Medicine worth $300k of debt?

[Raggaman]

I went to a state school for undergrad and graduated with zero debt. Had scholarships plus worked like a fiend. Then went to a private med school and now a few months out I already have a debt that is $270k+
Thankfully I have zero dependents and am doing residency in a low cost small to medium town. Doctors here are relatively happy. They make above average salaries and the hospital also has a loan repayment program. Most residents who graduate from here decide to stick around because they know that they won't get the same deal elsewhere. The catch is that the town is not a major metropolitan area with great culture and it snows alot. Most docs with families are able to afford a great lifestyle while the single ones are able to get enough vacation to fly about (ER and hospitalists).
So if u ask me after looking at my 270K+ loans if its worth it and I would say probably not. But if I am willing live in smaller places and away from major attractive cities (LA, NYC, chi town etc), then I still may have hope to live a decent life. If given a chance, I would rather live in Phoenix or Cali, but the truth is the cost of living in these areas (Cali more so then phx- which is still relatively cheap) is so much higher than a smaller sized city, that it is foolish to think you can have a "decent" living there.

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[psych]

First I have to say I have avoided sdn for the past few months because of threads like this. I'm going to graduate medschool with >375k in school loans. When I initially crunched the numbers about a year ago, I was a mess! Just walking around with such a huge debt burden depressed the hell out me. I wanted to drop out - knowing as a 1st year that it wasn't worth it for me - but I was already at the point of no return. I started regretting going to my private undergrad, the whole med school app/interview process, wondering why I made the choices I made... However I've been trying to accept my debt prison and still be "happy" but it is a hard pill to swallow.
Anyway, today I decided to check sdn and of course this is what I find.

 

[michaelrack]

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?

If you still have decent credit, starting buying gold (about 1 ounce a month), and hope for hyperinflation to wipe out your debts- hyperinflation is coming in late 2011 or early 2012

 

[exPCM]

This is one thread that is both amazing and sad.
In a strange way this thread has made me realize something that I had not thought about before. These high debt loads of the current students may actually provide some level of job security for attending physicians like myself who have no loan debt.
What I see is that people in my situation will be able to afford to work for lower pay than the new grads with big debts.
For instance as physician reimbursement is ratcheted down with healthcare reform, I think I will be able to do fine on a 120K per year salary but I don't think the same can be said for a new grad with 300K in student loans.

 

[Sneezing]

You are drawing the wrong conclusions. What this will mean is a new dynamic and culture of who is most fit for certain jobs. Academics will no longer be entered immediately post grad, except by md/phds. It will be a stepping stone into retirement for older physicians who have paid their debts off and are looking for a change. Just as the government wants, there will be less research and medical advancement and more of a clinical focus academia.

New grads will seek out the high paying places even if it means undesirable locations. More people will go into solo private practice to increase their income. More people will pursue concierge style practices to make do. I could even see a push to establish a culture that older physicians aren't as efficient as younger ones. Which is true. Any place that has EMRs is comical to watch older docs who don't know how to type hunt and peck their way through progress notes. Their inability to trouble shoot well on computers and simply get upset and throw a tantrum won't be a saught after commodity. Hence, there will be a younger preference for the next few years.

The military will finally see the surge of applicants they want.

 

[exPCM]

You are drawing the wrong conclusions. What this will mean is a new dynamic and culture of who is most fit for certain jobs. Academics will no longer be entered immediately post grad, except by md/phds. It will be a stepping stone into retirement for older physicians who have paid their debts off and are looking for a change. Just as the government wants, there will be less research and medical advancement and more of a clinical focus academia.

New grads will seek out the high paying places even if it means undesirable locations. More people will go into solo private practice to increase their income. More people will pursue concierge style practices to make do. I could even see a push to establish a culture that older physicians aren't as efficient as younger ones. Which is true. Any place that has EMRs is comical to watch older docs who don't know how to type hunt and peck their way through progress notes. Their inability to trouble shoot well on computers and simply get upset and throw a tantrum won't be a saught after commodity. Hence, there will be a younger preference for the next few years.

The military will finally see the surge of applicants they want.

I agree regarding the military.
What is a high paying location? (payment for services is based on CPT codes and there is not a great variation in CPT reimbursement in different locations when you account for cost of living) https://catalog.ama-assn.org/Catalog/cpt/cpt_search.jsp?_requestid=20774#
Do you really think cardiologists, pulmonologists, gastroenterologists, surgeons, anesthesiologists, radiologists, and other specialists can practice concierge style medicine?

