Expensive OOS school vs. cheap IS school

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GamecockWay

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I am trying to decide on which medical school to attend, and I have narrowed it down to two very different options. I'm looking for some feedback and advice to help make the decision.

Option 1: OOS Public School, top 30, vastly preferred curriculum, great resources, not ideal but decent location. Likely 150k - 200K debt on graduation.

Option 2: IS public School, very new school (just graduated its first class, but they have hosted third and fourth years for some time), not my ideal curriculum and limited institutional research funding, moderately better location.
Likely 0 - 40K debt on graduation.

Really I guess it comes down to what is a reasonable price to pay for the better fit. Any advice is much appreciated.

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What are your career goals? For the vast majority of medical students, it makes sense to attend the cheapest US MD program that will have you.
 
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Option 1: OOS public school is the clear choice. Nonfinancial factors are very important (here this is curriculum and resources) for long term success. And it seems you will be happier with Option 1 anyways. Location differences seem marginal, so the only hindrance is cost. I think it is well worth the extra money going with the OOS public school.

Financially-minded SDNers would pick Option 2 but honestly, you don't seem to be very happy with IS public school and the resources seem limited.
 
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depends how your financial situation is
 
Option 1: OOS public school is the clear choice. Nonfinancial factors are very important (here this is curriculum and resources) for long term success. And it seems you will be happier with Option 1 anyways. Location differences seem marginal, so the only hindrance is cost. I think it is well worth the extra money going with the OOS public school.

Financially-minded SDNers would pick Option 2 but honestly, you don't seem to be very happy with IS public school and the resources seem limited.
An extra 150k to attend a school ranked 20-30?! You're nuts lol.

It's easier to advise if we know the schools and your career goals.
 
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OP I'm trying to make a similar decision. It's tough for sure. Also, can you name the schools?

Do you want to stay in-state long term? And if your cost difference ends up being 150k or more, that is a huge amount of loans once it gains interest and you start paying back in residency.
 
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I should change that to ''without knowing the schools or OP's career goals, that's nuts'' (though I don't expect my advice to change much).
 
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An extra 150k to attend a top 20-30?! You're nuts.

Eh. I agree that the extra debt would be a problem, but I think the money is better spent on the school that would give you many more opportunities and educate you in a better curriculum. And of course personal happiness plays a role, and it seems that OP doesn't like Option 2 at all.
 
Just go to UVA you clearly want to.
 
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Eh. I agree that the extra debt would be a problem, but I think the money is better spent on the school that would give you many more opportunities and educate you in a better curriculum. And of course personal happiness plays a role, and it seems that OP doesn't like Option 2 at all.
You underestimate the burden of debt.

A different curriculum doesn't mean it's a "better" curriculum. If both schools are LCME accredited, then either curriculum will provide a solid education.
As for personal happiness, you can't guarantee the OP happiness in either location. I will say though that it's a hell of a lot easier to be happy when you don't have the stress of finances hanging over your head for the next decade+.
 
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In terms of career goals I haven't decided what to pursue, and most of the physicians I've worked with have said I'd likely change my mind anyway. Just from my experience working and talking to doctors I think IM or a sub-specialty within would be a reasonable guess, though. I don't want to close any doors for residency by going to a new school but the price difference is obviously a huge consideration. The schools are USC Greenville and UVA if that makes any difference.
 
In terms of career goals I haven't decided what to pursue, and most of the physicians I've worked with have said I'd likely change my mind anyway. Just from my experience working and talking to doctors I think IM or a sub-specialty within would be a reasonable guess, though. I don't want to close any doors for residency by going to a new school but the price difference is obviously a huge consideration. The schools are USC Greenville and UVA if that makes any difference.
If it makes you feel better, I just chose between a newer school and Dartmouth. The newer school gave me a full-tuition scholarship and Dartmouth would have run me around 170k. Dartmouth would definitely have been a better "fit": I'm a non-trad with an interest in policy and a strong research background. That said, my career goals will likely lead me to internal medicine with a fellowship to specialize, and I don't need to pay the extra 200k to get there. It was a very, very difficult decision, but now that I've made it I'm completely relieved and convinced that I made the right choice.
 
