Conclusion
Our economic modeling of a physician's household income and expenses across a range of medical school borrowing levels in high- and moderate-cost living areas shows that physicians in all specialties, including primary care, can repay the current median level of education debt. At the most extreme borrowing levels, even for physicians in comparatively lower-income primary care specialties, options exist to mitigate the economic impact of education debt repayment. These options include an extended repayment term or federal loan forgiveness/repayment program, such as IBR, PSLF, and the NHSC. Each option, however, has its own trade-offs. Our findings are important because, regardless of the degree to which education debt and/or income expectations influence specialty choice, medical students and new physicians should understand the long-term financial implications of their career choices.