Medicine worth $300k of debt?

[AttyHubby]

lol, most of the things you listed as reasons to hire a lawyer directly relate to another lawyer causing trouble.

So anytime a lawsuit is filed, it's just a "lawyer causing trouble"? Oh, I see. Something tells me you won't quite stick to your guns if, god forbid, you were ever harmed by someone and your only recourse was the legal system. Don't you think it's possible (let me answer for you, it is, and this is shown in hundreds of years of academic literature) that the vast majority of lawsuits that are filed have at least some validity to them, and therefore it was the defendant who is actually the one "causing trouble"?

It would be like having 80% of all physician visits being related to second opinions or correcting problems that other physicians cause. The ideal medical malpractice solution would be to have lawyers involved as little as possible - because lawyers tend to make the case about everything other than the actual pertinent facts (by doing things like having witnesses cry on the stand, having children testify about how much they miss their mother, etc). These are all sad things and important social phenomena, but they have nothing to do with whether Dr X killed the patient by not taking her gallbladder out in time.

That testimony would be for damages, not for liability. I think most people are smart enough to know that a kid missing their mommy isn't proof of malpractice. However, a kid whose mother was taken from them is certainly 'injured' by that, wouldn't you say? And if the defendant is liable, shouldn't the kid be compensated for that injury?[/QUOTE]

The main reason to hire a lawyer these days is to make sure another lawyer doesn't screw you. That's a sad statement about the legal profession.

How about when you want to start a business? All those legal documents have to be prepared by someone. When you get a new employment contract? Only a fool wouldn't have it read by an attorney before they signed it. What about planning your estate to ensure that your money and assets go where you want them to, with as small a fraction as possible going to taxes? What about when your medical practice and another want to merge?

It's not about screwing each other, it's about professional responsibility. A lawyer has the responsibility to represent their client to the fullest extent possible by law. A society can't function without laws, laws can't function without an adversarial legal system, and an adversarial legal system can't function unless both sides have someone trained in the legal system to advocate on their behalf.

And way to go, take a statement and imply that he/she meant that all lawyers suck and there is never any need for one.

Are we reading the same post? Clearly that is what they meant.

Just because 20% of what lawyers do isn't redundant or unnecessary or overly expensive doesn't mean the other 80% doesn't matter. By your logic, all physicians would suck because there are some who do procedures only for profit or who are untruthful to their patients. Good for you that you do some probono work (although "no money up front" doesn't really count). Unlike lawyers, doctors can get sued for refusing to do probono work.

Are you seriously implying that 80% of lawyers spend their time filing frivolous lawsuits? If so, you have no idea how the legal system functions, or the distribution of lawyers in it. A vast number of lawyers (more than 20%), myself included, have never and will never set foot in a court room.

I wasn't talking about probono work, I was talking about contingency work. Like it or not, contingency work allows cases that otherwise would NEVER be brought to happen and people that would have never been compensated for wrongs done to them be compensated. Lawyers can't get sued for refusing probono work, but they can certainly be sued for malpractice after they take it on. This is just like physicians, who (unless they work in a hospital ER, I believe) are allowed to turn away patients whenever they want for inability to pay. It's once you do the good deed that you open yourself to liability, and that's true for doctors and lawyers both.

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[yaah]

Let us not turn this into a legal thread please. Stay on topic, as best as can be hoped for in a three page thread.

 

[calvinNhobbes]

All we have to do as human beings is become completely honest, trustworthy, and reasonable people and all the lawyers will go away.

Ya... I don't see that ever happening either.

 

[Lonestar]

i love how people make comparisions of physicians to lawyers, teachers, other professionals, etc. But they all forget one thing.

Physicians take call!!! The most hated word in the physician community. so if the financial incentives are not there (i.e. 300K in debt), then the answer becomes a resounding "NO".

No one in their right mind would work for middle class pay all the way into their 40s with tons of debt, years of sleepless nights, millions of exams, contracting diseases from pts, etc.

Its not worth it folks. Even if you like it a lot, its still not worth it. Might as well work of habitat for humanity and a job to pay the bills. Atleast that way, you are not up all night.

 

[LeftyUM]

So ive read the thread, and i understand what everyone is saying about gaining massive debt throughout medical training. I believe the best way to truly see the outcome...is to talk to other doctors past residency about how theyve managed their debt. Residents could of course be biased. They aren't making too much money, the debt monkey is on their back, and theyre probably working **** hours...so of course they will be stressed about SOMETHING. So...I advise talking to some docs well past residencies and seeing the reality of how manageable this debt level is.

 

[medicinesux]

So ive read the thread, and i understand what everyone is saying about gaining massive debt throughout medical training. I believe the best way to truly see the outcome...is to talk to other doctors past residency about how theyve managed their debt. Residents could of course be biased. They aren't making too much money, the debt monkey is on their back, and theyre probably working **** hours...so of course they will be stressed about SOMETHING. So...I advise talking to some docs well past residencies and seeing the reality of how manageable this debt level is.

