I don't know many physicians who seem to show outward concern about their debt load, but I wouldn't say that I don't know many without significant debt to pay back. Its part of the equation, and most of them seem to factor it in. There are many ways to approach the system so that debt doesn't ruin you (or make you a slave). But it can be completely sustainable to carry high debt. I think there is something to be said for having a lot of debt along with a much higher cash flow vs having almost no debt, and much less cash flow. But I do know physicians that are leveraged very poorly, or else in a situation at work that they don't enjoy, but are stuck in. Those problems do exist, and you can read up on them here in you go to the other boards.
I think the questions you have to ask yourself are ones that have to do with the investment of time and energy for the better part of a decade. If money and respect are a big draw, there are easier and less stressful ways to make money and obtain prestige than medicine, so that's why I'm suggesting you disregard the debt issue and instead focus on the energy it takes to become a physician.
Medical school means intense study and delaying gratification. It also means relocation for medical school, and then relocation for residency, and possibly relocation for practice. You would be best served by having an attitude where you crave learning new things and working toward mastery, and are willing to spend your nights and evenings doing things to enhance that rather than participating in what the rest of the world tends to do on nights and weekends. There are ways to find balance, but most of what you will be doing along the way to a medical career will not be passiv....it will involve intense scheduling and sacrifice. At the end of all that effort, you will have missed events and experiences due to your training, and that might not be worth it if your heart isn't set on paying the cost in time. For instance, my neighbor is a newer physician, and missed out on a lot of their kids growing up. Meanwhile, I'm plugging away in nursing and NP'ing, and my kids had all their needs met very well, but I also got to be physically present for so much along the way. The difference between my neighbor and I isn't that my kids go without things that my neighbor's kids will have, but instead it is the difference between my neighbor's more expensive truck than mine, my neighbor's more expensive house than mine, and a few other aspects of living than mine. But I have NO debt, and my neighbor has literally hundreds of thousands of dollars to pay back to the bank... and that doesn't even count the home or the $50,000 truck. It will be a long time before my neighbor catches me financially, but once that happens, the gains might be significant. So who really has more money to spend? And who has more pressure placed upon them?
I have physician friends who have had good balance in their lives and enjoyed the journey. Moving around for training was an adventure, they didn't go overboard with spending along the way, but also didn't do without many of the typical experiences that young families outside the realm of medicine participate in. The education wasn't seen as a chore to be endured, but a moment to be lived in. Finishing residency and entering practice as a physician didn't become a license to spend with abandon and live hand to mouth on lavish things that were purchased with debt. I think that's the ideal model to look forward to if you want to find satisfaction in life as a physician.
So I think the issues you face that matter most are deeper than you might imagine, and speak to more than just what you think you want to have in terms of money, debt, respect, job outlook, etc. I was personally more motivated by what I might call the stepwise accomplishments that the nursing-to-NP path offered me. At key points in my pre med education, I just wasn't geared up to look several years ahead and see the reward as something I could hold out for. I liked doing a couple years of school and then getting the nursing degree, making money, and then moving to the next step along with way. That provided me with nice solid checkpoints that made me feel comfortable (probably because it felt safe if I wanted to stop for a while, which I never really ended up doing). Contrast that with being a premed, and then looking ahead 4 years to graduating, then looking at 4 more for med school, and then 4 more for residency. My mind couldn't see any reward beyond achieving a new set of issues to contend with. Yay for me. My conscious mind understood how delaying rewards was worthwhile, but I also felt as if a cloud was hanging over my life while I was waiting to get started with a career. So I jumped to something that suited me better. But some folks would live with regret while wondering what could have been if they had stuck out medical school. Again, with clear eyes I saw that I wouldn't enjoy the relocation, expense, and time commitment that came with the things that I wanted out of a career. I only saw two things that seemed worthwhile for me... financial reward, and the knowledge base. Financial reward didn't seem to match the effort required compared to other things out there (put 80 hour weeks into work as a lawyer or many other careers and you'd probably come out ahead of doctors that put that much time into their pathway to riches). Knowledge base is a would be nice to have, and while I don't take that lightly that as an NP I am lacking when compared to a physician, we also live in amazing times where knowledge is so easily obtainable (but of course, experience is not, so there's still that to contend with). But overall, I'm happy with my NP pathway, and the financial aspect of it is nice to look back on. I'm a worker, and derive a lot of satisfaction from plodding along and gaining skills along the way. I like flexibility, and resourcefulness, and the RN to NP journey catered to that sense.
Lately, so many folks have been focused on choosing NP or PA over MD/DO due to debt issues, and I really hope that folks set their sights on the big picture. You have to live with your job, and hopefully a lot longer than the debt you accrue. Go see what both of the professions do and see what you feel like you can enjoy enough to not hate every day you are working. That's where to start. Look at who seems to be most comfortable with their decisions for patient care, and who seems bored, or who seems to enjoy the process that they need to take to come up with diagnosis and treatment, and who is doing the kind of hands on work that you want to do. A lot of medicine outside of specialties that perform procedures involves simply talking to people and typing... all day. Prepare yourself for what the jobs entail.
