Medical education in the United States is expensive, with 4-year tuition at some institutions totaling more than 150,000 US dollars. Most US graduates have student debt burdens. Using an internet survey, we tested the hypothesis that high student debt adversely affects neurology residents' desire to pursue careers in academic neurology. The results indicate median year 2000 US graduate neurology resident student debt is in the 50,000 to 75,000 US dollars range and that this debt burden may deter US graduates from pursuing careers in academic neurology.