Medicine worth $300k of debt?

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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.

smart guy!....he should lateral up to the NY or Boston suburbs. Besides being a lot safer than Phoenix he could have happiness AND money. He could easily make six figures plus a nice sweet pension after 20 years. Police officers in this neck of the woods make the same as primary care docs with ZERO debt. If he were to decide to go onto captain or lieutenant, he could surpass 200K with ease.

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smart guy!....he should lateral up to the NY or Boston suburbs. Besides being a lot safer than Phoenix he could have happiness AND money. He could easily make six figures plus a nice sweet pension after 20 years. Police officers in this neck of the woods make the same as primary care docs with ZERO debt. If he were to decide to go onto captain or lieutenant, he could surpass 200K with ease.

i'm from new york suburbs and i can vouch for the amount that these guys make, but they are cutting down on the budget and there is a waiting list for those who wish to become police officers in lucrative areas (and it is extremely competitive). in theory if one was lucky enough to get the job, yeah it's great, but not everyone a) wants to be a cop b) is physically inclined.
 
america is so backwards! this free market economics is out of control. you guys have it right over there in South Africa.

This is the most ignorant statement I have heard in a long time. Medicine, and medical education, is the most highly regulated industry in America. Why do you think medical school tuition keeps rising? People are willing to pay more. Why are they willing to pay more? They can borrow the money. What allows them to borrow so much money? Federally subsidized student loans. If you could only get private loans for medical school, tuition prices would actually be falling over time. Not to mention, supply and demand would dictate the number of medical schools that would compete, not the federal government.

Medicine is not a free market. We haven't had one in the US since Medicare passed.
 
This is the most ignorant statement I have heard in a long time. Medicine, and medical education, is the most highly regulated industry in America. Why do you think medical school tuition keeps rising? People are willing to pay more. Why are they willing to pay more? They can borrow the money. What allows them to borrow so much money? Federally subsidized student loans. If you could only get private loans for medical school, tuition prices would actually be falling over time. Not to mention, supply and demand would dictate the number of medical schools that would compete, not the federal government.

Medicine is not a free market. We haven't had one in the US since Medicare passed.


Hmmm....

Medical schools in countries like SA are all run by the gov. They have a limited number of spots available and it's just about free to attend as a medical student. No loans (private or gov subsidized) are even needed!
 
This is the most ignorant statement I have heard in a long time. Medicine, and medical education, is the most highly regulated industry in America. Why do you think medical school tuition keeps rising? People are willing to pay more. Why are they willing to pay more? They can borrow the money. What allows them to borrow so much money? Federally subsidized student loans. If you could only get private loans for medical school, tuition prices would actually be falling over time. Not to mention, supply and demand would dictate the number of medical schools that would compete, not the federal government.

Medicine is not a free market. We haven't had one in the US since Medicare passed.

Your reaction was quite offensive and unjustified. i was referring to medical education being free market, not the practice of medicine. in that respect, it is unregulated and free market--supply and demand. the supply will always exceed the demand for medical school, so schools can justify charging more and more and more. If the government wanted to regulate post-secondary education costs, they would do it through a more effective means than subsidizing loans. I can assure you that even if there were only private loans, people would still be flocking to medicine, for the cost of loans are implicit and overlooked. The government keeps the cost of education high, they are able to woo people in the army with prospects of a debt free future, which is an excellent incentive for them to keep the price of medical school education relatively unregulated.

Your argument makes no sense; first you say i'm an idiot, then say there is basically a free market so medical schools can charge whatever they want, but there are subsidized loans so its not really a free market...If this truly was the most regulated industry we would have universal health care, less private hospitals/private practice, and tuition that is funded by the government. It's not like that, so maybe you should release your pent up anger and frustration elsewhere and offend someone to their face.
 
sorry, dyslexia. demand will always exceed supply.

Actually, I was referring to the basic economic principle that there is a market equilibrium (in most cases) between demand and supply in a free, unregulated market. If there is a shortage in medical school spots, it is because the market is not free and unregulated- for example, due to subsidies in the form of state taxpayers paying some of the cost of running public medical schools.
 
that doesn't make sense from an economic standpoint.