I advice others out there NOT to follow this TERRIBLE advice. Established attendings have no clue how to deal with 300-400K debt loads that you guys will be facing. We are entering unchartered territory here.

 

[yaah]

So ive read the thread, and i understand what everyone is saying about gaining massive debt throughout medical training. I believe the best way to truly see the outcome...is to talk to other doctors past residency about how theyve managed their debt. Residents could of course be biased. They aren't making too much money, the debt monkey is on their back, and theyre probably working **** hours...so of course they will be stressed about SOMETHING. So...I advise talking to some docs well past residencies and seeing the reality of how manageable this debt level is.

Your point is valid, but bear in mind that in terms of talking to doctors, the further out they are from med school graduation, the smaller their tuition likely was.

 

[Coastie]

I advice others out there NOT to follow this TERRIBLE advice. Established attendings have no clue how to deal with 300-400K debt loads that you guys will be facing. We are entering unchartered territory here.

I gotta say, sux, 300k debt (post residency) is liveable, as long as you are willing to live like a resident (and work like one).

Making 180k, you can still pay the 3800 a month payment for 300k debt, you just have to be willing to live like a "normal" person for a few years. Yeah, sucks, but doable. Not a great place to be, though.

 

[dynx]

When I take the average of my specialty from here, and plug it and my stats into here, it comes out with a tax rate of about 28%, making my take home pay roughly $3000/wk or $150K/yr. Add in state and local taxes, and it may be a little less. Add some more deductibles, maybe a little more. Throw a couple hundred bucks to an accountant, and you might do better.

Now, if you can't live off of $3000/wk and pay off your loans, you deserve a kick in the pants. What's so hard about $1000/wk for loans, $1000/wk for bills, and $1000/wk for everything else? Then, once you get your loans paid off, you can take your loan money and invest it. I mean geeze, I've been living off of $500/wk total for the last 8 years. This is SIX TIMES that much.

Another way to look at it is how much net worth you will have vs your friends / colleagues at age 40, 50, and beyond. The difference is astounding.

Hmmmm..well lets see, suppose I'm out and practicing at 36 years of age.

So your 150k/year or 3000 per week comes to 12000 a month.
My loan payments (if I hadn't paid them off allready) were 1300 per month for 150k. So at 300k and a little simplification lets put that at 2600 a month.
Now you have 9400 a month.
You want a house? I do. and i live in california. You'll need a mortgage, property tax and insurance. I have a great rate and lots of equity. You can trust me on this, if you want a decent house in the bay-area, you're looking at at least 3500 a month. By decent I mean you're not embarrased to live there and you probably can't walk next door and buy crack...not "nice".
5900.

Got kids? want them to have clothes? 300 a month (I don't have kids so somebody help me out if Im wrong)
Cable/internet - 100
electricity? yes please - 100
health insurance for my family - 350
Life insurance - 100
Food - 500
car payments - 300 (thats a nice civic you have thier doctor!)
...what does your wife drive? another cheap ass car...300.
Are those cars insured? 200

3950

Lets see...what am i forgetting? OH yeah! I don't want to work till the day I die...retirement! Thats where we really get screwed but you seem to have that all figured out looking at my net worth far in the future...lets see:
If i save 15% of my income it'll be 1875 a month, conservative 5% return (i dont want to gamble on my retirement. I'll have just enough to withdrawal 80k a year and die with nothing left but my house when I'm 86. God forbid something happens and the end of my life is really expensive but hell my kids can pick up the tab.

2075 a month left over!

Yay...nicer house? nicer car? Nice TV, vacation once or twice a year with the family. Dog/cat. Roof leaks. A little relief from not living paycheck to paycheck? Yep, you're sitting pretty.

 

[XRanger]

Hmmmm..well lets see, suppose I'm out and practicing at 36 years of age.

So your 150k/year or 3000 per week comes to 12000 a month.
My loan payments (if I hadn't paid them off allready) were 1300 per month for 150k. So at 300k and a little simplification lets put that at 2600 a month.
Now you have 9400 a month.
You want a house? I do. and i live in california. You'll need a mortgage, property tax and insurance. I have a great rate and lots of equity. You can trust me on this, if you want a decent house in the bay-area, you're looking at at least 3500 a month. By decent I mean you're not embarrased to live there and you probably can't walk next door and buy crack...not "nice".
5900.

Got kids? want them to have clothes? 300 a month (I don't have kids so somebody help me out if Im wrong)
Cable/internet - 100
electricity? yes please - 100
health insurance for my family - 350
Life insurance - 100
Food - 500
car payments - 300 (thats a nice civic you have thier doctor!)
...what does your wife drive? another cheap ass car...300.
Are those cars insured? 200

3950

Lets see...what am i forgetting? OH yeah! I don't want to work till the day I die...retirement! Thats where we really get screwed but you seem to have that all figured out looking at my net worth far in the future...lets see:
If i save 15% of my income it'll be 1875 a month, conservative 5% return (i dont want to gamble on my retirement. I'll have just enough to withdrawal 80k a year and die with nothing left but my house when I'm 86. God forbid something happens and the end of my life is really expensive but hell my kids can pick up the tab.

