A student studying at the University of Birmingham in the U.K. has discovered a disturbing trend among medical students. According to a paper by student Jodi Dixon, many medical students looking for a way to pay for their tuition are turning to prostitution.

According to Dixon the problem may be particularly acute among medical students because they generally go to school longer, accrue more debt and have less time for paid employment.

Dixon also pointed to a study of about 300 British university students, in which 10 percent reported knowing a student who had worked as a prostitute or escort in 2010. That’s up from about 6 percent in 2006, and 4 percent in 2000, a rise that coincided with an increase in college tuition fees.

“With escalating debts, students in the United Kingdom may view prostitution as an easy way to get rich quick. Some consider prostitution their only choice for paying for their education which I think is awful; I think it’s a shame.”

While the ethical implications of soon-to-be doctors working as prostitutes are unclear, The English Collective of Prostitutes, an organization that offers support for sex workers, has received an increased number of calls from students considering sex work and has medical students within its network.

In the UK, the act of prostitution is not illegal, but related activities are, including soliciting sex.

It’s not clear whether a similar problem exists in other countries.