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You underestimate the burden of debt.

A different curriculum doesn't mean it's a "better" curriculum. If both schools are LCME accredited, then either curriculum will provide a solid education.
As for personal happiness, you can't guarantee the OP happiness in either location. I will say though that it's a hell of a lot easier to be happy when you don't have the stress of finances hanging over your head for the next decade+.

Better curriculum was used to refer to OP's strong preference of one over the other. And I agree more debt is problematic especially with personal interests involved that would defer the repayment (like marriages, buying houses etc. during med school/residency and pushing back debt at a later time). But is the pain of larger debt worth it?

Given what OP presented, I think it is. Of course, if two schools are comparable in terms of opportunities, networking, P/F, resources etc., it is clear as day to choose the cheaper school.

The schools are USC Greenville and UVA if that makes any difference.

I'd still choose UVA, even though I'm aware of the painful debt involved and I know many people who turned down UVA to go for cheaper options. But looking at the personal preferences you mentioned, I still think it's worth the money.
 
If it makes you feel better, I just chose between a newer school (I'd be in the 6th graduating class) and Dartmouth. The newer school gave me a full-tuition scholarship and Dartmouth would have run me around 170k total. Dartmouth would definitely have been a better "fit"; I'm a non-trad with an interest in policy and a strong research background. That said, my career goals will likely lead me to internal medicine with a fellowship to specialize, and I don't need to pay the extra 200k to get there. It was a very, very difficult decision, but now that I've made it I'm completely relieved and convinced that I made the right choice.

It seems we are in a similar situation, then. How did you decide that your residency options wouldn't be limited at the newer school relative to Dartmouth?
 
It seems we are in a similar situation, then. How did you decide that your residency options wouldn't be limited at the newer school relative to Dartmouth?
This 'bout to be long lol I mulled this over extensively. You really want to do your due diligence here and I want to make sure I'm clear that the right decision for me may not be the right decision for you :).

I currently work in clinical research at a major academic hospital. I have a team of PIs who I work closely with and who I trusted to give me candid advice, and they all strongly advised me to take the scholarship and never look back. From their perspectives (and they interview med students applying for residency here, a top program), there is plenty you can do to overcome attending a medical school that lacks pedigree. These were the main points they offered me to consider:
- The first two years will teach the same material regardless of which school you choose. You control how you perform on Step 1.
- Step 1 score is a filter for most residencies. If you score strongly on Step 1, you'll get looked at.
- You can do research at any US MD program. If you feel your program limits your access to research, do your research at a nearby program instead.
- You can do away rotations your fourth year and get your name out at hospitals you'd like to do residency at.
- Debt can be more limiting than lack of pedigree. My PIs had many classmates choose residencies based on locations that were financially beneficial to live in rather than where they wanted to train. Even worse, they saw some of their classmates choose specialties that were financially beneficial to choose rather than their best "fit". If you want to scale back hours later to start a family, travel, pick up a project, etc the financial freedom of low/no debt allows you to do that.
- "Once you get to residency, nobody cares where you went to medical school. You'll look around at your new colleagues and realize that the person who got there with the least amount of debt definitely won that game."

I think Goldenfish and MeatTornado recently had awesome posts that I think sums this up nicely:
"Here's what helps you match into a top 20 IM program:

- High step scores (245+, realistically)
- H in IM and fantastic third year grades in general
- AOA
- Published research
- Medical school pedigree

The more of those you have, the better off you'll be. There are tons of factors that go into this, so none of the above are "musts" for any program."

"This is a great way to look at the formula for getting your foot in the door at these "elite" IM programs. Basically you need 3 of the above listed criteria to reliably be considered for an interview. Those at top schools basically get a freebie. In addition those at top med schools tend to have associated "elite" IM programs as their home program(s) that tend to be significantly more lenient with the standards for their med school's students."