 

[Sneezing]

*Radiology no.
*Anesthesiology no. (unless they start a massive ad campaign against CRNA's)
*Surgeons yes. It is harder, but there are currently a handful out there. If enough do it and it becomes recognized as a legitimit option, people will seek them out. GS more than the subspecialists. Tiers are already starting to emerge with surgery centers. It will be interesting to see how long this lasts with hospitals fighting back legislatively against them.
*Cardiology absolutely yes! Every one has CAD, HTN, strokes, afib, etc. People would be willing to pay top dollar for their cardiologist.
*Pulmonary, not likely, but many already opt into sleep and occupational medicine for better lifestyle.
*gastroenterology yes. However, they would have to go for the niche of "pain free" scopes, even if it means general anesthesia.

Medicare reimburses higher in some rural areas. Certain rural hospitals subsidize incomes to bring in specialists. This is the more likely route from my understanding.

 

[glasshouse]

Residency deferment was stopped with The College Cost Reduction and Access Act of 2007. They changed it so if you work in public service for 10 years (I believe many hospitals qualify as "public service" as the majority of hospitals are nonprofit) then federal loans are forgiven. I think this will work for most residents and physicians, right? Nurses seem to qualify...

There's also the income based repayment, if by paying 15% of your income (which has to be within some % of the poverty level) towards loans over 25 years they are still not paid off (unlikely for most physicians) then your loans are forgiven. So, its not ideal but you also shouldn't have to feel that you'll be paying loans your whole life...

I think these programs were put into place to help people with similarly high debt going into even lesser paying jobs (can you imagine being a teacher after going to private college? yikes...) The effect of this legislation may mean more physicians seeking employment in nonprofit hospitals over government or privately run hospitals

Some of this may be inaccurate, but at least this is how it was spun to me by my school's financial aid department. Have any residents had experience with these new programs or are you all still using the deferment option?

 

[michaelrack]

I agree regarding the military.
What is a high paying location? (payment for services is based on CPT codes and there is not a great variation in CPT reimbursement in different locations when you account for cost of living)?

Reimbursement by private insurers tends to be higher in states in which there are several competing insurance companies. Rates are lower in states like Alabama, in which BC/BS controls approx 80% of the private market.
The average reimbursement rate by private insurers for a sleep study (CPT code 95810) is several hundred dollars higher in Mississippi, which does not have 1 dominant private insurer, than in Alabama.

 

[FIREitUP]

this thread, albeit harsh, has given me great insight. thanks to all.

 

[FloatOn]

The military will finally see the surge of applicants they want.

A couple of months ago, this option was looking very attractive for various reasons, including yes...the money.

 

[MicA]

I will end up spending a grand total of $12000 over 6 years if I continue to get scholarships like I have been getting. Medicine here is only $4000 a year and you can get a scholarship for academics and for sport.

 

[FloatOn]

I will end up spending a grand total of $12000 over 6 years if I continue to get scholarships like I have been getting. Medicine here is only $4000 a year and you can get a scholarship for academics and for sport.

Is that USD? If so, that's what I call pretty freakin' sweet.

 

[MicA]

Is that USD? If so, that's what I call pretty freakin' sweet.

Ha ha, yes it is USD. If you want to convert properly I pay about R32 000 for fees and it is R7,59 to the USD. The government heavily subsidises medicine here, I think that they end up paying R2 million ($263504) for every med student that they put through school. There are no private medical schools in this country and most private colleges don't have international recognition for their degrees, so it is public university all the way.

 

[FIREitUP]

Ha ha, yes it is USD. If you want to convert properly I pay about R32 000 for fees and it is R7,59 to the USD. The government heavily subsidises medicine here, I think that they end up paying R2 million ($263504) for every med student that they put through school. There are no private medical schools in this country and most private colleges don't have international recognition for their degrees, so it is public university all the way.

america is so backwards! this free market economics is out of control. you guys have it right over there in South Africa.

 

[SRK Jerk]

Personally, I think a private medical school education is the only advanced degree which is financially unsound.
A private law degree allows one access to partner in a lucrative firm.
A private MD degree does not mean you are paid more by insurance/medicare, etc.
I can't understand how private medical schools continue to fill their classes.

You've probably been taken to task elsewhere in this thread (haven't read past this post yet), but in case you haven't, some private schools have started to give substantial financial aid to students coming from low-midlow household incomes. My debt is less now than it would have been at a public school.

 

[Neuronix]

You've probably been taken to task elsewhere in this thread (haven't read past this post yet), but in case you haven't, some private schools have started to give substantial financial aid to students coming from low-midlow household incomes. My debt is less now than it would have been at a public school.

