FACTORS INFLUENCING STUDENTS BORROWING THAT MAY AFFECT THEIR SPECIALTY CHOICES AND OTHER AFTER-GRADUATION BEHAVIORS

Purpose. To assess the factors that influence medical students' borrow ing and how these factors may affect access to the profession, special ty choice, and medical graduates' repayment behaviors. Method. The bor rowing patterns of the 3,495 indebted students enrolled at Jefferson M edical College of Thomas Jefferson University between 1989-90 and 1994 -95 were analyzed. (Debt included both subsidized and unsubsidized deb t.) These borrowing patterns were assessed in relation to changes in t he cost of education, family (i.e., parents') income, availability of grant funding, legislative changes to loan-eligibility criteria (speci fically, the Higher Education Amendments of 1992), and average interes t rates on federal unsubsidized loans. Results. The annual changes in average debt levels suggest that while cost of education, family resou rces, and availability of grant funding may be significant factors, ch anges in loan eligibility and prevailing interest rates on unsubsidize d loan source also influence medical students' borrowing. A comparison of the borrowing patterns for three income groups (low, middle, high) further demonstrated that while overall fluctuations for low-income g roup mirrored changes in-the cost and resource variables, annual borro wing fluctuations for the middle-and high-income groups were more refl ective of the expansion of loan eligibility and reduced interest rates on unsubsidized loans. From 1989-90 to 1994-95 the average cost of ed ucation increased by $2,368. Average unsubsidized debt increased by $1 ,544 for the low-income group, $3,960 for the middle-income group, and $4,439 for the high-income group. The percentage of unsubsidized fund ing included in the borrowers' financing packages increased by just un der 6% for the low-income group but almost 10% and 11% for the middle- and high-income groups, respectively. Conclusion. The results suggest that medical students borrow for a variety of reasons, ranging from fi nancial need to personal financing or-lifestyle choices. These reasons should be considered in relation to institutional and governmental fi nancial aid policies and future research on the relationship between d ebt and specialty choice.