Big loans (with interest)

[Tissue issue]

I've had a few conversations with residents the last year or two regarding how indebted they are (seems like many people have 200-300K in loans). I am curious as to how younger pathologists are being advised on their finances. Are people recommending you pay off these loans as soon as you can by living modestly for several years when you start practicing?

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[KCShaw]

My advice is to not get that far in debt. I went to med school with people who chose to spend probably $100-200k more than I did simply on living expenses. To them it seemed like a good idea at the time -- why live above a balloon shop and eat pita bread and hummous for dinner (me), when one is going to make "lots of money" and easily pay it off a few years later?

Unfortunately many, many people have already sunk to that debt level, one way or another. I've certainly still got debt, but I'm not swimming in a bottomless pit of it like some people, so I haven't had to face quite the same dilemmas. With that in mind, my advice is to work on it with a financial advisor who can take into account your specific income vs interest rate on your school loans, etc., because while it can seem like a good idea to keep living on the cheap until you pay off the school stuff, much of the time school loans can be consolidated into low interest loans and you might actually be better off paying the minimum on them while spending more on "necessary" new things which are higher interest but may be of substantial long-term value, like a home (rather than dumping money into rent), vehicle, or simply eating real food. Which is, personally, pretty much what I'm doing -- but again, my school debt level is NOT at the point where interest alone is a thousand plus a month.

That said, I'm a little curious as to whether there's a current "trend" with this too.

 

[Torsed]

I am living modestly, haven't bought a house yet, only 7 months into a new job, no real point until it pans out. I owe prolly in the range of 150k all told, but I moonlighted during pathology residency and was able to make interest payments on my med school loans all during residency and fellowship.

I would advise obtaining a personal banker, I obtained one my first week here and its made all the differnence, he/she is the go between and can get you much lower rates (IMO) than random bank consolidation loans (i.e. I consolidated all my credit card debt into one loan at a interest rate of about 5%). The private banker also helped me get my own DI policy, I would avoid group policies that are offered, these are often mediocre and not tailored to you as an individual. Look at the CAP offered DI policy and it is not that great.

Considering my interest rate on my med school loan is 3.7 percent I am not in a hurry to pay it off other than the regular payments thus far. I am concentrating on other bills, etc. If I happen to come upon a large envelope of cash in a partner's office I may knock it out. If your credit stinks perhaps the long payment of the student loan may be somewhat of a plus. Thats all I got on this.

 

[levels x3]

It is absolutely advisable to live modestly when you start practicing, but not necessisarily to pay down student loan debt more quickly. Living modestly and having excess income gives you choices. Other than that there is no one right answer to this question. There are some objective factors to consider, such as the interest rate on your loans vs. the rates on other debt you might be carrying (e.g. a mortgage), vs. expected returns of other investments. There are subjective things to consider as well. For some people, being debt free is a top priority. Less so for others.

For example, I was lucky. When I graduated and consolidated my student loans (about 150k), the rate was 2.85%. That's the cheapest debt I'll ever have, so does it make sense for me to pay that off early? Sure, and I probably will someday, because even at that rate I am still paying interest. But, my mortgage is at 4.85%, so I'm better off directing excess money there. And even in today's market, I can reasonably expect long-term investment returns to be higher than the rate on my debt, so I ensure that I'm adequately saving and investing.

I haven't checked, but I have heard that loan consolidation rates over recent years have gone significantly higher, in the 6-7% range. That makes the decision more difficult because the rates start to overlap. Just remember that you can eat neither your house nor a loan pay-off letter in retirement.

With regard to financial advisors, some are good, many are simply used car salesmen with nicer offices. If you feel like you are the type of person who just doesn't want to worry about managing finances yourself, fine, get one. But look for a "fee-only" advisor. You will pay a flat or hourly rate, but the advisor isn't making comissions anywhere and so won't try to sell you investments based upon their bottom line. Note: "fee-based" is not the same as "fee-only".

If you want to learn, which is advisable either way so you know whether your advisor is full of it or not, there are many resources out there. With a bit of reading you can do all of this yourself. I do recommend an estate planning attorney though if you have a spouse, kids, etc..

I happen to believe in a passive investing, costs matter more than anything else, philosophy. This is not seeking alpha stuff. You can all decide for yourselves.

www.bogleheads.org (great wiki and very very intelligent discussions)
www.whitecoatinvestor.com (ER doc with boglehead point of view)

 

[levels x3]

p.s. As a general rule, physicians are horrible investors and savers. The joke in the investment industry is that when physicians start buying, it's time to sell. Also, having generally been among the smartest of our peers our entire lives, we tend to overestimate our abilities in areas where we may have limited expertise...such as investing. Take financial advice from fellow physicians with a hefty grain of salt...including those on internet forums

 

[pxjx]

Currently, I think the student debt is in a huge crisis. Speaking with my attendings during rotations, our situation is vastly different in that current med students have much higher debt (undergrad + med school) with much higher interest rates. I believe the next bubble that is going to burst and bring this country to a halt will be the student loans. The gov't owns most people's loans for medical school. I worked 2 jobs in undergrad so I have no debt there and have very minimal credit card debt, but my student loans are ~300,000 (just for med school). This is partly because I chose to attend a private school, but my friends who are in public school are not doing much better (most average ~250,000). I lived very simply, had a roomate all 4 yrs to split costs and didn't buy any thing I didn't need. Currently the stafford interest rate is 6.80% and grad plus is 7.9%. With the declining job market in pathology and decreased compensation this is going to make really difficult for most students to pay off their student loans and adequately safe for retirement. I imagine this is going to get much worst for current med students because there is no subsidized loans anymore.