If you think you can manage to get 3/5 of those at Greenville, I think you have a pretty easy choice here. If you don't expect to do well on Step 1, 3rd year rotations or get published, then that's another story (but in that case you may not be competitive for a "top" residency anyway).
 
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Oh, and one more thing that helped: my PIs assured me that the types of students who are stuck choosing between "going free" and "going big" (not that I was "going big" by SDN standards lol) are likely to succeed regardless of where they attend. So take comfort in that.
 
Better curriculum was used to refer to OP's strong preference of one over the other. And I agree more debt is problematic especially with personal interests involved that would defer the repayment (like marriages, buying houses etc. during med school/residency and pushing back debt at a later time). But is the pain of larger debt worth it?

Given what OP presented, I think it is. Of course, if two schools are comparable in terms of opportunities, networking, P/F, resources etc., it is clear as day to choose the cheaper school.



I'd still choose UVA, even though I'm aware of the painful debt involved and I know many people who turned down UVA to go for cheaper options. But looking at the personal preferences you mentioned, I still think it's worth the money.
Have you ever paid off a large loan before?
 
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Have you ever paid off a large loan before?

It's terrible I know. But I'm curious. In regards to strictly US MD schools, would you say it's always a good idea to choose the cheapest MD school possible? Even despite differing opportunities available (like say Harvard vs a new MD school as an extreme example)?
 
It's terrible I know. But I'm curious. In regards to strictly US MD schools, would you say it's always a good idea to choose the cheapest MD school possible? Even despite differing opportunities available (like say Harvard vs a new MD school as an extreme example)?
It's not terrible, but I think if you're going to advise people that it's "worth it" to take on an avoidable six figures of debt you should probably preface that advice by admitting you've never had a large loan before.

To answer your question, it really depends on the individual's career goals. For the VAST majority of applicants, it's going to make more sense to choose the cheapest option. Would I pay a little bit extra to attend my dream school over a new school? Yes, but the numbers we're discussing here are in the six figures and that's not ''a little bit extra'' by any means.
 
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It really depends on the individual's career goals. For the VAST majority of applicants, it's going to make more sense to choose the cheapest option. Would I pay a little bit extra to attend my dream school over a new school? Yes, but the numbers we're discussing here are in the six figures and that's not ''a little bit extra'' by any means.

So for the OP, you would suggest him to stick with the cheap IS school? Because it seems that the large debt is basically preventing OP from choosing UVA.

It's not terrible, but I think if you're going to advise people that it's "worth it" to take on an avoidable six figures of debt you should probably preface that advice by admitting you've never had a large loan before..

But it depends on the types of schools involved. Yes paying a large loan is troublesome. Debt is something that should be minimized as much as possible. I'm well aware of that. However, I feel that there are instances where the extra money, even when it's painful when it comes to repayment with interest (as well as deferring personal plans of family etc.), can be an important investment for much better opportunities involved in attending the better school.
 
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So for the OP, you would suggest him to stick with the cheap IS school? Because it seems that the large debt is basically preventing OP from choosing UVA.
Money is THE factor here. Of course if we didn't consider cost we would all choose the "best" program we got into; the reality is that OP will likely excel at either program but the difference in cost between the two is substantial.

Yes, I would advise OP to choose the hella cheaper IS school and save that money for a dope house, traveling, or a cushy retirement later.
 
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If you pick the cheaper school, you have a real chance to be debt free, or nearly so, by the time you are an attending. Imagine being able to make the rest of your decisions about your career without having to consider how you will afford your student loan payments.

If you already know you want to go into a competitive specialty, pick the OOS school. Otherwise, the more affordable school wins. Especially if you realize you want to do something that isn't as highly remunerative.

BTW... what a nice problem to have! My cheapest option was still $150-200k of debt.
 
Money is THE factor here. Of course if we didn't consider cost we would all choose the "best" program we got into; the reality is that OP will likely excel at either program but the difference in cost between the two is substantial.

Yes, I would advise OP to choose the hella cheaper IS school and save that money for a dope house, traveling, or a cushy retirement later.