As a student from a state with no state medical school and no partnerships with neighboring states who attends a private med school with a lower debt burden than its state schools, I agree. One can't make these sorts of generalizations. Not everyone is fortunate enough to grow up in Texas or NC or someplace that cares about its medical students. When I applied the financial aid packages extended to me by private schools were far better than the packages extended to me as an out-of-state student at public schools.

 

[FIREitUP]

i think those schools that are generous are definitely a minority. and what if you are those people that fall in the cracks because "they have too much money"? these schools know whatever they charge, we will pay.

 

[lilycat]

No. Absolutely, definitively not worth it.

 

[Winged Scapula]

No. Absolutely, definitively not worth it.

I haven't read this thread in weeks but had to log in and see what the good ol' lilycat had to say.

Why don't you drop me a PM sometime and let me know what you're up to.

 

[lilycat]

Old-timers unite!

I will definitely PM when I have recovered from a weekend of call.

As for my previous post, I probably should have clarified, but $300K debt... I would find it hard to justify. I can barely justify my own, lower debt level, esp. in light of what is looking to be an increasingly glum job market - it had me down all weekend.

I haven't read this thread in weeks but had to log in and see what the good ol' lilycat had to say.

Why don't you drop me a PM sometime and let me know what you're up to.

 

[FIREitUP]

Old-timers unite!

I will definitely PM when I have recovered from a weekend of call.

As for my previous post, I probably should have clarified, but $300K debt... I would find it hard to justify. I can barely justify my own, lower debt level, esp. in light of what is looking to be an increasingly glum job market - it had me down all weekend.

yeah, but the job market is bad for every profession, if that makes you feel any better

 

[babel]

You've probably been taken to task elsewhere in this thread (haven't read past this post yet), but in case you haven't, some private schools have started to give substantial financial aid to students coming from low-midlow household incomes. My debt is less now than it would have been at a public school.

Another point to be made is that there are PLENTY of private law schools that with hefty tuitions that are not in any way prestigious nor guarantee one a spot at a top law firm. Medicine is still a better bet, overall, in terms of job security.

 

[babel]

As a student from a state with no state medical school and no partnerships with neighboring states who attends a private med school with a lower debt burden than its state schools, I agree. One can't make these sorts of generalizations. Not everyone is fortunate enough to grow up in Texas or NC or someplace that cares about its medical students. When I applied the financial aid packages extended to me by private schools were far better than the packages extended to me as an out-of-state student at public schools.

Well, public schools outside of your own state are under no obligation to provide you with a good financial aid package, and I'm not in the least surprised that a private school in the same state was a better deal. Public schools are designed to subsidize the education of their residents, and out-of-staters are going to get shafted, for the most part. It certainly sucks for you that your home state didn't have a medical school, though.

 

[sunset823]

Lord did I wrestle with this same question for a long time before starting med school - I had no undergrad debt, but between my masters and med school I will definitely be near or over 300k in the end. And I want to do academic medicine in a relatively low paying field.

In the end, it came down to me recognizing this career was the best fit with my interests and personality, I'm pretty good with finances, and since I have no intention of ever getting hitched or having a family and am willing to live as the 'cougar' of the undergrad apartment complexes when I'm a resident/attending, I can pay off my debt relatively fast. I would NOT recommend this much debt to anyone thinking of starting a family in the next 20 years.

 

[UBCvan]

alright...

what if you're 300K in debt and you DIE....

who's paying for you? your family? insurance?

it's a sweet way to get out of the loans...

 

[ChiDO]

When you die, your loans die with you (at least the government ones).

 

[scurred09]

Can you elaborate on the lost time? Are you married? Do you have kids? What would you have done with this "lost time" if it wasn't robbed by medicine? This is a non sarcastic questions because I'm debating whether to pursue something else other than medicine. I'm 29 so the lost time issue is a concern for me.

Absolutely Not!!!.....as I've said before, if offered a free ride I still wouldn't go back and do medicine over again. Give me a bible and let me put my hand on it and I will swear this is so. It is not just the massive debt, it is the lost time that you can never get back that kills me more.

 

[medicinesux]

Can you elaborate on the lost time? Are you married? Do you have kids? What would you have done with this "lost time" if it wasn't robbed by medicine? This is a non sarcastic questions because I'm debating whether to pursue something else other than medicine. I'm 29 so the lost time issue is a concern for me.

