I am a little apalled to say the least about Nova's new announced rates for tuition for OOS, $44,500. This is a 10% increase over the previous year. If a 10% increase continues each year, those of us graduating in 2015 will pay $59,230 in tuition for our last year. Taking into consideration, origination fees, interest, cost of living expenses, and interest accruing during residency, I estimate that my total debt will be in excess of $480,000 at the end of my residency.

This seems like the school is taking advantage of students who want to go to medical school. Is there a reason for such large increases in tuition or is the school just trying to get as much $$ as they can?

There is no real reason for the increase. Except for perhaps, people are willing to pay it and once they enter medical school, they can't really transfer or get out.

Tuition is skyrocketing everywhere, so its not just Nova. Eventually, going to school, both undergraduate and medical school just wont be worth it.

My school's tuition next year will be $47,515, and goes up by about 5.4% every year!!! :eek: And that's JUST tuition, no living expenses or interest included... Ridiculous!

And they wonder why primary care isn't more competitive... I'm gonna be like $300k in debt!!!

That amount of debt is blatantly not worth it. I don't care if the 480k price tag comes with a guaranteed derm/rad onc/ENT residency certificate ... just not worth it.

That amount of debt is blatantly not worth it. I don't care if the 480k price tag comes with a guaranteed derm/rad onc/ENT residency certificate ... just not worth it.

Why not. If you open your own practice in one of those fields you can easily make 400-500k a year.

Why not. If you open your own practice in one of those fields you can easily make 400-500k a year.

This is another concern. Going to osteopathic school, the specialty selections are a little more narrow. I'm not saying derm is impossible. Just much less likely. In addition, I have heard a lot about insurance reinbursement being reduced.

How am I supposed to follow the school's mission and practice in an underserved area with $480 in debt, making $180/year?

Why not. If you open your own practice in one of those fields you can easily make 400-500k a year.

how are you going to open up private practice in rad onc? Those particle acclerators arent exactly cheap.

Good luck making 180K/year doing primary care in an underserved area.

I recently read an editorial about higher education being the next bubble to burst, and it's really easy to see how that could be true. Say you even go into a moderately competitive field and make a competitive salary of $250K/year. By all standards you're making a very good salary. But you're probably also in your early to mid 30's, have absolutely nothing saved for retirement, do not own a home, and you're still expected to pay back nearly half a million dollars in loans? It's insane.

That being said, I would definitely do it again. While I was originally interested in pediatrics, I decided to go into EM in part because of the compensation difference and in part because I loved EM too. I still think your "unmeasurable happiness factor" is important, and doing anything besides being a physician wouldn't have made me this happy. That being said, if the government is so concerned with the lack of PCPs, something either has to be done about the cost of medical education or physician reimbursement.

Check out the MedScape Physician Compensation Report 2011 (I don't know if you need to have an account, but it MedScape has tons of useful info and is worth signing up for the free account). There is a lot of really useful and detailed information there.

http://www.medscape.com/sites/public/physician-comp/2011

how are you going to open up private practice in rad onc? Those particle acclerators arent exactly cheap.

Ok maybe not rad onc. But as far as derm and ent go, there's no limit to what you can make with once you have a established practice.

This is another concern. Going to osteopathic school, the specialty selections are a little more narrow. I'm not saying derm is impossible. Just much less likely. In addition, I have heard a lot about insurance reinbursement being reduced.

How am I supposed to follow the school's mission and practice in an underserved area with $480 in debt, making $180/year?

Making 180 per year might be a problem. I agree that something has to be done in regard to pcp compensation.

Why not. If you open your own practice in one of those fields you can easily make 400-500k a year.

1. The days of hanging a shingle, even in lucrative fields like derm/rads, and making half a million dollars have slowly gone the way of the buffalo in my opinion. You could work a lot in derm and probably come close, but it would involve massive amounts of patients, several midlevels working with you, and probably some other more lucrative procedures (cosmetics, MOHS) that you were performing while your team was looking at the 150 moles that come in daily.

2. There's probably like a 99% chance you won't match into derm, which makes it a moot point, and sharpens the reality when making 190k in family practice or IM is a far more likely option (again, nothing to scoff at, but when you have 7% interest on 480k growing like cancer every day ... it's not ideal).

3. You won't start making the 'big bucks' until your early to mid thirties

4. Remember that making 300-400k a year is NOT the same as well ... making 300-400k a year or owing that money to some 3rd party entity. After taxes, the house payment, college tuition for your 2 kids, braces, new car payment, 1/2 of it going to taxes, etc, etc, etc it becomes more difficult to stretch that out and make fat cat loan payments each month (though you can definitely make some moves and get them within reasonable levels, but you'll be paying them for quite some time).

Having said that ... I'm in medical school right now, so I'm not saying it's all doom and gloom. What I am saying is that entering residency 1/2 a MILLION dollars in debt is scary, and I'd think long and hard about opportunity costs and ways to lessen that debt before taking the plunge.

If you're concerned about the debt and want to go into primary care, there are many incentive programs that help with the debt. Quite frankly, the debt IS worth it, and that's why medicine is still so competitive. Paying $300-400k one time in return for many years of 150k+ is a sound investment. and if something happens and you are unable to work for many years, you don't have to pay back the debt.

$44.5k and still cheaper than in state for PNWU which is now $45,650.

$44.5k and still cheaper than in state for PNWU which is now $45,650.

Too be fair that is the price for OOS too :D.

I can't imagine just starting out on the BS/DO track for Nova right now. Scurry...

Where is the money going from these tuition increases? Are people from private schools getting rich off of them? I thought that schools were supposed to be not for profit?

No idea. Administrators prob make 300K+ a year. So, some goes toward salary for all the random administrators around the campus. Some goes back into the school to expand it (add dental/PA/nursing programs), add more buildings, etc etc.

Regardless, eventually, it just wont be worth it to go to medical school. Some argue we have already passed that point. But, definately see it happening in the next 10 years. After all, you can become a nurse practitioner part-time and through an online program and still be called a doctor and function independently. Why put in this much time, effort, and money? PA program enrollment has been increasing dramatically also because it is a good career and much much shorter than medical school. Eventually, I think medical school will no longer be the way to go. It just wont be financially a smart move.

Higher education is getting cut just as much as any of your K-12 public schools. I don't know a single school that hasn't had 5-10% tuition increases a year up here in Michigan. I went to a B10 university and 4 years later when I went back to do premed at the local state university it was as much there as it was when I started at the big school. It sucks :mad:

Where is the money going from these tuition increases? Are people from private schools getting rich off of them? I thought that schools were supposed to be not for profit?


If the school is a non-profit you can access the I-990 forms and see many of the salaries of people who are in administrative roles. Those are public information that sadly too few people bother to read.

No idea. Administrators prob make 300K+ a year. So, some goes toward salary for all the random administrators around the campus. Some goes back into the school to expand it (add dental/PA/nursing programs), add more buildings, etc etc.

Regardless, eventually, it just wont be worth it to go to medical school. Some argue we have already passed that point. But, definately see it happening in the next 10 years. After all, you can become a nurse practitioner part-time and through an online program and still be called a doctor and function independently. Why put in this much time, effort, and money? PA program enrollment has been increasing dramatically also because it is a good career and much much shorter than medical school. Eventually, I think medical school will no longer be the way to go. It just wont be financially a smart move.

My wife will out earn me with her nursing degree at her current rate plus she will only work a 36 hour week with 6 weeks paid vacation. If I specialize and work until my late 60's I'll pass her, but it's going to be way more hours and effort. This is not something to do for the money.

Im paying 47,515 at Western. You still arent the highest for tuition so its all good

Im paying 47,515 at Western. You still arent the highest for tuition so its all good

It's still a pretty hefty chunk of change, man--and it's sure as hell not a competition, lol.

with capitalized interest I think we're all roughly in the same boat =(

Another one here ready to take the big debt plunge. I just finished an SMP which cost me 55K, and I will be starting at Touro Nevada this fall in which I will be borrowing 80k a year for the next 4 years. When I graduate med school in 2015, I will be 375k in the hole. At 7 percent interest that 375k will turn into about 480k by the time I finish a 4 year residency or about 450k if I do a 3 year residency.

