Introduction
Medical students in the United States have acquired a vast amount of debt, with the latest median debt being more than $195,0001. Previous studies have found that medical students do not have a robust financial literacy2, 3. Students with lower socioeconomic status have much higher debt rates than their White and Asian peers4. Such demographic factors, lack of financial literacy, have compounded inequity for students. In this study, we sought further to examine financial literacy among medical students, present a higher representation of Black students, and examine additional factors that differentiate between literacy scores.
Methods
We conducted a multi-institutional, cross-sectional study of US medical students and residents across the country between June - August 2023. The survey consists of two parts. Part 1 focused on demographics and debt information. Part 2 of the survey included eleven questions assessing financial literacy. Each question was weighted based on the difficulty level. The survey questions were adapted from validated sources, including the National Financial Capability Study and the Advanced Financial Education Test 5,6. Survey responses with an incomplete Part 2 were excluded. Statistical methods used were a two-sided t-test assuming equal variances and an analysis of variance (ANOVA). A p-value of 0.05 or lower was considered significant.
Results
213 students responded to our survey. Based on a passing score of 75%, only 59 respondents (27.7%) passed the quiz. Analysis of responses split based on Part 1 responses can be found in Table 1. Year in training was correlated with increased literacy, with the mean score of upperclassmen (M3s and above) significantly greater than lowerclassmen. Moreover, the mean scores of Black respondents were lower than Asian and White respondents, but there was no statistically significant difference. Respondents with greater than $100,000 of loans had lower mean scores, although the difference was not statistically significant (p = 0.0611). However, we did find that students with increased amounts of credit card debt were associated with decreased scores. Higher self-ranking of financial knowledge was also associated with increased scores.
Conclusions
We found that medical students of all levels have low overall rates of financial literacy. Medical students can be impacted in terms of managing their high education debt and investing for retirement since these areas are correlated with financial literacy levels7,8.
Tables and Figures
Table 1. This table includes the overall demographics of survey responses. Mean scores and standard deviations for each group are shown in the second column. Subsequent statistical analyses were performed, with the last three columns describing the relevant values to determine significance.
* for p-value < 0.05; ** for p-value < 0.01
References
1. Association of American Medical Colleges. (2021). Medical Student Education: Debt, Costs, and Loan Repayment Fact Card for the Class of 2021. Retrieved from https://students-residents.aamc.org/media/12846/download.
2. Jayakumar, Kishore L., et al. "Personal financial literacy among US medical students." MedEdPublish 6 (2017): 35.
3. Nowotny, Dustin J. "Financial status and literacy among residents and medical students." The American Surgeon 88.7 (2022): 1427-1431.
4. Dugger, Robert A., et al. "The color of debt: racial disparities in anticipated medical student debt in the United States." PloS one 8.9 (2013): e74693. 5. Financial Industry Regulatory Authority (2023). Foundation National Financial Capability Study. Retrieved from
https://finrafoundation.org/knowledge-we-gain-share/nfcs
6. National Financial Educators Council (2023). Advanced Financial Education Test. Retrieved from
https://www.financialeducatorscouncil.org/advanced-financial-education-test/. 7. Lusardi, A., & Tufano, P. (2009). Debt literacy, financial experiences, and overindebtedness. National Bureau of Economic Research. Retrieved from http://www.nber.org/papers/w14808
8. Van Rooij, M., Lusardi, A., & Alessie, R. (2007). Financial literacy and stock market participation. National Bureau of Economic Research. Retrieved from http://www.nber.org/papers/w13565