2075 a month left over!

Yay...nicer house? nicer car? Nice TV, vacation once or twice a year with the family. Dog/cat. Roof leaks. A little relief from not living paycheck to paycheck? Yep, you're sitting pretty.

let's say you have a wife and she also works (well..at least I'm planning to marry someone who has a job). Let's say even if she makes $50,000/year, that turns out to be around $3000/month. And since you already paid for everything (mortgage, insurance, food, utilities, kids clothing), she can save all of it. So you guys end up with extra $5000/month. that seems doable

I mean for engineer who makes..lets say $120,000/year, which is about $7000/month.
going by your calculation:
no debt so 7000-0=7000
house in bay area: -3500 = $3500
utilities, clothing, food, insurance: -2250 = $1250
retirement...%15 of income = -1050 = $200!!

how does anyone who makes <$100,000 gonna live?

300k is a lot of money but I think it's still doable and you'll still be able to live pretty comfortably, not luxuriousy, but has a decent house, car, and not worry about not being able to put food on table.

 

[dynx]

let's say you have a wife and she also works (well..at least I'm planning to marry someone who has a job). Let's say even if she makes $50,000/year, that turns out to be around $3000/month. And since you already paid for everything (mortgage, insurance, food, utilities, kids clothing), she can save all of it. So you guys end up with extra $5000/month. that seems doable

I mean for engineer who makes..lets say $120,000/year, which is about $7000/month.
going by your calculation:
no debt so 7000-0=7000
house in bay area: -3500 = $3500
utilities, clothing, food, insurance: -2250 = $1250
retirement...%15 of income = -1050 = $200!!

how does anyone who makes <$100,000 gonna live?

300k is a lot of money but I think it's still doable and you'll still be able to live pretty comfortably, not luxuriousy, but has a decent house, car, and not worry about not being able to put food on table.

never said you couldnt have a decent life and put food on the table. Just saying...is it WORTH it. No. You work twice as hard to have the same life as someone that works half as much and started saving for retirement and paying a house a decade before you. Sure, if adults in your household work a total of 120 hours a week you can have the nice life of a household that works 80 hours a week total...good point.

 

[Scylin]

PCPs are in a worse positions, because their salary is more like $150,000 pre-tax.

For a salary of $150k/year, you're looking at being in the 30% federal tax bracket. That doesn't count state taxes, and that's assuming that you don't have any tax shelters (although hopefully your retirement contributions will be from pre-tax dollars).

 

[dragonfly99]

Not everyone is done w/training at 36. I know it seems hard for some of you premeds to believe, but sometimes people get sidetracked, like by wanting or needing to do an extra research year(s), or doing a longer residency or fellowship. If you started later, even by 3-4 years, that just magnifies everything. Just something to consider.

Part of the question(s) you have to answer for yourself is what lifestyle are you willing to accept if you are working >> the number of hours that most other people work. For many medical specialties, that will be not just when you are a trainee but also when you are in practice. How many general surgeons, cardiologists, etc. work 40-50 hours a week? They don't. Not any one that I have met. And don't discount the mental stress that comes w/being under water by 300k. I'm under water by 120k and it's not all that fun, I can tell you. It doesn't freak me out, but then again I have 2.9% interest...300k at 6% would not please me, I can tell you.

I love medicine and I'm not sure what my personal limit would be for the debt I'd have been willing to go in to. I think it would be somewhere in the 200k range, but if I'd been actually faced with that decision perhaps my answer would have been different. I think at the 300k level of debt you are looking at needing to do the military, NHSC or some other loan repayment thing unless you go into something like radiology or ortho or anesthesia or interventional cards.

 

[slippy22]

PCPs are in a worse positions, because their salary is more like $150,000 pre-tax.

For a salary of $150k/year, you're looking at being in the 30% federal tax bracket. That doesn't count state taxes, and that's assuming that you don't have any tax shelters (although hopefully your retirement contributions will be from pre-tax dollars).

Worth it financially? It depends on what the alternatives are, how much additional schooling they require if any, and how much you'd make. It also depends on where you want to live and what kind of doctor you want to be. Physicians often make more in lower cost of living places. The same is less often true of other jobs. It's not impossible by any means that the OP could come ahead financially doing medicine and if he does a high paying specialty, he could come out ahead a lot. It's also possible he would come out significantly behind alternatives. It's only meaningful to say "worth it" in comparison to concrete alternatives he's considering.

Also some of his debt is from undergrad apparently and he's going to have that no matter what he does.