 

[2121115]

Currently, I think the student debt is in a huge crisis. Speaking with my attendings during rotations, our situation is vastly different in that current med students have much higher debt (undergrad + med school) with much higher interest rates. I believe the next bubble that is going to burst and bring this country to a halt will be the student loans. The gov't owns most people's loans for medical school. I worked 2 jobs in undergrad so I have no debt there and have very minimal credit card debt, but my student loans are ~300,000 (just for med school). This is partly because I chose to attend a private school, but my friends who are in public school are not doing much better (most average ~250,000). I lived very simply, had a roomate all 4 yrs to split costs and didn't buy any thing I didn't need. Currently the stafford interest rate is 6.80% and grad plus is 7.9%. With the declining job market in pathology and decreased compensation this is going to make really difficult for most students to pay off their student loans and adequately safe for retirement. I imagine this is going to get much worst for current med students because there is no subsidized loans anymore.

Agree. Higher education is the next bubble to burst. I was fortunate to have no undergrad debt and to have attended a state medical school and consolidate my loans at 2.5%. I feel bad for the people with high interest private school debt. That is going to be tough.

 

[pxjx]

Given what I know now, I would not choose to go into medicine if I had do it all over. I didn't go into medicine to become rich, but I also don't want to be enslaved with debit. This is extremely unfortunate, because I really love what I do and couldn't imagine doing anything else for a living. I just don't see how people are going to be able to have a family and make a decent living in medicine anymore. For anyone interested see below.

http://www.youtube.com/watch?v=xl7R8xIxzKI&feature=player_embedded (great video)

 

[sirenomelia]

Given what I know now, I would not choose to go into medicine if I had do it all over. I didn't go into medicine to become rich, but I also don't want to be enslaved with debit. This is extremely unfortunate, because I really love what I do and couldn't imagine doing anything else for a living. I just don't see how people are going to be able to have a family and make a decent living in medicine anymore. For anyone interested see below.

http://www.youtube.com/watch?v=xl7R8xIxzKI&feature=player_embedded (great video)

There was no guidance for me on $. The loan czar lady at my med school gave me incomplete/ wrong information as I was leaving and my crap (was only 70k) went into forebearance at PGY3. I only needed Staffords and I was starting paying it back all along anyway but I started having to pay interest before I should have had too. Point is you need to start understanding, managing and taking control of this stuff on your own from first day of PGY1.

 

[gbwillner]

Given what I know now, I would not choose to go into medicine if I had do it all over. I didn't go into medicine to become rich, but I also don't want to be enslaved with debit. This is extremely unfortunate, because I really love what I do and couldn't imagine doing anything else for a living. I just don't see how people are going to be able to have a family and make a decent living in medicine anymore. For anyone interested see below.

http://www.youtube.com/watch?v=xl7R8xIxzKI&feature=player_embedded (great video)

please. I don't know any starving physicians out there. Maybe it's not the 80's anymore and most of us won't be driving Lambos to work, but we'll all do OK.

 

[deleted314957]

this thread demonstrates one of the beauties of the military. med school of your choice paid for. superior salary in residency/fellowship, a couple years post boards "attending" experience, then you get out and you are not competing with all the fresh-out-of-training folks for a job. and you have investments with no debt. however, that was a long time ago---things may have changed.

 

[pxjx]

please. I don't know any starving physicians out there. Maybe it's not the 80's anymore and most of us won't be driving Lambos to work, but we'll all do OK.

You clearly misunderstood what I was saying! No where did I mention that physicians were starving. Like I said before, I didn't go into medicine to become rich or drive fancy cars, but did so because I really enjoyed it. If my goal was to become extremely rich, then medicine would not be the avenue I would of have chosen. There are much easier ways of making money, then spending 4 yrs in undergrad, 4 yrs in med school, and another 3-6 yrs in residency+fellowships. Not to mention that you are extremely tired and sleep deprived at the prime of your life! All I was saying is that the burden of debt has become way too outrageous than it needs to be for many reasons.

 

[2121115]

Debt is a major problem for our colleagues going into academics. And it has made several people I know turn to private practice after making a go at academics. When you are a resident it is easy to look at 150K and think "wow that is living large". Things change when you are trying to make a life for your family with 250K hanging over your head already. I don't know any long term academic pathologist who doesn't have a spouse making serious bank. Those that don't leave quickly. Think seriously about that when making decisions.

 

[malchik]

I don't know any long term academic pathologist who doesn't have a spouse making serious bank. Those that don't leave quickly. Think seriously about that when making decisions.