Being a physician is definitely a middle class job. However the way I look at the financial mess I am creating by going to medical school, is through the amount of time on the job it will take me to pay back this whole experience. The 480k I owe when I start repayment, will probably be about 600k paid total by the time I pay off my debt during my first 5 years as an attending.

So 600k for the whole med school/smp experience. If I work hard in EM or Anesthesia, I should be able to make 300k a year pre-tax and 200k a year take home. It will take 100% of my pay for 3 years as an attending, to pay off all of my interest/loans. That's really not that bad in my opinion. If I need to work 3 years past normal retirement age in the future to fulfill my dream its definitely worth it.

Another one here ready to take the big debt plunge. I just finished an SMP which cost me 55K, and I will be starting at Touro Nevada this fall in which I will be borrowing 80k a year for the next 4 years. When I graduate med school in 2015, I will be 375k in the hole. At 7 percent interest that 375k will turn into about 480k by the time I finish a 4 year residency or about 450k if I do a 3 year residency.

Being a physician is definitely a middle class job. However the way I look at the financial mess I am creating by going to medical school, is through the amount of time on the job it will take me to pay back this whole experience. The 480k I owe when I start repayment, will probably be about 600k paid total by the time I pay off my debt during my first 5 years as an attending.

So 600k for the whole med school/smp experience. If I work hard in EM or Anesthesia, I should be able to make 300k a year pre-tax and 200k a year take home. It will take 100% of my pay for 3 years as an attending, to pay off all of my interest/loans. That's really not that bad in my opinion. If I need to work 3 years past normal retirement age in the future to fulfill my dream its definitely worth it.


I think your math is a bit off.

Could you elaborate where my math is off?

Another one here ready to take the big debt plunge. I just finished an SMP which cost me 55K, and I will be starting at Touro Nevada this fall in which I will be borrowing 80k a year for the next 4 years. When I graduate med school in 2015, I will be 375k in the hole. At 7 percent interest that 375k will turn into about 480k by the time I finish a 4 year residency or about 450k if I do a 3 year residency.

Being a physician is definitely a middle class job. However the way I look at the financial mess I am creating by going to medical school, is through the amount of time on the job it will take me to pay back this whole experience. The 480k I owe when I start repayment, will probably be about 600k paid total by the time I pay off my debt during my first 5 years as an attending.

So 600k for the whole med school/smp experience. If I work hard in EM or Anesthesia, I should be able to make 300k a year pre-tax and 200k a year take home. It will take 100% of my pay for 3 years as an attending, to pay off all of my interest/loans. That's really not that bad in my opinion. If I need to work 3 years past normal retirement age in the future to fulfill my dream its definitely worth it.

Wowwwww methinks you doth assume too much.

If you work hard in EM, chances are you'll make around 220-250/year, and 350/yr in anesthesia. Your take home will be more like 100k and 150k, respectively, accounting for taxes, malpractice insurance, and overhead. If you've got a family or kids, watch your ability to save that cash go down pretty quick. Like having a car? A home? Regular meals?

Expenses add up fast, and if the bolded part of your comment doesn't bother you, it should. You're vastly overestimating your ability to generate cashflow.

My wife will out earn me with her nursing degree at her current rate plus she will only work a 36 hour week with 6 weeks paid vacation.

This doesn't seem right. What are nurses making where you are, and what are you using for a doctor's compensation? A new grad, full-time nurse here makes about $45,000, an EM doctor pulls down $300,000+ and bonuses for 14 8 hour shifts a month, and apparently more as they move down the partner path.

If you work hard in EM, chances are you'll make around 220-250/year, and 350/yr in anesthesia. Your take home will be more like 100k and 150k, respectively, accounting for taxes, malpractice insurance, and overhead. If you've got a family or kids, watch your ability to save that cash go down pretty quick. Like having a car? A home? Regular meals?

Expenses add up fast, and if the bolded part of your comment doesn't bother you, it should. You're vastly overestimating your ability to generate cashflow.

I suspect you're underestimating your ability to generate cashflow. But I'm also pretty sure I'm passing on NSU between the tuition, COA, and preferring PBL. Either way, tuition increases are out of control. I've heard from more than one fairly recent EM residency grad that I'd never pay off my loans if I took out NSU's full COA (and these are from the aformentioned, pretty well-to-do group). They weren't facing down anything close to what we're looking at.

If you end up making 100-150k take home, you will be fine paying off that amount of debt honestly.

That amount of debt is blatantly not worth it. I don't care if the 480k price tag comes with a guaranteed derm/rad onc/ENT residency certificate ... just not worth it.
I would take 480k debt for derm. But as it is I'll be taking a slightly lower debt to do primary care or ER (I do think in the op's case the numbers are exaggerated. $45k/yr tuition *4 does not equal 480k unless you also take debt to drive an Audi A6). If you are certain about going into primary care you can always do HPSP and avoid any debt.

Wowwwww methinks you doth assume too much.

If you work hard in EM, chances are you'll make around 220-250/year, and 350/yr in anesthesia. Your take home will be more like 100k and 150k, respectively, accounting for taxes, malpractice insurance, and overhead. If you've got a family or kids, watch your ability to save that cash go down pretty quick. Like having a car? A home? Regular meals?

Expenses add up fast, and if the bolded part of your comment doesn't bother you, it should. You're vastly overestimating your ability to generate cashflow.

Hey Munchers do you really think EM physicians only take home 100k a year after taxes, malpractice, and overhead? Most EM physicians work for groups and hospitals that pay for their malpractice insurance and overhead as part of their benefits. As for taxes go find a tax bracket calculator, if you make 250,000 as a single tax payer, and you dont deduct a single thing (which most people do, i.e. mortgage interest, retirement contributions) you still only have to pay the feds 67k, leaving a 183k for yourself. In my state there is no income tax.

You stated earlier that I am vastly over estimating my ability to generate cashflow, I disagree. An EM physician who is willing to work hard and pick up extra shifts can easily take home 200k a year after taxes.

And like I said earlier if I end up paying 600k for med school when all is said and done. That is equivalent to three years of take home attending salary. I am not saying that its all going to be payed off in the first 3 years rather that the total paid off is equivalent to 3 years worth of salary.

If the school is a non-profit you can access the I-990 forms and see many of the salaries of people who are in administrative roles. Those are public information that sadly too few people bother to read.

Would someone post the link to Nova's I-990? Thanks.

Would someone post the link to Nova's I-990? Thanks.

http://www.nova.edu/cwis/fop/forms/oe2008.pdf That's the latest one I got.

I wonder how much of the tuition at NSU is going to support other academic programs- anthropology research or history professors and title 9 scholarships for athletics. I'm not questioing the value of Title 9.

My impression is that at larger universities (opposite of most osteopathic schools) administrations are able to finding funding and endowments for medical students to keep costs in control.

Consider the following:

1. Student Debt is now owned by the US goverment.
2. The US Government -HHS- pays for the vast majorities of residencies.
3. IBR and PSLF will allow physicians to discharge debt after 10 years (PSLF) or allow physians to let debt accumulate for 25 years and then discharge a massive amount of debt (IBR -25 years)

This means that the US governemnt is footing more or less the entire bill for training physicians. There is absolutely no incentive for schools to keep costs down. The more they charge, the more they rake in. This is free money to schools- and students are not ultimately footing the bill.

Anyone got some extra skrilla layin' round to open Dewey Cheatem and How medical school?

If the school is a non-profit you can access the I-990 forms and see many of the salaries of people who are in administrative roles. Those are public information that sadly too few people bother to read.

how do you access it? Is there a website of all, or is it only found digging around a schools website?

I'm having trouble just googling "X school I-990" and finding the results of dif schools

I am a little apalled to say the least about Nova's new announced rates for tuition for OOS, $44,500. This is a 10% increase over the previous year. If a 10% increase continues each year, those of us graduating in 2015 will pay $59,230 in tuition for our last year. Taking into consideration, origination fees, interest, cost of living expenses, and interest accruing during residency, I estimate that my total debt will be in excess of $480,000 at the end of my residency.

This seems like the school is taking advantage of students who want to go to medical school. Is there a reason for such large increases in tuition or is the school just trying to get as much $$ as they can?

It's not a 10% increase! The tuition+fess was ~$42,000 for 2010-2011 year. If next year its $44,500, then its a 5% increase, which is typical of most schools...