 

[MOHS_01]

I'm in the camp of "it's f'ing nuts to borrow $300k for a career in medicine in today's climate if you have any choice in the matter at all -- including the choice of a different career".

Nuts.

 

[bigpharmD]

I'm in the camp of "it's f'ing nuts to borrow $300k for a career in medicine in today's climate if you have any choice in the matter at all -- including the choice of a different career".

Nuts.

really, why?

 

[Haybrant]

no f'ing way is it worth that. no f'ing way.

 

[MOHS_01]

really, why?

Opportunity costs associated with minimum of 7 years, 10 or more for many, 300k, uncertain (but fairly stormy) outlook for physician compensation in the out years, the rise and expected proliferation of corporate medicine -- along with its concomitant loss of autonomy, etc

The math does not work is the simplest -- and best -- answer.

 

[highyield]

Several of my buddies from college went and did investment banking. Following college, since the age of 22 they have been working like me, about 70 - 80 hours/week. The one exception they have been getting PAID! I was just talking with one of them, he is now 28 years old. He is currently making about $300,000 year and was doing much better before the economy went south. I've got a five year residency ahead of me and won't even sniff the money he brings in. When I'm done at the age of 33 I'll be lucky to make $300,000. Conservatively, he'll be making $450,000 with no income ceiling. Do the math on that.

My buddy told me is financially set for the rest of his life. He's a reasonable guy that likes to save his cash. Drives a modest car, lives in a modest home, and has $0 debt. Yeah, the economic meltdown caused quite a bit of fear in his life, but he made it through so did the rest of my friends. The banks are already handing out BILLIONS in bonuses! Banks run this country! (For those who don't know, when you hear of corporate bonuses, that is going to guys like my buddy. They get a base sallary, then quarterly bonuses.)

Once I graduate I'll probably have $280,000 worth of debt from undergrad and medical school. I am glad I went to medical school, so far it's been worth it, even though I see what I could be doing when I look at my friends. I'll be FURIOUS if there is a significant decline in physician reimbursement and I have to live like a resident for the rest of my life. I'm telling you if there is a government take over of health care, there better be a government take over of health professional's debt.

If you are teetering between I-banking and medicine make sure you think it through. The careers come with comparable stresses and incomparable sallaries. I guess it comes down to what fulfills you.

 

[J ROD]

yes for me it is!! to the OP...

 

[bigpharmD]

yes for me it is!! to the OP...

U r nuts

 

[J ROD]

U r nuts

perhaps!! Crazy as a crazy does!! That's what ma'ma says....

 

[GoodmanBrown]

The question that comes to my mind when reading this is, did you expect to be the richest person you know when you applied to med school?

Or perhaps less jackass-y sounding, what were your salary expectations going into medicine?

Several of my buddies from college went and did investment banking. Following college, since the age of 22 they have been working like me, about 70 - 80 hours/week. The one exception they have been getting PAID! I was just talking with one of them, he is now 28 years old. He is currently making about $300,000 year and was doing much better before the economy went south. I've got a five year residency ahead of me and won't even sniff the money he brings in. When I'm done at the age of 33 I'll be lucky to make $300,000. Conservatively, he'll be making $450,000 with no income ceiling. Do the math on that.

My buddy told me is financially set for the rest of his life. He's a reasonable guy that likes to save his cash. Drives a modest car, lives in a modest home, and has $0 debt. Yeah, the economic meltdown caused quite a bit of fear in his life, but he made it through so did the rest of my friends. The banks are already handing out BILLIONS in bonuses! Banks run this country! (For those who don't know, when you hear of corporate bonuses, that is going to guys like my buddy. They get a base sallary, then quarterly bonuses.)

Once I graduate I'll probably have $280,000 worth of debt from undergrad and medical school. I am glad I went to medical school, so far it's been worth it, even though I see what I could be doing when I look at my friends. I'll be FURIOUS if there is a significant decline in physician reimbursement and I have to live like a resident for the rest of my life. I'm telling you if there is a government take over of health care, there better be a government take over of health professional's debt.

If you are teetering between I-banking and medicine make sure you think it through. The careers come with comparable stresses and incomparable sallaries. I guess it comes down to what fulfills you.

 

[RegularNihilist]

Value is something statistical, and something personal.

But NO. It ain't worth it. Unless you really, really like it, and hate everything else.

I am a grass is greener on the other side type of person. I just don't know which side atm.

 

[mercaptovizadeh]

Several of my buddies from college went and did investment banking. Following college, since the age of 22 they have been working like me, about 70 - 80 hours/week. The one exception they have been getting PAID! I was just talking with one of them, he is now 28 years old. He is currently making about $300,000 year and was doing much better before the economy went south. I've got a five year residency ahead of me and won't even sniff the money he brings in. When I'm done at the age of 33 I'll be lucky to make $300,000. Conservatively, he'll be making $450,000 with no income ceiling. Do the math on that.