Interesting, I've made the same observation. And this may prove to be what sends me to PP.

 

[pathstudent]

Just another comparison to how the prior generation had it. Had a similar debt conversation that included an imminently retiring 70 year-old pathologist who said his state med school tuition was $150 a semester back in the early 60s and how it was the best return he made on any investment. Given that he was PP since the early 70s (back then you had to do a few years in the military), he probably spent a good 3 decades making 500,000 or more a year and I know his group sold about five years a go. Off that 1,000 in tuition he probably earned 20,000,000 over his 40 year career. But you could tell by talking to him that unlike residents today he didn't want or expect this sort of lucrative career. It just happened to the genteel docs of the days of old.

 

[KCShaw]

Dunno, I think there's some truth in the dangers of the educational debt load these days. I had no idea the student loan interest rates were now so high. People assume that because even in the last 5-10 years folks have done okay that no matter how expensive it looks it will work out for them, too -- without realizing it's getting harder and harder every -year-, not every -generation-.

I think it was posted here in the last year or so, but someone pointed out an article which concluded that based on their calculations of an 'average' I believe hospitalist/IM salary and considering debt and time drawing salary, etc., over the course of a career the physician kept only a dollar or so more per hour more than an average chronically underpaid high school teacher. Not to belittle the high school teachers, and recognizing they chose the lower, if perhaps common, end of the physician scale for comparison... that's just not a very appealing result. But if anything it appears to be worsening, not improving. This is the kind of thing people considering applying to medical school need to recognize -before- jumping in. By the time you hit PGY1 you're trying to manage it, because really it's too late to do anything else -- the average person is in debt the value of a decent to reasonably nice house, with only a degree and board certification (hopefully), and lots of interest -- not a house -- to show for it, and the prospect of possibly needing to also...actually buy a house.

Eventually the looming threat of substantial reimbursement/income cuts may come to pass and crash headlong into climbing debt loads, and I can see how a proportion of people could very well find themselves in a very bad position.

 

[LADoc00]

I've had a few conversations with residents the last year or two regarding how indebted they are (seems like many people have 200-300K in loans). I am curious as to how younger pathologists are being advised on their finances. Are people recommending you pay off these loans as soon as you can by living modestly for several years when you start practicing?

I paid off my debt in 5 years after training. People now with BONKERS crazy loan amounts in excess of 250K are flirting with disaster in my opinion.

I cant imagine having that monkey on my back. Sucks.

 

[Darkskies]

I am currently a pre-med and this topic regarding the ever-increasing tuition for schools and the interest on Stafford and Grad Plus loans has me very concerned. I applied to med schools this year with a GPA of a 3.45 and an MCAT of 32R.
I am in a dilemma in that I have 2 DO acceptances(3 MD interviews out of over 20 secondaries completed, no acceptances) but would really prefer an MD and am debating whether I should complete a postbacc year in a program that has >90% success rate in gaining admission to the affiliated MD school. My issue with this is that I would be 25(versus 24 as a DO) when I become an MS-1 and I am probably looking at nearly 400k(not counting interest)in debt counting my undergrad loans, postbacc loans, and the 4 years of OOS cost of attendance I would have to pay to the medical school.

I have been distressing about this decision for a long time now and recently found out about the IBR plan and the additional benefit of the public service loan forgiveness option. After reading through some of the threads on the financial aid forum it appears that many believe that the PSLF option will be unsustainable within the next 10 years. Is that really true? What then? Would the 25 year forgiveness option that is standard with IBR still be viable? Even so, I would have to pay all of the taxes on the entire loan amount at the end of the 25 year period within that same final year. Even with 400k(and 6.8-7.9% interest including stafford and grad plus loans) can I expect to have paid it all off on the IBR plan before the 25 year period if I end up pursuing a lower paid specialty such as in pathology or even primary care?

Is there some way to get locked into the IBR plan straight from medical school so that even if the government decides to do away with it or change certain agreements, I wouldn't be affected since I had already signed up for the plan and could be 'grandfathered in'?

I was really hoping that the IBR plan could turn out to be a saving grace and still allow me to achieve my goals of an MD without overburdening myself with so much debt that it wouldn't make any financial or professional sense(versus settling for the DO and starting on an attendant's salary a year earlier) leaving me miserable. I apologize if my questions are naive but this is the first time I'm contemplating what my education loans are going to end up costing me. Thanks so much in advance!

 

[KCShaw]

Good questions, IMO. I don't know enough about IBR to really comment there.

As far as DO vs MD goes, while it's true that getting a DO will somewhat narrow your opportunities, there are plenty of successful DO physicians out there. Depends on your career goals. If you want to be the biggest, coolest name in X subspecialty and be a god (not THE God, but A god) at Big Name Medical School Hospital, your best bet is probably to start with an MD -- even if some DO's occasionally accomplish it, there's enough politics, bias, and competition that I think it would be harder. If you want to be a "good doctor" and do "good work", I think there's no reason to turn up your nose at an opportunity to get a DO.

