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The Debt and the Cash Flow of Residents: I. The Grim Present

James W. Marshall, DO
JAMA. 1990;264(10):1247-1248. doi:10.1001/jama.1990.03450100037008.
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To the Editor.—  The article regarding student loan indebtedness1 overlooked several issues we "new" physicians must face. Having attended school from 1981 through 1985, I was influenced in my borrowing by several factors that later changed. Foremost among these were income averaging and tax deductibility of student loans. When my residency was complete and all deferments were past, so too was any hope of obtaining any tax breaks from the huge debt incurred for obtaining my degree. It seems paradoxical to penalize students and starting practitioners with ever-increasing tuition and longer residencies, while eliminating methods of off-setting debts our predecessors enjoyed.At least the present trainees know not to expect any break from the federal government. It's a sad day when a board-certified internist in his second year of practice is turned down by four banks (including the one holding my Health Education Assistance Loan [HEAL]) for a car


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