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 1 st 2010 and March 27 th 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.