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"I Live Week to Week": Medical Students' Experiences with Financial Burden in Online Discourse
Brian Cho1, Gabrielle Pundaky1, Salman H Choudhry1
1Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Teaching and Learning in Medicine
|July 5, 2026
Summary
Financial hardship significantly impacts low-income medical students, affecting basic needs, mental health, and career choices. Addressing these challenges requires institutional support and transparency in medical education costs.
Area of Science:
- Medical Education
- Socioeconomic Disparities in Health
- Qualitative Research Methods
Background:
- Financial hardship is a significant, underexplored challenge for medical students from lower socioeconomic backgrounds.
- Limited research exists on the nuanced financial struggles medical students face after matriculation.
- Traditional qualitative data collection methods may limit disclosure of sensitive financial experiences.
Purpose of the Study:
- To uncover deeper insights into the experiences of financially disadvantaged medical students.
- To identify key themes related to financial burdens in medical training.
- To analyze the impact of financial hardship on medical students' well-being and career decisions.
Main Methods:
- Thematic analysis of anonymous Reddit comments (r/medicalschool) from February 2019-2024.
- Inductive coding process applied to 9,590 comments across 144 threads by three researchers.
- Interpretation using Bourdieu's and Freidson's frameworks.
Main Results:
- Four key themes emerged: personal costs, institutional/systemic barriers, social isolation/peer comparisons, and career trade-offs.
- Students reported compromising basic needs (food, healthcare) and experiencing mental health concerns (anxiety, inadequacy).
- Financial disparities led to social isolation, envy, and debt-influenced career choices (high-earning specialties, loan forgiveness).
Conclusions:
- Financial hardship is a pervasive challenge for low-income medical students, extending beyond individual struggles to systemic issues within medical training.
- Findings highlight the need for greater transparency regarding medical education costs.
- Recommendations include enhanced financial support and increased institutional empathy for students' financial difficulties.
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