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Crushed by Debt: A systematic literature review on the impact of graduate debt on early career choices for new physical therapists in comparison to other clinical doctorates

Treshinsky, Carley
Holahan, Leigh
Sanders, Matt
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Background: Graduate debt is a concern for new professionals with clinical doctorates, especially Doctors of Physical Therapy(DPT). Little research explores the impact of debt on early career choices(ECC) across these professions. The authors conducted a SLR investigating the effects of educational debt on ECC in clinical doctorate professions, with a primary focus on physical therapy. Methods: Using OvidMEDLINE, CINAHL, and Web of Science 1,125 articles were screened, 34 full text articles were assessed for eligibility and 15 were excluded by the authors for not meeting inclusion criteria. Results: Nineteen studies met inclusion criteria. Secondary educational debt influences a variety of ECC amongst clinical doctorate professions. DPTs experience debt burden at unproportionally higher rates than other professionals due to increasing cost of education, increasing loans, and stagnant salaries. ECC most commonly influenced among professions included practice setting, pursuing a desired specialty, and post-graduate education. Conclusions: Educational debt affects ECC in clinical doctoral fields, but more markedly for DPTs. Solutions for decreasing this effect include education on loan repayment and forgiveness, advocating for higher reimbursement rates, and more DPTs in leadership positions. Additional research is suggested for the influence of DPT student debt on the sustainability of the profession.
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Graduate
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2021-01-01
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