My buddy told me is financially set for the rest of his life. He's a reasonable guy that likes to save his cash. Drives a modest car, lives in a modest home, and has $0 debt. Yeah, the economic meltdown caused quite a bit of fear in his life, but he made it through so did the rest of my friends. The banks are already handing out BILLIONS in bonuses! Banks run this country! (For those who don't know, when you hear of corporate bonuses, that is going to guys like my buddy. They get a base sallary, then quarterly bonuses.)

Once I graduate I'll probably have $280,000 worth of debt from undergrad and medical school. I am glad I went to medical school, so far it's been worth it, even though I see what I could be doing when I look at my friends. I'll be FURIOUS if there is a significant decline in physician reimbursement and I have to live like a resident for the rest of my life. I'm telling you if there is a government take over of health care, there better be a government take over of health professional's debt.

If you are teetering between I-banking and medicine make sure you think it through. The careers come with comparable stresses and incomparable sallaries. I guess it comes down to what fulfills you.

While I sympathize:

1.) A lot of people are earning a lot less than you will and do struggle and have difficult lives and are always worried about finances. And they're not idiots or lazy. It's not all about you.

2.) The I-banking thing so incredibly dishonest. Getting bonuses for what? For f*cking up the US economy so they needed a taxpayer bailout and now they're getting congratulatory cash? And what do they do, anyway? Seems to me it's an elitist racket they run on WallStreet. You can console yourself on the fact that:

a.) Your money will be earned a lot more honestly than theirs. You will treat patients and be remunerated for your work. The I-bankers are stealing taxpayer money after their failure to make the economy run smoothly by taking huge risks.

b.) If (or rather when) the **** hits the fan and the public finds wealthy targets to attack, the dishonest I-bankers and the entire financial "industry" will be the first target. Doctors are much more important for the basic functioning of a society than I-bankers.

 

[dragonfly99]

There's another article in Time magazine this week about how doctors are overpaid and order too many tests, and that there is plan to pay docs a fixed amount per problem (or per patient, for managing chronic diseases like diabeted). I think people forgot that we tried that with HMO's and capitation and patients HATED it. I do sympathize with policy makers who see medical costs continue to expand and are trying to figure out what to do, but I'm not sure cutting doctor's salaries in the face of ever-increasing student loan burdens is a workable plan.

 

[Substance]

Medical school is only worth $300k in debt if you consider the following:

1. You're extremely intelligent and confident and are certain that you will graduate near or at the top

2. You can navigate around people with personality issues easily

3. You are going to go for a lucrative field from day one of medical school

4. You're a consistent over-achiever

If you say yes to all four, then you have a chance of making 300k of debt worth it in the end. Otherwise, I'd find something else. Do banking or something.

 

[dynx]

I do sympathize with policy makers who see medical costs continue to expand and are trying to figure out what to do.

You should sympathize with them...they have a very hard time avoiding tort reform and meaninful revamping of medicare all while trying to make doctors look like villans. Its a hard job and they only get paid for the rest of thier lives.

 

[Lonestar]

Anybody here thinks physicians salaries will go up, please raise their hand.

If you don't think salaries are going up, then don't go into medicine.

See, its that simple.

 

[highyield]

While I sympathize:

1.) A lot of people are earning a lot less than you will and do struggle and have difficult lives and are always worried about finances. And they're not idiots or lazy. It's not all about you.

2.) The I-banking thing so incredibly dishonest. Getting bonuses for what? For f*cking up the US economy so they needed a taxpayer bailout and now they're getting congratulatory cash? And what do they do, anyway? Seems to me it's an elitist racket they run on WallStreet. You can console yourself on the fact that:

I guess I don't quite understand your first point. How did I say that people who worry about money and finances are idiots or lazy? Or that this post is all about me? Maybe I am missing something.

I do agree that the banking industry in this country is disgusting, they were the key players in taking the economy down. They took billions of dollars in bailout money and have been the first to turn profits in the new economy. Meanwhile the average joe didn't get a raise this year or worse yet lost their job. Joe six pack is still unemployed while the banks are bonusing themselves with profits spawned by our tax dollars. The financial structure and reliance on banks in this country is repugnant. There is really nothing we can do about it, our own ******* government won't stand up to the banks.

As I stated in my post. I am glad I went to medical school, I'll be able to sleep at night.

The question that comes to my mind when reading this is, did you expect to be the richest person you know when you applied to med school?

Or perhaps less jackass-y sounding, what were your salary expectations going into medicine?

Again, I guess I don't understand where you would get this. I have no desire to be the richest person I know. I wrote this post from an economical perspective in regard to the question "is this worth 300k in debt". If you look at it from a return on time invested perspective then no it doesn't make sense. The lifestyle is similar but the financial aspects aren't even comparable, especially if you're in primary care working with the underserved. The kind of people that only care about making money should go into I-banking, I don't want them in medicine with me.

