Med School Tuition is Insane

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Thank you for the link. It's even worse than I imagined. They screw you on the interest rate (exceedingly high) and nail you on high disbursement fees on those plus loans. I guess these high fees and rates are to offset all the dead beats who won't be paying back those loans

I wish that were true. The high fees and rates were a gift from the Bush administration to his banking friends (as well as the bailouts everyone loves :laugh:)

Before the Bush administration pegged the rates at 6.8% the interest rates were market based. Many students who graduated 6 years ago have locked in rates at the prevailing market rates of 2-3%.

Then Obama comes along and screws us all with ObamaCare with massive handouts to the insurance companies. I still don't get these political ideologue nutjobs who think one party is better than the other. They are all out to screw over the individual and give money to their true constituency, corporations.

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This is what I dont get. Loans today are dirt cheap. You can get a mortage for 3.XX. Though, my student loans are at 7.X -8.X percent. State budgets have also been cutting back on state school contibutions and students make up the difference.

I could go on and on - but it just makes me angry. I think alot of this is a generation issue - the baby boomers will not likely feel much of this or understand. They had it so freaking easy.

See my post above
 
Payments in Anesthesiology are based on Units. Currently Medicare pays $20 per unit and Medicaid pays $17. Insurance companies pay anywhere between 40 and $150 per unit. Most decent anesthesia groups have a blended unit value of about $40 to $65. Most anesthesiologists in a fairly busy practice generate 12000 units a year. Do the math. Most anesthesiologists in a fairly busy practice in a hospital with decent payor mix will make $600k gross.

With Obamacare the average unit value will drop close to medicare rates. An average unit value of $25 would mean that if one works just as hard, working post-call, and taking not more than 6 weeks of vacation, you would be pulling in $300k gross. Work hard now and live simple, pay off your loans early and be debt free so you can start saving for retirement.
 
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With Obamacare the average unit value will drop close to medicare rates. An average unit value of $25 would mean that if one works just as hard, working post-call, and taking not more than 6 weeks of vacation, you would be pulling in $300k gross. Work hard now and live simple, pay off your loans early and be debt free so you can start saving for retirement.

You make it sound like a bad thing to be earning $300,000 a year mate, bloody hell I can only ever dream of making that much money.

I guess with it costing you $250,000 to go through medical school and with the risk of getting sued left, right and centre plus no universal retirement maybe you need to earn a bit more than elsewhere; but still.
 
The average anesthesiologist here will start his career in private practice at the age of 32. He has 10 years to pay off his student loans, 10 years to pay off his other debts and maybe 12 years to save for retirement. There is no government pension. Social Security payments are a pittance. One has to earn big and save a lot.

By the way, I was in Australia last year and stayed with a friend who is an anesthesiologist in Brisbane. He makes $400 k a year. I cannot believe that New Zealand is any less than that?
 
The average anesthesiologist here will start his career in private practice at the age of 32. He has 10 years to pay off his student loans, 10 years to pay off his other debts and maybe 12 years to save for retirement. There is no government pension. Social Security payments are a pittance. One has to earn big and save a lot.

I'll be starting out as a House Officer (intern) at 32; I won't hit private practice until I'm 40 (two years as a House Officer + five years Anaesthesia training) and remember here you have to work in the public system as well so private practice is only the sweet bit on the side.

Medical debt here is between $80-100,000

By the way, I was in Australia last year and stayed with a friend who is an anesthesiologist in Brisbane. He makes $400 k a year. I cannot believe that New Zealand is any less than that?

Oh hell yes, basic pay for a Consultant Anaesthetist is like $120,000 plus whatever you can make in private practice on the side, so maybe two hundred k a year if you're lucky?

If you want a nice house you're looking at easily $250,000 upwards; gas is $7 a gallon etc
 
I'll be starting out as a House Officer (intern) at 32; I won't hit private practice until I'm 40 (two years as a House Officer + five years Anaesthesia training) and remember here you have to work in the public system as well so private practice is only the sweet bit on the side.

Medical debt here is between $80-100,000



Oh hell yes, basic pay for a Consultant Anaesthetist is like $120,000 plus whatever you can make in private practice on the side, so maybe two hundred k a year if you're lucky?

If you want a nice house you're looking at easily $250,000 upwards; gas is $7 a gallon etc

7 years of medical training, not including a fellowship?
Low pay, expensive living costs, plus educational debt. No thank you. God bless the U.S.
 