That said, I wouldn't be concerned about being 24 vs 25 per se. But I would certainly be concerned about 400k of interest laden debt, which relates to age/time only as far as 1 extra year = more debt and longer before making enough money to start denting it.

 

[deleted314957]

I am currently a pre-med and this topic regarding the ever-increasing tuition for schools and the interest on Stafford and Grad Plus loans has me very concerned. I applied to med schools this year with a GPA of a 3.45 and an MCAT of 32R.
I am in a dilemma in that I have 2 DO acceptances(3 MD interviews out of over 20 secondaries completed, no acceptances) but would really prefer an MD and am debating whether I should complete a postbacc year in a program that has >90% success rate in gaining admission to the affiliated MD school. My issue with this is that I would be 25(versus 24 as a DO) when I become an MS-1 and I am probably looking at nearly 400k(not counting interest)in debt counting my undergrad loans, postbacc loans, and the 4 years of OOS cost of attendance I would have to pay to the medical school.

I have been distressing about this decision for a long time now and recently found out about the IBR plan and the additional benefit of the public service loan forgiveness option. After reading through some of the threads on the financial aid forum it appears that many believe that the PSLF option will be unsustainable within the next 10 years. Is that really true? What then? Would the 25 year forgiveness option that is standard with IBR still be viable? Even so, I would have to pay all of the taxes on the entire loan amount at the end of the 25 year period within that same final year. Even with 400k(and 6.8-7.9% interest including stafford and grad plus loans) can I expect to have paid it all off on the IBR plan before the 25 year period if I end up pursuing a lower paid specialty such as in pathology or even primary care?

Is there some way to get locked into the IBR plan straight from medical school so that even if the government decides to do away with it or change certain agreements, I wouldn't be affected since I had already signed up for the plan and could be 'grandfathered in'?

I was really hoping that the IBR plan could turn out to be a saving grace and still allow me to achieve my goals of an MD without overburdening myself with so much debt that it wouldn't make any financial or professional sense(versus settling for the DO and starting on an attendant's salary a year earlier) leaving me miserable. I apologize if my questions are naive but this is the first time I'm contemplating what my education loans are going to end up costing me. Thanks so much in advance!

i think this kind of stuff is more thoroughly covered on one or more of the pre-med fourms.

 

[gbwillner]

My issue with this is that I would be 25(versus 24 as a DO) when I become an MS-1 and I am probably looking at nearly 400k(not counting interest)in debt counting my undergrad loans, postbacc loans, and the 4 years of OOS cost of attendance I would have to pay to the medical school.

How the hell do you aquire $400K in debt? How is that even possible? Aren't there banks or something that look at this practice, and maybe say "hmm... you probably should just stop borrowing money because you'll never pay this off."?
If I were you, I'd finish DO and then just move to another country to practice, never paying the debt off. In 7-10 years, when you finish residency, your debt could easily be $800K when the interest comes in.

 

[CocoaMD]

I am currently a pre-med and this topic regarding the ever-increasing tuition for schools and the interest on Stafford and Grad Plus loans has me very concerned. I applied to med schools this year with a GPA of a 3.45 and an MCAT of 32R.
I am in a dilemma in that I have 2 DO acceptances(3 MD interviews out of over 20 secondaries completed, no acceptances) but would really prefer an MD and am debating whether I should complete a postbacc year in a program that has >90% success rate in gaining admission to the affiliated MD school. My issue with this is that I would be 25(versus 24 as a DO) when I become an MS-1 and I am probably looking at nearly 400k(not counting interest)in debt counting my undergrad loans, postbacc loans, and the 4 years of OOS cost of attendance I would have to pay to the medical school.

I have been distressing about this decision for a long time now and recently found out about the IBR plan and the additional benefit of the public service loan forgiveness option. After reading through some of the threads on the financial aid forum it appears that many believe that the PSLF option will be unsustainable within the next 10 years. Is that really true? What then? Would the 25 year forgiveness option that is standard with IBR still be viable? Even so, I would have to pay all of the taxes on the entire loan amount at the end of the 25 year period within that same final year. Even with 400k(and 6.8-7.9% interest including stafford and grad plus loans) can I expect to have paid it all off on the IBR plan before the 25 year period if I end up pursuing a lower paid specialty such as in pathology or even primary care?

Is there some way to get locked into the IBR plan straight from medical school so that even if the government decides to do away with it or change certain agreements, I wouldn't be affected since I had already signed up for the plan and could be 'grandfathered in'?

I was really hoping that the IBR plan could turn out to be a saving grace and still allow me to achieve my goals of an MD without overburdening myself with so much debt that it wouldn't make any financial or professional sense(versus settling for the DO and starting on an attendant's salary a year earlier) leaving me miserable. I apologize if my questions are naive but this is the first time I'm contemplating what my education loans are going to end up costing me. Thanks so much in advance!

You only qualify for IBR (Income-Based Repayment) during repayment on your loans. So there is no way to qualify for it while you're in school b/c you are not in repayment. Once you graduate only then are you able to fill out the forms (with your income) and turn it into your lender to see if you qualify.

 

[LADoc00]

400K?!