I don't really want many possessions in life. I just came to medicine knowing it would be a great career with awesome job security. I don't care much about the salary, I just don't want to have medical school loans hanging over my head when I'm 80 years old.

 

[dragonfly99]

You won't have med school loans hanging over your head until you are 80...perhaps until you are 50, though.

 

[notinkansas]

NOT WORTH IT AT ALL

Why?

Once you are awarded the almighty MD degree, you will be "rich". Regardless of what your balance sheet says. After all, you're a doctor, so you are rich!

You will have less and less control of your income. Doctors don't get to decide how much to charge for their services. The government (via medicare) and insurance companies (often tied to a percentage of medicare) tells you how much they will pay for your services. And only if you meet certain criteria. Pretty much guarenteed to go down, regardless of what happens with "health care reform"

We are increasingly being told how to take care of patients, and it is becoming more and more a matter of merely following an algorithm. You don't follow the algorithm, not only are you not paid, but you are put on a bad doctor list by some consumer advocate agency

People feel they are entitled to your services. For free. Without assuming any personal responsibility.

Medicine is a nasty, nasty field. Anybody with seniority over you can make your life miserable if they don't like you. Ditto for nurses. All a nurse had to do is say to the nurse manager "I don't feel comfortable with Dr X" there doesn't have to be a bad patient outcome. They can simply say you don't answer pages fast enough, or you make them feel stupid.

Because you are rich, you will have a huge target painted on your chest for the get rich quick crowd. You are at high risk for lawsuit. You will have to pay for malpractice insurance, premiums often more than some people make in a year.

Because you are rich, Uncle Sam will come after you for more and more taxes.

Nobody will give a rat's ***** if sleep, eat or pee. You are expected to be at somebody's beck and call at all times when on call (and in some specialities, even when not on call)

Its a lot like running a restaurant. Your patients will complain to you for the most minor perceived infraction, like your receptionist didn't smile, or they didn't think they were brought back quickly enough....

And, in case you haven't checked some of the other threads, the student loan people morph from friendly people who hand out money like water to vicious badgers when it's time to pay up. Interest racks up during almost all deferrals. You can't discharge student loan debt for any reason. If you have hard times, you're hosed.

These are just a few of the reasons why I regret paying as much as I did for my medical education.

 

[michaelrack]

IThere is really nothing we can do about it, our own ******* government won't stand up to the banks.

.

Our government is the banks. The banks control the 4th branch of government, the Federal Reserve. The banks (primarily Goldman Sachs) also control the Treasury Department.

 

[medicinesux]

Its a lot like running a restaurant. Your patients will complain to you for the most minor perceived infraction, like your receptionist didn't smile, or they didn't think they were brought back quickly enough...QUOTE]

I think you are being way too generous here notinkansas. I'd rather equate it to customers ordering off the one dollar menu at McDonald's. Did you know that margins are so razor slim that each hamburger sold is only a few pennies in profit? At both Mcdonald's and the Primary Care Office you surely have to "move the meat" to pay overhead and make any profit.

 

[causalinference]

I can't speak with any authority here, but I definitely would not pay $300,000 to become a physician. You might be able to dig yourself out of that hole depending on the circumstances, but it would be extremely risky. I anticipate having around $200,000 when I graduate, and I won't be entering primary care.

 

[babel]

I can't speak with any authority here, but I definitely would not pay $300,000 to become a physician. You might be able to dig yourself out of that hole depending on the circumstances, but it would be extremely risky. I anticipate having around $200,000 when I graduate, and I won't be entering primary care.

Pardon me if this doesn't apply to you, but I just heard a bit of myself in your statement...... I thought I was going to graduate with ~$200-$220k, too, and it's going to be more like $270k, getting uncomfortably close to that $300k mark. Make sure you account for tuition hikes, increased COL 2nd and 3rd year (at least at my school, they just quoted the first year expenses, which are only for 9mo, while 2nd and 3rd year are 12mo long), cost of Steps 1&2, cost of interviewing 4th year, and of course, interest.

 

[medicinesux]

This thread should really be titled, "Is Medicine Worth 750K?". This is how much you will really wind up paying with a loan balance of 300K at graduation payed off over 30 years at a 7.5% interest rate. Run the numbers at finaid.org and see for yourself.

 

[link2swim06]

More reasons to marry another doctor and live in a low cost area.

 

[FIREitUP]

this is the most depressing thread i've ever read.

 

[ILikeDrugs]

this is the most depressing thread i've ever read.

Seriously though, do you think radiologists and neurologists (my top two specialties that I'm looking into) would be making these same comments? Does all of this only apply to PCPs?

 

[smq123]

Seriously though, do you think radiologists and neurologists (my top two specialties that I'm looking into) would be making these same comments? Does all of this only apply to PCPs?

