there are actually quite a few opportunities for people who know where they want to practice. my DO mentor said that three of his classmates knew where they wanted to live after graduation/residency and set up a contract in their first year at school that they would come to that area to work for a fixed length of time in exchange for paying for med school. it wasn't an organized thing, they just knew what they wanted and found the people to talk to about it. that's another option...
i was really worried about coming out with $200K in debt... one of the docs i work for said that it truly isn't a big deal... right now, grads are coming out of med school locking in interest rates around 3% for 30 years. that's significantly less than what we'll spend on houses... right now, at our present incomes (at least mine) $200K seems like a LOT of money and it is, but the math works out alright....
assume you make $150,000 salary (that's probably a bit low, but easy to demostrate with). after 37% in taxes, your takehome pay is $81,900. That's roughly $7875/month. Assume $200,000 total in debt. At 5% over 30 years, your payments will be less than $1100/month. That leaves $6775. Put a pile in savings/retirement fund and I know I can live off what is left... And the reality is $150.000 is probably a lower salary figure...
Just some bits to think about... It made me feel better.