I'll be starting out as a House Officer (intern) at 32; I won't hit private practice until I'm 40 (two years as a House Officer + five years Anaesthesia training) and remember here you have to work in the public system as well so private practice is only the sweet bit on the side.

Medical debt here is between $80-100,000



Oh hell yes, basic pay for a Consultant Anaesthetist is like $120,000 plus whatever you can make in private practice on the side, so maybe two hundred k a year if you're lucky?

If you want a nice house you're looking at easily $250,000 upwards; gas is $7 a gallon etc

If I may ask, is this the norm? or are you a nontraditional student?
 
300k is good money but it's such a grind to make near 4.0 through undergrad, do research, and shadow. Then move on to more challenging (but more enjoyable) studies in professional school and endure opportunity loss of wages and more debt... It's all a choice - but when you assume risk it's nice to be able to fully capitalize on that risk.

I want to do go into a surgical field and I hope to make 500+. I will scratch and claw my way into that bracket and live well below what ever my income level is so then I can break free into privite equity (hopefully) by the time I'm in my 40's. Then I can start to build real wealth. I dont know many students that go into these fields hoping to do just over average...

I grew up dirt poor and want to leave my (future) kids with an outstanding shot at life.



You make it sound like a bad thing to be earning $300,000 a year mate, bloody hell I can only ever dream of making that much money.

I guess with it costing you $250,000 to go through medical school and with the risk of getting sued left, right and centre plus no universal retirement maybe you need to earn a bit more than elsewhere; but still.
 
If I may ask, is this the norm? or are you a nontraditional student?

I'm a non-trad

Medical school is six years undergraduate here so like 25 when they graduate; start vocational training at 27 or 28 and are a Consultant by 35 at the latest assuming no time off.

300k is good money but it's such a grind to make near 4.0 through undergrad, do research, and shadow. Then move on to more challenging (but more enjoyable) studies in professional school and endure opportunity loss of wages and more debt... It's all a choice - but when you assume risk it's nice to be able to fully capitalize on that risk.

When you look at it that way then maybe it's not such a bad thing we earn less; we don't have to do any of that; medical school is all undergraduate here and once you get in nobody cares about your grades; honestly as long as you pass you're sweet

7 years of medical training, not including a fellowship?
Low pay, expensive living costs, plus educational debt. No thank you. God bless the U.S.

All our vocational training programs include Fellowship as standard; the Medical Council says you have to be a Fellow to be vocationally registered in whatever scope of practice you want e.g. to practice as a general practitioner you must have FRNZCGP, anaesthetist needs FANZCA, FACEM for an emergency physician etc

Our educational debt is at the most like $100,000; med school eats up $70k and if your parents earn too much for you to get a student allowance from Government then you add living costs onto your student loan as well so that eats up another thirty k or there abouts

And yeah our pay may be low compared to US but having lived in the US I'd rather have our health care system; no massive inequality and lack of access; everybody gets health care; if you need a million dollar operation then you get it and it won't cost you a cent
 
I'm a non-trad

Medical school is six years undergraduate here so like 25 when they graduate; start vocational training at 27 or 28 and are a Consultant by 35 at the latest assuming no time off.

Are you guaranteed to make consultant, though, or could it be like the UK or the Caribbean, where you could be a senior registrar for your entire career?
 
Where does the million dollars come from?

It was a euphemism but the million dollars (or whatever the cost) comes from the general health funding from Central Government. The patient doesn't pay a cent except if they're sent home with some prescriptions they pay $3 per item.

Are you guaranteed to make consultant, though, or could it be like the UK or the Caribbean, where you could be a senior registrar for your entire career?

Yes you're guaranteed to become a Consultant at the end of your training but if you want to stay a Senior Registrar your entire career you can, a friend of mine dropped off the ANZCA training program in final year and holds a non-training Registrar post.
 
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Yes you're guaranteed to become a Consultant at the end of your training but if you want to stay a Senior Registrar your entire career you can, a friend of mine dropped off the ANZCA training program in final year and holds a non-training Registrar post.

Honestly, why would someone not become a consultant (and, just as honest - is it custom to capitalize the C?), and choose to stay a registrar? I don't think I could find anyone to say they wanted to be a resident for the rest of their career.
 
