Vol. 16 Issue 5
Student Debt: A Cost to the Profession
"I'm over 100,000 dollars in debt."
I remember the very first time I heard a PT student say that. It was nearly 15 years ago. I also remember my reaction, which can be summarized by surprise and one word: "Ouch." Now, I regularly hear from students that they are in debt for six figures. I'm not surprised anymore, but the word "ouch" still reaches my lips. A six-figure school debt is like having a mortgage without the house.
Sometimes they nervously make fun of their debt, laughingly telling me they would never date another PT student. Cupid, though, also likes a good laugh, and he's been known to shoot his arrows at two heavily indebted students. "Mr. $115,000 in debt, I'd like you to meet Ms. $108,000 in debt. Don't plan on a big wedding."
A Big Chunk of the Paycheck
Though some may joke about their debt, the truth is many are quite worried about how they're ever going to pay it back. They do have something to show for ita PT degreewhich is both an accomplishment and a ticket to a decent-paying job. After taxes are taken out of that decent paying job, the new grad might bring home $2,800 or so per month. Not bad, but it's about to be whittled down by another $1,000 or so by the student loans that now have to be paid off. The amount borrowed, the period to pay it back, and the interest rate will determine how much is owed each month. And there's potentially some bad news in store–many economists predict a rise in interest rates.
Moving to the DPT has resulted in many cases of people going to school for two or three more years compared to when the entry level was a bachelor's degree. That's two or three more years of tuition, housing and deferred income, leading to some monstrous debts.
Some might say, "but look at medical doctors, they also graduate with large debts." While the statement is true, the implied analogy is faulty. Physicians, after completing their residencies, often enjoy starting salaries about two and a half times, or more, the starting salaries of PTs. As a result, their debt burden, as a percentage of their salaries, will often be considerably lower compared to that of PTs.
Being so far in debt upon graduation can lead to some tough choices, or maybe no choices at all, like having to move back in with the parents because you can't afford the rental market. Dreams of buying a car or a home might have to be deferred. Lenders look at what is called the "debt-to-income ratio." If it's too high they won't let you borrow money.
Scary Debt Load
I must admit I find the amount of debt students are acquiring to be quite scary. It's an issue that might impact applications to PT schools, type of practice chosen after graduation, and satisfaction with the profession. Could it be that one reason we saw such a large drop in applications when the DPT was enacted was because students did the math in their heads, and decided the potentially crushing debt they would assume wasn't worth it? And will students who graduate with large debts migrate, either voluntarily or out of necessity, to higher-paying PT specialties, even if it's not their first love? Finally, what type of satisfaction will PT graduates have if they have to work an incredible number of extra hours because they are so far in debt? They might love PT, but that doesn't mean they want a 60-hour work week.
Reconsidering the Master's
I've heard many useful suggestions on how to decrease the amount of money students owe after graduation. Have parents buy textbooks for holiday gifts. Avoid credit-card debt. Create a budget. These are all helpful, but to make a tremendous dent in student debt, more aggressive measures are called for.
Since much of the debt increase stems from the increased number of years that PT students are now spending in school, I propose a mid-course correction to Vision 2020 by taking another look at the master's degree, and possibly affording that an emphasis equal to the one provided the DPT.
Some master's programs were as short as five years total, a two-plus-three format. That is one or two years less than the DPT but, like the DPT, still has three years of professional training. It would make obtaining the PT degree considerably less expensive. Students with a master's who want the doctorate could obtain it through a transitional program following graduation. Also, in an area with several PT schools, there could perhaps be a mix, with some offering the entry-level master's and others offering the entry-level DPT.
Having been a clinical instructor for bachelor's, master's and doctoral students, I can honestly say I can't tell any difference among the three types in the clinic. Is an extra $30,000 plus in debt worth it for a difference in clinical professionalism that is not noticeable, or might not even exist at all?
There are academic advantages to decreasing the debt load of PT students. Some students might cut back on the number of hours they work outside of class. That extra time could, in part, be used for studying, service learning or some other academically beneficial activity.
One comment I sometimes hear from PTs with bachelor's degrees is that they would never apply for PT school if they had to do it over again. These are incredibly dedicated PTs, but they tell me that, financially, they just wouldn't have been able to do an entry-level DPT.
I wonder how many students who would have made outstanding PTs are being driven away because the DPT is financially beyond their reach. They can't afford the profession, but can the profession afford to lose them? And for those who have decided to go to PT school, and assume an enormous debt, how will they feel about the profession five years down the road?
• The opinions expressed in this article are those of the author, and do not necessarily represent the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.
Major Bob Feldman is an army reservist presently on active duty. In his civilian career, he teaches physical therapy at Widener University, Chester, PA.