When I finally do escape from the Alcatraz of medicine, I will immediately go back doing what I wished I could've been doing since graduating from college a decade ago. I wrote more about this here http://medicinesux.wordpress.com/2008/11/10/88/. As much as it sucks that I lost so much time in such a soul sucking endeavor, it truly makes me appreciate how much more blessed I am to have found something that I will love doing well into my 70's and never want to retire. Compare this to medicine where I was ready for retirement like five years ago! If I could've better foreseen the housing collapse, the passage of IBR, and fully realized that specialty Y sucks almost as much as specialty X, I would never have returned to residency. I've also seen how money can be like a drug and the pursuit of it can trap and ruin a person as much as a nasty crack cocaine habit. Learning to live and be content on less has liberated me to live the future life I always wanted. Hopefully one day, I can change my name from MEDICINESUX to *******ROX!

Lastly my best advice to your indecision is this:

There is a saying in medicine:

IF THERE IS ANYTHING ELSE YOU MAY ENJOY DOING, DO THAT THING! ONLY DO MEDICINE IF YOU ARE ABSOLUTELY PASSIONATE ABOUT IT AND YOU CAN'T SEE YOURSELF DOING ANYTHING ELSE.

The decision to go to medical school is a decision that will change your life in ways you never thought possible. I know it has for me. I wish you the best with such a momentuous decision to make.

 

[dynx]

Can you elaborate on the lost time? Are you married? Do you have kids? What would you have done with this "lost time" if it wasn't robbed by medicine? This is a non sarcastic questions because I'm debating whether to pursue something else other than medicine. I'm 29 so the lost time issue is a concern for me.

Good question.
Lost time: I spent 4 years undergraduate 2 graduate and 4 medical school. As an undergrad I had a job with benefits that would have paid about 50K a year. I currently make that as a resident and save around 700 a month.
Thats 84k banked IF I worked a 40 hour a week job and lived my life as I have so far. Now, pretend I worked the "80" hours a week I work as a resident at ANY other job I guarantee I could have a lot more banked. But just looking at that...invested earning ONLY 3% interest over the next 30 years would have me 200k or so by the time I retire...instead of six figure debt. Thats part of the cost of lost time.
(to run the numbers...if I made double (50K x 2) by working 2 full time jobs = residency and saved only double [1400 a month, could probably save more if making double] id be out 400k in lost time so far.)

Now...instead, as in the title you start with 300k in debt. That also accumulates over your "lost time". IF, and thats a big if...you pay it off over 10 years at ONLY 3% you pay about 350k.

So in the simplest equation you're out 550k for "lost time. For equal work you're out about 750k.

How do you make that up? well lets assume you come out and you get a good job. 250k a year. You pay 33% in federal taxes if single = 167500. Now dont forget that you're paying 35000 a year to get that loan payed off in 10. 132500 a year. You live like a resident (50k @ 25% tax = 37500) and save the rest. 8400 (the 700 a month you saved before) + 95k...you're working another 7 years or so just to break even, if living like a resident/student the whole time and working like a dog...till you're about 47 years old just to break even in terms of "lost time".

Then the payoff comes, but keep in mind the avg. joe has been working all that time too so in reality he's far ahead still. Is it worth it? Hard to say. Thats just how the numbers would hypothetically work out for me. In reality i have a rich family and no loans, I like my job...but i hope to be in a position to retire by 50 and work on my own terms. I wouldn't do it otherwise. And if payment drops I still won't do it if they don't pay me what I feel is worth it.

 

[Dr.Millisevert]

It doesn't cost 300k to complete medical school. Other countries goverments pay for medical school tuition because when they graduate, doctors will be providing a valuable public service to the community.

The US is in the process of most likely lowering salaries of their doctors at the same time raising the tuition for medical school (as well as skyrocketing malpractice insurance). There will reach a breaking point soon.

We may soon see US pre meds leaving the US to complete medical school (and then remaining overseas to work!!!).

We may soon see US medical school graduates completing residency overseas because the resident pay and hours are better (and then remaining overseas to work!!!).

We may soon see US doctors retireing early because they can no longer afford to continue practicing.

US students have the highest student loan debt in the entire world!!

US student loans have absolutly NO normal consumer protections available to them. (this too is unique to anywhere else in the entire world).

Being a US student and doctor is begining to sound like a pretty raw deal if you ask me.

 

[slippy22]

When I finally do escape from the Alcatraz of medicine, I will immediately go back doing what I wished I could've been doing since graduating from college a decade ago. I wrote more about this here http://medicinesux.wordpress.com/2008/11/10/88/. As much as it sucks that I lost so much time in such a soul sucking endeavor, it truly makes me appreciate how much more blessed I am to have found something that I will love doing well into my 70's and never want to retire. Compare this to medicine where I was ready for retirement like five years ago! If I could've better foreseen the housing collapse, the passage of IBR, and fully realized that specialty Y sucks almost as much as specialty X, I would never have returned to residency. I've also seen how money can be like a drug and the pursuit of it can trap and ruin a person as much as a nasty crack cocaine habit. Learning to live and be content on less has liberated me to live the future life I always wanted. Hopefully one day, I can change my name from MEDICINESUX to *******ROX!