It's not a 10% increase! The tuition+fess was ~$42,000 for 2010-2011 year. If next year its $44,500, then its a 5% increase, which is typical of most schools...

Tuition was $40,200 last year. It will be $44,750, this year.

It's still a pretty hefty chunk of change, man--and it's sure as hell not a competition, lol.

with capitalized interest I think we're all roughly in the same boat =(

lol definitely a contest i DONT want to win:p

http://www.google.com/url?sa=t&source=web&cd=3&sqi=2&ved=0CCkQFjAC&url=ftp%3A%2F%2Fftp.mgma.com%2Fsurvop%2Fglacierpub lishing%2FCompleted%2520Projects%2FPS%25202010%2Fp revious%2FPS2010Proof2.pdf&rct=j&q=2010%20mgma%20compensation%20survey%20pdf&ei=KXm8TYSYOdH3gAer_Zm5BQ&usg=AFQjCNEsyP-SQuW5uzNPuLdF3-837Jf01g&cad=rja


This is the largest and most comprehensive physician salary survey with just under 60,000 physicians. Also keep in mind that the avg physician works 46 weeks out of the year.

Also if you are a primary care doctor you have multiple programs willing to pay off your debt. So I don't see why everyone is saying that most of the debt they incur is a large problem.

If you can endure the strict rules of LECOM-erie or Bradenton, then it is well worth the 28,000 a year in-state and 29,000 OOS tuition. I will graduate next year with just over 225,000 in debt and I have two kids. I took out around 52,000, the full amount every year for tuition+living expenses. The tuition over the 3 years that I have been there has only risen 3,000. Not sure why every other school's tuition is skyrocketing.

As we're sitting here trying to justify half a million dollar debt as 'worth it,' Obama just nominated a nurse to become the new U.S. surgeon general:

http://fayobserver.com/articles/2011/05/03/1091390?sac=Home

Welcome to the future. Is it worth it to spend 500k, 12 years, and 1 soul to achieve something that's been 100% devalued and taken over in our society? You tell me ...

As we're sitting here trying to justify half a million dollar debt as 'worth it,' Obama just nominated a nurse to become the new U.S. surgeon general:

http://fayobserver.com/articles/2011/05/03/1091390?sac=Home

Welcome to the future. Is it worth it to spend 500k, 12 years, and 1 soul to achieve something that's been 100% devalued and taken over in our society? You tell me ...

For some reason, that just made me sick. A nurse as surgeon general just dosnt sound right.

The average med student debt in 2011 is $156,456 according to the AAMC.

We can talk about extremes all we want, but IMO a 350k loan is still worth an MD today, even if you are going to primary care. There are plenty of people living very comftable lives making 65-70k (45-50k after taxes) ...Compare that to 170k as a FP (130k after taxes) and if you devote 50k to your loan it will be easily paid off in 8-9 years. So you make 80k after taxes (equivalent of a 120k salary before taxes) for 8-9 years of your career and then after that point, all of your 170k salary is yours, till you retire. Unless the person is completely irresponsible with money, they'd still be making "bank" despite their loans. And this is an example with 2x the average student debt and an FP salary. People need to get out and see how difficult it is to be making the money we do doing something else and perhaps that'll make you appreciate medicine and its benefits.

Its just funny how everyone just takes the latest ridiculous number they've heard someone pay for med school and assume that is the norm. There are pharmacists that come out with 300k in loans (I know, cuz I married one!) and with the right financial planning, it's possible to even pay that off within 10-15 years making 110k. The average doc makes over 250-275k; please guys have some perspective.

The average med student debt in 2011 is $156,456 according to the AAMC.

We can talk about extremes all we want, but IMO a 350k loan is still worth an MD today, even if you are going to primary care. There are plenty of people living very comftable lives making 65-70k (45-50k after taxes) ...Compare that to 170k as a FP (130k after taxes) and if you devote 50k to your loan it will be easily paid off in 8-9 years. So you make 80k after taxes (equivalent of a 120k salary before taxes) for 8-9 years of your career and then after that point, all of your 170k salary is yours, till you retire. Unless the person is completely irresponsible with money, they'd still be making "bank" despite their loans. And this is an example with 2x the average student debt and an FP salary. People need to get out and see how difficult it is to be making the money we do doing something else and perhaps that'll make you appreciate medicine and its benefits.

Its just funny how everyone just takes the latest ridiculous number they've heard someone pay for med school and assume that is the norm. There are pharmacists that come out with 300k in loans (I know, cuz I married one!) and with the right financial planning, it's possible to even pay that off within 10-15 years making 110k. The average doc makes over 250-275k; please guys have some perspective.

I agree completely with what you wrote.

The AAMC average of 156k is quite a funny number because at face value a student might look at that and think the typical med student will borrow 156k for their entire education. When the reality is that average includes students borrowing zero money during med school because their mom or dad is a doctor or other high income earner and is paying for med school, or due to HPSP/military scholarships paying for med school. It'd be nice if the AAMC took the average only for those students who borrowed money, instead of including all allopathic med students.

For some reason, that just made me sick. A nurse as surgeon general just dosnt sound right.

Its for Army only, but still doesn't make sense to give RN the title of Surgeon.

We can talk about extremes all we want, but IMO a 350k loan is still worth an MD today, even if you are going to primary care. There are plenty of people living very comftable lives making 65-70k (45-50k after taxes)

Did the people making 65-70k start earing at 35 or 22?


...Compare that to 170k as a FP (130k after taxes) and if you devote 50k to your loan it will be easily paid off in 8-9 years. So you make 80k after taxes (equivalent of a 120k salary before taxes) for 8-9 years of your career and then after that point, all of your 170k salary is yours, till you retire.

Technically, I think making 170k would put you into a 33% tax bracket automatically for federal tax purposes, so it seems like the 130k number is inaccurate off the bat. Furthermore, I don't think this takes into consideration the additional overhead of running a medical practice (which the 65k cube dweller doesn't have).

Once you take paying your staff, paying absurd rent on your practice, paying high malpractice insurance rates, you're looking at a much more significant figure, and this also doesn't even take into consideration the loan payments WHICH are not stagnant and grow at close to 7% each year.

Additionally, 80k after taxes then goes straight into your excessive house payment (have to keep up that doctor image), then into the braces, car payment, and college tuition payments as you didn't start having kids until later and you're dealing with these types of BS headaches for a bit longer than the average 65k'er

Unless the person is completely irresponsible with money, they'd still be making "bank" despite their loans.

No one makes bank ... period. You saying the average pediatrician makes 'bank' in MY OPINION is just as big of an extreme as the people throwing around the 480k a year number. In fact, I'd be willing to bet that there are far more pediatricians barely clearing 6 figures or making very low 6 figures out there then there people with the 500k student debt. Run your numbers again at 100k instead of 170k, and it simply doesn't come out to 'bank.'


People need to get out and see how difficult it is to be making the money we do doing something else and perhaps that'll make you appreciate medicine and its benefits.

While I agree that many people underestimate the security and it's difficult to find many other professions out there where you are guaranteed 6 figures for simply attending medical school, but I think you'd also be hard pressed to find many people in random fields that came out of their education in their early 30s with absolutely no assets and 200k in debt. The average guy in sales may only be making 80k, but he started making this at 24 years old with 0 debt and has been saving, making investments, and working steadily for the 8 years you were building debt and opportunity costs in medical school.

Its just funny how everyone just takes the latest ridiculous number they've heard someone pay for med school and assume that is the norm. There are pharmacists that come out with 300k in loans (I know, cuz I married one!) and with the right financial planning, it's possible to even pay that off within 10-15 years making 110k. The average doc makes over 250-275k; please guys have some perspective.

Pharmacists are done in what ... 3 years? Additionally, if you paid off a 300k loan over 15 years, you're looking at an additional 20k that you paid just in interest alone.

PS - you guys may start to feel a little different when you add your loans on to your spouse's.

No one here is saying it can't be done, no one here is saying that it isn't a safe choice, etc, but people (especially young students right out of college) should be very aware of the financial aspects of taking out that much loan money. People get in over their heads all the time, and more importantly, people begin to find out that the 500k debt maybe didn't afford them the 'bank' lifestyle they assumed they would have working as a PCP making 180k a year. If you went to some financial planner and said you wanted to take out 500k, build interest on it, and leverage it against making 170k in an declining market WHERE a similar and much more cost effective path existed to essentially the same end goal (PAs and especially, barf, NPs) ... they would call you nuts.

