The authors provide a brief overview for thoracic surgeons in topics essential to achieving financial well-being as a student, trainee, practicing surgeon, and beyond. While broad in nature, the authors\' article is comprehensive, and they cover topics including student loans, asset and wealth management, investment opportunities, financial and estate planning, and insurances. It is hoped that the information provided will allow thoracic surgeons to become more familiar with the financial topics that pertain to thoracic surgeons and provide an introduction to explore financial wellness and literacy more thoroughly.

BACKGROUND: Borrowers burdened by high student debt generally experience financial constraints that can impact them both personally and professionally. To date no published data exists that profiles the education-related debt accrued by entry-level certified athletic trainers.
OBJECTIVE: To assess the scope and scale of student debt associated with the completion of an entry-level athletic training degree.
METHODS: Cross-sectional study.
METHODS: Online web-based survey.
METHODS: Participants were recruited with assistance from the National Athletic Trainers\' Association, who disseminated the survey to 18,689 certified athletic trainers who were members in good standing and who had earned their certification between 2004 and 2022. A total of 2,271 individuals accessed the survey.
METHODS: The overall amount of student debt incurred to complete an entry-level degree in athletic training and the initial monthly repayment amount were collected from survey respondents. Education-related debt-to-income ratio (DTIR) and monthly payment DTIR which are measures of financial health/stability were also calculated from the acquired survey data.
RESULTS: Among athletic trainers who took out student loans, the average amount owed by entry-level athletic trainers for the period spanning 20042022 was $61,717, with an average initial monthly loan payment amount reported to be $453. The mean education related DTIR calculated from respondents was 169%, which exceeded the benchmark value of 100% recommended within the finance industry. Also, the average monthly payment DTIR calculated from study participants was .144, which approached the recommended acceptable upper-limit of .15.
CONCLUSIONS: Education-related DTIR and monthly payment DTIR values reported by respondents suggests the potential for entry-level athletic trainers to experience financial challenges related to their student debt.

Surgical residents make decisions that may have a dramatic impact on career earnings based off conceptions regarding future income potential. This study examines the effect of debt burden, repayment plan, and practice setting on a general surgeon\'s career value.
Debt levels, repayment plans, and practice setting were considered to model a surgeon\'s career value using net present value (NPV) across 35 scenarios. The NPV was calculated using salary, education debt, yearly spending, and a discount rate of 5%. Salary data were obtained from the Medical Group Management Association, student debt information from the Association of American Medical Colleges, and tax and household spending data from U.S. government records. Assumptions included no gaps in training, no prior debt, single-person household, and career duration of 35 y.
A general surgeon\'s salary adequately repays debt burdens from $100,000-$300,000 over 10-25 y, regardless of repayment plan or practice setting. Practice setting decreased career value for academic surgeons when debt burden and repayment plan were held constant: the NPV for an academic surgeon was $382,000 compared to $500,000 for a nonacademic surgeon with the same debt and repayment plan. Debt burden repaid through unsubsidized and income-based repayment plans reduced NPV for all surgeons, while subsidized plans increased NPV. The projected NPV for all scenarios ranged $2.35M-$2.87 M.
Though the modeled scenarios do not account for prior debt burden, major expenditures, or increases in yearly household spending beyond national averages, surgery residents should be aware that general surgery remains a financially feasible career.

Evolution of personal finance beliefs over the course of a college career are unknown. The purpose of this study is to compare perceptions and knowledge of personal finance in undergraduate and pharmacy students at baseline and after completing a personal finance course.
A personal finance elective course was implemented for second- and third-year doctor of pharmacy (PharmD) students and for undergraduate freshman students. On the first and last day of class, students completed an anonymous survey evaluating demographics, opinions and knowledge regarding personal finance, and current financial status. Baseline data between undergraduate and pharmacy students was compared and the impact of the personal finance course was assessed.
The median score on the baseline knowledge assessment was 58% for freshman (n = 19) and 50% for pharmacy students (n = 28) (P = .571). Five percent of freshman and 86% of pharmacy students reported having debt at baseline (P < .001) compared to 84% and 68%, respectively, having savings (p = .110). After completing the personal finance course, knowledge assessment scores were 54% and 73% for freshman and pharmacy students, respectively (P < .001).
Despite additional years of education and life experience, PharmD students had similar knowledge and perceptions of personal finance while reporting more debt than freshmen. Pharmacy students, however, exhibited improvement in knowledge after taking a personal finance course, while freshman students did not. Personal finance-focused education may help empower graduating pharmacists for financial decision-making upon entering the workforce.

Objective: Determine relationships between college students\' student loan presence and self-rated physical and mental health, major medical problems, mental health conditions, physical, dental, and mental health care visits and delays, and medication use and reductions. Participants: A total of 3,248 undergraduates at two regional public U.S. universities, surveyed Spring 2017. Methods: OLS and Logistic regression. Results: Loan presence was related to significantly worse self-rated physical and mental health and more major medical problems, but not to mental health conditions, or physical or mental health medication use. Respondents with loans were less likely to visit the dentist and more likely to report delaying medical, dental, and mental health care, and reducing medication use to save money. Conclusions: Results provide evidence of health and health care use divides among college students by loan presence.