Lastly my best advice to your indecision is this:

There is a saying in medicine:

IF THERE IS ANYTHING ELSE YOU MAY ENJOY DOING, DO THAT THING! ONLY DO MEDICINE IF YOU ARE ABSOLUTELY PASSIONATE ABOUT IT AND YOU CAN'T SEE YOURSELF DOING ANYTHING ELSE.

The decision to go to medical school is a decision that will change your life in ways you never thought possible. I know it has for me. I wish you the best with such a momentuous decision to make.

If you like that job so much more, why not quit now and do it?

 

[Dr.Millisevert]

alright...

what if you're 300K in debt and you DIE....

who's paying for you? your family? insurance?

it's a sweet way to get out of the loans...

This is how America treats it's students... Wow.. The USA has a bright future ahead! ...mmmm

 

[benjee]

Good question.
Lost time: I spent 4 years undergraduate 2 graduate and 4 medical school. As an undergrad I had a job with benefits that would have paid about 50K a year. I currently make that as a resident and save around 700 a month.
Thats 84k banked IF I worked a 40 hour a week job and lived my life as I have so far. Now, pretend I worked the "80" hours a week I work as a resident at ANY other job I guarantee I could have a lot more banked. But just looking at that...invested earning ONLY 3% interest over the next 30 years would have me 200k or so by the time I retire...instead of six figure debt. Thats part of the cost of lost time.
(to run the numbers...if I made double (50K x 2) by working 2 full time jobs = residency and saved only double [1400 a month, could probably save more if making double] id be out 400k in lost time so far.)

Now...instead, as in the title you start with 300k in debt. That also accumulates over your "lost time". IF, and thats a big if...you pay it off over 10 years at ONLY 3% you pay about 350k.

So in the simplest equation you're out 550k for "lost time. For equal work you're out about 750k.

How do you make that up? well lets assume you come out and you get a good job. 250k a year. You pay 33% in federal taxes if single = 167500. Now dont forget that you're paying 35000 a year to get that loan payed off in 10. 132500 a year. You live like a resident (50k @ 25% tax = 37500) and save the rest. 8400 (the 700 a month you saved before) + 95k...you're working another 7 years or so just to break even, if living like a resident/student the whole time and working like a dog...till you're about 47 years old just to break even in terms of "lost time".

Then the payoff comes, but keep in mind the avg. joe has been working all that time too so in reality he's far ahead still. Is it worth it? Hard to say. Thats just how the numbers would hypothetically work out for me. In reality i have a rich family and no loans, I like my job...but i hope to be in a position to retire by 50 and work on my own terms. I wouldn't do it otherwise. And if payment drops I still won't do it if they don't pay me what I feel is worth it.

Since you are from a rich family, why bother to work or go to medicine field ?? may enjoy for the rest of your life as well...

 

[dynx]

Since you are from a rich family, why bother to work or go to medicine field ?? may enjoy for the rest of your life as well...

Like I said. I enjoy my job. Looking at it from a financial point-of-view I wouldn't have done it if I had to take out loans...I don't enjoy it enough to justify that debt burden. The point where the cost outweighs the benefits is clearly different for everyone.

 

[benjee]

Like I said. I enjoy my job. Looking at it from a financial point-of-view I wouldn't have done it if I had to take out loans...I don't enjoy it enough to justify that debt burden. The point where the cost outweighs the benefits is clearly different for everyone.

Even take out the financial factor, do you enjoy taking calls, sleepless/busy nights, taking risks of being sued or contracting illnesses or being assaulted which may be part of the job you enjoy??

 

[scurred09]

I really appreciate your detailed explanation. The average joe making $50K a year probably comes out ahead of the docs who just started medical school at 31. It all makes economic sense.

Good question.
Lost time: I spent 4 years undergraduate 2 graduate and 4 medical school. As an undergrad I had a job with benefits that would have paid about 50K a year. I currently make that as a resident and save around 700 a month.
Thats 84k banked IF I worked a 40 hour a week job and lived my life as I have so far. Now, pretend I worked the "80" hours a week I work as a resident at ANY other job I guarantee I could have a lot more banked. But just looking at that...invested earning ONLY 3% interest over the next 30 years would have me 200k or so by the time I retire...instead of six figure debt. Thats part of the cost of lost time.
(to run the numbers...if I made double (50K x 2) by working 2 full time jobs = residency and saved only double [1400 a month, could probably save more if making double] id be out 400k in lost time so far.)

