The Color of Debt: Racial Disparities in Anticipated Medical Student Debt in the United States

Context: The cost of American medical education has increased substantially over the past decade. Given racial/ethnic inequalities in access to financial resources, it is plausible that increases in student debt burden resulting from these increases in cost may not be borne equally. Objective: To evaluate racial/ethnic disparities in medical student debt. Design, Setting, and Participants: Authors collected self-reported data from a non-representative sample of 2414 medical students enrolled at 111/159 accredited US medical schools between December 1st 2010 and March 27th 2011. After weighting for representativeness by race and class year and calculating crude anticipated debt by racial/ethnic category, authors fit multivariable regression models of debt by race/ethnicity adjusted for potential confounders. Main Outcome Measures: Anticipated educational debt upon graduation greater than $150,000. Results: 62.1% of medical students anticipated debt in excess of $150,000 upon graduation. The proportion of Blacks, Whites, Hispanics, and Asians reporting anticipated educational debt in excess of $150,000 was 77.3%, 65.1%, 57.2% and 50.2%, respectively. Both Black and White medical students demonstrated a significantly higher likelihood of anticipated debt in excess of $150,000 when compared to Asians [Blacks (OR = 2.7, 1.3–5.6), Whites (OR = 1.7, 1.3–2.2)] in adjusted models. Conclusion: Black medical students had significantly higher anticipated debt than Asian students. This finding has implications for understanding differential enrollment among minority groups in US medical schools.