I am worried about $302,000 of debt

[Colbare]

I just graduated residency in anesthesia and have $460k in student loans. I was able to refinance to a ~4.1% interest rate with a 5 year note. I plan to stay in my apartment. Car is paid off and no kids. I'm starting at $250k and I'm going to pick up every call shift I can to bump my salary and knock the debt out in ~3 years. It's always a good motivator to put on some white coat investor podcasts when you have downtime and hear some success stories.

Once you've taken out these loans they are yours and there's no looking back. You can't think about it daily like that although it is tough especially as you go through residency with a salary that can't even touch the monthly interest you're accumulating. Your best protection will be to invest your time into your future career. Make it worth it by studying hard and getting all you can out of your rotations. Match into the best residency you can and keep as many doors open as possible for future job opportunities (do MD residency if at all possible).

Once you're in residency get involved early with your affiliated specialty of choice PAC. As you know the insurance/reimbursement landscape is a moving target and physicians are notoriously less present in this arena yet we should be front and center. At least for anesthesia income it could be cut by 1-2 thirds if we don't strongly advocate for ourselves.

But for now enjoy medical school and work hard because you're future self will thank you

---

Members don't see this ad.

 

[Angus Avagadro]

I just graduated residency in anesthesia and have $460k in student loans. I was able to refinance to a ~4.1% interest rate with a 5 year note. I plan to stay in my apartment. Car is paid off and no kids. I'm starting at $250k and I'm going to pick up every call shift I can to bump my salary and knock the debt out in ~3 years. It's always a good motivator to put on some white coat investor podcasts when you have downtime and hear some success stories.

Once you've taken out these loans they are yours and there's no looking back. You can't think about it daily like that although it is tough especially as you go through residency with a salary that can't even touch the monthly interest you're accumulating. Your best protection will be to invest your time into your future career. Make it worth it by studying hard and getting all you can out of your rotations. Match into the best residency you can and keep as many doors open as possible for future job opportunities (do MD residency if at all possible).

Once you're in residency get involved early with your affiliated specialty of choice PAC. As you know the insurance/reimbursement landscape is a moving target and physicians are notoriously less present in this arena yet we should be front and center. At least for anesthesia income it could be cut by 1-2 thirds if we don't strongly advocate for ourselves.

But for now enjoy medical school and work hard because you're future self will thank you

Very well said, from a recent grad. All SDNers take heed from the above. It can be done with some discipline and you save a ton in interest. 4% of 460 k us 18k a year in interest. If you are paying the min loan payment, and investing, you are borrowing money to invest. Not the best idea.

 

[MidwestPAC]

I'm not sure why the idea that primary care providers live like starving artists is so widely promulgated on here, but it's largely nonsense. FM/IM can pretty reasonably expect to earn mid-200k salaries and up, as long as you don't have unreasonable demands of hours/location/etc. If someone can't imagine paying off a few hundred grand while earning upwards of 20 grand a month (pre-tax, of course), they need to re-evaluate their finances. Medical school is expensive for many of us, but the job payoff often far exceeds that initial cost.

Here is just a mock budget that I came up with in 5 minutes. Not saying it's perfect or all-encompassing, but I'll use it to illustrate a point.

Salary: 240,000/year

Net monthly income in my random state: ~$14,000

Mortgage/taxes/insurance on a ~300k home: $1,500

House maintenance fund: $250 (1% of house value/year)

Utilities: $300

Car loan: $400

Insurance (health/car): $250

Groceries/dining out: $1,000 (generous, IMO)

Household items: $100

Cell/internet: $150

Clothing: $50


I'm sure I'm forgetting other common things, but that is the gist of it. That budget, which I think is probably overly generous as you do not need to spend a grand a month on food, buy a new car, or live in a 300k house right out of residency, would leave you with around $10,000 a month to allocate towards debt, retirement, and whatever else you choose. So, I have to respectfully disagree with others when they say primary care salaries are difficult to manage.

Unless you get a FHA/VA loan you need 20% down or pay PMI, so factor that into mortgage. Also, get rid of that awful car loan and you can put another ~$5,000 per year towards debt, if you have a car loan then you truly cannot afford that car. When you pay cash then you can afford it. Good post!

 

[MidwestPAC]

Lol, being a non traditional student with a family and career before med school, I guarantee you $1k food budget is extremely generous and absolutely unnecessary. It’s easy to live off 1/2 that for a family, maybe if you have two teen boys, it might be more difficult but I will digress.

Anyone living in the real world (taxes, health insurance, and rent/mortgage) with a family of four and a 60k income (before taxes, insurance, 401k, and rent/mortgage) is not spending $1k a month in food..

I agree $1,000/month for food is a lot, but I can tell you we spend more than that per month for a house of 4 (kiddos < 5 years) cause we shop 95% organic and local. Now for people that eat out you will spend > $1,000 per month.