Now...instead, as in the title you start with 300k in debt. That also accumulates over your "lost time". IF, and thats a big if...you pay it off over 10 years at ONLY 3% you pay about 350k.

So in the simplest equation you're out 550k for "lost time. For equal work you're out about 750k.

How do you make that up? well lets assume you come out and you get a good job. 250k a year. You pay 33% in federal taxes if single = 167500. Now dont forget that you're paying 35000 a year to get that loan payed off in 10. 132500 a year. You live like a resident (50k @ 25% tax = 37500) and save the rest. 8400 (the 700 a month you saved before) + 95k...you're working another 7 years or so just to break even, if living like a resident/student the whole time and working like a dog...till you're about 47 years old just to break even in terms of "lost time".

Then the payoff comes, but keep in mind the avg. joe has been working all that time too so in reality he's far ahead still. Is it worth it? Hard to say. Thats just how the numbers would hypothetically work out for me. In reality i have a rich family and no loans, I like my job...but i hope to be in a position to retire by 50 and work on my own terms. I wouldn't do it otherwise. And if payment drops I still won't do it if they don't pay me what I feel is worth it.

 

[medicinesux]

If you like that job so much more, why not quit now and do it?

I figured since I finished my residency, I might as well make a little bit of money to compensate for all my pain and suffering. However, I am finding that this is turning out to be a wash.

 

[daveyjwin]

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.

I can't help but notice my response here was pretty much completely disregarded.

 

[InternationlDoc]

I actually agree a bit with medicinesux

As a current MS4 going into Rads, I now am seeing the whole process and how long it would take me to make real money - meaning attending level money. None of that is much guarenteed in this environment. I say all this because I also work part time (more like HAD to) as a pseudo-accountant of sorts. Made/Make good money. Also invested a bit and this is the point: if you want to make money, save money, not have much debt medicine really is such a loooooooonnnnggg and idiotic process of going about it as you accumulate that much debt. So passion is required.

 

[FIREitUP]

i can see why people with other prospects can be disgruntled; but if you really don't have a desire to pursue anything else, then this thread won't deter you from medicine.

 

[Dr.Millisevert]

if you really don't have a desire to pursue anything else, then this thread won't deter you from medicine.

really?

Everyone has a breaking point. At the end of the day it has to be financially viable for you to do it (no matter how much you love the job).

I have a question.... How much is too much for you? Would you be willing to take on 300k of non dischargeable loans with interest? How about 500k.... A cool 1 mil USD???

People are already saying because of the amount of student debt they have they feel they no longer have the option in life to get married, to buy a home, or to have children!!!

It's pretty sad. (only in America)

At some point you have to say "this is impossible financially to take on this job".

 

[scurred09]

I do believe this; I don't think it is econonimically sound for those who start med school at 30 and have to also take 100% loans to cover their tuition and living expense. The best time and situation to pursue medicine is when you are in your early 20's, be rewarded a scholarship or have financial help from parents.

really?

Everyone has a breaking point. At the end of the day it has to be financially viable for you to do it (no matter how much you love the job).

I have a question.... How much is too much for you? Would you be willing to take on 300k of non dischargeable loans with interest? How about 500k.... A cool 1 mil USD???

People are already saying because of the amount of student debt they have they feel they no longer have the option in life to get married, to buy a home, or to have children!!!

It's pretty sad. (only in America)

At some point you have to say "this is impossible financially to take on this job".

 

[KindaRambo]

Man, you guys are depressing! If I had read this thread as a pre-med I would be so confused and anxious right now.

About me...I have 2 more years left in Rads residency and then going straight into private practice. I'm 30, $150K in debt, not married (thank god), and have LOTS of interests outside medicine.

I have a few points...

There is still money to be made in medicine in our generation, but you have to be smart about it. Pick something that pays well!

I know things cycle and change, but that takes years. Rads, Anesthesia, Derm, Rad Onc, GI, Cards currently would be my ONLY options. I HATE surgery, but if you were a surgery type, Ortho wins hands down.

Don't CHOOSE to go into Peds, FP, psych, general IM or general surgery and then complain about money. Google is a powerful tool people.

Don't CHOOSE to go into ENT, vascular, trauma, CT or any other surgical specialty and then complain about hours worked.

That being said - the specialties I listed are currently ultra competetive (ever wonder why? duh!). I worked my butt off in med school so I would have the option to pick any of what I considered to be the "best specialties." And even after working as hard as I did, I honestly dont think I could have matched into Derm or Rad Onc. Med school is a tough, grueling, competetive road.