Okay so just to clarify for any School X vs School Y related threads. If the two schools differ by six figures in tuition, you would strongly recommend to choose the cheaper school, even if the more expensive school has much better resources and opportunities? Assuming that these schools equally satisfy the career goals of the OP in question.

It is a wise move for OP to turn down UVA for the state school. UVA is indeed problematic when it comes to high tuition and some friends and other students there are suffering from the debt burden even despite enjoying the opportunities. It's just that given what OP presented, UVA might seem a better choice, but I think your posts hold more merit and should be taken into account.
 
Okay so just to clarify for any School X vs School Y related threads. If the two schools differ by six figures in tuition, you would strongly recommend to choose the cheaper school, even if the more expensive school has much better resources and opportunities? Assuming that these schools equally satisfy the career goals of the OP in question.

It is a wise move for OP to turn down UVA for the state school. UVA is indeed problematic when it comes to high tuition and some friends and other students there are suffering from the debt burden even despite enjoying the opportunities. It's just that given what OP presented, UVA might seem a better choice, but I think your posts hold more merit and should be taken into account.
I'm not going to make a blanket statement like that. If you read my previous posts, you'll see that I'm referring to the "vast majority" of applicants, not all applicants.

I think the trouble with your advice is that you don't really grasp the gravity of such significant debt and you can't guarantee these "much better opportunities" you're pitching. Higher ranked doesn't necessarily equate to better opportunities. Even if the opportunities are better, it's up to the individual to take advantage of them, and those who take full advantages of their opportunities are likely to seek out opportunities not readily at another program anyway.
 
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I'm not going to make a blanket statement like that. If you read my previous posts, you'll see that I'm referring to the "vast majority" of applicants, not all applicants.

I think the trouble with your advice is that you don't really grasp the gravity of such significant debt and you can't guarantee these "much better opportunities" you're pitching. Higher ranked doesn't necessarily equate to better opportunities. Even if the opportunities are better, it's up to the individual to take advantage of them, and those who take full advantages of their opportunities are likely to seek out opportunities not readily at another program anyway.

I'm aware. I'm just a bit hopeful that OP belongs to that tiny minority fraction of applicants :angelic:

All I'm doing is just matching the price to the value for each school involved. Given what OP presented (I probably should've been clearer that I'm strictly referring to information and preferences provided by OP, so I'm not really guaranteeing anything):

Option 1: OOS Public School, top 30, vastly preferred curriculum, great resources, not ideal but decent location. Likely 150k - 200K debt on graduation.

Option 2: IS public School, very new school (just graduated its first class, but they have hosted third and fourth years for some time), not my ideal curriculum and limited institutional research funding, moderately better location.
Likely 0 - 40K debt on graduation.

OP likes Option 1 since he is basically praising the school, while he seems hesitant about Option 2. So I felt that with the pros/cons listed, Option 1 would be a better deal even despite a large debt.

However, when asked about career goals, we see:

In terms of career goals I haven't decided what to pursue, and most of the physicians I've worked with have said I'd likely change my mind anyway. Just from my experience working and talking to doctors I think IM or a sub-specialty within would be a reasonable guess, though. I don't want to close any doors for residency by going to a new school but the price difference is obviously a huge consideration. The schools are USC Greenville and UVA if that makes any difference.

So, I probably would agree that your views hold a much larger weight especially since OP doesn't seem to have a concrete plan, and thus he probably belongs in the "vast majority of applicants" category. In this case, OP should probably follow the money and choose the cheaper option.

But just to clarify things, I agree that large debt is problematic and should be taken to account, and I'm familiar with the difficulties involved in debt repayment. Student loans are a pressing issue now and whatever can be done to minimize the debt burden should be considered and implemented accordingly. The differences are basically whether the much larger debt is worth it. Yeah it depends on career goals and interests, but I personally feel the large cost differential can be compensated by matching the pros/cons of each school to their respective COA amounts. And the school that has better economic profits (financial + nonfinancial) should be pursued.