I'll say it again ... 480k in debt isn't worth all the wonders that a life in medicine has to offer. Don't believe me ... ask attendings. Hell, they should actually be the only people you ask.

If you want it, do it, but find a way to do it for cheaper. Do the service corps, look into a PC loan forgiveness program, or find a field where you can think outside the box and clear half a million a year.

The average med student debt in 2011 is $156,456 according to the AAMC.

We can talk about extremes all we want, but IMO a 350k loan is still worth an MD today, even if you are going to primary care. There are plenty of people living very comftable lives making 65-70k (45-50k after taxes) ...Compare that to 170k as a FP (130k after taxes) and if you devote 50k to your loan it will be easily paid off in 8-9 years. So you make 80k after taxes (equivalent of a 120k salary before taxes) for 8-9 years of your career and then after that point, all of your 170k salary is yours, till you retire. Unless the person is completely irresponsible with money, they'd still be making "bank" despite their loans. And this is an example with 2x the average student debt and an FP salary. People need to get out and see how difficult it is to be making the money we do doing something else and perhaps that'll make you appreciate medicine and its benefits.

Its just funny how everyone just takes the latest ridiculous number they've heard someone pay for med school and assume that is the norm. There are pharmacists that come out with 300k in loans (I know, cuz I married one!) and with the right financial planning, it's possible to even pay that off within 10-15 years making 110k. The average doc makes over 250-275k; please guys have some perspective.

A lot of pharm schools take people after finishing their 3rd year of undergrad. Well, in the South, anyway. Also, pharm school is 3 years? Maybe 4? No residency required. You start making a cool 6 figures after that. My question is, how the F*CK did your SO accue 300K in debt? Must be combining undergrad and pharm school. In that case, should have pursued a cheaper state school. Debt load from college would be close to, if not, $0.

My debt load is less than most since I did the state school option. However, my med school debt is well > 200K. Also, getting paid in the 50K range for 4 years of residency, and then likely a fellowship, isn't real $$ to pay off that debt load within 4-5 years.

A lot of pharm schools take people after finishing their 3rd year of undergrad. Well, in the South, anyway. Also, pharm school is 3 years? Maybe 4? No residency required. You start making a cool 6 figures after that. My question is, how the F*CK did your SO accue 300K in debt? Must be combining undergrad and pharm school. In that case, should have pursued a cheaper state school. Debt load from college would be close to, if not, $0.

My debt load is less than most since I did the state school option. However, my med school debt is well > 200K. Also, getting paid in the 50K range for 4 years of residency, and then likely a fellowship, isn't real $$ to pay off that debt load within 4-5 years.
If you go to a 6-year school where you pay $28-29k for the first three years, then an increase for the professional years ($32,500X2) + 45k for your rotation year you're at:

$219,000 without interest. Full bill. No breaks. Throw in interest and if you do a residency and it could be a lot.

Most pharmacy schools are 4 years, with most people doing a bachelors before now. There are a few 3 year programs though, and a few who take people with less than a bachelors regularly but for the norm figure 8 years of school.

If you go to a 6-year school where you pay $28-29k for the first three years, then an increase for the professional years ($32,500X2) + 45k for your rotation year you're at:

$219,000 without interest. Full bill. No breaks. Throw in interest and if you do a residency and it could be a lot.

Isn't 6 years combined BS and PharmD?

Yeah.

Tuition was $40,200 last year. It will be $44,750, this year.

This is actually an 11.3% increase.

Well then don't go there OOS unless the government or your parents are footing the bill :o

It'd be nice if the AAMC took the average only for those students who borrowed money, instead of including all allopathic med students.

I think the average is closer to 185k for those who actually took out loans.. I don't remember the source for this.

I personally think there should be some legislation, or at least a widespread practice, requiring schools to provide incoming students with a tuition schedule for their entire 4 years. I think it is ridiculous that they can not only lock you into paying out of state tuition the entire 4 years (even though you will be paying state taxes if your SO works just like everybody else), but they can do whatever they want with tuition and you are gonna pay.

Say they keep raising tuition by $5k a year, what are you gonna do about it? Quit school? If they want to raise tuition, fine, but do it on the incoming class and let me pay an amount I agree upon BEFORE entering school.

This bubble will eventually burst. Now all the loans owned by the US government, so that's even worse. As much as I hate debt, maybe I should just let my loans dangle in the wind and wait for the inevitable government bailout...:(

I personally think there should be some legislation, or at least a widespread practice, requiring schools to provide incoming students with a tuition schedule for their entire 4 years. I think it is ridiculous that they can not only lock you into paying out of state tuition the entire 4 years (even though you will be paying state taxes if your SO works just like everybody else), but they can do whatever they want with tuition and you are gonna pay.

Say they keep raising tuition by $5k a year, what are you gonna do about it? Quit school? If they want to raise tuition, fine, but do it on the incoming class and let me pay an amount I agree upon BEFORE entering school.

This bubble will eventually burst. Now all the loans owned by the US government, so that's even worse. As much as I hate debt, maybe I should just let my loans dangle in the wind and wait for the inevitable government bailout...:(

You know it's too bad you're not some banking executive. Then you could take millions of dollars worth of taxpayer bailout money, spend it all on ferarris, cocaine, and hookers, and get away with it! [/end rant]

Anyway, I find it interesting that all these DO schools love to blab about their commitment to primary care, while making it more difficult financially for anyone to choose primary care as their profession.

Anyway, I find it interesting that all these DO schools love to blab about their commitment to primary care, while making it more difficult financially for anyone to choose primary care as their profession.


I think thats a bit harsh .. I think the increase in tuition is more to keep them up to date with technology compared to their M.D. counterparts and specifically in regards to the instruction of medicine for their students. You like having that test prep course paid for? having enough cadavers well maintained for anatomy? How about having PhDs / physicians teach your classes... as opposed to PAs or maybe an RN could come in and teach you some biochem?


Don't get me wrong, I definitely agree that tuition is outrageous across the board and I liked the idea of a previous post about subsidizing tuition for students who can promise they would go into primary care as a career. I just think its unnecessary to bash "all these DO schools" and group them together as some sort of evil organization trying to screw students over in the long run.

I think thats a bit harsh .. I think the increase in tuition is more to keep them up to date with technology compared to their M.D. counterparts and specifically in regards to the instruction of medicine for their students. You like having that test prep course paid for? having enough cadavers well maintained for anatomy? How about having PhDs / physicians teach your classes... as opposed to PAs or maybe an RN could come in and teach you some biochem?


Don't get me wrong, I definitely agree that tuition is outrageous across the board and I liked the idea of a previous post about subsidizing tuition for students who can promise they would go into primary care as a career. I just think its unnecessary to bash "all these DO schools" and group them together as some sort of evil organization trying to screw students over in the long run.

it's not a DO thing. Heck, it's not even a medical school thing. Tuition is increasing at rates that exceed inflation drastically in undergrad, law school, grad school etc. It's primarily the result of government policy of subsidizing student loans which allows colleges (across the board) to charge ridiculous new fees each year (and to compete in an arms race with each other), since they have a guaranteed stream of revenue no matter how high it goes.

it's not a DO thing. Heck, it's not even a medical school thing. Tuition is increasing at rates that exceed inflation drastically in undergrad, law school, grad school etc. It's primarily the result of government policy of subsidizing student loans which allows colleges (across the board) to charge ridiculous new fees each year (and to compete in an arms race with each other), since they have a guaranteed stream of revenue no matter how high it goes.

:thumbup:

They keep charging more every year because they can. Our incoming class size is increasing by about 30 students next year and at ~$30,000/student that will bring in $900,000 in tution. They might add 1 more faculty member? And thats just tuition, there are fees and fees and more fees on top of that.

They do it because they can. Everyone is guaranteed at least a certain amount of loans from the government, no credit check no nothing, just "here you go". My concern is that this really puts the taxpayers at risk if/when a lot of people start defaulting on their student loans.