Be flexible in where you are willing to work. Jobs in Podunkville, USA pay a hell of a lot more than jobs in San Diego. I mean like double or triple.

Be real careful about picking something you "love". Thats stupid - I love surfing, but I'm not naive enough to try to become a professional surfer, thats just not practical or realistic (well, that and i kinda still suck at it). Pick a specialty based on $, hours, lifestyle, etc. Obviously don't pick something you hate just for money or lifestyle, but it's ok to just tolerate what you do. Medicine is a job like any other, not a GD calling. Get over it.

I love how everyone thinks the grass is so much greener outside of medicine.

Lawyers - look up how much the average lawyer makes, you'd be surprised.

I Banking/Business - job security is a mother. My old roomate went from making 300k to 50k to unemployed to 70k in 5 years. No thanks.

Dentistry - I heavily considered this but have you stuck your hands in 20 peoples gnarly mouths day in and day out for even a week? Nasty. (Although I do consider Orthodontics and OMFS great career choices.)

Pharm/PA/CRNA - Stable idiot proof careers, but you max out in the mid 150's and have almost no autonomy or decision making power - you're a paid monkey. Not good enough for me.

Porn Star - well, maybe.

My rant aside, I think it sucks that my collegues in FP, peds, etc. are getting f'ed in todays market while the paid monkeys are making more and more. Specializing in medicine is somewhat protective now, but not for long. No one can predict this kind of stuff. Just get informed, roll the dice, and hope for the best.

So was it worth it for me? So far yes. Ask me again a few years down the road when I'm in practice. I hope its still worth it then, but who knows.

 

[FloatOn]

I have a question.... How much is too much for you? Would you be willing to take on 300k of non dischargeable loans with interest? How about 500k.... A cool 1 mil USD???

Apparently, some on the pre-allo forum are...

Is Tufts Worth 315k plus interest?
http://forums.studentdoctor.net/showthread.php?t=671557&highlight=$500,000

 

[scurred09]

Awesome post Doc.Thank you for taking the time. I'm that confused pre-med. I can honestly say that if I do pursue medicine; I would be more than likely end up in FP 1) 8 yrs is enough for me 2) I doubt I be the top students in my class. So in my case, med school may not be right. At the same time, I would be starting med school at 31 and taking out 100% loans. My dream when I was a child was to be a porn star but I'm not very good looking nor do I have the connection. On the other hand, taking on those paid monkey jobs is probably not a bad idea given that there are other things that I want to do outside medicine.

Man, you guys are depressing! If I had read this thread as a pre-med I would be so confused and anxious right now.

About me...I have 2 more years left in Rads residency and then going straight into private practice. I'm 30, $150K in debt, not married (thank god), and have LOTS of interests outside medicine.

I have a few points...

There is still money to be made in medicine in our generation, but you have to be smart about it. Pick something that pays well!

I know things cycle and change, but that takes years. Rads, Anesthesia, Derm, Rad Onc, GI, Cards currently would be my ONLY options. I HATE surgery, but if you were a surgery type, Ortho wins hands down.

Don't CHOOSE to go into Peds, FP, psych, general IM or general surgery and then complain about money. Google is a powerful tool people.

Don't CHOOSE to go into ENT, vascular, trauma, CT or any other surgical specialty and then complain about hours worked.

That being said - the specialties I listed are currently ultra competetive (ever wonder why? duh!). I worked my butt off in med school so I would have the option to pick any of what I considered to be the "best specialties." And even after working as hard as I did, I honestly dont think I could have matched into Derm or Rad Onc. Med school is a tough, grueling, competetive road.

Be flexible in where you are willing to work. Jobs in Podunkville, USA pay a hell of a lot more than jobs in San Diego. I mean like double or triple.

Be real careful about picking something you "love". Thats stupid - I love surfing, but I'm not naive enough to try to become a professional surfer, thats just not practical or realistic (well, that and i kinda still suck at it). Pick a specialty based on $, hours, lifestyle, etc. Obviously don't pick something you hate just for money or lifestyle, but it's ok to just tolerate what you do. Medicine is a job like any other, not a GD calling. Get over it.

I love how everyone thinks the grass is so much greener outside of medicine.

Lawyers - look up how much the average lawyer makes, you'd be surprised.

I Banking/Business - job security is a mother. My old roomate went from making 300k to 50k to unemployed to 70k in 5 years. No thanks.

Dentistry - I heavily considered this but have you stuck your hands in 20 peoples gnarly mouths day in and day out for even a week? Nasty. (Although I do consider Orthodontics and OMFS great career choices.)