Honestly, why would someone not become a consultant (and, just as honest - is it custom to capitalize the C?), and choose to stay a registrar? I don't think I could find anyone to say they wanted to be a resident for the rest of their career.

It's not mandatory to capatalise but I think it's respectful

As to why mate mate dropped off the ANZCA training I think he just got sick of to be honest and elected for a non-training post
 
For those of us who are looking ahead and looking to get out of debt - I follow this guys advice and it's been working pretty well. He has other good common sense investing solutions too if you look further:

Kevin O'Leary

[YOUTUBE]http://www.youtube.com/watch?v=UG9FWRbD9ac&fb_source=message[/YOUTUBE]
 
I took a little different approach than Sevo. Like MTgas I am locked at 2 and change and I just don't see the point in paying it off at an accelerated rate just yet. Take as much out pretax as possible. Invest and buy hard goods with intrinsic value (4F+1). Build a nest egg for my family. If I die, my student loans are forgiven. Not planning on going anywhere, but if it did happen, I would be leaving a lot more to my family. I want to own my house and land free and clear first so that if I die, my family won't have to worry about the house being repossessed. Then I will move on my student loans. At such low interest, I am making money on investments by not paying the loans off.

- pod
 
I took a little different approach than Sevo. Like MTgas I am locked at 2 and change and I just don't see the point in paying it off at an accelerated rate just yet. Take as much out pretax as possible. Invest and buy hard goods with intrinsic value (4F+1). Build a nest egg for my family. If I die, my student loans are forgiven. Not planning on going anywhere, but if it did happen, I would be leaving a lot more to my family. I want to own my house and land free and clear first so that if I die, my family won't have to worry about the house being repossessed. Then I will move on my student loans. At such low interest, I am making money on investments by not paying the loans off.

- pod



I think even if you don't have the interest rates the pod and I do its still important not to overlook a few basics, put away your rainy day/FU fund, probably at least three months of expenses, max out any matched retirement contributions (don't pass on free money), and (this is probably debatable) if you can, max your roth, cause eventually your going to phase out if you haven't already.

With what's left, chose between swatting away at your loans vs. buy a house vs. cramming away additional retirement vs. vegas trips

I'm with POD, I took the longest term on my consolidation that I could, which was only 20 years, and I doubt that I'll pay it off any sooner, just not worth it, even with an FU fund, a good chunk headed to retirement each year, and staying on track for a big down payment on a house.
 
So this is the place that you hang out after hours...:laugh:
For those of us who are looking ahead and looking to get out of debt - I follow this guys advice and it's been working pretty well. He has other good common sense investing solutions too if you look further:

Kevin O'Leary

[YOUTUBE]http://www.youtube.com/watch?v=UG9FWRbD9ac&fb_source=message[/YOUTUBE]
Why Trust a New Zealand Trust
http://assetprotection.escapeartist.com/newsletter/why-trust-a-new-zealand-trust#

Looks like future visits to New Zealand maybe in the cards..

Took a leap of faith during my last visit in 1995..
http://www.bungy.co.nz/
 
I think even if you don't have the interest rates the pod and I do its still important not to overlook a few basics, put away your rainy day/FU fund, probably at least three months of expenses, max out any matched retirement contributions (don't pass on free money), and (this is probably debatable) if you can, max your roth, cause eventually your going to phase out if you haven't already.

With what's left, chose between swatting away at your loans vs. buy a house vs. cramming away additional retirement vs. vegas trips

I'm with POD, I took the longest term on my consolidation that I could, which was only 20 years, and I doubt that I'll pay it off any sooner, just not worth it, even with an FU fund, a good chunk headed to retirement each year, and staying on track for a big down payment on a house.

Solid post based on your income. SEVO, however, earns much more than you so paying his loans off over 12-36 months made sense.

POD is a smart guy. He will get to those loans eventually in his career; I hope he pays them off before his own kids start college.
 
I got a PM from a Med Student (MS1) at a DO School. That person said his/her debt will be $600K by the time graduation comes around. I was asked for my advice. I recommend a military scholarship because $600K is simply too much debt under a ObamaCare health system.

Have any of you heard of that much debt after College and Medical School? I assume with $600K in debt the goal would be some kind of loan forgiveness down the road. I have heard of ER docs, CRNAs, etc getting big $$$ loan forgiveness from the Federal govt. in my area.

