Loans, PSLF, etc.

[DoctorDude]

Would appreciate any advice: I'm an MS4 with about $230,000 in loans by the time I graduate in May. The option to use IBR and only pay 15% of my discretionary income as a resident is appealing when coupled with PSLF. My only concern is how likely is it that I will be working for a non-profit anesthesia group after residency so that I can qualify for PSLF? Can anyone shed light on what percentage of anesthesia jobs are in non-profit settings? And also, is the difference in pay between non-profit anesthesia jobs and private practice anesthesia jobs enough to where it wouldn't make sense to purposely work in a non-profit setting (lower pay) for the sole purpose of qualifying for PSLF?

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[2ndyear]

Interesting question. It's hard to generalize anesthesia salaries because they vary greatly depending on region and specific locale. You might find an employed job in BFE that pays much more than a partnership gig in LA, SF or NYC. Similarly just because a job is academic doesn't mean it can't pay well. There are academic people on here who do quite well, so that's always something to consider. Are there still private practice jobs out there where you can work hard and absolutely kill it when you're a partner? Sure. You'll just need to prioritize your needs. Money, location, and lifestyle. Very personal decisions and you have plenty of time to think about it.

 

[kazuma]

I wouldn't count on PSLF being around for you. The first eligible cohort will be in 2017 so we'll see if it comes to fruition, but I'm skeptical. That doesn't mean you shouldn't do IRB in residency if you can afford it, it will save you thousands of dollars in the long run.

 

[S@xplayer]

I whole-heartedly agree with Kazuma. I doubt this program will exist after its first payout in 2017 when the fed govt notices the highly specialized MDs having 200-300k in debt forgiven. Remember, Congress enacted this repayment plan as part of a very large bill and can easily take it away. That they will do.

My advice - if a future job is a 501c(3) org and you will qualify for the forgiveness (should it be around) - take the job if it is the job you want! If not - get the job you want and worry about the debt after.

I joined a PP group and did NOT do income-based repayment during residency. I will make much more than academia, but I will definitely pay more debt off. If they dont' keep this program around, I win for sure. If they do - I pay more debt off but I will have it paid off around the same time.

At the end of the day - do what job and location makes you happy. Debt payment comes next. If you prioritize a job and location based on debt (to work for a tax-free institution for 10 years - to only have debt "written off" by the govt) - and it falls through - you're screwed.

 

[koan]

I always planned on doing IBR during residency but as the time draws near and I estimate my budget I wonder if it's worthwhile. On the one hand, I realize deferment will result in a few thousand more in compounded interest. But the monthly payments during residency under IBR wouldn't even cover monthly interest accumulation on my loans. And having those extra few hundred bucks each month while on a tight budget may make me breathe easier. Once you're making an attending salary do you look back and say the added stress was worth saving a few thousand? The main reason I would make IBR payments throughout residency at this point is to qualify for PSLF in case it does stick around. Fwiw, I do plan to stay in academics (knowing that could change).

 

[anbuitachi]

there are non profit anesthesia jobs??

 

[deleted126335]

Don't know anything about this program. But, I suspect that it is not only the health care facility that you work at that needs to be a not for profit- The corporation that employs the doc also has to a non profit. There are, or at least were, plenty of very profitable private practice groups that work at not for profits. I would bet the farm that those don't qualify.

 

[maxxor]

I always planned on doing IBR during residency but as the time draws near and I estimate my budget I wonder if it's worthwhile. On the one hand, I realize deferment will result in a few thousand more in compounded interest. But the monthly payments during residency under IBR wouldn't even cover monthly interest accumulation on my loans. And having those extra few hundred bucks each month while on a tight budget may make me breathe easier. Once you're making an attending salary do you look back and say the added stress was worth saving a few thousand? The main reason I would make IBR payments throughout residency at this point is to qualify for PSLF in case it does stick around. Fwiw, I do plan to stay in academics (knowing that could change).

One benefit of IBR is that it halts capitalization so you aren't paying interest on the interest. You really need to directly run the numbers to make a true comparison.

 

[Chip N Sawbones]

I wouldn't count on PSLF being around for you. The first eligible cohort will be in 2017 so we'll see if it comes to fruition, but I'm skeptical. That doesn't mean you shouldn't do IRB in residency if you can afford it, it will save you thousands of dollars in the long run.

I don't think anyone should bank on PSLF, but I'll bet that it'll still be around, not because it massively benefits doctors, but because it also massively benefits lawyers. Law school tuition is almost as bad as medical school tuition, and there's plenty of nonprofits that lawyers can work for after graduating. Lots of politicians are former lawyers or have children who want to go to law school, so I have a feeling the politicians who could repeal PSLF will instead choose to protect their own kind.