The Toll of Student Debt: Stress Among Health Professions Students and the Promising Role of Financial Self-Efficacy on Career Choices

Abstract

Introduction. As the cost of higher education rises, the debt associated with degree attainment also increases, including that of the Doctor of Physical Therapy degree. Research suggests that a relationship between financial debt and postprofessional career aspirations may exist, and financial self-efficacy could attenuate debt-related stress. These relationships have not been studied in the health professions outside of medicine. Methods. A total of 139 participants among 6 health professions programs housed in one public, academic medical center were surveyed. Surveys administered to participants provided Likert scale data for a multiple regression analysis. Results. Eighty-one percent of students reported having a medium, large, or extreme amount of stress from the total amount of debt they are accruing. More than 70% of student responses indicated that the amount of student loan debt they expect to accumulate will influence their posttraining 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 students' self-reported stress from debt by itself. Students' career selection and stress were strongly associated, with career selection explaining 85% of the variance explained in students' self-reported stress by itself. Discussion. Health professions students in a public academic medical center had a “medium amount” of stress, on average, from financial debt. Stress was associated with the amount of student loans students expect to accrue and their financial self-efficacy. Students also appeared to base their postprofessional 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. Conclusion. Stress appears to be associated with higher student loan debt, but financial self-efficacy may moderate this trend. Level of Evidence. IV, Cross-sectional descriptive survey design. What Is Known About the Subject? Costs of physical therapy programs continue to rise, requiring more physical therapy students to use loans to pay for their education. Other professions, including medicine, have noted that student loan debt can cause high amounts of stress and has the potential to influence career choices. What This Study Adds to the Existing Literature? Health professions students in one academic medical center appear to base their postprofessional career aspirations, at least in part based on the stress they experience from financial debt. Financial self-efficacy appears to attenuate the amount of stress students feel from student loan debt.