Monday, April 5, 2010

The Green Stuff

Oof, I’ve been thinking a lot about the green stuff lately.  A couple of weeks ago, we had our financial aid exit counseling sponsored by multiple corporate groups (including the army) for managing student loans and massive debt.  My medical school class of 140 students borrowed over $16 million for four years of private medical education. 

In 2007, seemingly unbeknownst to me and my friends, although I do remember a bit of buzz from the more politically attuned legion of students, George W passed legislation enacted in 2009 that federal loans cannot be deferred through residency anymore.  Residency does pay a modest but decent salary, but certainly not any glamorous wages, particularly for the amount of hours worked.  The terms of repayment are fair and based on a resident’s income, but interest rates are not that low and debt multiplies fast. 

Looking at the match list from my class, I am convinced that high debt steers medical students towards more lucrative specialties.  The data, however, is not convincing as I would have thought.  A 2005 study published in Academic Medicine showed that indebtedness slightly decreased senior medical students’ likelihood to pursue primary care; the correlation was even greater if the student had more than $150,000 in loans [1].  However, a 2006 study of 2022 senior medical students showed that there was no correlation between debt amount and specialty choice [2].  Even so, it is very hard to explain the primary care shortage without looking at the sky-rocketing cost of medical school. 

If debt only slightly affects career choice, it has also been shown to affect physicians’ lives long after graduating.  A 2009 study in the Annals of Surgery of 550 academic surgeons reported that many surgeons felt that their academic debt affected their academic productivity, career choices and quality of life [3]. 

I certainly am not worried about living on a budget and spending within my means, but growing up is hard!  Responsibilities beyond my professional obligations are accumulating rapidly.  I can barely do laundry.  And I certainly can’t keep my room clean.  Now I have to keep track of my cash and make sure I don’t forget to pay the loan man.  Yeah, I know I sound like a big baby crying about things that every adult confronts.  WAAAH!

Fortunately, spring is here and the attainable green stuff is popping up all over.  No, money still doesn’t grow on trees, but broccoli grows on stalks and you get to eat it.  This broccoli dish that I threw together last week is bright, light and easy and is a great accompaniment to pasta, chicken or really anything else.  Raisins seem like a strange thing in vegetables, but they add the slightest bit of sweetness and mellow out with the salty, acidic accompaniment of the broccoli.  Plus, they were sitting on the counter and I need to get rid of them.  Isn’t that the biggest motivator for eating anything?

The green stuff (broccoli with raisins and pine nuts)

1 bunch of broccoli, rinsed, trimmed into crowns with ~1 inch of stalk
½ tbsp butter
½ tbsp olive oil
1/2 tsp salt
2 tbsp raisins
2 tbsp vermouth, sherry, white wine or water
2 tbsp pine nuts, walnuts, sliced almonds (any nuts really, optional)
Juice of 1/2 lemon

Rinse broccoli and cut into florets.  Over medium high heat in sauté pan, melt butter and oil.  Add florets and raisins, cook until slightly brighter green, about 3 minutes.  Add vermouth, cover another 2 minutes.  Add pinenuts, sauté for another minute, dress with lemon and serve. 

1. Rosenblatt, RA.; Andrilla, CH. “The impact of U.S. medical students' debt on their choice of primary care careers: an analysis of data from the 2002 medical school graduation questionnaire.” Academic Medicine, v. 80 issue 9, 2005, p. 815-9.
2. Kahn, MJ., et al. “Is medical student choice of a primary care residency influenced by debt?.” MedGenMed, v. 8 issue 4, 2006, p. 18.
3. Kibbe, MR., et al. “Effect of educational debt on career and quality of life among academic surgeons.” Annals of Surgery, v. 249 issue 2, 2009, p. 342-8.


  1. When I was a resident I had always planned to live on a resident's salary for 2 years "residency postpartum" and pay off my debt. Then I got married and that went out the window. Paying off debt is tough. Fortunately its all consolidated at 2.75%!

  2. speaking of $$$ and med school, if i went to SW:
    no rent!
    in-state tuition!
    dinner at my bro's!

    so, um, maybe when you get there in may you can put in a good word for me. :)

  3. Sounds like a great recipe! It reminds me of Roman-style spinach, which also uses pine nuts and raisins for that little crunch and burst of sweetness.

  4. @ academicobgyn--not sure if you can consolidate at that rate anymore. loan repayment has changed quite a bit

    @ Liz--not sure if I can do anything but I'd love it if you were my neighbor!

    @ Blake yeah I think it's a similar theme. Pretty yummy. Well, at least I think so