You know it's too bad you're not some banking executive. Then you could take millions of dollars worth of taxpayer bailout money, spend it all on ferarris, cocaine, and hookers, and get away with it! [/end rant]

Anyway, I find it interesting that all these DO schools love to blab about their commitment to primary care, while making it more difficult financially for anyone to choose primary care as their profession.

this is in reply to you and the post above you:
1) i agree that tuition hikes are unfair. but who is to gain from any freezes to tuition increase? you and a 1000 other students? you do not represent 50% of the u.s. population... so why should the govt intervene on your behalf? please, there is no need for some madeup story about how lower expenses for you is beneficial to everybody else.
2) most of those banks did not get any bailout. they got loans at serious % rates. and many of the bigger banks who were not in danger of failure were forced to take on those loans.
3) you do go into primary care if you cant match into a cushy specialty or if you just want to. no one is forcing you to do derm:). whats so hard to understand about that? if you think that medical tuition is too high for someone making primary care wages you may do HPSP which will rid you off any loans. the scholarship is not competitive and you only delay entry into civilian primary care practice by 4yrs. obviously the vast majority of DO students do not take advantage of this scholarship(i don't) because it basically forces you into primary care.

This entire thread just makes me so grateful that I live in Texas

how do you access it? Is there a website of all, or is it only found digging around a schools website?

I'm having trouble just googling "X school I-990" and finding the results of dif schools


http://foundationcenter.org/findfunders/990finder/

Just search away.

I think thats a bit harsh .. I think the increase in tuition is more to keep them up to date with technology compared to their M.D. counterparts and specifically in regards to the instruction of medicine for their students. You like having that test prep course paid for? having enough cadavers well maintained for anatomy? How about having PhDs / physicians teach your classes... as opposed to PAs or maybe an RN could come in and teach you some biochem?


Don't get me wrong, I definitely agree that tuition is outrageous across the board and I liked the idea of a previous post about subsidizing tuition for students who can promise they would go into primary care as a career. I just think its unnecessary to bash "all these DO schools" and group them together as some sort of evil organization trying to screw students over in the long run.


Ya, we have so much new technology.

I think thats a bit harsh .. I think the increase in tuition is more to keep them up to date with technology compared to their M.D. counterparts and specifically in regards to the instruction of medicine for their students. You like having that test prep course paid for? having enough cadavers well maintained for anatomy? How about having PhDs / physicians teach your classes... as opposed to PAs or maybe an RN could come in and teach you some biochem?


Don't get me wrong, I definitely agree that tuition is outrageous across the board and I liked the idea of a previous post about subsidizing tuition for students who can promise they would go into primary care as a career. I just think its unnecessary to bash "all these DO schools" and group them together as some sort of evil organization trying to screw students over in the long run.

Medical schools cost a lot of money to run. Public schools usually get much more funding from the government. Private schools pass the costs on to students due to necessity, and they likely will continue to raise tuition as long as any students will pay it. These schools realize that you would have chosen a cheaper public school over them, so they have little sympathy. Its them or nothing.

For those that believe tuition is too high, the military will pay for your education in exchange for service and there are numerous loan forgiveness programs out there for primary care physicians willing to work in underserved areas.

So there are already programs out there to help you down. You just have to agree to their terms.

3) you do go into primary care if you cant match into a cushy specialty or if you just want to. no one is forcing you to do derm:). whats so hard to understand about that? if you think that medical tuition is too high for someone making primary care wages you may do HPSP which will rid you off any loans. the scholarship is not competitive and you only delay entry into civilian primary care practice by 4yrs. obviously the vast majority of DO students do not take advantage of this scholarship(i don't) because it basically forces you into primary care.


Not necessarily true. You do your military service after your residency, which, if you do a civilian one, bumps up the number of years in your service commitment. Want to be a surgeon and don't want to do a military residency? That's 9 years AFTER you've completed your residency training.

Of course, the recruiter I talked to didn't tell me any of this. They're so full of crap I can't believe it. Only do HPSP if you're interested in being a military officer. Outside of that you're much better off doing something like the natl health service.

Medical schools cost a lot of money to run. Public schools usually get much more funding from the government. Private schools pass the costs on to students due to necessity, and they likely will continue to raise tuition as long as any students will pay it. These schools realize that you would have chosen a cheaper public school over them, so they have little sympathy. Its them or nothing.

For those that believe tuition is too high, the military will pay for your education in exchange for service and there are numerous loan forgiveness programs out there for primary care physicians willing to work in underserved areas.

So there are already programs out there to help you down. You just have to agree to their terms.

If private medical schools are raising tuition to ensure that the quality of education is high, I am all for it. If they are just raising it by as much as possible to see how much they can get, I think that is a problem. It is interesting that the cost is making its largest increases as the demand to go to medical school is increasing.

If private medical schools are raising tuition to ensure that the quality of education is high, I am all for it. If they are just raising it by as much as possible to see how much they can get, I think that is a problem. It is interesting that the cost is making its largest increases as the demand to go to medical school is increasing.

There is a point of diminishing returns though. Under the current policy of providing government subsidized loans to ANYONE, regardless or individual circumstances, colleges (medicine, dental, undergrad) can constantly raise tuition EVERY year, and at any rate they want, because it's guaranteed the money will come in via the US government. There is no sense of fiscal responsibility among administrations, and no interest in doing things that would cut bloated administrative costs or tuition fees. It's not unique to Nova, or the DO world, but any private institution in the US.

The point is that with every hike in tuition costs, while some will go towards improving the "educational quality," many are not needed or only provide marginal returns in comparison to the tuition hike that results from them. For example, if you add a new 25 million dollar simulation center, that would surely mean a higher quality of medical education, but would that be worth a 10K tuition spike for students?

Medical Schools, because revenue is guaranteed, don't think in terms of cost: benefit ratios when they hike fees...they only consider the benefits to their name recognition/reputation. i.e. Harvard needs a new 100 million dollar student center, because Yale just got a 100 million dollar student center. If we didn't have subsidized loans, the costs of all higher education would drastically drop, as colleges would be forced to restructure, eliminate waste and unnecessary aspects of medical education. If they didn't, they would go bankrupt because no one would be able to pay...

this is in reply to you and the post above you:
1) i agree that tuition hikes are unfair. but who is to gain from any freezes to tuition increase? you and a 1000 other students? you do not represent 50% of the u.s. population... so why should the govt intervene on your behalf? please, there is no need for some madeup story about how lower expenses for you is beneficial to everybody else.
2) most of those banks did not get any bailout. they got loans at serious % rates. and many of the bigger banks who were not in danger of failure were forced to take on those loans.
3) you do go into primary care if you cant match into a cushy specialty or if you just want to. no one is forcing you to do derm:). whats so hard to understand about that? if you think that medical tuition is too high for someone making primary care wages you may do HPSP which will rid you off any loans. the scholarship is not competitive and you only delay entry into civilian primary care practice by 4yrs. obviously the vast majority of DO students do not take advantage of this scholarship(i don't) because it basically forces you into primary care.

In response to your first point: I'm not even asking for a tuition freeze. I'm just asking that they provide you with information on how much your degree will cost (assuming you finish in 4 years) BEFORE you are admitted. If that means that tuition increases 5%/yr, fine, but at least it will be outlined beforehand so that one could make an informed decision. The way it is now, they can do whatever they want with tuitions and you have no idea how much it may change over the course of your education. It is analogous to an ARM and I'd much rather see tuition schedules be fixed so at least people will understand exactly what they are getting into.

I have seen a lot of people comparing expected salaries that they will earn to pay their loans. None of them seem to take into consideration that if you are enter medical school this year the salaries will have risen over those 8 years. A job paying $250k per year (such as EM) will pay $342K per year based on a 4% yearly pay increase. Pay increase might not be that much yearly but it gives a good example of how much pay can increase in a decade. A PCP making $180k would make $246k following the same logic.

$480k on a 30 year loan would be payed off with $37k per year. To pay it off in 10 years would take $66k. The PCP making $246k would take home 160k assuming 35% an effective tax rate (which is probably more than you will pay). So $123k for the rest of your expenses does not seem terrible. Yes it is not as much as you would like but that is what it comes down to. It is not as bad as many of you are trying to make it out to be! The ER doc would bring home $222k.

