As the cost of higher education rises, the debt associated with degree attainment also increases, including that of the Doctor of Physical Therapy degree.1 Research suggests that a relationship between financial debt and post-professional career aspirations may exist,2,3 and financial self-efficacy could attenuate debt-related stress.4 These relationships have not been studied in the health professions outside of medicine. The purpose of this study was to assess how studentsÕ loan debt affects perceived financial and general stress while in health professions programs. A second purpose of the study was to assess if self-efficacy and stress from loan debt affected studentsÕ post-professional career aspirations.
A focus group consisting of four academic faculty members from two health professions reviewed the existing literature on financial literacy assessments4,5,6,7,8 and developed a survey that assessed financial lifestyle and habits (8 questions), savings knowledge (9 questions), credit and borrowing strategies (10 questions), and investment expertise (16 questions). The survey assessed financial self-efficacy through six additional items rated on a four-point Likert scale, as well as self-assessed stress and career expectations. The survey was administered to a convenience sample of health professions graduate students in one public, urban academic medical center.
139 out of 268 students completed the survey, for a response rate of 51.9%. Of those who had educational loans (n = 90), 81% reported having a medium, large, or extreme amount of stress from the total amount of debt they are accruing. Over 70% of student responses indicated that the amount of student loan debt they expect to accumulate will influence their post-training career selection to some extent. The regression model indicated some predictive ability of stress from student debt. Two of the covariates, self-efficacy and career selection, were statistically significant. Self-efficacy accounted for 36% of the variance explained in studentsÕ self-reported stress from debt by itself. StudentsÕ career selection and stress were strongly associated, with career selection explaining 85% of the variance explained in studentsÕ self-reported stress by itself.
Conclusions/Relevance to the conference theme:
On average, health professions students in a public academic medical center had a Òmedium amountÓ of stress from financial debt. Stress was associated with the amount of loan debt students expect to accrue and their financial self-efficacy. Students also appeared to base their post-professional career aspirations, at least in part, on the stress they experienced from financial debt. Financial self-efficacy appears to be a promising moderator for debt-related stress. Institutions may be able to enhance the well-being of interprofessional health care teams by providing a knowledge base of financial literacy, which may then positively influence financial self-efficacy, stress, and post-professional career choices.