The central question of this investigation is: To what degree, if any, does physician assistant (PA) student loan debt impact the career decisions of PAs? A mixed-methods approach to this question found that PA students are heavily influenced by their clinical rotations, especially their preceptors, and that a few weeks prior to graduation PA students may still be “undifferentiated” in their specialty choice. Additionally, PA student loan debt appears to have a non-linear relationship with a student’s desire to practice in a rural location or an area with an underserved population. In other words, PA students in lower and higher debt categories were found to have a different response to debt load than PA students in middle debt categories