I was aware there was a price to pay when I decided to become a doctor: the extensive hours, postponed satisfaction, the strained connections with others. These aspects felt familiar from my own experiences. I understood there would be a financial strain, and having grown up with two immigrant parents, an electrician and a nurse, I was well acquainted with the challenges of financial instability. I was also fortunate: my parents did everything in their power to meet my needs, allowing me to concentrate on the lengthy path to becoming a physician.

However, at some point, my student loans began to feel like just a figure. I had never truly owned debt, and was unaware of what it meant to carry that weight – until it was time to consider my financial future.

Currently, I am a practicing primary care physician – I diagnose ailments, take care of patients, and guide them toward improved health. I also carry over $300,000 in student loan debt.

Primary care was an appealing option for me: I would serve as a generalist overseeing my patients’ health, and over many years, forge trusted connections with them. Although it is not particularly lucrative, it does present various chances to qualify for Public Service Loan Forgiveness (PSLF). Opting for primary care allowed me to finally embark on my career and start experiencing the life I felt excluded from. While my professional ambitions were achievable, I also yearned for the life I had postponed, especially as those dear to me realized their American dreams of starting families, having children, and purchasing homes.

My student loan weight persisted as a personal Sword of Damocles, reminding me of the cost of the role I had achieved. However, the potential for loan forgiveness, especially through PSLF, shone like a lighthouse along my journey. By continuing to serve patients and performing the work I aspired to do, PSLF provided the hope of finding safe harbor.

I placed my trust in the decision I had made and in the system that provided this opportunity, and I began working in a nonprofit environment. Nonetheless, the viability of the PSLF program has felt fragile, considering that the criteria for forgiveness must be meticulously adhered to, that applications are frequently rejected, and that a shift in administration or government policy could make it obsolete.

I had experienced a glimpse of the freedom that the future might hold while student loan payments were paused, an unexpected reprieve during COVID-19, making it all the more painful to see our current administration continue to challenge loan forgiveness initiatives and PSLF – these crucial supports for building lives beyond medicine, giving our personal lives significance beyond our professional duties.

Administrative hurdles remain, conveying a discouraging message rooted in systemic failure: That choosing service, particularly in primary care, equates to choosing sacrifice. As the population of America ages, and the growing prevalence of chronic illnesses further burdens already strained health systems, our administration quickly acknowledges the necessity for quality primary care and emphasizes our importance. Our medical schools encourage students to consider careers in underserved areas and serve marginalized populations. Yet, our systems depend on altruism to meet these demands. While the goodwill of medical students and doctors is commendable and abundant, it is not limitless. In this era of escalating administrative and clinical demands, there are already increased pressures on generosity. Absent substantial policy reform, our administration sends the signal that contributing to the common good and genuinely caring for patients means earning less, choosing a path of servitude tied to a life of debt.

I firmly believe that physicians pursue medicine not for financial gain but for purpose. So did I. However, in addition to choosing medicine, I was choosing life: the chance to have a modest home and a family, without the specter of a six-figure loan balance influencing every decision I make.

Physicians are not seeking preferential treatment. But we are requesting that commitments be honored. PSLF must be safeguarded, not diminished. Furthermore, public health needs to be regarded as an investment, not a burden. Undermining resources for public health will lead to increased burnout, heightened physician shortages, and escalating costs for our already pressured healthcare system. We are advocating for a healthcare system that does more than deem us essential; we require one that invests in primary care as indispensable. Supporting primary care equates to supporting everyone, through health access, equity, and sustainability.

I continue to believe that primary care is, indeed, primary. I chose this route knowing it would be challenging, but I did not anticipate facing so many barriers to serving my communities or obtaining financial stability. Caring for patients is a tremendous privilege and responsibility, and yet sacrificing personal security to do so is a cost we may find unsustainable. We need more primary care physicians in our communities, caring for patients, and we need to back our physicians and communities in achieving that.