Med School Close-Up: Which Specialties Have the Best Debt-to-Dollars Ratio?

Jen Williamson Updated on May 13, 2019

If you're planning to go to medical school, you're probably also planning to take on significant student loan debt. The question is, is the debt worth it?

There’s no question medical students are going further and further into debt. From 1992 to 2017, medical student debt went up a whopping 123.4% — rising from an average of $87,297 in 1992 to $195,000 in 2017.


But some specialties are more debt-ridden than others and some pay off better than others — both in terms of salary and job satisfaction. 

We recently took an in-depth look at which medical school specialties were the best investment, based on annual Medscape Physician Compensation reports from 2011 to 2016.

Here we’ll go a little more in detail about the debt-to-salary picture for various specialties. We'll also dig in to the data on non-tangible indicators of job satisfaction to help you determine if paying off the debt for your chosen specialty will be worth it in the long run. 

Which medical specialties carry the highest and lowest debt?

Those specialties that carry the highest student debt are*:

  • Emergency medicine: $195,432 (as of 2016)
  • Radiology: $185,490
  • Psychiatry: $184,323
  • Orthopedic surgery: $183,778
  • General surgery: $183,285

Those with the lowest amount of student debt include:

  • Dermatology: $153,827 (as of 2016)
  • Radiation oncology: $168,297
  • Urology: $171,322
  • Ophthalmology: $172,564
  • Internal medicine: $173,278

*These numbers are from a research letter published in the Journal of the American Medical Association.

Which medical specialties earn the highest salary?

According to our recent report, the top earners include:

  • Orthopedics: $489,000 (as of 2016)
  • Plastic surgery: $440,000
  • Cardiology: $410,000
  • Urology: $400,000
  • Radiology: $396,000

You might expect the highest earners to carry the most debt, as these are the most “valuable” medical degrees according to the market. But you’d be wrong.

Only two of the specialties on the high-salary list — orthopedics and radiology — also make the top five for highest student debt. Another — urology — is among the specialties with the lowest student debt.

Which brings us to …

Which medical specialties earn the lowest salary?

  • Pediatrics: $202,000 (as of 2016)
  • Family medicine: $209,000
  • Endocrinology: $220,000
  • Infectious disease: $228,000
  • Rheumatology and psychiatry: $235,000

Pediatrics is also on the lower end of the student debt scale, with an average student debt of $174,764. Family medicine comes with a middle-to-high average student debt of $180,729. Neither makes it into the top or bottom five for student debt, however.
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Which physicians have the highest job satisfaction?

Of course, there’s more to happiness than money. According to the 2016 Medscape survey we based our analysis on, the following medical professionals are happiest in their jobs:

  • 39% of the dermatologists surveyed reported feeling “very or extremely happy” with their careers.
  • Ophthalmologists come in a close second, with 38% job satisfaction. Ophthalmologists are also among the bottom five for student debt. 
  • About 37% of psychiatrists reported being extremely happy at work, despite being among the bottom salary earners.
  • 36% of nephrologists surveyed said they were very happy at work.
  • Pulmonologists are the lowest of the high end, with 33% reporting elevated levels of happiness at work.

When we’re talking debt to dollars, however, satisfaction with pay makes a big impact on quality of life.

As is expected, those with the highest increase in pay satisfaction are also among the highest paid, such as plastic surgeons. But that’s not the whole picture.

Others who saw a serious rise in pay satisfaction include endocrinologists — who are in fact some of the lowest paid, although their salaries have risen at a fairly fast 30.9% clip — and rheumatologists, who report some of the lowest job satisfaction overall.

Which physicians have the lowest job satisfaction?

The specialties where people are least likely to be happy in their jobs include:

  • Internal medicine: 24% job satisfaction
  • Critical care: 25% job satisfaction
  • Rheumatology: 26% job satisfaction

So, which specialties have the best debt-to-dollars ratio? Among those is urology — it made the top 5 for highest salary and lowest student debt. But urologists also experience a 55% burnout rate — so this career is not for the faint of heart.

Job satisfaction is about more than money. But student debt and salary can certainly make an impact on your quality of life over time. By all means, crunch the numbers — but that’s only a small factor in finding medical work you enjoy.

If you've got medical school loans and you're looking to pay less in interest, hit up our Refi Ready Calculator to see how much you may be able to save.  

About the Author
Jen Williamson

Jen Williamson is a freelance writer living in Brooklyn. She has written for a variety of industries, including software, education, business, and personal finance. Prior to that, she worked at an adult literacy nonprofit in Philadelphia, where she coached nontraditional students in passing the GED test and applying for college. When she isn’t writing or reading—which is rare—she can usually be found planning her next travel adventure, training for a marathon, or sneaking in somewhere she’s not supposed to be. Read more by Jen Williamson

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