In case you haven't noticed, most of the people on this thread saying that it "wouldn't be worth $300K" AREN'T in primary care.

Even if you make $350K a year as a starting radiologist, for instance, do you really want $300K+ hanging over your head? A lot of people go into those fields to make money that they want to keep and spend for their own needs and pleasures, not dole it out to Sallie Mae.

Plus, with interest, that $300K is going to explode to a much, much, much higher number.

This is not even mentioning how competitive some of the higher paying specialties are (i.e. radiology) and that there is a very good chance that you won't be a good candidate for that field.

 

[medicinesux]

More reasons to marry another doctor and live in a low cost area.

Yeah, owing 1.5 million and living in Fargo sounds swell

 

[ILikeDrugs]

This is not even mentioning how competitive some of the higher paying specialties are (i.e. radiology) and that there is a very good chance that you won't be a good candidate for that field.

Oh really? Wow, you know me so well. I really like you're ability to predict the future. Perhaps you could tell me what lottery numbers to play this week?

 

[smq123]

Oh really? Wow, you know me so well. I really like you're ability to predict the future. Perhaps you could tell me what lottery numbers to play this week?

My point was just that, in some cases, which specialty you get to practice isn't quite up to you. I've had classmates who were AOA, top notch board scores, and still not match in radiology, or ortho, or derm, or ophtho, or urology. And it gets progressively harder to match into those fields the farther you are from med school. There's no need to be sarcastic - this is just the scary truth. It'll be harder for you if/when you get to that point, in addition, because the number of US med students is increasing, but at a faster rate than the number of residency spots is increasing.

 

[Neuronix]

Oh really? Wow, you know me so well. I really like you're ability to predict the future. Perhaps you could tell me what lottery numbers to play this week?

You'd also have to be seeing into the future to assume that the currently high paying specialties will still actually continue to pay well in the future. With Obamacare we may all be averaging $150k/year incomes in the near future. It may sound like a lot, but $300k in debt plus interest takes a lot out of your $100k/year post-tax income.

 

[mercaptovizadeh]

You'd also have to be seeing into the future to assume that the currently high paying specialties will still actually continue to pay well in the future. With Obamacare we may all be averaging $150k/year incomes in the near future. It may sound like a lot, but $300k in debt plus interest takes a lot out of your $100k/year post-tax income.

True. We have no way of projecting what reimbursement will look like in 10 years, or even what the most competitive specialties will be. In the 1970s-80s, IM was king and derm was dregs; now it's the reverse.

You have to go into this with the possibility that the current lowest paying specialty - for instance FM - might be the specialty you enjoy the most and in fact the only one you'll match into.

Everyone goes into med school thinking they'll excel because they were smart and excelled in college. It doesn't work that way. Do not expect a derm residency because you're smart, and do not expect that derm will always be paying great, even if you manage to match in it.

 

[dragonfly99]

Everyone goes into med school thinking they'll excel because they were smart and excelled in college. It doesn't work that way. Do not expect a derm residency because you're smart, and do not expect that derm will always be paying great, even if you manage to match in it.

quoted for truth.

I think that radiologist will almost certainly see their incomes stagnate in the next few years. This is because they are relatively overpaid, relative to other physicians, for the number of hours they work, etc. The insurance companies and gov't are getting wise to this. Neurologists don't really get paid that much, and many med students see it as a depressing field so I don't see it becoming super hard to get into in the near future. I don't see IM and FM becoming more popular again soon, simply because I don't see the paperwork burdens and generally difficult social work type issues getting much better in the near future for them...although if the gov't pours more money into primary care they may attract a few more students to those fields.

 

[v-lander]

A very sobering thread, but I think that's a good thing.

I, for many reasons, have recently been teetering on doing something that's probably even more crazy than what the OP has asked about. Here's a bit about me:

-31 years old
-Two young children, probably about to get divorced (don't want to but not always up to you in this day and age)
-2nd year of med school (but with debt more like a 3rd or 4th year due to expensive post-bacc. education and having to extend my current program to 5 years)
-Already at ~$227,000 in total debt, student loans + 1 credit card (credit card only about $8K of that)
-Without a great scholarship or other help (NHSC, military, etc.), likely to yet add about $150,00 to that number at the current pace (how does that grab ya?!)
-Zero savings, inheritance, assets, etc.
-$50K a year for your student budget? I could only wish! Try about $72,000 (and climbing yearly). That's what you get with a private school + Hawaii cost of living!
-Most of the time, REALLY feeling a lack of passion for the field right now (probably in part because of having the life sucked out of me with all the personal issues I'm facing right now, see 2nd point above)
-Nowhere near the top of the class, high-paying specialty highly doubtful (actually I feel like I have but one nostril above water most of the time, academically - UNBELIEVABLY stressful and discouraging by itself without any of the above)

My big problem is I feel all the time like I would love to walk away from this...if only I knew where I would walk to! I seriously have no idea, and so the vicious cycle continues, simply because of the fear of stepping away into the unknown. I feel like I can identify with one of the earlier posts - I often feel like I have to stick with it because I've passed that point of no return in terms of being over my head already.