Did you start a failed investment bank while in undergrad?

That is crazy dude. Change your name and start a new life

that will hit 7 figs when inflation goes through the roof in the next few years....


You are looking at more than 3K a month when rates start pounding 7-8%.

Join the army or something.

 

[Darkskies]

400K?!

Did you start a failed investment bank while in undergrad?

That is crazy dude. Change your name and start a new life

that will hit 7 figs when inflation goes through the roof in the next few years....


You are looking at more than 3K a month when rates start pounding 7-8%.

Join the army or something.

I have nearly 30k from undergrad. The master's program's estimated cost of attendance is 56k. The cost of attendance for out of state or private medical schools is around 75k. Adding all that up results in 386k for total debt not counting interest. It's close enough to 400k. Some of you don't seem to be aware of what the tuition and estimated costs of attendance are at med schools nowadays. That being said are the cost of attendance figures for schools grossly overestimated????

 

[CocoaMD]

I have nearly 30k from undergrad. The master's program's estimated cost of attendance is 56k. The cost of attendance for out of state or private medical schools is around 75k. Adding all that up results in 386k for total debt not counting interest. It's close enough to 400k. Some of you don't seem to be aware of what the tuition and estimated costs of attendance are at med schools nowadays. That being said are the cost of attendance figures for schools grossly overestimated????

I went to undergrad, took two years off and did a post-bacc program, and am about to graduate from medical school and I only have $129,000 of loans total (and that includes all schools for the past 10 years of my life). Since we're in the same ballpark age (I'm 3 years older than you) I can guess that the cost of school hasn't changed drastically between us. So I don't know what to tell you. The best advice I ever got was: do NOT take out the max loan amount. Simply because you never really need to max out your loans b/c the cost of attendance is an estimate (and who knows how the school comes up with these figures.) If you take the least amount needed, you can always get more. Its not like you can't request more money if you originally turned it down. Take this advice when you start medical school. Seriously.

 

[deleted314957]

like LADoc said, you should SERIOUSLY look at the military. you may get some lone payoff and you would stop the hemorrhaging.

 

[Torsed]

I have nearly 30k from undergrad. The master's program's estimated cost of attendance is 56k. The cost of attendance for out of state or private medical schools is around 75k. Adding all that up results in 386k for total debt not counting interest. It's close enough to 400k. Some of you don't seem to be aware of what the tuition and estimated costs of attendance are at med schools nowadays. That being said are the cost of attendance figures for schools grossly overestimated????

As mentioned previously, sounds like you need some damage control. Apply to an IN-STATE medical school, you most likely have the best option with those in terms of tuition costs. Why the heck would you go to an out of state private medical school? If you can get into one of those private schools you most likely could get into a state school. I am presuming you are stating 75k a year in tuition for private medical school? The bulk of my personal student loans was not through tuition as stated here, but through cost of living. Jehovah knows how people with kids do all this hub bub.

 

[KCShaw]

400k is a lot, but I don't think it's that farfetched either. I know several people in my age bracket in the vicinity of 300k as of residency, so while 400k is over the "high" end of the bell curve it's not unbelievably higher than what people have already been hitting in the last 5 or so years. Still, I agree with the notion of minimizing what you take, holding onto just enough cushion to not be homeless before you have to get more, and making a concerted effort to not spend for the sake of spending on the assumption that it doesn't matter 'cause you'll be a rich doctor eventually regardless. 400k is simply not unrealistic debt these days, especially considering the meteoric rise in costs; add in interest accrual and it's crippling. Sprinkle in some societal banter about physicians needing to be paid less and society expecting physicians to be "servants" of the greater good (enough people are without jobs that a doctor making 150k..much less 500k..sounds unfairly high, regardless of our debt & work load required to get there), and the business appeal just isn't what it used to be.

AAMC Oct 2011 "debt fact card": https://www.aamc.org/download/152968/data/debtfactcard.pdf

There's also a paper on the history of med student debt here: http://hospitalmedicine.ucsf.edu/downloads/history_of_med_student_debt_greysen.pdf

 

[Darkskies]

As mentioned previously, sounds like you need some damage control. Apply to an IN-STATE medical school, you most likely have the best option with those in terms of tuition costs. Why the heck would you go to an out of state private medical school? If you can get into one of those private schools you most likely could get into a state school. I am presuming you are stating 75k a year in tuition for private medical school? The bulk of my personal student loans was not through tuition as stated here, but through cost of living. Jehovah knows how people with kids do all this hub bub.

Mainly because it is so difficult to get into an in-state medical school nowadays. I applied with a 3.45 GPA and a 32R MCAT to over 23 schools and only had 3 interviews,0 acceptances. As I said, I have been accepted to DO schools but hate thinking that I'm settling. The postbaccs I'm applying to are all at private or out of state medical schools that more or less guarantee admittance to their medical school with the successful completion of their rigorous postbacc program.

Is 400k(well 386k) with interest really that insane? After residency I would be making around 75k pre-tax real income on a salary of 175k(lower paid specialties) if paying out 4k in loans a month(plus taking out for taxes) for 10 years. If IBR is still available when I'm an attending/resident then the amount I would pay would be even less. Is living on 75k a year after residency for 10 years that terrible? I'm still wondering if I should save a year and just run with my DO acceptances...???

