Impact of financial background and student debt on postgraduate residency choices of medical students in Singapore.

Jie Ming Nigel Fong; Yeong Tze Wilnard Tan; Andrew Arjun Sayampanathan; Niraj Mohan; Yun Qing Koh; Jin Hao Justin Jang; Jin Rong Ivan Low; Anupama Vasudevan; Chew Lip NG; Paul Ananth Tambyah

Return

Impact of financial background and student debt on postgraduate residency choices of medical students in Singapore.

Author: Jie Ming Nigel FONG ¹ ; Yeong Tze Wilnard TAN ² ; Andrew Arjun SAYAMPANATHAN ¹ ; Niraj MOHAN ³ ; Yun Qing KOH ³ ; Jin Hao Justin JANG ³ ; Jin Rong Ivan LOW ³ ; Anupama VASUDEVAN ⁴ ; Chew Lip NG ³ ; Paul Ananth TAMBYAH ³
Author Information

1. Division of Medicine, Singapore General Hospital, Singapore.
2. Department of Medicine, Tan Tock Seng Hospital, Singapore.
3. Department of Medicine, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
4. Baylor Scott and White Research Institute, Texas, USA.
Publication Type:Journal Article
Keywords: medical education; residency selection; student debt
MeSH: Career Choice; Choice Behavior; Education, Medical; economics; Humans; Internship and Residency; economics; Odds Ratio; Schools, Medical; economics; Singapore; Social Class; Students, Medical; statistics & numerical data; Surveys and Questionnaires; Training Support
From:Singapore medical journal 2018;59(12):647-651
CountrySingapore
Language:English
Abstract: INTRODUCTION:Medical school fees are rising globally. Student debt and financial background may affect residency choices, but few studies have been conducted in Asia. This study aimed to explore the relationship between financial background, student debt and postgraduate residency choices among medical students in Singapore.
METHODS:An anonymised survey of all medical students in Singapore was conducted and had a response rate of 67.9%.
RESULTS:40.5% of our study population would graduate with debt. Medical students with monthly per capita household income < SGD 1,000 were more likely to graduate with debt (unadjusted odds ratio [OR] 2.0, 95% confidence interval [CI] 1.6-2.7; p < 0.001) and feel burdened by the cost of medical education (unadjusted OR 2.8, 95% CI 2.0-3.9; p < 0.001). Students with monthly per capita household income < SGD 1,000 (unadjusted OR 1.818, 95% CI 1.338-2.470, p < 0.001; adjusted OR 1.692, 95% CI 1.202-2.381, p = 0.003) and those with debt (unadjusted OR 1.623, 95% CI 1.261-2.090, p < 0.001; adjusted OR 1.393, 95% CI 1.048-1.851, p = 0.022) were more likely to rank at least one economic factor as 'very significant' in influencing their postgraduate training choices.
CONCLUSION:It is concerning that despite financial aid schemes, the cost of medical education remains a burden to students from lower-income households in Singapore. Student debt and financial background may distort postgraduate career choices, creating an undue push towards high-paying specialties.