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Does anyone else have any experience with NHSC loan repayment programs after residency?
You really shouldn't be paying 40% of your income in taxes even with the most unfavorable tax profile:
http://whitecoatinvestor.com/doctors-dont-pay-50-of-their-income-in-taxes/
Interesting article. The author (an ED Attending) frequently does math off of an "average primary care salary" of $200k and in this post his math gives a Primary Care Attending a take-home of $8,125/mo. My math has come out higher, closer to $10k/mo off of the $180-200k salary range. Anycomments (even just low/high/about right) from the attendings in the audience?
This entire thread answers your question. It's already been covered.
Interesting article. The author (an ED Attending) frequently does math off of an "average primary care salary" of $200k and in this post his math gives a Primary Care Attending a take-home of $8,125/mo. My math has come out higher, closer to $10k/mo off of the $180-200k salary range. Anycomments (even just low/high/about right) from the attendings in the audience?
I read the whole thread. CabinBuilder, thank you for the quick response but I already knew your viewpoint. I was hoping for more viewpoints than yours (low end of spectrum?) and SnakeOil (higher end of spectrum?)....any other attendings able to give some real world info?
The article's author is more accurate than your calculations (in my own personal experience). His numbers are awfully close to my real take-home.
i was referring to the programs after you are an attending (where youa re not an nhsc scholar). Cabinbuilder referenced that she has tried to get loan repayment several times but has been unsuccessful.
Does anyone else have any stories to share about loan repayment programs, not an nhsc scholar, but applying after you are an attending?
I assume this is after having things like any life insurance, health insurance, 401K, etc...pulled?
FM seems almost out of the question for someone with $400k in loans.
Why would you say that? If you made $200k/yr in a typical midwest state, married, after taxes you would take home about $11450/mo. If you did IBR your payment on 400K loan would be $2300/mo leaving you around $9000/mo to live on and pay the bills. That's plenty.
If you started working at 30, in 25 years the loan would be forgiven. You'd be 55 with a good chunk of change in the bank. Completely doable as long as you are financialy wise.
Some people find the idea of being in debt until they are over 50 while making just over $100k/year after loans and taxes are paid a hard pill to swallow. I think FM is great but it would have been much harder for me to make the decision to go into FM if I had almost half a million in debt hanging over my head.
If you work in one of a large variety of "public service" jobs, after 120 monthly payments, the rest of your debt is relieved. This includes time in residency and being an employee hospital (as long as it's a non-profit).
I'm skeptical about the realistic possibilities regarding these programs (skeptical of the government in general...). Anyone with any experience want to chime in? From what I've read, the NHSC scholarship and loan forgiveness are difficult to obtain, and access to loan forgiveness through employers is a bit shaky as well.
The 10yr loan repayment is for public sector jobs isn't an application. You can do IBR and after you've made 120 payments working for a qualified PS job, your loans are forgiven. So, if you worked for the VA, a prison, blah blah... loans forgiven in 10yrs, no application. If we still have a government in 10+yrs I am sure it will still be around. It was started a while ago...
http://studentaid.ed.gov/PORTALSWebApp/students/english/PSF.jsp
While I agree you shouldn't base your entire life around a government program, there just aren't certainties in life sometimes. As the above poster said, the IBR is not a government program you apply to, it's just one method of loan repayment.
Why would you say that? If you made $200k/yr in a typical midwest state, married, after taxes you would take home about $11450/mo. If you did IBR your payment on 400K loan would be $2300/mo leaving you around $9000/mo to live on and pay the bills. That's plenty.
If you started working at 30, in 25 years the loan would be forgiven. You'd be 55 with a good chunk of change in the bank. Completely doable as long as you are financialy wise.
I'm skeptical about the realistic possibilities regarding these programs (skeptical of the government in general...). Anyone with any experience want to chime in?
Keep in mind that $400k is just principal. I'm likely looking at over half a mil once residency is done just with the interest alone.
I'm also a bit skeptical about whether IBR will even be available in the next 30 years or so when I'd acually take advantage of it. Given the budget woes of this country, and the world really, in addition to the exploding cost of tuition (I'll likely be paying $48k/year) I sincerely doubt the government is going to be forgiving several hundred thousand dollar loans for professional students.
Granted, it's still doable. A quick calculation has me paying ~$4000/month on a 20 year non-IBR payment plan (with just over a million in total payments! Yipee!) I wouldn't starve, but it still seems like a hard sell to be bringing home less than most of my friends are making now one year out of college for 20 years after nearly a decade of training.
I totally understand the skepticism about IBR, but don't you have some skepticism about specialists making 2x-3x more than PCP in 30 years? Most other first world countries with more public healthcare don't pay specialists that much more than general practitioners.
For me, it still remains, do what you enjoy most and work the financial angle to the best of your ability.
Seems like most have issues with the total amount of their student loans. Here is what I am doing because it is a mix of options. I am part of the Army National Guard, they have raised their loan repayment amount to $240k. However, I am not taking this, I took the STRAP during residency. Yes, I did deploy, but it was for 4 months and it was not bad- please understand that I am an outdoors person, so staying in tents in Afghanistan was not an issue.