Comments?
 
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I got a PM from a Med Student (MS1) at a DO School. That person said his/her debt will be $600K by the time graduation comes around. I was asked for my advice. I recommend a military scholarship because $600K is simply too much debt under a ObamaCare health system.

A big chunk of that projected $600K has got to be from undergrad debt. Maybe 4-5 years of private undergrad plus a masters or other post-bac to get grades up to gain admission to medical school?

If he's a MS1 at most he can get a 3-year HPSP deal to cover the MS2-4 years, so maybe the $400K he probably already has won't grow to $600K. Even so, that's a steep hole to climb out of no matter what he does.

I'm not saying he shouldn't join the military, but in general the people who do so just for the money tend to be miserable, and making payments on the $400K or so he already has on a military attending salary ($150K or less during the payback years) or a GMO salary ($90K or less) is going to be tough.

Income based repayment or other forgiveness routes might be better.


Another, possibly better military alternative might be to enter via FAP during residency. Depending on specialty and branch of service, there may or may not be openings, and there may or may not be an accession bonus (which I think might be a few hundred K split over a few years). One benefit of FAP is that you aren't at risk of doing GMO time between PGY1 and PGY2.
 
I'm looking at about 375k when I finish my anesthesia residency in 20 months.

I had 20k undergrad debt, borrowed 32k, 38k, 42k, 48k for my 4 years of med school, with no help from family or scholarship. Add in cost of living during med school of about 1-1.5k per month, and I finished med school at $220k ish (Creighton, where tuition this year is mid 50k). Interest is 6.8 on 40 percent of the debt, 8.5 on the rest.

Here's my dilemma, I plan on working in the Midwest, and right now am not planning in doing a fellowship as my opp cost is high, my avg yr of interest is 35-40k as it is compounded...that could be a net loss of 240-300 the first year out. So, I'm leaning away from fellowship now, and starting in a private group in July 2014.

Blade, POD, pgg, sevo - any thoughts? Thanks.
 
The fellowship decision is a personal one.
There are some who suggest that you don't need a fellowship to get a good job, and that's true. However if you are passionate about a cardiac, peds, pain, or ccm, you should be doing a fellowship. It's unlikely you'll get far in those areas without a fellowship. A few years ago you could talk a group into training you in cardiac on the fly. I think those days are probably over.
I wouldn't recommend a regional, neuro, trauma, ob, or management, etc fellowship though.
 
I got a PM from a Med Student (MS1) at a DO School. That person said his/her debt will be $600K by the time graduation comes around. I was asked for my advice. I recommend a military scholarship because $600K is simply too much debt under a ObamaCare health system.

Have any of you heard of that much debt after College and Medical School? I assume with $600K in debt the goal would be some kind of loan forgiveness down the road. I have heard of ER docs, CRNAs, etc getting big $$$ loan forgiveness from the Federal govt. in my area.

Comments?

Yup, that was me. I'm debating quitting to pursue a CRNA instead. The 600K would be at the completion of residency. Previous debt was from SMP (regrets there). I've talked to people in my class, and they expect to have 400K+ at graduation from medical school. They say, "well it's a lot, but you can still get by on what you will earn in primary care." I think that's stupid. You should get a good return on your investment after all of this. What do ya'll think? Worth it to continue? Election day is a few days away.
 
Regarding loan repayment: yes, I have heard good things about CRNA loan repayment. Another reason I'm considering it.
 
I'm horrified about the amount i will owe at the end of residency. I'm guessing I'll be around 300k..I think I'm just gonna work for free while i mooch off my partner for a few years when i start out, so that i can pay off the loans.
 
Yup, that was me. I'm debating quitting to pursue a CRNA instead.

I don't think that's going to work. You'll have to become a nurse first, then become a CRNA (both will cost money and time).

Then you'll enter the CRNA labor force right about the time that a lot of us expect market forces to really give their overproduced mediocre product a kick square in the nuts.
 
So I'm better off sticking it out and paying back 600K?
 
It's a tough situation, I don't know if there are any really excellent or obviously best answers.

Minimize new debt if you can, live frugally, maybe work some on the side during school (not easy but my brother did it and kept his debt down), do well enough that you don't find yourself stuck in a low paying specialty, pick a residency program that allows moonlighting and work your ass off ... Not sure what else you can do.