His whole post doesn't make sense. He's more concerned about being called an idiot than thinking about why his reasoning is off.
 
I'm not sure medicine is worth 300k in debt. I had 132k in debt, and it was/is worth it because it was one of the few careers I would have wanted to do, and honestly better paying than the other things I'd have wanted to do. If you are going to be 300k in debt, you'd better get yourself into one of the higher paying specialties...the problem is that some of you won't be able to. I think for someone who is already going to be late 20's or in his/her 30's, going to med school is a dubious financial prospect, especially if you have to pay for 100% of it with loans. If your spouse or family can support you (at least by paying living expenses) then it becomes a bit less problematic. Whether you have kids already also needs to get factored in, IMHO. It's not just that you'll have no income for 4 years...you'll have no income for 4 years and then little income for 3-9 years after that, taking into account residency + fellowship.
 
Awesome post doc. I will turn 31 if I start med. school and will be borrowing 100% from the government. In my case, med. school may do more harm than good.
I'm not sure medicine is worth 300k in debt. I had 132k in debt, and it was/is worth it because it was one of the few careers I would have wanted to do, and honestly better paying than the other things I'd have wanted to do. If you are going to be 300k in debt, you'd better get yourself into one of the higher paying specialties...the problem is that some of you won't be able to. I think for someone who is already going to be late 20's or in his/her 30's, going to med school is a dubious financial prospect, especially if you have to pay for 100% of it with loans. If your spouse or family can support you (at least by paying living expenses) then it becomes a bit less problematic. Whether you have kids already also needs to get factored in, IMHO. It's not just that you'll have no income for 4 years...you'll have no income for 4 years and then little income for 3-9 years after that, taking into account residency + fellowship.
 
1. My phone costs 10 dollars a month--I'm on my family's "family plan."

I do not currently have internet--I use internet at the library. I don't currently have a car; I just bike to the store. No, it doesn't take me much time; I'm a fast biker.

(I do know that a car will be needed after the first two years of medical school)

2. My rent is so cheap because I'm very creative at saving money. That is characteristic of chinese culture; we're amazing at playing "defense" and saving money. My apartment is right on campus of my college, amazing location.

3. Looking at the objective data of the NRMP, a student with a median Step 1 score has the median score of an ER/anesthesiology residency. 93% of US allopathic seniors match and 75% of US allopathic seniors match to "competitive" specialties. It will be difficult, but definitely attainable. (I'm not talking about dermatology and the extremely competitive specialties, though)

4. Yes, I've done my research and while I would be mightily disappointed with a 150,000/year pre tax salary, I could survive with it and save as much possible. Also, I am not happy about paying 400,000 or 600,000 (not 900,000) for the loan amount depending on the repayment period.

5. The length of time that one spends repaying their loan is misleading. If one had only 20,000 of debt after medical school (old doctors) and decided to pay it off over 30 years since the loan interest rate was 2.8%, its not a big deal at all. However, with 200,000 of debt...

6. Currently getting 5% off on groceries due to my sweet credit card...pay it off at the end of the month while the interest accrues in my high interest money market account...a free 0% interest loan. Just bought 4 20 ounce premium cereal boxes for 4 dollars due to coupons....invest in ROTH IRA...save, save, save.

7. Yes, I'm in my early 20s.
guess you are lucky that you a family to partially supporting you. Just Wait till when you starts your own family, have kids, then you may feel more pressure financially even you and your whole family save every dime/penny, live frugally , still need to pay back the loans for 10 or more years. Most young people may find it easier/optimisstic to repay loans becoz they have not faced being sick or financial burden..etc.
 
Someone pointed this out on an advocacy site I frequent and thought it was pretty damn funny/sad-

Did you know that you could now go to freaking outer space for less than a med school education.

http://www.usatoday.com/tech/science/space/2007-05-07-space-tourist_N.htm

FREAKING OUTER SPACE PEOPLE!!! OUTER SPACE!!!

If we are not on the verge of a student loan bubble in this country than you can call me Pinocchio.
 