 

[Postictal Raiden]

I just graduated residency in anesthesia and have $460k in student loans. I was able to refinance to a ~4.1% interest rate with a 5 year note. I plan to stay in my apartment. Car is paid off and no kids. I'm starting at $250k and I'm going to pick up every call shift I can to bump my salary and knock the debt out in ~3 years. It's always a good motivator to put on some white coat investor podcasts when you have downtime and hear some success stories.

Once you've taken out these loans they are yours and there's no looking back. You can't think about it daily like that although it is tough especially as you go through residency with a salary that can't even touch the monthly interest you're accumulating. Your best protection will be to invest your time into your future career. Make it worth it by studying hard and getting all you can out of your rotations. Match into the best residency you can and keep as many doors open as possible for future job opportunities (do MD residency if at all possible).

Once you're in residency get involved early with your affiliated specialty of choice PAC. As you know the insurance/reimbursement landscape is a moving target and physicians are notoriously less present in this arena yet we should be front and center. At least for anesthesia income it could be cut by 1-2 thirds if we don't strongly advocate for ourselves.

But for now enjoy medical school and work hard because you're future self will thank you

To each their own but I’d much rather live in a BFE temporarily and get paid 500k than living in SF and having to take q3 call and work every other weekend to generate the same income.

250k in gas is nothingburger, but again everyone has their own priorities

 

[Splenda88]

To each their own but I’d much rather live in a BFE temporarily and get paid 500k than living in SF and having to take q3 call and work every other weekend to generate the same income.

250k in gas is nothingburger, but again everyone has their own priorities

I did not think Anesthesia pays 250k anywhere except for academia...

 

[jw3600]

That is the lowest full time anesthesia salary I’ve ever seen reported.

 

[Splenda88]

That is the lowest full time anesthesia salary I’ve ever seen reported.

Come to think of it, the VA might pay that much. I know of one internist making <180k at the VA

 

[jw3600]

Come to think of it, the VA might pay that much. I know of one internist making <180k at the VA

Possibly. But anyone working for the VA usually has no medical school debt.

 

[AnatomyGrey12]

Possibly. But anyone working for the VA usually has no medical school debt.

Not to mention, from my understanding, is that the benefits are pretty good. So lower salary but generally lower debt load and good benefits.

But yes, I’ve never seen an anesthesiologist make so little except in academia. All of ours make around 500k.

 

[jw3600]

Not to mention, from my understanding, is that the benefits are pretty good. So lower salary but generally lower debt load and good benefits.

But yes, I’ve never seen an anesthesiologist make so little except in academia. All of ours make around 500k.

I was thinking more 350-400 but still a large discrepancy.

 

[Postictal Raiden]

Salaries at the VA are 25-50% lower than their counterparts in PP. However the VA has awesome perks. Most physicians I know work 40 hr a week and very little nights/weekend coverage. The patient load is much more manageable too. For example, neurologists see 6-8 patients total in a clinic day! On top of all that, you get 25k/year for loan repayment that is free of taxes, and they are going to increase it to 40k from what I’ve heard.

 

[Saleemrodman1]

Want to eliminate your medical school debt? Maybe moving to California should be in your future...

California doesn't have enough doctors. To recruit them, the state is paying off medical school debt

California will spend $340 million paying off doctors’ debts. In exchange, doctors must pledge that at least 30% of their caseloads will be devoted to Medi-Cal patients for five years.

www.latimes.com

I am FROM California, so that's the goal

 

[Alkain]

I was thinking more 350-400 but still a large discrepancy.

I mean, you can just go to gaswork and see what people are offering for Anesthesiology positions right now. Quick search shows listed salaries with a low end at $250-300k and high end at $600-800k with the bulk around $350-500k.

 

[jw3600]

I mean, you can just go to gaswork and see what people are offering for Anesthesiology positions right now. Quick search shows listed salaries with a low end at $250-300k and high end at $600-800k with the bulk around $350-500k.

Thanks?

 

[prodrome]

only 300k?

 

[Colbare]

Raw salary number is meaningless without knowing all the other job factors (call schedule, case mix, supervising ratio, practice environment, benefits, optional call for cash, people you work with). Those things can make any number more or less appealing. Building wealth is easier with a bigger shovel but your expenditures and investment strategy is more important

 

[Splenda88]

Salaries at the VA are 25-50% lower than their counterparts in PP. However the VA has awesome perks. Most physicians I know work 40 hr a week and very little nights/weekend coverage. The patient load is much more manageable too. For example, neurologists see 6-8 patients total in a clinic day! On top of all that, you get 25k/year for loan repayment that is free of taxes, and they are going to increase it to 40k from what I’ve heard.

If they increase it to 40k free of taxes, I might consider getting a job at the VA... Even if they pay 180k/yr, that 40k free of taxes is like another 60k added to the salary, which is essentially a fair market value for IM... Adding other perks on top of that will make the VA very attractive.