This is a subjective thing that something OP is aware from his own interviews/perspectives of the schools in hand. But I think you brought up strong points that should be factored into the overall decision.
 
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I'm aware. I'm just a bit hopeful that OP belongs to that tiny minority fraction of applicants :angelic:

All I'm doing is just matching the price to the value for each school involved. Given what OP presented (I probably should've been clearer that I'm strictly referring to information and preferences provided by OP, so I'm not really guaranteeing anything):



OP likes Option 1 since he is basically praising the school, while he seems hesitant about Option 2. So I felt that with the pros/cons listed, Option 1 would be a better deal even despite a large debt.

However, when asked about career goals, we see:



So, I probably would agree that your views hold a much larger weight especially since OP doesn't seem to have a concrete plan, and thus he probably belongs in the "vast majority of applicants" category. In this case, OP should probably follow the money and choose the cheaper option.

But just to clarify things, I agree that large debt is problematic and should be taken to account, and I'm familiar with the difficulties involved in debt repayment. Student loans are a pressing issue now and whatever can be done to minimize the debt burden should be considered and implemented accordingly. The differences are basically whether the much larger debt is worth it. Yeah it depends on career goals and interests, but I personally feel the large cost differential can be compensated by matching the pros/cons of each school to their respective COA amounts. And the school that has better economic profits (financial + nonfinancial) should be pursued.

This is a subjective thing that something OP is aware from his own interviews/perspectives of the schools in hand. But I think you brought up strong points that should be factored into the overall decision.
Personally, I don't put much stock in how someone *feels* about a program and I certainly wouldn't advise someone to fork over an extra 200k because they praise one school more than another. That ''go with what feels right'' crap seems completely idiotic to me. If I'm going to invest 200k in something it's because it's logical to do so and I'm 100% certain I'm getting value for my money, not because I *feel* like my gut tells me I should.
 
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Personally, I don't put much stock in how someone *feels* about a program and I certainly wouldn't advise someone to fork over an extra 200k because they praise one school more than another. That ''go with what feels right'' crap seems completely idiotic to me. If I'm going to invest 200k in something it's because it's logical to do so and I'm 100% certain I'm getting value for my money, not because I *feel* like my gut tells me I should.

Yeah I completely agree with this.
 
Oh, and one more thing that helped: my PIs assured me that the types of students who are stuck choosing between "going free" and "going big" (not that I was "going big" by SDN standards lol) are likely to succeed regardless of where they attend. So take comfort in that.

The times they are a-changing
 
Personally, I don't put much stock in how someone *feels* about a program and I certainly wouldn't advise someone to fork over an extra 200k because they praise one school more than another. That ''go with what feels right'' crap seems completely idiotic to me. If I'm going to invest 200k in something it's because it's logical to do so and I'm 100% certain I'm getting value for my money, not because I *feel* like my gut tells me I should.

This is definitely something I have considered. The value of a "better" school is such an unknown quantity it's difficult to justify a well-defined massive investment, despite my gut feeling you've (probably fairly) ridiculed. I appreciate your detailed feedback, by the way, this has given me a lot to think about.
 
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With interest added you're looking at a lot more $ than what you're thinking it's going to be. Choice 2 by far.
 
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This is definitely something I have considered. The value of a "better" school is such an unknown quantity it's difficult to justify a well-defined massive investment, despite my gut feeling you've (probably fairly) ridiculed. I appreciate your detailed feedback, by the way, this has given me a lot to think about.
Good luck! And do remember that this is a good problem to have!
 