Someone pointed this out on an advocacy site I frequent and thought it was pretty damn funny/sad-

Did you know that you could now go to freaking outer space for less than a med school education.

http://www.usatoday.com/tech/science/space/2007-05-07-space-tourist_N.htm

FREAKING OUTER SPACE PEOPLE!!! OUTER SPACE!!!

If we are not on the verge of a student loan bubble in this country than you can call me Pinocchio.

Interesting...

Yeah, I don't understand how American's pay that much for school. Its crazy.
 
Because americans are sold on the "prestige" and "delayed gratification" concepts. It's cool and dandy until they realized, "oh ****, it's too late to turn back!" That's when they are in massive debt, get older, get grouchier, and no time to date and get laid.
Interesting...

Yeah, I don't understand how American's pay that much for school. Its crazy.
 
Actually, there's a post on the nontrad forum from a guy who went to med school thinking it will get him laid...
 
4. Yes, I've done my research and while I would be mightily disappointed with a 150,000/year pre tax salary, I could survive with it and save as much possible. Also, I am not happy about paying 400,000 or 600,000 (not 900,000) for the loan amount depending on the repayment period.

Just for perspective, there's nothing wrong with "just" making $150K a year if you're willing to trade whatever lifestyle considerations you have/want for the difference between a higher paying specialty/position.

It's still well above the median salary for the nation and if you manage your resources well you can live quite happily on $150K. Getting paid more will commonly mean more work. If that makes you happy, wonderful. But keep in mind that some people are willing to trade potential pre-tax earnings for intangible lifestyle benefits.
 
Chino brings up a good point, and I'd like to point out that I think most people have a skewed view of how much other graduate degree's end up paying people. All these people saying they could have gotten an MBA or whatever and be earning $300K+ are essentially the the same as the lay people who assume all Doctor's make $500K+.

Some stats:
http://en.wikipedia.org/wiki/Personal_income_in_the_United_States
http://www.earnmydegree.com/online-education/learning-center/education-value.html
http://www.topuniversities.com/grad...lary_benefits_for_masters_and_phd_candidates/

The fact is though, that even with reform and all this other BS, being a physician will put you in the top 5% of earners in the country. People complaining about that, to me, need some serious perspective.
 
Chino brings up a good point, and I'd like to point out that I think most people have a skewed view of how much other graduate degree's end up paying people. All these people saying they could have gotten an MBA or whatever and be earning $300K+ are essentially the the same as the lay people who assume all Doctor's make $500K+.

Some stats:
http://en.wikipedia.org/wiki/Personal_income_in_the_United_States
http://www.earnmydegree.com/online-education/learning-center/education-value.html
http://www.topuniversities.com/grad...lary_benefits_for_masters_and_phd_candidates/

The fact is though, that even with reform and all this other BS, being a physician will put you in the top 5% of earners in the country. People complaining about that, to me, need some serious perspective.

They don't necessarily need perspective... If it all goes to crap, earning the top 5% of crap, is well, crap.
 
The fact is though, that even with reform and all this other BS, being a physician will put you in the top 5% of earners in the country. People complaining about that, to me, need some serious perspective.

And in order to get there, you have to borrow enough to put you in, oh let's just ballpark here, the top 1% of all non-mortgage borrowers...which "reform" isn't addressing at all.

How's that for perspective?
 
It is no secret that pediatrics is the most underpaid of all medical specialties. Exactly how bad has it gotten? Check out and see for yourself on this forum where DC housewives congregate and discuss the matter.

“I left private practice as an internist because the money was awful and the hours were even worse. I made $110K and worked my butt off; on top of that I have to pay down $150K in student loan debt.
My friends are leaving practice in droves — esp. OB’s because of increasing malpractice premiums.”

“I always assumed that my sister in law who has a nice practice in Baltimore was doing well. Then I found out that she made 89k last year. That is after all the late nights and weekends, her pager is always going off.”
“I worked for an insurance company in claims, and at times (sadly) we laughed at the small checks we would send the docs.”


