The amount of debt a medical student has may influence their long-term choices, according to a paper published in the Journal of the American Board of Family Medicine.

For the study, researchers used data from a questionnaire administered by American Board of Family Medicine and were able to gather data about third year family medicine residents. Based on answers to the question “What was your level of educational debt (undergraduate and graduate) at the end of medical school,” the research team was able to used what is called descriptive statistics to categorize the students’ responses.

The results revealed that while 18% of the student reported having no education debt, more than half reported having some education debt. Specifically, 58% of students reported having greater than $150,000, and 26% reported having greater than $250,000 in total educational debt.

Background information provided in the paper revealed that researchers from the American Association of Medical Colleges found that graduating with at least $200,000 in debt required extended loan repayment and/or the selection of service-related loan forgiveness programs; graduating with at leas $250,000 in debt required an even longer loan repayment requirement and service in a shortage area, and reduced the ability to live in a desirable neighborhood. “Published students reactions to the American Association of Medical Colleges’ findings affirmed suspicions that high debt levels help to explain why students are less likely to choose family medicine and raise concerns for those who still do,” the authors wrote. “Students from disadvantaged backgrounds may be dissuaded from this choice at even lower debt levels.”

“Policymakers hoping to increase output in primary care specialties such as family medicine should be aware of this growing debt burden and consider strategies such as loan repayment, small business loans, practice transformation support, and payment reform targeting the physician payment gap,” the authors concluded.