I'm picking the (way) more expensive school because I have a partner who would be able to keep his job if we stay in a major city. The amount of money we would loose from him changing jobs or being out of work would not be worth it. Cities also have a better job market on the off chance something does happen. Not to mention the amount of money he makes in a year at his current job > the amount of money we would get in aid from the other medical school. So there are lots of factors at play here for people. I would love to not be in debt, but lots of people do it, and we're making the best choice for our happiness. I don't want him to resent me for living in the suburbs with no friends around and nothing to do. :)
 
I'm picking the (way) more expensive school because I have a partner who would be able to keep his job if we stay in a major city. The amount of money we would loose from him changing jobs or being out of work would not be worth it. Cities also have a better job market on the off chance something does happen. Not to mention the amount of money he makes in a year at his current job > the amount of money we would get in aid from the other medical school. So there are lots of factors at play here for people. I would love to not be in debt, but lots of people do it, and we're making the best choice for our happiness. I don't want him to resent me for living in the suburbs with no friends around and nothing to do. :)
Is he using some of dat $$ from his current job to pay down some of your tuition costs? If so, I'm not sure the situations are comparable because you have an income to subsidize your total cost of the more expensive school.
 
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Pretty good discussion in this thread so far. Ill also add if this were my situation, South Carolina>UVA all the way.

Only caveat Ill add though is family background, finances, wealth etc all matters here. Is the "happiness" of going where you want or the "boost" you might get going to a better name school etc worth 150k? For many, and Id include myself, no way. But losing 150k means different things to differnet people and has a different impact on them.

The number of people in med school who come from wealthy families is probably more than alot might realize. "Upper middle class" as my friend graduating next month was telling me last week is the favorite catch term for people in his class to describe themselves as, but for many this involves coming from 800k homes in California or New England and spending summers on boats and personal beach houses.

Point is, 150k lost to many means a far far different thing than it might mean to others. There are many med students who come from well off families with at least one doctor who at least partially or completely foot the bill for med school tuition without hesitation. For someone like that, the "cost" for being happier at a school and that school being more "high end" could absolutely be worth it.
 
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Depends on which school we end up going to (wait lists) and the cost of living there. Probably won't be paying down tuition though. I was just putting forward a situation in which it made sense to turn down a hefty scholarship. Being a 2 person unit, for us, means paying loans for a while so that the non-medical one can continue to develop his career. Hopefully this decision will be good for us both financially (he can continue to excel at a company with fantastic benefits) and personally.
 
Pretty good discussion in this thread so far. Ill also add if this were my situation, South Carolina>UVA all the way.

Only caveat Ill add though is family background, finances, wealth etc all matters here. Is the "happiness" of going where you want or the "boost" you might get going to a better name school etc worth 150k? For many, and Id include myself, no way. But losing 150k means different things to differnet people and has a different impact on them.

The number of people in med school who come from wealthy families is probably more than alot might realize. "Upper middle class" as my friend graduating next month was telling me last week is the favorite catch term for people in his class to describe themselves as, but for many this involves coming from 800k homes in California or New England and spending summers on boats and personal beach houses.

Point is, 150k lost to many means a far far different thing than it might mean to others. There are many med students who come from well off families with at least one doctor who at least partially or completely foot the bill for med school tuition without hesitation. For someone like that, the "cost" for being happier at a school and that school being more "high end" could absolutely be worth it.
The problem isn't so much ''150k lost'', it's the ''oh ****, now I owe 300k'' once interest accumulates lol.
 
The problem isn't so much ''150k lost'', it's the ''oh ****, now I owe 300k'' once interest accumulates lol.

Meh, for me at least, I personally still wouldnt pick UVA over South Carolina even if it was 150k after loans.
 
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This is probably gonna sound stupid so don't feel bad about correcting me....
But is 150-200k in loans plus whatever interest going to be that debilitating for a doctor in a non-surgical specialty- income range 170,000-250,00? Let's say the doctor has little interest in kids (will only be supporting him/herself)
It seems like there would be enough money to live comfortably, pay loans, buy a nice car?
 
This is probably gonna sound stupid so don't feel bad about correcting me....
But is 150-200k in loans plus whatever interest going to be that debilitating for a doctor in a non-surgical specialty- income range 170,000-250,00? Let's say the doctor has little interest in kids (will only be supporting him/herself)
It seems like there would be enough money to live comfortably, pay loans, buy a nice car?
You'll be able to pay it back but you'll be sacrificing other things along the way. You're paying back loans with capitalized interest with a post-tax salary, and you'll be at a time in your life when you want to buy a house and catch up on retirement savings. Why put yourself through that if you don't have to?
 
