Pediatricians-in-training are more likely to plan to go into primary care, rather than a speciality field, if they have lots of debt from college and medical school, according to a U.S. study.
Researchers publishing in Pediatrics also found that the average pediatric resident doctor's debt increased 34 percent between 2006 and 2010.
That suggests financial considerations may keep young doctors out of medical specialities, they said, especially those fields that aren't known for paying well but still require extra training.
"(The debt) keeps climbing, and it doesn't seem like there's an end," said Mary Pat Frintner, the study's lead author, from the American Academy of Pediatrics (AAP).
"There are multiple factors that (affect) a pediatrician's career decisions, and debt is just one part of that," she told Reuters Health. "Since there's no end in sight to the rise in debt, that relationship may become more important in the future."
The findings also hint that rising debt, due to increases in medical school tuition, is not what's driving young doctors away from primary care, as many people have suggested, according to one health economist.
The new data collected by the AAP are based on five years of surveys of young doctors finishing their residencies, the training that follows medical school. The study included about 2,700 pediatric residents.
Close to three-quarters of the responders had debt from school. The average graduating resident's debt increased from $104,000 in 2006 to $139,000 in 2010.
Forty-three percent of residents had career plans requiring further subspeciality training, such as in pediatric cardiology or adolescent medicine. The rest planned to go straight into primary care or hospital medicine.
Frintner and her colleagues found residents with at least $51,000 in debt were about 50 percent more likely to be planning a primary care or hospitalist career than those who owed less or no money.
Women and residents with children were also less apt to be seeking further speciality training before entering the workforce, the research team said.
Peter Bach, at Memorial Sloan-Kettering Cancer Center in New York, said that residents with more debt may come from more disadvantaged backgrounds, which might influence the type of medicine they want to practice. So the link between debt and career plans might not be cause-and-effect, he told Reuters Health.
So far, there hasn't been a spike in the number of pediatric residents pursuing primary care careers rather than becoming specialists, Frintner said. In fact, there's still concern there may be too few primary care doctors, at least in some parts of the United States.
Increasing debt may create or worsen other shortages by discouraging young doctors from pursuing speciality training in fields that aren't particularly lucrative, such as adolescent medicine, the researchers said.
Amitabh Chandra, an economist and health policy researcher from Harvard University, said the findings go against conventional wisdom that debt is one concern driving medical students to specialities and away from lower-paying primary care jobs - and that raising salaries for fields that need more doctors may be a more effective strategy than focusing on debt.