I think the real question is how to handle your med school debt load while in residency... Most attending physicians can make payments on loans even up to $250,000 on a monthly basis over even a 10 year repayment plan, and still have money leftover for other expenses.
If you go into a reasonable specialty where your income is $150,000, according to
www.paycheckcity.com (which is a great site, by the way), that leaves 12,500 monthly gross, and about $7500.00 take home per month after the government (federal, state) is through stealing your money to give it to General Motors and Citibank. If you contribute to 401k, kids college fund, health insurance, etc, it's obviously less.
For a $140,000 loan at a passable interest rate of 5%, payments are about $1500/month over 10 years (you're paying like 40,000 in interest or something, BTW).
That leaves $6,000 per month for living after loan payments. Which is definitely doable.
You run into problems if you don't make any interest-only payments on that $140,000 while in residency. Instead of a principal of 140k, it could go up as high as $180,000 or higher during a 5 yr. residency, depending on your interest rate and terms of the loan.
Then your monthly payments when you're out go up from $1500.
If you can avoid taking med school loans in the first place, great. To the original poster: if you can really save 80k before matriculation, that would be absolutely awesome--you could use that money to finance your tuition for first and second years and then only take out loans for 3rd and 4th years.
Your loans will enter a 6 mo grace period after than, and you can then choose to either set them up for a 30 year repayment schedule (or some other kind of graduated payment plan or hardship plan) and actually enter repayment (and pay the loans during residency) or you can apply for a residency deferment (private loans) or forbearance (federal loans) so you don't *have* to make any payments at all in residency. But you should try to pay the interest at least during residency if you can't afford the monthly rates for the "repayment schedule" they give you.
Depending on your living situation and the loan amounts you ultimately have, you might be able to actually start repayment during residency. If you can't afford that, then you can do the forbearance thing, figure out how much you have to pay monthly to prevent your principal from going any higher, and pay that during residency. The downside is that you still have a big principal to pay when you get out of residency but the upside is that your principal balance will not have grown (from interest) while you were training in your specialty.
Then there are things to think about during medical school like...
Federal programs for loan forgiveness when going into primary care or working in underserved areas...
State programs for the same..
Specialty choice (pediatrics [~100,000 starting] vs. radiation oncology [~250,000+ starting] vs. neurosurgery [prob. even higher]
Private practice vs. academics (salaries are generally lower in academics, except for a few fields in primary care, maybe)
Generally the lower-reimbursed fields have more opportunity for federal/state loan forgiveness/repayment options (peds, family medicine, even OB/GYN in some programs etc).
I'm sure most people know this stuff already, but the money stuff I actually just had to figure out for myself, once and for all, because I've been burying my head in the sand and now that the loans are coming into repayment I have to think about it.
Hopefully some of that gives you a better idea, anyway.