“I am a pediatrician. Full-time docs starting out make $90,000. I’m part-time, so I actually make proportionately less.”
“If you thought I had it made…I really HAD IT!!”
“I do not have any desire to go to the hospital anymore. It cost more to pay the malpractice insurance than what you collect for your services in the hospital”
“The problem is that you are on a treadmill to keep up with expenses in the face of lower insurance reimbursements — so the way to make up for it is to see more and more patients.”
“There’s no prestige left in it, and the salary is not that great. Last year, had I worked full-time, I would have made 1/10 what my non-physician husband made (who spent 9 fewer years in formal education than I did). And I’m a surgeon.”
“I doubt it will be too long before I stop going back to work.”
“My husband is a dean at one of the medical schools in town and while I don’t have an exact figure, I know that a daily concern of his is just how much debt his medical students are graduating with these days. Almost universally 100K+ and often $250K+.”
 
It is no secret that pediatrics is the most underpaid of all medical specialties. Exactly how bad has it gotten? Check out and see for yourself on this forum where DC housewives congregate and discuss the matter.

“I left private practice as an internist because the money was awful and the hours were even worse. I made $110K and worked my butt off; on top of that I have to pay down $150K in student loan debt.
My friends are leaving practice in droves — esp. OB’s because of increasing malpractice premiums.”

“I always assumed that my sister in law who has a nice practice in Baltimore was doing well. Then I found out that she made 89k last year. That is after all the late nights and weekends, her pager is always going off.”
“I worked for an insurance company in claims, and at times (sadly) we laughed at the small checks we would send the docs.”


“I am a pediatrician. Full-time docs starting out make $90,000. I’m part-time, so I actually make proportionately less.”
“If you thought I had it made…I really HAD IT!!”
“I do not have any desire to go to the hospital anymore. It cost more to pay the malpractice insurance than what you collect for your services in the hospital”
“The problem is that you are on a treadmill to keep up with expenses in the face of lower insurance reimbursements — so the way to make up for it is to see more and more patients.”
“There’s no prestige left in it, and the salary is not that great. Last year, had I worked full-time, I would have made 1/10 what my non-physician husband made (who spent 9 fewer years in formal education than I did). And I’m a surgeon.”
“I doubt it will be too long before I stop going back to work.”
“My husband is a dean at one of the medical schools in town and while I don’t have an exact figure, I know that a daily concern of his is just how much debt his medical students are graduating with these days. Almost universally 100K+ and often $250K+.”

I wonder who will be there when their child is sick, or when they have pregnancy complications. i don't see any reasoning behind the disproportionate pay for different specialties. Why should a general surgeon receive a couple hundred dollars for a lap cholecystectomy, but a dermatologist gets more for doing some biopsy?
 
I wonder who will be there when their child is sick, or when they have pregnancy complications.

there is still a little idealism left in many docs right after residency. This combined with poor medical business education given most residents will continue the steady pipeline of young docs thrown into the meat grinder
 
there is still a little idealism left in many docs right after residency. This combined with poor medical business education given most residents will continue the steady pipeline of young docs thrown into the meat grinder

Idealism and poor medical business education? Graduates are buried by debt and have no job prospects outside of medicine. Even for those within many specialties, there's no options to avoid working very hard for low pay. Are people going to go back to the indentured servitude called residency for a higher paying field within medicine? Even those are very hard to come by. The high paying or low hour fellowships are also extremely competitive for a reason (see OB/GYN for example).

What choice do they have but to practice? The pipeline starts at the pre-med phase. At this point, posting in Gen Res, you're just preaching to the choir of those who are locked into a medical career by debt.
 
there is still a little idealism left in many docs right after residency. This combined with poor medical business education given most residents will continue the steady pipeline of young docs thrown into the meat grinder

What opportunities are available to med students to learn about the business of medicine. I assumed this would be part of the medical curriculum...??
 
What opportunities are available to med students to learn about the business of medicine. I assumed this would be part of the medical curriculum...??

Self-education or an MBA is probably about your only options. This is not a part of any medical cirriculum I'm aware of.

I think a course relevant to medical business should be required of pre-meds instead of that **** you will never use like Orgo Chem.
 
Self-education or an MBA is probably about your only options. This is not a part of any medical cirriculum I'm aware of.