Any good suggestions?

 

[benjee]

A very sobering thread, but I think that's a good thing.

I, for many reasons, have recently been teetering on doing something that's probably even more crazy than what the OP has asked about. Here's a bit about me:

-31 years old
-Two young children, probably about to get divorced (don't want to but not always up to you in this day and age)
-2nd year of med school (but with debt more like a 3rd or 4th year due to expensive post-bacc. education and having to extend my current program to 5 years)
-Already at ~$227,000 in total debt, student loans + 1 credit card (credit card only about $8K of that)
-Without a great scholarship or other help (NHSC, military, etc.), likely to yet add about $150,00 to that number at the current pace (how does that grab ya?!)
-Zero savings, inheritance, assets, etc.
-$50K a year for your student budget? I could only wish! Try about $72,000 (and climbing yearly). That's what you get with a private school + Hawaii cost of living!
-Most of the time, REALLY feeling a lack of passion for the field right now (probably in part because of having the life sucked out of me with all the personal issues I'm facing right now, see 2nd point above)
-Nowhere near the top of the class, high-paying specialty highly doubtful (actually I feel like I have but one nostril above water most of the time, academically - UNBELIEVABLY stressful and discouraging by itself without any of the above)

My big problem is I feel all the time like I would love to walk away from this...if only I knew where I would walk to! I seriously have no idea, and so the vicious cycle continues, simply because of the fear of stepping away into the unknown. I feel like I can identify with one of the earlier posts - I often feel like I have to stick with it because I've passed that point of no return in terms of being over my head already.

Any good suggestions?

Definitely, this is pretty stressful for anyone. do you have any spport systems?? meaning your parents, siblings who can help out on child care so that you can have more time to focus on school. How about your spouse?? does he/she help in child care? once divorced, if your children stay with you, then your spouse will need to pay child support.

 

[deltamed]

A very sobering thread, but I think that's a good thing.

I, for many reasons, have recently been teetering on doing something that's probably even more crazy than what the OP has asked about. Here's a bit about me:

-31 years old
-Two young children, probably about to get divorced (don't want to but not always up to you in this day and age)
-2nd year of med school (but with debt more like a 3rd or 4th year due to expensive post-bacc. education and having to extend my current program to 5 years)
-Already at ~$227,000 in total debt, student loans + 1 credit card (credit card only about $8K of that)
-Without a great scholarship or other help (NHSC, military, etc.), likely to yet add about $150,00 to that number at the current pace (how does that grab ya?!)
-Zero savings, inheritance, assets, etc.
-$50K a year for your student budget? I could only wish! Try about $72,000 (and climbing yearly). That's what you get with a private school + Hawaii cost of living!
-Most of the time, REALLY feeling a lack of passion for the field right now (probably in part because of having the life sucked out of me with all the personal issues I'm facing right now, see 2nd point above)
-Nowhere near the top of the class, high-paying specialty highly doubtful (actually I feel like I have but one nostril above water most of the time, academically - UNBELIEVABLY stressful and discouraging by itself without any of the above)

My big problem is I feel all the time like I would love to walk away from this...if only I knew where I would walk to! I seriously have no idea, and so the vicious cycle continues, simply because of the fear of stepping away into the unknown. I feel like I can identify with one of the earlier posts - I often feel like I have to stick with it because I've passed that point of no return in terms of being over my head already.

Any good suggestions?

I'm sorry about your situation... you are really in a bad position. Honestly, I think the best thing you could do is join the military to get the rest of med school paid for and have a higher reimbursement during residency. If not you are going to end up with almost 500k in debt. Also if you quit now you will have enormous debt with no way to pay it off.

Each person has a different threshold for how much medicine is worth. I admire those that are willing to go 300k+ in debt for medicine, IF THEY KNOW WHAT THAT MEANS AND ARE WILLING TO LIVE WITH IT.

My threshold was way lower. I would not have entered medicine with more than 100k in debt. I'm happy now, but I thought about it for several years beforehand and would NOT have done it if I needed to take out massive debt... so that meant not going if I couldnt get into state school, have some family support etc.

Even with a relatively low debt burden, people have to realize the opportunity cost is huge. If you had a decent career before, say making 80k a year with the opportunity to make maybe 150k in the future (like me, an engineer)... you lose on 7-10 years of savings. That is HUGE when taken over 30 more years of interest. For example, if you saved 15% per year during that time instead of going into debt, assuming an average 10% return, that would be about 3 million extra dollars when you retired (counting ONLY the time while in medical school and residency, assuming you save ZERO after). Think you can make that up while paying your debt down? Probably not, even if you DO make 300k a year. So make sure the financial hit is worth the extra job satisfaction.