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This is probably gonna sound stupid so don't feel bad about correcting me....
But is 150-200k in loans plus whatever interest going to be that debilitating for a doctor in a non-surgical specialty- income range 170,000-250,00? Let's say the doctor has little interest in kids (will only be supporting him/herself)
It seems like there would be enough money to live comfortably, pay loans, buy a nice car?
Not debilitating, but really sucky. And you can also get high pay by specializing in any IM field.... you see why people aren't going into primary care
 
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So what about a school A that is $295K vs school B that is $360K?

School A is not-well known, does not have residencies in many surgical departments. They've had people match into surgical fields for which they don't have residencies, but they are more primary care focused and never had a neurosurg match, I think, in their entire history. It's not in a particularly exciting or bad location.

School B is mid-tier, has residencies in every specialty, and sends many people to strong academic programs, and is in a good location.

I'm interested in exploring surgical fields, but what if that isn't what I end up wanting to do? Which school would you all choose? @Affiche you seem sensible, so I would like your opinion if you have one
 
From what I can see, you can't really go wrong with either options. . .

There's a reason UVA has a more impressive match list, but I've seen people matched into Derm, Neurosurgery, and Ortho at USC as well.

I would not recommend UVA if you're looking to buy a house soon after med school or have to raise a family as others have said here.

If you're gunning for IM, USC is a far more reasonable choice. That is all I can say . . .
 
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I gotta say take option 1 because it sounds like you will be happier there. Don't underestimate this. As physicians, you will be able to pay it back and you can do so with a decent lifestyle too compared to the average population. If you have regrets about the curriculum and environment and low mental health, that is something that will really be with you forever. If you have 300K debt, you may have regrets about what you lifestyle you could have had (not that this should be your primary factor for becoming a physician) but you will eventually pay it off. Worst case scenario you live like a resident for a bit longer (boo hoo...).
 
So what about a school A that is $295K vs school B that is $360K?

School A is not-well known, does not have residencies in many surgical departments. They've had people match into surgical fields for which they don't have residencies, but they are more primary care focused and never had a neurosurg match, I think, in their entire history. It's not in a particularly exciting or bad location.

School B is mid-tier, has residencies in every specialty, and sends many people to strong academic programs, and is in a good location.

I'm interested in exploring surgical fields, but what if that isn't what I end up wanting to do? Which school would you all choose? @Affiche you seem sensible, so I would like your opinion if you have one
This is a hard one and I'm probably not the best to ask because I have zero interest in surgery. A few things I would consider though:
- Have you noticed that a lot of "lower tier" schools tend to spit out a lot of primary care docs? This is likely because lower tier schools matriculate lower tier candidates, who score lower on Step 1 and match into less competitive specialties. This is one of the reasons why it's bad to choose a school based on its match list.
- It would make me nervous to attend a school that has never matched someone into my residency of interest. That said, it wouldn't phase me at all if I had no interest in that area (do you care about general surgery or neuro?)
- How much clinical experience and working experience do you have right now? I'm non-trad and have a career in clinical research right now. I have a pretty damn good idea of what kinds of things I want in a career and what I'm not going to tolerate. I don't what specialty I want yet, but I'm pretty damn confident that I won't all of a sudden develop a tolerance for the lifestyle of a surgeon. If you have kind of an interest in surgery but no significant exposure to the field, that's something to consider.
- You're in a lot of debt either way. 65k extra isn't going to make or break you, but man would it suck to to take out 360k pre-interest and find out you aren't interested in surgery/a high-paying specialty. If you find out you don't like surgery, it would really suck to feel pressured into it in order to pay off your debt.
 
option 2 all the way. 150k ends up out of residency after interest 200+. thats about 2k/month for 10 years. if im, youll make 250k or so, taxes, insurance etc. gonna bring that down to 170k
13k/ month. take off house, kid expense, retirement... things dont look so rosy. put that 2k month back into your pocket so you can chose what you want and work where you wabt and for as long as you want.


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