Analysis of the Educational Debt of Board-Certified Pediatricians by Gender, Race, and Ethnicity Across the Age Spectrum

Objective: To assess the characteristics of pediatricians’ educational debt. Methods: Using publicly available results from the American Board of Pediatrics Maintenance of Certification surveys (2019–2023), this cross-sectional study assessed the proportion of 1) female to male pediatricians and 2) pediatricians of various races and ethnicities to White pediatricians with educational debt by age, debt amount, and subspecialty. Results: Overall, 31.9% (12,286/38,499) of pediatricians had educational debt. Of pediatricians aged ≤40 years, 58.8% (5120/8713) had debt. Debt decreased with age, but of the pediatricians who had debt, 46.1% (111/241) of those aged 61 to 70 years and 64.3% (9/14) of pediatricians older than 70 years owed ≥$100,000. A greater proportion of female than male pediatricians had debt overall (34.6%, 8588/24,846 vs 27.1%, 3696/13,644; relative risk 1.28; 95% confidence intervals 1.24–1.32; P < .0001) and for every bracket above $25,000. However, male pediatricians carried the highest debt amounts when stratified by age. Subspecialty pediatricians and Black or African American pediatricians had the most debt at all ages up to 70 years. The proportion of Asian, Middle Eastern or North African, and Hispanic, Latino, or Spanish Origin pediatricians with debt was lower than that of White pediatricians. Conclusion: Educational debt is unequally distributed among board-certified pediatricians concerning gender, race, ethnicity, and subspecialty. Even though most pediatricians pay off their educational debt, some still owe ≥$100,000 late in their career or retirement age. Further investigation and targeted interventions are needed to address financial inequities and reduce educational debt within the pediatric workforce.