Pharm/PA/CRNA - Stable idiot proof careers, but you max out in the mid 150's and have almost no autonomy or decision making power - you're a paid monkey. Not good enough for me.

Porn Star - well, maybe.

My rant aside, I think it sucks that my collegues in FP, peds, etc. are getting f'ed in todays market while the paid monkeys are making more and more. Specializing in medicine is somewhat protective now, but not for long. No one can predict this kind of stuff. Just get informed, roll the dice, and hope for the best.

So was it worth it for me? So far yes. Ask me again a few years down the road when I'm in practice. I hope its still worth it then, but who knows.

 

[avatarftw]

...

 

[scurred09]

I know what you mean. I am too asian. How old are you bro? I'm assuming you're in your early 20's.

1. I'm a little confused. I'm going to start
med school next year and will have roughly 200,000 in debt accruing at 6.8% when I finish residency. I calculated the debt value while accounting for tuition, food, exams, and the interest accruing.

2. Thankfully, I have no debt from undergrad. However, it is VERY feasible to pay off the debt. One can live very frugally (my apartment+food+heating+electricity, etc is only 450 a month.) I eat a TON but spend 100 dollars/month since I buy on sale.

Perhaps its cultural. I'm chinese and in my culture we save about 20-30% of our income, buy on sale, reuse, and live very humbly. Its not how much you make, but how much you keep. Yes, 200,000 is a lot of money (300,000 in other cases) to repay but if you paid 30,000 of gross salary over 30 years, the debt would be eliminated. That's not too bad if you are making 200,000-250,000 as an ER doctor, for example. Furthermore, the equation gets much better if you are a radiologist, etc.

Just my two cents.

 

[babel]

1. I'm a little confused. I'm going to start med school next year and will have roughly 200,000 in debt accruing at 6.8% when I finish residency. I calculated the debt value while accounting for tuition, food, exams, and the interest accruing.

2. Thankfully, I have no debt from undergrad. However, it is VERY feasible to pay off the debt. One can live very frugally (my apartment+food+heating+electricity, etc is only 450 a month.) I eat a TON but spend 100 dollars/month since I buy on sale.

Perhaps its cultural. I'm chinese and in my culture we save about 20-30% of our income, buy on sale, reuse, and live very humbly. Its not how much you make, but how much you keep. Yes, 200,000 is a lot of money (300,000 in other cases) to repay but if you paid 30,000 of gross salary over 30 years, the debt would be eliminated. That's not too bad if you are making 200,000-250,000 as an ER doctor, for example. Furthermore, the equation gets much better if you are a radiologist, etc.

Just my two cents.

Ah, young grasshopper. I'm very happy for you that you can subsist on $450/mo - but have you no phone? internet? car? These things will be essential for medical school in most cases (except perhaps for some large cities like NYC, you will be hard pressed to find public transportation to get you to far flung hospitals at 5am for surgery or ob-gyn). And really, how is your rent so cheap? Perhaps it's location - I've only ever lived on the coasts and the cheapest rent I ever paid was $550/mo back in 2002 for a SHARED room!

I long planned on going into EM myself largely because I was attracted to the $200K+ salary out of residency. The truth of the matter is though, you have NO IDEA what field of medicine you will a) be able to get into or b) want to go into. Congrats to the rads resident above who was able to kick butt in medical school and go into the well-paying field of his choice. However, the fact of the matter is, based on the #of residency slots (especially in the face of rising medical school enrollment without an increase in residency positions) most medical students will NOT be going into these specialties - and you just have no way of predicting where you'll end up.

It's just always best to plan for the worst - crunch the numbers with a $150k/year salary. And then factor in all those things that you are probably going to start to want as you are finishing residency - a house, a family, saving for retirement etc. And anyway, doesn't it make you sick to think of paying $900K for $200K in loans? And do you realize that such a plan will have you paying off your student debt until darn near retirement age? What about saving for said retirement?

Look, I'm all for being frugal, living within your means, and I do think that by doing so people can pay off their loans, myself included. It is just going to suck a lot more for some of us than others - and we don't really know how much, because so few have come before us with such astronomical debt levels.

After all the number crunching I've done, I think a good rule of thumb is to limit your debt an amount equal to your annual salary (pre-tax). And since I always think it's good to err on the side of caution, I'd say that $150K is a truly comfortable limit (I'm well over that amount myself though of course! )

 

[exPCM]

The former head of the Arizona Medical Board quit medicine and is now working as a Phoenix policeman. From what I hear he enjoys being a cop a lot more than he liked practicing medicine. I say good for him.