Also, I do not see where you are coming up with the amount of $480k in the first place. The overall increase of attending the school only increased by about 6%. The COA for last year OOS was ~80k. Assuming this trend continues, you are looking at a maximum of $360k in loans taken out. The only people who should be taking out the maximum are students supporting families. If you are by yourself you can easily save $16k per year on their housing estimate alone (spend 500 per month rooming with others for 6k per year compared to 22k estimated).

And on top of everything else, if the current IBR system stays in place you will have all of that debt forgiven after 10 years working in a public program. Also PCPs can have their debt forgiven by many programs.

I will say that I am glad that I am an instate student though!

@Adsargen - physician salaries do not follow the general inflation curves. There are some specialties that were making more twenty years ago than today. Also, you failed to consider interest on loans. If you took out the max 80 every year, then you wouldn't look at your finances on graduation day and see 360, you would see something more like 400 and it gets worse from there.

As I mentioned before, however, I think we are not at the point where medicine is "not worth it."

I have seen a lot of people comparing expected salaries that they will earn to pay their loans. None of them seem to take into consideration that if you are enter medical school this year the salaries will have risen over those 8 years. A job paying $250k per year (such as EM) will pay $342K per year based on a 4% yearly pay increase. Pay increase might not be that much yearly but it gives a good example of how much pay can increase in a decade. A PCP making $180k would make $246k following the same logic.

$480k on a 30 year loan would be payed off with $37k per year. To pay it off in 10 years would take $66k. The PCP making $246k would take home 160k assuming 35% an effective tax rate (which is probably more than you will pay). So $123k for the rest of your expenses does not seem terrible. Yes it is not as much as you would like but that is what it comes down to. It is not as bad as many of you are trying to make it out to be! The ER doc would bring home $222k.

Also, I do not see where you are coming up with the amount of $480k in the first place. The overall increase of attending the school only increased by about 6%. The COA for last year OOS was ~80k. Assuming this trend continues, you are looking at a maximum of $360k in loans taken out. The only people who should be taking out the maximum are students supporting families. If you are by yourself you can easily save $16k per year on their housing estimate alone (spend 500 per month rooming with others for 6k per year compared to 22k estimated).

And on top of everything else, if the current IBR system stays in place you will have all of that debt forgiven after 10 years working in a public program. Also PCPs can have their debt forgiven by many programs.

I will say that I am glad that I am an instate student though!

From what I have have read on SDN, it sounds like physician reimbursements are being cut from medicare and private insurance. I hope you are correct about pay increasing as we take on more debt. However, if you read some of the resident/physician forums, it may scare you. GI docs are getting less for coloscopies; anesthesiologist are getting replaced by CRNAs, primary care docs are getting 25% less for office visits thru Medicare. This trend is expected to continue. Who knows what we will get in 7-8 years when we have completed everything. :(

From what I have have read on SDN, it sounds like physician reimbursements are being cut from medicare and private insurance. I hope you are correct about pay increasing as we take on more debt. However, if you read some of the resident/physician forums, it may scare you. GI docs are getting less for coloscopies;anesthesiologists are hiring CRNAs, primary care docs are getting 25% less for office visits thru Medicare. This trend is expected to continue. Who knows what we will get in 7-8 years when we have completed everything. :(

Fixed that for you. Unless you step into an OR is hard to understand the role of the CRNA, but they are basically an anesthesiologist's best friend.

I have seen a lot of people comparing expected salaries that they will earn to pay their loans. None of them seem to take into consideration that if you are enter medical school this year the salaries will have risen over those 8 years. A job paying $250k per year (such as EM) will pay $342K per year based on a 4% yearly pay increase. Pay increase might not be that much yearly but it gives a good example of how much pay can increase in a decade. A PCP making $180k would make $246k following the same logic.


Sadly, this is not correct. Physician salaries do not increase with inflation. There are many ways to continue boosting your salary in medicine but inflation adjusted raises do not generally occur. This is why physicians need to be smarter with their money these days.

Also, I do not see where you are coming up with the amount of $480k in the first place. The overall increase of attending the school only increased by about 6%. The COA for last year OOS was ~80k. Assuming this trend continues, you are looking at a maximum of $360k in loans taken out.

You graduate medical school with $360k, but during residency the interests on your loans still accumulates. If someone does a 4 year residency, that 360k will compound into 480k by the time you become an attending and can afford to start paying back ones loans.

Fixed that for you. Unless you step into an OR is hard to understand the role of the CRNA, but they are basically an anesthesiologist's best friend.

I don't know about that. Most anesthesiologists on SDN would not agree with that...I think what you are referring to is when anesthesiolgoists supervise like 5 CRNA's at a time, bill them for it, and get a major cut which increased their own profits. Those days are over, though.

Today, it's come back to bite them, and anesthesiologists are suffering because of it. The CRNA lobby is very strong and powerful, they publish a bunch of bogus outcome studies claiming complete equivalency to an MD, and they've even managed to sway legislatures in some states to attain equal, unsupervised practice rights (the goal of the AANA is complete parity with an MD/DO, and for anesthesia to be a nursing profession.)

CRNAs are by far the most successful mid-level healthcare profession to exist. They make more money than primary care physicians, and often 150-200K for 40 hours week (many make 2-300K who choose to work anesthesiologist hours). If they can do it...who's to say others can't make similar gains in other fields?

I don't know about that. Most anesthesiologists on SDN would not agree with that...I think what you are referring to is when anesthesiolgoists supervise like 5 CRNA's at a time, bill them for it, and get a major cut which increased their own profits. Those days are over, though.

Today, it's come back to bite them, and anesthesiologists are suffering because of it. The CRNA lobby is very strong and powerful, they publish a bunch of bogus outcome studies claiming complete equivalency to an MD, and they've even managed to sway legislatures in some states to attain equal, unsupervised practice rights (the goal of the AANA is complete parity with an MD/DO, and for anesthesia to be a nursing profession.)

CRNAs are by far the most successful mid-level healthcare profession to exist. They make more money than primary care physicians, and often 150-200K for 40 hours week (many make 2-300K who choose to work anesthesiologist hours). If they can do it...who's to say others can't make similar gains in other fields?

This is correct and is a big topic in the Anesthesiology forum. So far, I believe 17 states have made laws allowing CRNAs to administer anesthesia without an anesthesiologist present and the CRNA lobby is working on the rest. I would really like to choose anesthesiology as a specialty. This and Nova's tuition increases are going to really hurt the class of 2015 that are interested in anesthesiology.

While it is good to have an idea of what is going on in different specialities, you haven't started school yet, so relax! You may completely change your mind before you are done.

@Adsargen - physician salaries do not follow the general inflation curves. There are some specialties that were making more twenty years ago than today. Also, you failed to consider interest on loans. If you took out the max 80 every year, then you wouldn't look at your finances on graduation day and see 360, you would see something more like 400 and it gets worse from there.

As I mentioned before, however, I think we are not at the point where medicine is "not worth it."
Yes salaries do not follow inflation curves (which I tried to say in my post) but saying salaries will not increase over decade is naive. It may not increase the amount that I posted but it will increase. I would also love to know what specialties make the same or less than they did 20 years ago. If this is true it would be interesting to know. I admit I have not done a lot of research on salary trends of specialties.

You graduate medical school with $360k, but during residency the interests on your loans still accumulates. If someone does a 4 year residency, that 360k will compound into 480k by the time you become an attending and can afford to start paying back ones loans.

Yes if you do not start paying on your loans until 10 years after you take them out you can say you owe $480k. But this figure is not good for comparison purposes.


All-in-all I am just trying to point out that it is a lot of money but by no means are you going to be in the poor house if you are going into medicine. This mentality is rampant on these forums and it always bothers me. Then again my view on finances and what I need to be happy is probably not shared by most Americans (for better or for worse). If you are accepted to a school that will be cheaper then go for it. If you aren't then not going and loosing out on a year of attending salary will make up for any possible financial gain of going to a different (cheaper) school the following year.

I think the smartest thing to do with loans at this point is to work at a nonprofit hospital and do IBR. While doing this, save a ton of money in the bank. If the program is still intact where they forgive your loans after 10 years of "public service" (residency counts btw) then your loans are gone and you have a bunch of money in the bank. If the program falls through, which could happen our 9th year of public service, then you still have cash in the bank to pay the loans off.