If you work for a non-profit ( I work for a Catholic Health System) or military then you will qualify for income based student loan repayment that allows you to make a reduced monthly payment based on family size and income. After 10 yrs what ever is left over is written off. I also live in rural Alaska (yes I live here because I absolutly love it), I get the SHARP program which is $35k per year. Plus a salary over $200k, most salaries are about $180-210k up here where ever you are.
So for someone who likes to hunt, fish, ski, crab, ride ATV, snowmachines, live in a log cabin on the ocean, and have a view of the ocean with bears, eagles and deer from his office... it can be tough, but I manage OK
So it all depends on what you want out of your practice
Seems like most have issues with the total amount of their student loans. Here is what I am doing because it is a mix of options. I am part of the Army National Guard, they have raised their loan repayment amount to $240k. However, I am not taking this, I took the STRAP during residency. Yes, I did deploy, but it was for 4 months and it was not bad- please understand that I am an outdoors person, so staying in tents in Afghanistan was not an issue.
If you work for a non-profit ( I work for a Catholic Health System) or military then you will qualify for income based student loan repayment that allows you to make a reduced monthly payment based on family size and income. After 10 yrs what ever is left over is written off. I also live in rural Alaska (yes I live here because I absolutly love it), I get the SHARP program which is $35k per year. Plus a salary over $200k, most salaries are about $180-210k up here where ever you are.
So for someone who likes to hunt, fish, ski, crab, ride ATV, snowmachines, live in a log cabin on the ocean, and have a view of the ocean with bears, eagles and deer from his office... it can be tough, but I manage OK
So it all depends on what you want out of your practice
The SHARP program is a rural Alaska student loan repayment plan that you have to qualify for, but my job applied for me and it was approved, I simply had to give them my student loan information. If you like surfing Yakatat is the place, I believe they are looking for a Doc. Big long run on black sand, I have not been there, but have heard it is awesome. Plus no white sharks...just sea lions and killer whales.... Ocean temp there is approx 50 degrees, depending on the season.
If you come up, pack heavy... I came up for a rotation in Medical School and had to come up for residency and never see myself leaving the state... But then again, I would always choose to hike a mountain or glacier vs a mall....
Too cool.
My wife is a family doc working for a FQHC here in the Midwest. She participated in the NHSC and received $60,000 for her first two years toward loan repayment.
Her salary at the clinic is 100K.
Having just read through this entire thread, I believe my wife may have gotten seriously screwed by her employer re: salary.
We live very modestly and are not money-hungry to any extent. My wife greatly enjoys her work and loves serving at-risk populations. We don't care to be rich or anything, but I'm worried we were taken advantage of.
I'm not looking for advice or anything really. I was just stunned after reading all of this, and felt I needed to vent.
BTW, I begin post-bac in the Fall and am interested in pursuing medical school for a career in primary care. I'm glad to have been apprised of the financial side of all this as early as now.
My wife is a family doc working for a FQHC here in the Midwest. She participated in the NHSC and received $60,000 for her first two years toward loan repayment.
Her salary at the clinic is 100K.
Having just read through this entire thread, I believe my wife may have gotten seriously screwed by her employer re: salary.
We live very modestly and are not money-hungry to any extent. My wife greatly enjoys her work and loves serving at-risk populations. We don't care to be rich or anything, but I'm worried we were taken advantage of.
I'm not looking for advice or anything really. I was just stunned after reading all of this, and felt I needed to vent.
BTW, I begin post-bac in the Fall and am interested in pursuing medical school for a career in primary care. I'm glad to have been apprised of the financial side of all this as early as now.
I'll tell you it's just really difficult to read the range of what other family docs are making, knowing my wife is making substantially less.
No, it's not about the money; not even close. But to know we are WAY beneath the lower end of earnings is difficult to accept, is all.
Now, what about the non-profit sector? I wonder if my wife's pay is commensurate with what other FPs make in non-profit clinics.
Slp,
Did the nhsc put her in this position or did she choose it? If she chooses to leave make sure the nhsc isn't going to nail you for defaulting... But considering she's not even making what many NPs & PAs are making, she got screwed for sure....
One more thing:
How many docs coming out of residency have an idea of what is fair compensation? Do attendings, or others, sit down and explain to the residents what they could/should expect to earn--or what they should shoot for--once they are out in the job market?
I just wonder how many residents have a concept of what is fair pay.
Again, I have to ask if what my wife makes is consistent with other non-profits. Sure, she is way beneath the mean for docs in private practice, hospitals, or for-profit clinics; but, what about the FQHCs?
I know the $60K salary quoted is after taxes, and it doesn't take into account any loan repayment, but I just wanted to say one thing:
$60K a year / 60 hours a week = $20 per hour
I know the $60K salary quoted is after taxes, and it doesn't take into account any loan repayment, but I just wanted to say one thing:
$60K a year / 60 hours a week = $20 per hour
Keep in mind also that salary does not take into account the value of any additional benefits, such as retirement, disability or malpractice insurance, health insurance, CME, etc. Most employers provide their employees with most or all of these perks. If you're self-employed, most of that will come out after taxes. So, don't be confused by inflated income figures for locums or independent contractor jobs.