My wife and most of our friends are physicians and I don’t know anyone with $750k in debt.
The average debt is a little over $200k. Only 30% of graduates have over $300k in debt and they are considered high debt graduates.
Family Medicine salaries are above $200k in every state in the nation for full time doctors.
None of the doctors I know come from families with generational wealth.
Here is the nationwide average for resident salaries by year and its higher in higher cost of living areas.
Program year 1—$68,166.
Program year 2—$70,499.
Program year 3—$73,301.
Program year 4—$77,593.
Program year 5—$81,807.
Program year 6—$84,744.
Program year 7—$89,187.
Program year 8—$94,215.
Your entire picture is inaccurate.
If "only" 30% of graduates are graduating with over $300k in debt, that means that of the 30,000 graduates that graduate from both allopathic and osteopathic programs each year [1] there are almost 9,000 physicians that are high debt graduates. At high interest rates, that debt can easily grow by hundreds of thousands of dollars while you complete a residency program.
The resident salaries that you listed are an average taken across all specialties. Family Medicine is the lowest paid specialty with 2026 PGY-1 salaries at $58,500 (representing an increase of over 15% since 2021) [2] That is simply not enough to pay the cost of living in a state like Massachusetts where the median household income is more than double that [3] and the average rent in Boston metro is almost $40,000 annually [4]. Not only can you not afford to pay down your student loan debt, you are extremely likely to accrue additional consumer debt on things like credits cards or vehicles.
My main point is that training to become a doctor carries so much financial risk that it selects against folks from poor socioeconomic backgrounds that would otherwise make great physicians. In 2018 the AAMC published a study showing that 51% of medical school matriculants were from families in the top quintile for family income [5] and if I were a betting man, I'd guess that proportion has only increased.
1. https://www.kff.org/state-health-policy-data/state-indicator...
2. https://www.inspiraadvantage.com/blog/how-much-do-medical-re...
3. https://fred.stlouisfed.org/series/MEHOINUSMAA672N
4. https://www.zillow.com/rental-manager/market-trends/boston-m...
5. https://www.aamc.org/media/9596/download