Almost half of medical students are finishing their studies with a student loan of more than $90,000, according to a new study which shows the average medical student debt has increased by $20,000 in the last decade.

The report, written by Antonia Verstappen and Phillippa Poole and published in today's New Zealand Medical Journal, showed 46 per cent of medical students graduating from the University of Auckland in 2014 and 2015 reported a student loan of more than $90,000, whereas in 2006 and 2007 only 12.5 per cent of medical graduates reported a debt of this magnitude.

The reasons for that may include yearly increases in student fees pf 4 per cent - the maximum allowable, increased living costs in Auckland, reduced opportunities for part-time employment, increased course costs, or changes in borrowing behaviour by students, the report said.

This year, the annual fee for a full-time domestic student in years two to six of medical school at Auckland University was $15,082.80.

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In comparison, the Auckland University website showed for 2017 engineering students would pay between $6785 and 9926 per year, architecture students between $6430 and $7845, law students $6337 and arts students between $5882 and $6784.

For domestic students, New Zealand Government student loans could be used to cover compulsory student fees, course-related costs up to $1000, and living costs up to $176.86 per week.

The results raised concerns that more than a hundred Auckland University medical graduates each year would be a taking a six-figure debt into their post-graduate training, the study said.

According to the study, almost all New Zealand doctors worked in the public sector for at least the first two years after graduation and starting salaries ranged from $70,000 to $116,000 depending on hours worked.

"The effect of this on individual doctors and the New Zealand health system is uncertain, but has the potential to be negative if it forces graduates into higher paid careers away from areas of need, or impacts on the way individuals live or conduct their practice."

The report cited a US study which found medical graduates in the US with higher debts reported higher levels of stress, delay starting a family and said they were less likely to work in under-served locations.

Hawke's Bay Hospital medical registrar Tom Wilkinson, who was in his third year of work, said he was lucky enough to finish his study with a smaller debt than many although it would still take him years to pay off.

The 26-year-old earned about $82,000 in his first year and said most graduates would earn between $70,000 and $90,000 although it varied widely based on district health board, what shifts you worked and how many hours you did, he said.

He believed it was only fair that students contributed to their education and took on some debt but worried about the excessively high loans some were ending up with.

"I know plenty of people whose debt is over $100,000. That debt is going to take them 10 years to pay off. That seems to me an unreasonable burden."

Also, the prospect of a $100,000 loan would potentially put students from lower socio-economic backgrounds off studying medicine, he said.

Association of Salaried Medical Specialists chief executive Ian Powell said he believed it would be a consideration for graduates considering going into general practice with the view of eventually buying into a practice because they already had debt.

He agreed that level of debt could encourage graduates toward high paying private specialist positions rather than helping fill desperately needed general practice positions in rural areas.

New Zealand Resident Doctors' Association advocate Melissa Dobbyn said while medical school fees were increasing 4 per cent every year, pay rates had not kept up with that, she said.

Facing a huge debt

Fourth year medical student and president of the Auckland University Medical Students Association Jibi Kunnethedam said it was increasingly a problem among medical students.

He and his peers were facing huge levels of debt when they finished their studies but were also struggling to get by as students as the cost of living increased.

Because medicine was such a demanding degree and students were working in hospitals around the country for a large part of the last three years, there was limited scope for them to hold down part-time jobs to help support themselves or reduce their debt, he said.

He believed the amount of debt required to study medicine made it a degree many from lower socio-economic areas were not able to consider.

"We want medicine to be a degree that all students can consider and we don't want medicine to be a degree that's only considered by students who are from wealthy backgrounds."

The size of their loans also played a part in what area graduates looked to train in, he said.

"We dedicate so much time, so much training, so much effort and we graduate with a huge financial burden so it does have an impact on the specialities we choose ... many students will aim to achieve a career where they can repay those debts in order to make it worthwhile.

"If we make medicine a subject for the wealthy we will continue to face hardship in terms of finding medical professionals such as GPs in hard to staff areas such as rural communities and the communities that need doctors the most will continue to face a struggle."