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Philip Brost has just graduated after 4 years at the University of Saskatchewan with a medical degree and a debt load of $160 000. He's also president of the Canadian Federation of Medical Students and strongly backs what some provinces are already allowing medical students to do: defer their student loan payments and the accrual of interest on those loans until after their residencies are complete.
![Figure](https://www.cmaj.ca/content/cmaj/176/13/1814.2/F1.medium.gif)
Figure. The average debt load of postgraduate medical trainees stands at $158 728. Photo by: corbis
“I have friends in Saskatchewan who benefit immensely by not having the expense of paying back their student loans until they're making more money,” Brost says. “Personally, my amount of debt would be much more manageable if I could defer paying back my student loan until after my residency.”
But Brost won't be able to do that. He's en route to BC where he will be a resident in psychiatry for the next 5 years, and, unlike Saskatchewan, Alberta, Quebec and Newfoundland, BC does not allow medical students to put off paying back their loans.
Nor does Canada's largest province give residents a break. Ontario Minister of Health and Long-Term Care George Smitherman is under pressure to follow suit, but remains noncommittal. “The minister is willing to look at the issue of deferral of student loans as part of a larger discussion to make Ontario a more attractive place for doctors to practise,” says spokesperson Jeff Rohrer. “Interest deferral would require further discussion with the Ministry of Training, Colleges and Universities.”
Brost argues that the move would have enormous benefits. “One of the best ways the province of Ontario can improve accessibility to medical education is to defer loan payments.”
The executive director of the Canadian Association of Internes and Residents concurs. “Not only would it encourage more students to choose medicine, it would also attract a broader spectrum of future doctors from a more diverse socioeconomic background,” says Cheryl Pellerin. “You want medical students to come from a variety of economic backgrounds. You want them to represent the Canadian population. And, hopefully, they would then go back into their community to work. Like Aboriginals, … are they financially able [to become a doctor]? Same with students from rural communities.”
The Canadian Association of Internes and Residents also found that debt load was one of the biggest factors when it comes to choosing a residency, Pellerin adds. “There is a feeling that students or medical residents are less likely to choose lower-paying residencies such as family medicine, due to the debt load they are carrying.”
A survey conducted last year by the association indicated the average debt of postgraduate trainees stands at $158 728. The association, which surveyed 5538 residents at 13 medical schools, also found that debt grows during residency training. “In some cases, almost half of your take-home income as a resident can go to servicing student debt,” Brost says.
The length of residency varies, as does the income. Family Medicine requires a 2-year residency, whereas most Royal College specialties are 4–6 years long. Incomes range from $37 000 per year in Quebec to $47 000 in provinces such as Ontario, Saskatchewan, BC and Alberta.