 

[LADoc00]

Living on 75K a year for a decade after training is a very sobering revelation. You will likely be renting with little to no 401K savings. If 10 years into your career if you dont have 300-500K BANKED in a 401K, you are looking at working well into your late 60s or conversely committing yourself to dying young.

Realize that Obama doesnt let you deduct your student loan interest if your AGI is like over 90K (I think, someone confirm), which guaranteed it will be. Remember Obama hates all rich people, even those with crazy amounts of debt and lost opportunity cost to make up for.

If you were a unionized nurse, you might be better off. He always goes on and on about how nurses are paying more in taxes than Romney etc. (which is absurd, but he goes with it...have to appreciate the man's audacity!).

Think LONG AND HARD about this before making the decision. Medicine when you get out wont be the same it is today (and today's medicine isnt good dude...shudder at 5 years from now).

 

[Darkskies]

Living on 75K a year for a decade after training is a very sobering revelation. You will likely be renting with little to no 401K savings. If 10 years into your career if you dont have 300-500K BANKED in a 401K, you are looking at working well into your late 60s or conversely committing yourself to dying young.

Realize that Obama doesnt let you deduct your student loan interest if your AGI is like over 90K (I think, someone confirm), which guaranteed it will be. Remember Obama hates all rich people, even those with crazy amounts of debt and lost opportunity cost to make up for.

If you were a unionized nurse, you might be better off. He always goes on and on about how nurses are paying more in taxes than Romney etc. (which is absurd, but he goes with it...have to appreciate the man's audacity!).

Think LONG AND HARD about this before making the decision. Medicine when you get out wont be the same it is today (and today's medicine isnt good dude...shudder at 5 years from now).

Medicine isn't backbreaking work so would working into your late 60s and beyond really be so stressful? Also 75k a year would still leave you with a somewhat upper middle class lifestyle, wouldn't it? I realize that politicians and the government aren't really looking out for my best interests but is my hypothetical loan situation really that terrible? Will I be miserable? I need some perspective...Thanks!

 

[Ruination]

Medicine isn't backbreaking work so would working into your late 60s and beyond really be so stressful? Also 75k a year would still leave you with a somewhat upper middle class lifestyle, wouldn't it? I realize that politicians and the government aren't really looking out for my best interests but is my hypothetical loan situation really that terrible? Will I be miserable? I need some perspective...Thanks!

You're right, its not back-breaking, its soul crushing. I owe <1/3rd of what you are projected to owe and I still think its too much for the kind of crap that physicians deal with. No amount of intellectual stimulation and do-gooder feelings was worth the loss of my 20s and the fact that I have a goose-egg in the retirement column. If you can see yourself happy in another profession, don't go into medicine.

 

[rollwithit]

Living on 75K a year for a decade after training is a very sobering revelation. You will likely be renting with little to no 401K savings. If 10 years into your career if you dont have 300-500K BANKED in a 401K, you are looking at working well into your late 60s or conversely committing yourself to dying young.

Realize that Obama doesnt let you deduct your student loan interest if your AGI is like over 90K (I think, someone confirm), which guaranteed it will be. Remember Obama hates all rich people, even those with crazy amounts of debt and lost opportunity cost to make up for.

If you were a unionized nurse, you might be better off. He always goes on and on about how nurses are paying more in taxes than Romney etc. (which is absurd, but he goes with it...have to appreciate the man's audacity!).

Think LONG AND HARD about this before making the decision. Medicine when you get out wont be the same it is today (and today's medicine isnt good dude...shudder at 5 years from now).

Modified adjusted gross income must be less than 75k (150k if married, filing jointly) to take any of the deduction. Modified is your adjusted gross income plus items such as student loan deductions, higher education deductions, IRA contribution deductions, foreign income and foreign housing deductions. Max deduction is $2,500 - which is essentially nothing if you are paying interest on loans of this size.

The $2,500 also gets phased out once you reach 60k MAGI (120k if married, filing jointly).

 

[deleted314957]

Here is you perspective my friend----GET OUT NOW or GET IN THE MILITARY. You will be SCREWED if you follow your envisioned path. You will work ALL YOUR LIFE, you will have a VERY middle class existence and you will be UNABLE to give your children the kind of things you might like to in the way of education. I have been a physician since 1977 and I am the voice of experience.

 

[LADoc00]

Here is you perspective my friend----GET OUT NOW or GET IN THE MILITARY. You will be SCREWED if you follow your envisioned path. You will work ALL YOUR LIFE, you will have a VERY middle class existence and you will be UNABLE to give your children the kind of things you might like to in the way of education. I have been a physician since 1977 and I am the voice of experience.

Wow, you are even scaring me...

darkskies your name appears to be apt.

 

[Darkskies]

You're right, its not back-breaking, its soul crushing. I owe <1/3rd of what you are projected to owe and I still think its too much for the kind of crap that physicians deal with. No amount of intellectual stimulation and do-gooder feelings was worth the loss of my 20s and the fact that I have a goose-egg in the retirement column. If you can see yourself happy in another profession, don't go into medicine.