I think a course relevant to medical business should be required of pre-meds instead of that **** you will never use like Orgo Chem.

I just looked through the schools I'm interested in and you're right they don't offer it. I'm currently doing an MS with a management component, so I've had some financial/mgmt courses. Although the courses do have value, they are generic and not geared towards healthcare or medicine...

I still can't believe medical business isn't offered at least as an elective... how do residents learn the business of medicine... about insurance, reimbursements, uncompensated care etc etc??
 
Self-education or an MBA is probably about your only options. This is not a part of any medical cirriculum I'm aware of.

I think a course relevant to medical business should be required of pre-meds instead of that **** you will never use like Orgo Chem.

By "medical business education", I was referring to things like billing, the basics of running a medical practice, etc. An MBA won't help much for this. Self-education is helpful- read Medical Economics. There are some books available, including this one (free online):
http://theindependenturologist.blogspot.com/2009/12/early-praise-for-my-book-suddenly-solo.html

http://medicaleconomics.modernmedicine.com/about
 
By "medical business education", I was referring to things like billing, the basics of running a medical practice, etc. An MBA won't help much for this. Self-education is helpful- read Medical Economics. There are some books available, including this one (free online):
http://theindependenturologist.blogspot.com/2009/12/early-praise-for-my-book-suddenly-solo.html

http://medicaleconomics.modernmedicine.com/about


thanks for clarifying, i still feel like this is important enough to deserve at least a "workshop" somewhere along the road of medical education.

thanks for the links..
 
This is why most ppl are going to NP/PA school. I personally know a girl that failed out of a Carib med-school 2nd semester and she busted over to PA school and is acing the classes (per her updates on FB, I see every now and then). Also bumped into another girl, who told me she'd rather be a PA and move to Oregon where she can write her own scripts instead of go through "ALL THAT TIME" in medical school...What does this say about our health care system in this country? Less education, comparable pay to PCP's...infuriating, saddening...
:thumbup:
 
I still can't believe medical business isn't offered at least as an elective... how do residents learn the business of medicine... about insurance, reimbursements, uncompensated care etc etc??

You learn about it after residency, when you become an attending. Or you keep your eyes open and try to learn something about the business of medicine as you go through.

My residency is an anomaly because they have a faculty member dedicated to educating us on the business of medicine. He sets up lectures that are part of our protected time - he's brought in malpractice insurers, guys from HR to go over contracts with us (extremely helpful, and eye-opening), etc.

But, like I said, we're kind of an anomaly. You could ask the program while interviewing how much they teach about this, but I don't think that many places do. One of my friends heard that I was learning how to bill patients, how to buy malpractice insurance, etc., and remarked that they don't get any of this....they're expected to learn as attendings, apparently.
 
You learn about it after residency, when you become an attending. Or you keep your eyes open and try to learn something about the business of medicine as you go through.

My residency is an anomaly because they have a faculty member dedicated to educating us on the business of medicine. He sets up lectures that are part of our protected time - he's brought in malpractice insurers, guys from HR to go over contracts with us (extremely helpful, and eye-opening), etc.

But, like I said, we're kind of an anomaly. You could ask the program while interviewing how much they teach about this, but I don't think that many places do. One of my friends heard that I was learning how to bill patients, how to buy malpractice insurance, etc., and remarked that they don't get any of this....they're expected to learn as attendings, apparently.

Many thanks for the info.. I keep this in mind when residency matching comes around, but then again one generally doesn't get many match choices, so I guess you take what you get and make the best of it. I guess networking with and learning from Attendings and self-help are backup routes to become knowledgeable and informed about this important facet of medicine.. thanks again

Out of curiosity, how long is a typical workweek for resident... roughly (i know there's variation by specialty etc... ) thanks
 
79.5 hours/week with one day off per week....:smuggrin:

>13hrs/day ...:eek::eek::eek:..:thumbdown:thumbdown:thumbdown:..

so I guess overworked and under-appreciated is the mantra for residency... do u guys have "representation," some association that advocates for the humane treatment of residents??? Does AMA help??
 
