53% of doctors aren't sure medicine is worth it

More than half of doctors aren’t sure they would choose medicine again under the federal student loan cap that takes effect this summer, according to a new Panacea Financial customer survey.

In the survey of 269 physicians, dentists and veterinarians, 47% said they would still pursue medicine if they were starting over today under a $200,000 federal professional-degree loan cap. Twenty-seven percent said they would not. Twenty-six percent said they were unsure. The reservations were sharpest among trainees: only 46% of doctors still in school, residency or fellowship said they would make the same choice again, compared with 50% of practicing physicians.

The cap, set to take effect July 1, will limit federal student loan borrowing for professional programs and narrow the repayment options available to new borrowers, while phasing out several existing income-driven repayment plans that have shaped how many recent graduates manage payments during and after training.

"When more than half of doctors aren't sure the career was worth it, that's not a personal finance problem — it's a systemic one,” said Michael Jerkins, M.D., M.Ed., president and co-founder of Panacea Financial. “The debt load doctors carry is extraordinary, and it follows them well beyond training.”

Why does debt define doctors’ financial lives?

Paying off debt was the single most common financial priority across the survey, named by 79% of respondents. It outranked retirement savings (38%), investing for the future (41%) and homebuying (27%). Among respondents actively paying down debt, 88% identified student loans as the primary burden, with credit cards (61%), personal loans (54%) and mortgages (28%) trailing well behind.

The pressure shapes more than balance sheets. Seventy percent of respondents said they struggle to balance loan repayment with other financial goals, and 65% said they are trying to plan for a major purchase while managing debt.

"I like what I do… but I could be so much further ahead financially had I chosen another path," one attending orthopedic surgeon wrote in an open-ended response.

James Dahle, M.D., FACEP, founder of The White Coat Investor, told Medical Economics that financial stress directly fuels burnout among practicing physicians. "Sometimes people just feel like they’ve got to work a whole bunch because they've committed to make all these payments, and we’ve got student loans and a big fat mortgage to pay," Dahle said. "It just feels like they've got chains on keeping them from being able to do a lot of the things that would reduce their burnout."

Does higher attending pay solve the strain?

Not entirely. On a 5-point scale, self-rated financial confidence climbs from 2.33 in medical school to 2.63 in training and 3.27 in practice, but never approaches the top of the scale. Across the full sample, 71% of respondents rated their financial confidence at 3 or below.

Tax and compensation questions persist into practice. Of doctors who reported struggling with tax complexity, 48% were already practicing. For compensation uncertainty, 53% were still in training and 38% were in practice.

"The problem is, as doctors, we make enough money to be able to make mistakes. And on the outside, it does not look like we're making any mistakes. We still make enough cash flow per month to be able to pay for some of this debt," Jerkins told Medical Economics in late 2025. "But that doesn't allow you to save — which allows you more flexibility, which allows you to be in control of your time."

What gaps in financial education do doctors describe?

Forty-six percent of respondents said they do not fully understand their loan repayment, forgiveness or refinancing options. In open-ended responses, 45% of comments touched on student loans, repayment or refinancing — three times more than any other theme.

Fifteen percent cited a lack of financial education or guidance during training.

"It would have been useful to have more robust financial education during medical school and/or residency. I had to learn everything on my own," one attending endocrinologist wrote.

Bryan Jepson, M.D., CFP, a practicing physician, certified financial planner and host of “The Financial Checkup,” says the gap is both personal and structural.

"The most important thing, especially for physicians, is to be intentional and take ownership of your own financial success," Jepson said. "Don't just assume it's going to happen because you have high income. It won't unless you're intentional about it."

Jerkins, who trained as an internal medicine and pediatrics physician before co-founding Panacea, has argued that schools and accrediting bodies bear part of the responsibility.

"You're not going to make any changes until an ACGME-like body requires it," he said. "There are plenty of schools that have had really good financial literacy programs in place at medical schools, and what ends up happening is the clinical faculty in charge of that isn't generating revenue based on their time facilitating."

What does the new federal loan cap mean for the physician pipeline?

For some respondents, the policy raises questions about access to medical careers.

"I came from a poor family and have $500k in loans. I wouldn't have been able to pay for it," one attending family medicine physician wrote.

Another respondent, an internal medicine resident, said: "I accepted the debt burden because I knew I had repayment options (Income-Based Repayment (IBR), Public Service Loan Forgiveness (PSLF), etc.). If forced to take out 6 figures of private student loans, that would be a significant barrier."

Whether the cap will reshape the physician pipeline is an open question. PSLF itself remains in place, but borrowers taking out new federal student loans on or after July 1, 2026, will face a narrower set of repayment options.

The Saving on a Valuable Education (SAVE) plan ended in March after a court-approved settlement, and federal loan servicers are expected to begin notifying SAVE borrowers July 1 that they must move into another legal repayment plan within 90 days. Pay As You Earn (PAYE) and Income-Contingent Repayment (ICR) are scheduled to phase out by July 1, 2028.

For borrowers with new loans made on or after July 1, 2026, RAP — the Repayment Assistance Plan — will be the income-driven option, alongside the new standard repayment plan. For many borrowers, RAP is expected to produce higher payments than SAVE, though the impact will vary by income, dependents and loan balance.

Dahle noted that medical school debt has hovered around $200,000 for several years, a figure that closely tracks the new federal cap. Association of American Medical Colleges (AAMC) data show median medical education debt was $200,000 for the class of 2025, while median total education debt was $215,000.

With Grad PLUS eliminated for new graduate and professional borrowers and Direct Unsubsidized Loans capped at $50,000 per year and $200,000 in aggregate for professional students, minus prior graduate borrowing, students whose costs exceed the cap may need private loans or other nonfederal financing. Private loans are not eligible for PSLF or federal income-driven repayment.

The survey was conducted among 269 Panacea Financial customers between Jan. 26 and Feb. 28, with respondents receiving a $10 Starbucks gift card for participation.