U.S. young adults face the largest student loan burden in history, rising income inequality, and economic uncertainty. Personal debt and other financial stressors have been associated with problematic drinking and mental health symptoms. In this paper, we investigated whether student loan debt was more strongly linked to problem drinking and mental health symptoms among those in lower positions of socioeconomic status (SES) and those who perceived greater [in]stability in their SES (SES-instability). Using data from a larger study of college graduates, we investigated SES, SES-instability, student debt, and their 2-way interactions on problematic drinking and mental health symptoms. College graduates (N = 331), who were two years post-graduation, completed measures assessing student debt, perceived SES, SES-instability, problematic drinking, and mental health symptoms (depression, anxiety, and stress). The hypotheses and data analysis plan were registered prior to conducting analyses. The expected unique, positive associations of SES-instability with problematic drinking and mental health symptoms were supported. SES was uniquely linked with problematic drinking only and in the opposite direction as predicted. Student debt was uniquely and positively linked to stress only. The expected interactions were largely supported for SES-instability and student debt-i.e., the associations of student debt with problematic drinking, anxiety, and stress were stronger (more positive) for those with greater SES-instability. The expected interactions for SES and student debt were null. Though data are cross-sectional and come from an educationally-privileged group, study findings provide preliminary evidence of links between young adult student loan debt, greater SES-instability, and their drinking/mental health.

High educational debt is prevalent among resident physicians and correlates with adverse well-being outcomes, including symptoms of stress and burnout. Residents also report low financial literacy levels, affecting financial well-being. Understanding resident viewpoints toward financial well-being initiatives is crucial to develop targeted resident financial well-being programs. This study aims to examine residents\' experiences financing their medical education and how these experiences influence well-being and attitudes toward financial education in residency. We recruited residents from a Southern California health system with residency programs in Family Medicine, Internal Medicine, General Surgery, Orthopaedic Surgery, and Psychiatry. We contacted residents by email and text message to participate in semi-structured interviews. We conducted interviews from October 2020 to March 2021 and analyzed 59 resident interviews using reflexive thematic analysis. Among residents, 76% (45/59) had ≥ $200,000 in student loans. Residents perceived mounting medical education debt as unfairly burdensome for trainees engaged in socially beneficial work, leaving residents feeling undervalued - a feeling heightened by the stressors of the COVID-19 pandemic - and hampering well-being. Compartmentalizing debt attenuated financial stressors but often made financial education seem less pressing. A subset of residents described how financial planning restored some agency and enhanced well-being, noting that protected didactic time for financial education was crucial. Resident interviews provide practical guidance regarding designing financial education sessions. Desired education included managing debt, retirement planning, and the business of medicine. How residents framed educational debt and their degree of financial literacy impacted their well-being and sense of agency. Residents proposed that residency programs can aid in stress mitigation by providing residents with skills to help manage debt and plan for retirement. To reduce clinician indebtedness, this approach needs to occur in tandem with systemic changes to financing medical education.

An area for concern in public health research is the extent to which USA student loans are associated with poor health. This study\'s objective examines whether falling behind on student loans may compound ill-health by deterring people from seeking healthcare. The results of this study confirm that borrowers behind or in collections on student loans are forgoing healthcare after self-reporting general physical ill-health. This study used the 2019 Survey of Household Economics and Decision-making (SHED) questionnaire that measures the economic well-being of USA households. There were 337 participants behind or in collections on student loans. The size effects for forgoing mental healthcare and seeing a specialist were observed. Respondents behind on student loans were more likely to forgo mental healthcare (adjusted odds ratio (AOR) = 1.66, 95% confidence interval [CI] = 1.18, 2.33) and seeing a doctor/specialist (AOR = 1.53, 95% CI = 1.13, 2.07) even when controlling for sociodemographic variables, health insurance, childcare and eldercare payments, and medical debt. The implications for enlarging access to healthcare among people behind on student loans are discussed.

The purpose of study is to examine the association between one\'s past borrowing experience and borrowing decisions in a hypothetical survey scenario. A total of 1928 responses from an online survey panel were analyzed, with a built-in anchoring question. Using the concept of anchoring bias as a reference point, survey participants were shown a hypothetical scenario regarding college attendance and asked two relevant questions: is it wise to attend college and how much student loans one should take out to attend college. Results indicated that the more one borrowed personally, the more one is likely to think a higher amount being borrowed by a hypothetical high-school graduate is prudent. This connection between experience and present advice can be described as a novel anchoring effect.

Objective: Student loan debt has become a growing crisis. Considering that women are more likely than men to take on student loans and more likely to take on larger amounts, we examine whether the effects of student loans on young adults\' mental health and substance use differ by gender. Participants: We used the National Longitudinal Survey of Youth 1997 (NLSY97) data collected from 1997 to 2015. The NLSY97 consists of a nationally representative sample of American youths born between 1980 and 1984. Participants included 2,607 men and 3,004 women who reported college enrollment. Methods: We analyzed data using hybrid regression models. Results: Student loans have more negative effects on young men than young women, in terms of mental health problems, smoking, and heavy drinking. Particularly, young men tend to increase substance use in response to cumulative loan amounts. Conclusions: Borrowing patterns and the health consequences of student loans are gendered.