Did the people making 65-70k start earing at 35 or 22?




Technically, I think making 170k would put you into a 33% tax bracket automatically for federal tax purposes, so it seems like the 130k number is inaccurate off the bat. Furthermore, I don't think this takes into consideration the additional overhead of running a medical practice (which the 65k cube dweller doesn't have).

Once you take paying your staff, paying absurd rent on your practice, paying high malpractice insurance rates, you're looking at a much more significant figure, and this also doesn't even take into consideration the loan payments WHICH are not stagnant and grow at close to 7% each year.

Additionally, 80k after taxes then goes straight into your excessive house payment (have to keep up that doctor image), then into the braces, car payment, and college tuition payments as you didn't start having kids until later and you're dealing with these types of BS headaches for a bit longer than the average 65k'er



No one makes bank ... period. You saying the average pediatrician makes 'bank' in MY OPINION is just as big of an extreme as the people throwing around the 480k a year number. In fact, I'd be willing to bet that there are far more pediatricians barely clearing 6 figures or making very low 6 figures out there then there people with the 500k student debt. Run your numbers again at 100k instead of 170k, and it simply doesn't come out to 'bank.'




While I agree that many people underestimate the security and it's difficult to find many other professions out there where you are guaranteed 6 figures for simply attending medical school, but I think you'd also be hard pressed to find many people in random fields that came out of their education in their early 30s with absolutely no assets and 200k in debt. The average guy in sales may only be making 80k, but he started making this at 24 years old with 0 debt and has been saving, making investments, and working steadily for the 8 years you were building debt and opportunity costs in medical school.



Pharmacists are done in what ... 3 years? Additionally, if you paid off a 300k loan over 15 years, you're looking at an additional 20k that you paid just in interest alone.

PS - you guys may start to feel a little different when you add your loans on to your spouse's.

No one here is saying it can't be done, no one here is saying that it isn't a safe choice, etc, but people (especially young students right out of college) should be very aware of the financial aspects of taking out that much loan money. People get in over their heads all the time, and more importantly, people begin to find out that the 500k debt maybe didn't afford them the 'bank' lifestyle they assumed they would have working as a PCP making 180k a year. If you went to some financial planner and said you wanted to take out 500k, build interest on it, and leverage it against making 170k in an declining market WHERE a similar and much more cost effective path existed to essentially the same end goal (PAs and especially, barf, NPs) ... they would call you nuts.

I'll say it again ... 480k in debt isn't worth all the wonders that a life in medicine has to offer. Don't believe me ... ask attendings. Hell, they should actually be the only people you ask.

If you want it, do it, but find a way to do it for cheaper. Do the service corps, look into a PC loan forgiveness program, or find a field where you can think outside the box and clear half a million a year.



Unless a Pediatrician is part time they are not barely scraping six figs. And if you are in 480k debt for medical school then you make very poor financial decisions and can only blame yourself.


http://www.google.com/url?sa=t&source=web&cd=3&sqi=2&ved=0CCkQFjAC&url=ftp%3A%2F%2Fftp.mgma.com%2Fsurvop%2Fglacierpub lishing%2FCompleted%2520Projects%2FPS%25202010%2Fp revious%2FPS2010Proof2.pdf&rct=j&q=2010%20mgma%20compensation%20survey%20pdf&ei=KXm8TYSYOdH3gAer_Zm5BQ&usg=AFQjCNEsyP-SQuW5uzNPuLdF3-837Jf01g&cad=rja

I think the smartest thing to do with loans at this point is to work at a nonprofit hospital and do IBR. While doing this, save a ton of money in the bank. If the program is still intact where they forgive your loans after 10 years of "public service" (residency counts btw) then your loans are gone and you have a bunch of money in the bank. If the program falls through, which could happen our 9th year of public service, then you still have cash in the bank to pay the loans off.

This sounds great. Can you direct us to a website or thread that talks about this topic? Thanks.

This sounds great. Can you direct us to a website or thread that talks about this topic? Thanks.
The income based repayment system where you can have your loans forgiven after 10 years is brand new. It just started based on Obama's last state of the union address. No one has gotten it yet so do not count on it once the government starts to see that it has to pay out $200k+ per med student who starts to take advantage of it.

There have been quite a few threads on it though if you do a search. The simple idea is that you will pay a certain amount of your income to your loans. As a resident making $50k per year you will pay roughly $210 per month (if you are married with 2 dependents). If you work in a 501C3 workplace (like a non-profit hospital, school, government agency) you will have your loans forgiven after 10 years of repayment. On the year you have your $360k payday from the government you will have to pay taxes on the loans but that is not much to ask!

Assuming you go into a 5 year residency and you do it at a non-profit you will only have 5 years worth of payment at a higher rate. Assuming you then made $200k per year your IBR payment would only be $2080 per month.

In all you would only pay $137,400 towards your loans based on these specific conditions that I choose.

More info can be found here: http://www.ibrinfo.org/calculator.php

Since they can pull the plug on that at any time, though, I think it would be wise to have a backup plan and a bunch of money in the bank to pay it off just in case.

Yes if you do not start paying on your loans until 10 years after you take them out you can say you owe $480k. But this figure is not good for comparison purposes.

360k at 7.4% interest over a 4 year period brings your loan total to 483k owed. Type it into a calculator if you dont think I'm correct.

7.4% is the average interest of sub/unsub/gradplus loans. 10 years is a little different than 4 years. Also many residents have a family to support on a 40k to 50k budget, and are unable to pay off loans during residency. The figure is exact for comparison purposes. Unless a relative is fronting some of your medical education, it is safe to say if your starting out at a private MD or DO school this is what you could owe if your unable to make payments during residency.

I think the smartest thing to do with loans at this point is to work at a nonprofit hospital and do IBR. While doing this, save a ton of money in the bank. If the program is still intact where they forgive your loans after 10 years of "public service" (residency counts btw) then your loans are gone and you have a bunch of money in the bank. If the program falls through, which could happen our 9th year of public service, then you still have cash in the bank to pay the loans off.

This really only financially makes sense for certain specialties. Fortunately, my specialty is one of them. Anyway, premeds, you're getting way ahead of yourselves.

Consider the following:

1. Student Debt is now owned by the US goverment.
2. The US Government -HHS- pays for the vast majorities of residencies.
3. IBR and PSLF will allow physicians to discharge debt after 10 years (PSLF) or allow physians to let debt accumulate for 25 years and then discharge a massive amount of debt (IBR -25 years)

This means that the US governemnt is footing more or less the entire bill for training physicians. There is absolutely no incentive for schools to keep costs down. The more they charge, the more they rake in. This is free money to schools- and students are not ultimately footing the bill.

Anyone got some extra skrilla layin' round to open Dewey Cheatem and How medical school?
:thumbup::thumbup:
Excellent points. I'm not premed (I'm starting pharmacy school this fall), but I've been thinking about the exact same thing. It's messed up!

Nice Car Talk reference, btw.

360k at 7.4% interest over a 4 year period brings your loan total to 483k owed. Type it into a calculator if you dont think I'm correct.

7.4% is the average interest of sub/unsub/gradplus loans. 10 years is a little different than 4 years. Also many residents have a family to support on a 40k to 50k budget, and are unable to pay off loans during residency. The figure is exact for comparison purposes. Unless a relative is fronting some of your medical education, it is safe to say if your starting out at a private MD or DO school this is what you could owe if your unable to make payments during residency.
This is not correct. I do not know how you guys are coming up with these crazy figures so I went ahead and made the computations based on my own loan information I was offered. This is assuming that I took out everything that they offered which I do not believe I will have to. (and I have 2 kids and a wife to support)

Based on this, at the end of 4 years I would owe 400k. I have attached a spreadsheet used to calculate it. The only deviation I could see from reality is that you would need to add in any more tuition hikes. This however would only be maximum 20k on your loans with interest so you can take it for what its worth.

As for not paying off loans during residency I never said anything about that. That is what the IBR is for. You will be paying ~$220 a month and worrying about the rest later. Not like there is any option on that at all and you would be doing the same no matter how much you owed. Of course if you do not have a family or children then you could possibly moonlight to start getting stuff payed down. That really has nothing to do with this though.