I don't know enough about income based repayment or loan forgiveness programs. Used to be that you could get a $400K signup bonus to come into the military for a 4-year stint, but those were only offered to make up manning shortfalls and I think most of us don't expect the military to offer that again any time soon.

Loathe as I am to recommend the military for financial reasons, HPSP may not be a bad option. No more additional med school debt, significantly higher pay during residency, and the servicemembers civil relief act would cap all of your pre-existing debt at 6% starting the day you went on active duty. DO-friendly residency programs, and the military anesthesia residency programs while not top-tier are definitely solid. I don't think they're funding many 3-year HPSP spots these days though.
 
Pgg,

Thanks for your input. If you were in my situation, is HPSP what you would do? What if I can't get HPSP? The thing that concerns me about IBR is that the remaining loan continues to accrue interest (gov't loves that), and then I owe taxes on the remaining balance when 25 years is up.
 
I'm looking at about 375k when I finish my anesthesia residency in 20 months.

I had 20k undergrad debt, borrowed 32k, 38k, 42k, 48k for my 4 years of med school, with no help from family or scholarship. Add in cost of living during med school of about 1-1.5k per month, and I finished med school at $220k ish (Creighton, where tuition this year is mid 50k). Interest is 6.8 on 40 percent of the debt, 8.5 on the rest.

Here's my dilemma, I plan on working in the Midwest, and right now am not planning in doing a fellowship as my opp cost is high, my avg yr of interest is 35-40k as it is compounded...that could be a net loss of 240-300 the first year out. So, I'm leaning away from fellowship now, and starting in a private group in July 2014.

Blade, POD, pgg, sevo - any thoughts? Thanks.

I think you'll be fine, you're pretty close to the finish line. I'd pick a high paying, high 'overtime' potential job out in BFE, work like mad, and just attack the hell out of those loans for a few frugal years.
 
Another concern I have is stagnant residency positions and increasing medical school enrollment. People will be pushed more and more into primary care, while higher paying fields like Anesthesia will become more competitive. As it is, I am already at a disadvantage as a DO.
 
Pgg,

Thanks for your input. If you were in my situation, is HPSP what you would do?

Do you want to be in the military? There are some great up sides to it, but there's a lot of **** to put up with too. I'd spend a lot of time in the mil med forum before signing up.

You've got to understand that a huge % of HPSP recruiting happens because people are either debt averse or can't make their existing debt math work without HPSP, and even though these people sign up for the money and get the money, a lot of them are unhappy and regret it because of the drawbacks associated with being a doctor in the military. I've heard a lot of people say they'd rather owe money than time.
 
I don't particularly want to be in the military, but given the debt situation I would entertain it.
 
Yup, that was me. I'm debating quitting to pursue a CRNA instead. The 600K would be at the completion of residency. Previous debt was from SMP (regrets there). I've talked to people in my class, and they expect to have 400K+ at graduation from medical school. They say, "well it's a lot, but you can still get by on what you will earn in primary care." I think that's stupid. You should get a good return on your investment after all of this. What do ya'll think? Worth it to continue? Election day is a few days away.

As you can see, I'm a pre-med, so take my words with grain of salt.

Being 600K in debt is insane, no question about it, but if you quit now, you'll be in a much worse situation. I assume you had at least 100K in debts before entering med school, so quitting after your M1 year will put you ~180K in debts (including interests). Regardless of what the future holds, I think being a board certified anesthesiologist with 600K debt is a lot better than leaving now with nothing but a useless SMP degree and 180K loans.

To be honest with you, 600K in debt AFTER a 4-year residency is not unheard of nowadays. Consider this, someone attends a private med school and borrows 80K/year. That person will graduate with 320K loans PLUS ~60K interests. If that person decides to do, let's say pediatric surgery, he/she will accumulate another 220K of interests by the end of the 8-year training.

Another thing to consider is that the 600K, in 2020, will be ~420K in 2012 money.

Lastly, you are in med school. Many would kill to be in your position. Like pgg has mentioned earlier, pre-meds are welling to devour poop to be admitted.
 
I guess. It's a gamble whether or not I would be admitted to Anesthesia or another high paying specialty. That debt load compounds the stress of everything. I'm also quickly realizing how much I would hate other fields of medicine (ie, primary care), so that makes it even worse.
 
I don't particularly want to be in the military, but given the debt situation I would entertain it.