Here is you perspective my friend----GET OUT NOW or GET IN THE MILITARY. You will be SCREWED if you follow your envisioned path. You will work ALL YOUR LIFE, you will have a VERY middle class existence and you will be UNABLE to give your children the kind of things you might like to in the way of education. I have been a physician since 1977 and I am the voice of experience.

Wow... I can't deny that these responses are unsettling me. For one, I do not see myself and will not be in any other profession. I do believe that I can find a specialty within medicine that is amenable and gratifying to me. I don't really have the most concrete idea about finances since I'm only 23 but instead of writing hysterical, frantic, unhelpful posts would someone instead outline how and why my life will be miserable in a rational post that does not exaggerate? A 75k salary would put me near the top 5% of an individual's income in the US. Being paid this amount for a decade beginning when I'm 33 years old would lead to misery,how? Would I really be very behind on my 401k,savings,home purchase,etc.? Not that I'm incredulous but I need well-meaning,rational advice from you people who are mature and knowledgeable about this topic.

 

[Crossed Path]

Wow... I can't deny that these responses are unsettling me. For one, I do not see myself and will not be in any other profession. I do believe that I can find a specialty within medicine that is amenable and gratifying to me. I don't really have the most concrete idea about finances since I'm only 23 but instead of writing hysterical, frantic, unhelpful posts would someone instead outline how and why my life will be miserable in a rational post that does not exaggerate? A 75k salary would put me near the top 5% of an individual's income in the US. Being paid this amount for a decade beginning when I'm 33 years old would lead to misery,how? Would I really be very behind on my 401k,savings,home purchase,etc.? Not that I'm incredulous but I need well-meaning,rational advice from you people who are mature and knowledgeable about this topic.

They should be unsettling. The future of medicine is grim, and the model of pathology as a specialty run by physician-owned groups is dying.

1) Newt will be eating Big Macs on the moon before you pay off debt like that.

2) You will never command a salary commensurate with your years of training, the importance of what you do, and the risks you take.

3) Thanks to the robber baron physicians who came before and the chorus of idealists you will hear in medical school and residency, you will never know the difference.

My advice: pick a solid trade/skill - plumbing is hard work, but safer than being an electrician.

 

[LADoc00]

Plumbing is an interesting profession. Not bad at all IMO.

 

[2121115]

A 75k salary would put me near the top 5% of an individual's income in the US. Being paid this amount for a decade beginning when I'm 33 years old would lead to misery,how? Would I really be very behind on my 401k,savings,home purchase,etc.? Not that I'm incredulous but I need well-meaning,rational advice from you people who are mature and knowledgeable about this topic.

75K is not what you think it is, particularly if you live in any large city. It is not upper middle class. For example, in my zip code (according to wikipedia) the median family income is well over 110K per year according to IRS data. That is the median, my friend. Oh, you want a decent home in a good public school district? $$$$$

I am not saying you will be miserable, but you will not be "upper middle class", as you put it. If that is OK with you, then go for it. But remember by the time you get out that 75K may be adjusted down to 50K or less.

 

[Darkskies]

75K is not what you think it is, particularly if you live in any large city. It is not upper middle class. For example, in my zip code (according to wikipedia) the median family income is well over 110K per year according to IRS data. That is the median, my friend. Oh, you want a decent home in a good public school district? $$$$$

I am not saying you will be miserable, but you will not be "upper middle class", as you put it. If that is OK with you, then go for it. But remember by the time you get out that 75K may be adjusted down to 50K or less.

Median family income means that there are 2 income earners in the household..This is why I specifically wrote 'individual income' and not household income..Only 5% of the US population earns more than 75k a year..

 

[deleted314957]

Wow... I can't deny that these responses are unsettling me. For one, I do not see myself and will not be in any other profession. I do believe that I can find a specialty within medicine that is amenable and gratifying to me. I don't really have the most concrete idea about finances since I'm only 23 but instead of writing hysterical, frantic, unhelpful posts would someone instead outline how and why my life will be miserable in a rational post that does not exaggerate? A 75k salary would put me near the top 5% of an individual's income in the US. Being paid this amount for a decade beginning when I'm 33 years old would lead to misery,how? Would I really be very behind on my 401k,savings,home purchase,etc.? Not that I'm incredulous but I need well-meaning,rational advice from you people who are mature and knowledgeable about this topic.

Son, I do not have the time, effort or energy to write you a book, which it seems you would like but you ARE a deer in the headlights of an 18-wheeler headed for you at about 75 mph and your only chance is NOW. There is NOTHING in this for me except to keep you from really screwing up. I had to do the same for my Son but he was a more captive audience. He is happy he listened to me. The things that happened to me, my experiences and opportunities are GONE. LA Doc will back this up and he also has no ax to grind or agenda otherwise.

 

[LADoc00]

Everyone needs to just think long and hard before they make these decisions.