This is not correct. I do not know how you guys are coming up with these crazy figures so I went ahead and made the computations based on my own loan information I was offered. This is assuming that I took out everything that they offered which I do not believe I will have to. (and I have 2 kids and a wife to support)

Based on this, at the end of 4 years I would owe 400k. I have attached a spreadsheet used to calculate it. The only deviation I could see from reality is that you would need to add in any more tuition hikes. This however would only be maximum 20k on your loans with interest so you can take it for what its worth.

As for not paying off loans during residency I never said anything about that. That is what the IBR is for. You will be paying ~$220 a month and worrying about the rest later. Not like there is any option on that at all and you would be doing the same no matter how much you owed. Of course if you do not have a family or children then you could possibly moonlight to start getting stuff payed down. That really has nothing to do with this though.

Continuing with 11% tuition raises would add $31,583 to your calc without taking interest on that money into account. Did you also take origination fees and cost of living increases into account?

This is not correct. I do not know how you guys are coming up with these crazy figures so I went ahead and made the computations based on my own loan information I was offered. This is assuming that I took out everything that they offered which I do not believe I will have to. (and I have 2 kids and a wife to support)

Based on this, at the end of 4 years I would owe 400k. I have attached a spreadsheet used to calculate it. The only deviation I could see from reality is that you would need to add in any more tuition hikes. This however would only be maximum 20k on your loans with interest so you can take it for what its worth.

As for not paying off loans during residency I never said anything about that. That is what the IBR is for. You will be paying ~$220 a month and worrying about the rest later. Not like there is any option on that at all and you would be doing the same no matter how much you owed. Of course if you do not have a family or children then you could possibly moonlight to start getting stuff payed down. That really has nothing to do with this though.

In looking at your spread sheet, you are certainly correct with the absolute maximum you could owe at the end of medical school being 400k, and that's with borrowing the maximum amount plus interest that accumulates during med school.

The 480k number is what I was referring to the amount one would owe at the completion of a 4 year residency. Here is my break down. Upon med school graduation I will owe 360k.

End of PGY1= 360k + 28k (7.4% interest) - 3k(stud loan payment) = 385k
End of PGY2= 385k + 30k (7.4% interest) - 3k(stud loan payment) = 412k
End of PGY3= 412K + 32K (7.4% interest) - 3k(stud loan payment) = 441k
End of PGY4= 441K + 34K (7.4% interest) - 3k(stud loan payment) = 472k

So at the end of a 4 year residency, if Im making student loan payments of $250 a month, I will end up owing 472k for med school. Yes it is true I will graduate med school with 360k debt, but the reality is I'm still 4 years away from being able to make substantial payments towards the debt.

So at the end of a 4 year residency, if Im making student loan payments of $250 a month, I will end up owing 472k for med school. Yes it is true I will graduate med school with 360k debt, but the reality is I'm still 4 years away from being able to make substantial payments towards the debt.

Not exactly. During the first three years of IBR the government pays the interest on your subsidized loans, so it doesn't build up as fast. Also, the way your monthly payment is calculated will change in a couple years for new loans, making the monthly payment less. It will also be lower if you consolidate loans after that date. My payment, btw, is $0 monthly due to my family size and income and the goverment still pays my subsidized interest each month.

Again, I will recommend that you use a financial advisor who works specifically with medical education loans before you make any decisions on paying them off. The small amount I pay them for their services has benefited me greatly.

Yea, lots of very rough and unrealistic calculations going on in both directions here. I'd err on the side of assuming you are going to live frugally for a few more years, smaller house and sending kids to a state school. The costs of life build up very fast and 400,000+ is a ton of money to owe, regardless of specialty. Whether it is worth it depends on your intentions and goals with practicing medicine. I was offered positions out of undergrad that'd have me making about 120k by now (4 years out) and that started at 80k. No debt. It'd take some serious time to make up that difference if I owed 400k+, especially if I had a wife and kids. I may not ever make up the difference, who knows.

Tuition is just getting obscene across the board. I'm so glad I will finish with around 60 or 70k.

question.

im going to vcom and our tuition is 37k per year
that x 4 = ~150k for 4 years of education
I'm getting a loan for half of my tuition and will have family funds paying the other half. So after graduation I will be about 75k in debt that i personally will have to pay off.
Will I be able to live comfortably (apartment and have a 20k car) during residency while paying off 75k? I plan on going into psychiatry which is only 3 years of residency as you guys already know.

i went to an instate public university and never had to take a loan out since my entire college education was about 25K and my parents took care of it...so i'm extremely uneducated and naive about taking loans.

question.

im going to vcom and our tuition is 37k per year
that x 4 = ~150k for 4 years of education
I'm getting a loan for half of my tuition and will have family funds paying the other half. So after graduation I will be about 75k in debt that i personally will have to pay off.
Will I be able to live comfortably (apartment and have a 20k car) during residency while paying off 75k? I plan on going into psychiatry which is only 3 years of residency as you guys already know.

i went to an instate public university and never had to take a loan out since my entire college education was about 25K and my parents took care of it...so i'm extremely uneducated and naive about taking loans.

75K + interest is not bad at all. You could live very comfortably as a resident, or less comfortably, depending on if you choose to pay off those loans from day 1 of residency or wait until after you finish.

My theory for the huge jump:


Sharick v. Southeastern University of the Health Science


Scroll down to the find the date of the final award.

My theory for the huge jump:


Sharick v. Southeastern University of the Health Science


Scroll down to the find the date of the final award.

Any idea what the circumstances that led to his dismissal were? Obviously poor, but what on earth would cause them to give him the boot right before graduation?

Woops, nevermind, apparently I am not good at computer.

"Keith M. Sharick, a fourth-year medical student, was dismissed from the College of Osteopathic Medicine (Southeastern), when he was given a failing grade in the final course he required for graduation, a rural rotation in general medicine at the Clewiston Community Health Center."

Don't fail your rural rotation, I guess.

Don't fail your rural rotation, I guess.

Or do and get a 4.3 million dollar payday :idea:

Or do and get a 4.3 million dollar payday :idea:

I hope there are no more settlements so that the OOS students don't have to get screwed any harder. :laugh:

Woops, nevermind, apparently I am not good at computer.

"Keith M. Sharick, a fourth-year medical student, was dismissed from the College of Osteopathic Medicine (Southeastern), when he was given a failing grade in the final course he required for graduation, a rural rotation in general medicine at the Clewiston Community Health Center."

Don't fail your rural rotation, I guess.

seems pretty arbitrary of Nova to dismiss him on something silly like a "rural rotation." For one, mandatory rural rotations seems to screw people over who need to do audition rotations during those months. Maybe he had lots of interviews to be on, or something.

Even if he was just being lazy, the vast majority of medical schools would not dismiss a student for one failed rotation, but allow him to at least repeat the year or remediate the rotation. Yes, the judgment sucks for students and will raise everyones cost, but it also seems very cold-blooded of Nova to dismiss someone 4th year, and honestly, from talking to students I've heard very bad things about the higher-ups who run the school...

Do any Nova students know the details of this case or want to comment on it?

seems pretty arbitrary of Nova to dismiss him on something silly like a "rural rotation." For one, mandatory rural rotations seems to screw people over who need to do audition rotations during those months. Maybe he had lots of interviews to be on, or something.

Yes it was arbitrary, hence the $4.3 million award.

It happened in 1993 when Nova Southeastern was still Southeastern. The award from his original suit in ~1993 was $45,000. After a series of appeals it became $4.3 million in ~2008.

When he was randomly dismissed he had already signed an FM contract.


Even if he was just being lazy, the vast majority of medical schools would not dismiss a student for one failed rotation, but allow him to at least repeat the year or remediate the rotation. Yes, the judgment sucks for students and will raise everyones cost, but it also seems very cold-blooded of Nova to dismiss someone 4th year, and honestly, from talking to students I've heard very bad things about the higher-ups who run the school...
Do any Nova students know the details of this case or want to comment on it?

Many people in admin are incompetent and are paid good salaries to do little, and then do even less.

Some are called incompetent because hundreds of type-A med students go to them for various demands, ranging from reasonable to insane, and are pegged "incompetent" because they either couldn't or refused to yield to those demands.

^The concept of overpaid simpletons is not unique to NSU

I guarantee you that everyone's 4th year from 1993-now is better in part because of this guy.