$600K is too much debt. I imagine if you live like a person earning $60K then pay back over 5-10 years is possible. But, what a sacrifice to make in terms of time, money and effort.

That said, I know a few Tier 1 lawyers who paid $400K for undergrad (IVY League) then a top ten law school. There is no shortage of applicants to Top Ten Law Schools even at $60K per year for tuition alone.
 
Blade:

You should list University of Colorado Medical School.

OOS tuition, as I recall checking last year, >$80K per year!!!!!!!!!!!!!!

That tops couple of the others in your list.

Insane.

And a shame really.

D712
 
In addition, I have learned from some DO students here, you won't even get adequate advising on how to get a residency program of your choice. For the price you pay, you should get ample support.

I agree with that statement! I am a DO student and I have no clue how to go about applying for a residency and actually getting it. What I know is what I have read on here and I still have a million questions! There is absolutely no direction given from my school. I still am at a loss as to how to apply to enough programs and not go broke in the process. I am in MI and even with state school tuition I am going to be 300-400k in debt between undergrad and medical school. I didn't take much for cost of living in undergrad but take extra in medical school because I have a family of 4 and my husband stays home with the kiddos because daycare is astronomical in comparison to what he was making.

But really I want to do Anesthesia and am still floundering at what/how to go about picking programs for next summer when I fill out ERAS. My school is all about going DO but I keep hearing to stay away from DO residencies but am seriously worried about only applying MD because I cannot afford to pay application fees to 75+ schools. Its just not feasible. But I also only took COMLEX which is a disadvantage I think. I have spoken to a couple places and have been told my score is high enough that it doesn't matter but I am sure that is not the same for all places......
 
I got a PM from a Med Student (MS1) at a DO School. That person said his/her debt will be $600K by the time graduation comes around. I was asked for my advice. I recommend a military scholarship because $600K is simply too much debt under a ObamaCare health system.

Have any of you heard of that much debt after College and Medical School? I assume with $600K in debt the goal would be some kind of loan forgiveness down the road. I have heard of ER docs, CRNAs, etc getting big $$$ loan forgiveness from the Federal govt. in my area.

Comments?

When I finish residency I'll have ~ 400K in debt (finished undergrad debt free, this is all just from 4 years of med school). Some days I wake up with palpitations thinking about it. The only loan forgiveness I'm hoping for is the PSLF (public service loan forgiveness) which has been discussed on the forum before. We'll find out in ~2-3 years if it's going to work or not as the first group of folks hit the 10 year IBR (income based repayment) mark and will hopefully then have the remainder of their loans forgiven.

Some food for thought: college/grad-school tuition is one of the most bizzarre markets I've heard of. Basically, an 18 year old kid with no credit history has access to what is almost unlimited loans to pay WHATEVER the college wants to charge. If a school wants to charge 100K a year in tuition, as long as the kid/student says I want to go there, he/she will be given 100K a year in loans by the government. There's very little incentive for med schools to charge less--especially given how competitive it's becoming.
 
I got a PM from a Med Student (MS1) at a DO School. That person said his/her debt will be $600K by the time graduation comes around. I was asked for my advice. I recommend a military scholarship because $600K is simply too much debt under a ObamaCare health system.

Have any of you heard of that much debt after College and Medical School? I assume with $600K in debt the goal would be some kind of loan forgiveness down the road. I have heard of ER docs, CRNAs, etc getting big $$$ loan forgiveness from the Federal govt. in my area.

Comments?

$600k? If you search their post hx you find out they did a SMP like 5 years ago (probably 75k total for the year) and started dental school at some point, completed an unknown number of years there and is now a DO student. Yikes.
 
Yeah, I did an SMP and did a semester of dental school, but I had money to pay for a good chunk of that. SMP was nowhere near 75K.
 
Even without that, COA would put post residency debt at around 500K.
 
Lastly, you are in med school. Many would kill to be in your position. Like pgg has mentioned earlier, pre-meds are welling to devour poop to be admitted.

I'm at a DO program--no one eats poop to be a DO lol.
 
Blade, what kind of income do you think I can expect in ~10 years?
 
300k with the buying power of 200. And Higher taxes on the over $200 portion.
The futures so bright, I gotta' wear shares [to hide my tears].

Is your estimation based on Obama winning the election, and obamacare gets fully implemented?
 
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