in medicine ( ). However, we may be overlooking some important ramifications of the high debt burden carried by radiology residents. It may affect their career choices and how they spend their disposable incomes.
Are medical students who have high debt burdens more likely to select fields such as radiology in which the practitioners are well compensated? If so, we may be attracting students who want to retire medical student debt quickly rather than those who have a passion for imaging science.
If a medical student has selected a career in radiology because of the high level of expected compensation, will he or she be willing to consider a position in academic radiology rather than moving immediately into the higher paid private sector? If so, we may be depriving our academic programs of the next generation of faculty.
Are radiology residents who carry a high debt burden more likely to moonlight? And, if so, does the extent of moonlighting detract from their radiology education? Although some moonlighting jobs may occur on weekends, others involve night coverage, preventing them from getting their normal night of sleep.
The field of radiology continues to expand as new examinations and procedures are developed. Advances in interventional procedures have been numerous. The improved speed and computational capacity of computed tomography (CT) scanners has made CT urography, CT colonography, and cardiac imaging practical realities. Advances in magnetic resonance imaging may be even more striking with diffusion tensor imaging, fiber track mapping, and spectroscopy. No one can master the entire field ( ); therefore, most residents gain additional expertise in fellowship training ( ). This level of training is needed if radiologists are to add value to non-radiology subspecialists who review the images on their patients. Are radiology residents with a high debt burden less likely to seek the additional expertise from one or two years of fellowship training?
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