Well, when I marry, I hope that my wife and I both work to pay down the debt and mortgage. I've considered the crazy thought of not having kids...


What's the point in doing that? It'll just free up more taxable income so you can support other people's kids and encourage more unwed/jobless idiots to keeping getting knocked up since you'll always be more than happy to pay for them.
 
...Does AMA help??
No. AMA has a great PR campaign to misinform the non-medical public. However, the AMA does NOT represent the majority of physicians. In some instances, physicians "join" or become "members" of AMA without their knowledge.... AMA seems to have some sort of membership drive/campaign with hospitals & licensing boards... Hospitals often automatically enter you into the AMA. I had this happen to me. I can not even begin to explain how difficult it was for me to get the AMA to take me off its membership list when I told them:
1. I did NOT join their organization
2. I did NOT want to be associated with their organization or be a member of their organization.
It took numerous phone calls, several official letters and ultimately a threat to file a lawsuit to get their "membership" office to finally remove my name and say, "we apologize there clearly was some sort of misunderstanding.....".
 
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Business training (even legal training) would be an excellent addition to medical school curricula. But apparently it's more important to learn how to be sensitive and inclusive, so there we are.
 
The AMA does do things related to medical education and I think tries to protect the education process to some extent, but mostly it's run by docs and not the med students and residents (though they do have a voice within the organization). It gets maligned a lot and I'm not currently a member, but have been one in the past. Unfortunately the AMA has trouble pleasing all the people all the time...if one member doc likes something, the another one won't. There is always infighting between the conservative docs and the liberal ones, etc. Our inability to unite as a group is one of the things that I think has allowed other medical groups (nurses' unions, etc.) to be more effective advocates than we are. We (docs) tend to split ourselves off into different specialty groups and then we ignore what may be our common interests.

But as far as working 13 hour days...you'll find out that ain't nothin'.
It's the 30 hour days that kill...LOL!
 
as far as AMA and who it represents, I would be very interested in seeing out of that supposed ~30% of physicians that are members, I would love to know:

1. how many of the number are residents?
2. are they counting medical students in that number?
 
I would say no, because >35% of med students are members.
It used to be 35% of practicing physicians...that sounds crappy but considering that getting docs to agree on anything is like herding cats, not as crappy as it sounds. Some used to c/o AMA being too "conservative" and would not join, and now that it drifted a bit too the left then they lost some conservative members due to that. Not sure the AMA's supposed ineffectiveness is really the AMA's fault...I've seen how things work in DC and it's damned hard to get anything done..they actually do decently well IMHO considering they are hamstrung by the fact that docs can't really agree on anything. Like most big organizations, though, AMA ends up getting hampered by its own bureaucracy. I don't belong to it any more, but was thinking of rejoining...it's just they sent me a bill for 200 or 400 dollars or something, which would be the rate for full fledged docs, that I can't really afford..I probably would rejoin if I could do so at the resident/fellow rate.
 
The AMA has declined in membership and influence over the decades because the specialty societies have taken its place. It's the cardiology, radiology, ortho organizations who have been seeing their clout increase as medical students choose specialties over primary care. However, if health care reform means an increase in interest in primary care, then the AMA will be helped by that.
 
I don't know Taurus...when I was an AMA member I didn't get the impression they represented primary care...it was more the AAFP and ACP-ASIM doing that. And it seemed like the specialists were the ones who had the money and time to go to AMA meetings...for example in the resident/fellow section, there were all these radiology and opthalmology residents in leadership positions...peds/fp/obgyn/IM types were busy @home taking call, etc. and not so many at the meetings, if you consider their overall numbers vs. number of rads and ophtho residents
 
I created a spreadsheet and I ran the numbers between a $40,000 per year school ($160,000 total), versus a $70,000 per year school ($280,000) and I really don't see a problem with the financials in either case. Both cases seem quite manageable. The numbers and calculation formulas are loose, but I'm pretty sure that they're definitely in the ballpark. To you guys who are nay saying the financials of med school, please look at these spreadsheets and tell me where you think my numbers are wrong.

lifetime financials of $160,000 in loans

lifetime financials of $280,000 in loans
 
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