 

[cjw0918]

Dark, please listen to mike and LA. They have been at this a while and know what they are talking about. The opportunities are just not the same as they were many years ago. I promise you will feel differently about the issue of compensation AFTER you have climbed through the trenches of medical school, residency, board certification, licensing, and all of the other headaches that accompany the modern making of a physician. Think carefully and best of luck to you.

 

[Rete]

When thinking about the pros and cons of medicine, can't help hearing Jason Bourne's voice in my head from Ultimatum..."look at what they make you give"

 

[2121115]

Median family income means that there are 2 income earners in the household..This is why I specifically wrote 'individual income' and not household income..Only 5% of the US population earns more than 75k a year..

Listen. My friend graduated from pharmacy school at 23. Minimal to no debt. Started out making 90K per year counting pills by 5's at Target and working four 10 hour shifts per week which consisted of reading magazines and planning what he is going to do on his day off. He has bounced around and has some experience now. He makes well over 100K per year now, almost as much as a primary care physician, and has a nice 401K and plenty of vacation time. And he did that during his entire 20's pulling major tail while I was in school incurring debt and long hours studying/working. There are very similar stories out there about dental school, if you catch my drift.

I am merely saying that you are looking at putting in way more time and effort for far less return on investment than many, many other people.

 

[Tissue issue]

From my previous discussions with residents and the posts here, I am becoming convinced there's a "generational" difference regarding attitudes about student loans. It seems there is much more widespread acceptance of slowly paying off very large loans over a very long period of time. I guess to each their own on that one. I can't help but think an eighteen year old who is considering a career in health care is better off pursuing the PA, nurse practitioner or CRNA route. My advice to younger pathologists starting their careers would be to live a spartan lifestyle until the loans are paid off- I know that doesn't sound great but it saves you a lot of money (paying down principal instead of accruing interest) and grants you more freedom (can work less hours or choose a lower paying job) in your later years.

 

[Darkskies]

Listen. My friend graduated from pharmacy school at 23. Minimal to no debt. Started out making 90K per year counting pills by 5's at Target and working four 10 hour shifts per week which consisted of reading magazines and planning what he is going to do on his day off. He has bounced around and has some experience now. He makes well over 100K per year now, almost as much as a primary care physician, and has a nice 401K and plenty of vacation time. And he did that during his entire 20's pulling major tail while I was in school incurring debt and long hours studying/working. There are very similar stories out there about dental school, if you catch my drift.

I am merely saying that you are looking at putting in way more time and effort for far less return on investment than many, many other people.

Pharmacists have an oversaturated job market nowadays and I could never see myself as a dentist as I don't think I'd like surgery/hands-on work. I've already decided that I'm going to medical school.. The issue now is how to incur the least amount of debt. If most fields really are 'soul-crushing' and not 'worth the investment/hard work' there are still others that are much more benign that aren't necessarily competitive like psychiatry, PM&R,etc.

How are people coming out with 150-160k in debt unless they go to their state school? Tuition alone at many private schools is over 50k and out of state tuition at state schools is the same.. As I mentioned before are schools overestimating their cost of attendance? How much do I really need to live on for the 4 years I'm in med school? I want to have the least debt possible..How much should I take out beyond the cost for tuition?

Also, I don't see how everyone can be so pessimistic. Doctors in other countries don't even make close to what physicians in the US do. In the UK most make a salary equivalent to a little over 100k. Of course, no one is burdened with loans since education is socialized in most other countries..

 

[pxjx]

I concur with this as well. Unfortunately, I found the grim reality of this situation a little too late. Anyway you cut it, medicine just does not make any economic sense. I really love medicine, but unfortunately you have to look at your medical education as an investment. The amount you are putting in ($$$ and time) is simply not worth the return. These are the facts. You can choose to accept it and cut your losses or you can try to make it work, but mark my words and mark them carefully WE ARE ALL GOING TO PAWNS grinding to make ends meet because the gov't will eat up 60% (or more) of your income while sticking you with a lot of debit. Currently most people pay ~3 months salary to gov't as taxes. The gov't is taking from the needy and giving it to the greedy. I wish I would have had someone like LA DOC or MIKE giving me advice like this before I decided to attend medical school.

http://www.youtube.com/watch?v=q_qgVn-Op7Q&feature=related
http://www.youtube.com/watch?v=qXBswFfh6AY

 

[Torsed]

When thinking about the pros and cons of medicine, can't help hearing Jason Bourne's voice in my head from Ultimatum..."look at what they make you give"

Funny, I hear Colonel Kurtz saying: "The HORROR....The HORROR....."

 

[Darkskies]

Funny, I hear Colonel Kurtz saying: "The HORROR....The HORROR....."

Really?? You're comparing a physician's situation to the experience and outlook of a sadistic colonizer in the Belgian Congo? Why is there so much doom and gloom on the pathology forums? Folks in the Psychiatry forum seemed much more content with their chosen path and gave me reasoned responses arguing for both sides(going DO or completing postbacc+MD). Wouldn't you still say there are many specialties(like psychiatry) that still offer a rewarding,meaningful career with flexible practice options that don't all but require you to be a slave to the hospital?