To attend or postpone? Toughest decision of my life

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mdr8

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While I can count myself lucky that the toughest decision I have had to make in my 28 years of life is one involving opportunities, it remains a painstaking decision. I applied to roughly 10 MD and 10 DO schools for this application cycle, and have been fortunate enough to have one acceptance to a DO program (turned down 2 other DO interviews). My MCAT score was a 28, so I was well aware DO school would be my best bet. I have my 2000 dollar deposit down at the DO school I was accepted to, with 1500 of that being refundable up until June. I am struggling with the decision of whether to attend medical school at all this fall, due to financial reasons. I am currently a 4th year pharmacy student set to graduate this spring(research old threads if you want to see exact reasons as to why I want to be a doctor and not a pharmacist, how I ended up in pharm school etc.). I still want to be a doctor as badly as I did when I was in undergrad (frankly I'm not sure I would have been accepted to medical school without my pharmacy experience) but I now will have 234K of total educational debt post pharmacy school. The DO school I have been accepted to is private and costs 52K per year. With more living expense loans to be taken out on top of that, you can imagine the staggering number I would be facing upon graduation of medical school. I am considering working as a pharmacist for a year or two and putting as big of a dent as possible in my pharmacy school loans then reapplying to medical school. The biggest reason I am scared to go that route is fear I may not get accepted to medical school again. I applied to 20 schools and only one is giving me a chance. If I turn down that offer, I am scared they will not want to accept me again two years from now, and I will have let my opportunity to become a doctor slip away. On the other hand, my 234K of undergrad/pharm debt collecting interest for 4 years (and likely more in residency) sends chills up my spine as well. While I understand pharmacy is a career many people in this country would be thankful for, it is not what I am passionate about. The job market is also TERRIBLE right now with the opening of 48 new pharmacy schools over the past ~10 years. I have work experience, decent grades and a solid resume and I am having great difficulty securing work upon graduation in the northeast. It all boils down to what is scarier, fear of future debt or not chasing my dreams. A tough one I must say. I welcome all advice and perspective on my situation. Thank you!

Edit: and no, the school I was accepted to does not allow deferment for any reasons, even financial.

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I could be wrong, but if you apply in the future and schools see that you already turned down a medical school acceptance, I think that pretty much torpedo's your chances.
 
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This is one of those times when the military starts looking really really good.

(Nothing against those who chose to go the military route without a pre-existing mountain of student debt)
 
While I can count myself lucky that the toughest decision I have had to make in my 28 years of life is one involving opportunities, it remains a painstaking decision. I applied to roughly 10 MD and 10 DO schools for this application cycle, and have been fortunate enough to have one acceptance to a DO program (turned down 2 other DO interviews). My MCAT score was a 28, so I was well aware DO school would be my best bet. I have my 2000 dollar deposit down at the DO school I was accepted to, with 1500 of that being refundable up until June. I am struggling with the decision of whether to attend medical school at all this fall, due to financial reasons. I am currently a 4th year pharmacy student set to graduate this spring(research old threads if you want to see exact reasons as to why I want to be a doctor and not a pharmacist, how I ended up in pharm school etc.). I still want to be a doctor as badly as I did when I was in undergrad (frankly I'm not sure I would have been accepted to medical school without my pharmacy experience) but I now will have 234K of total educational debt post pharmacy school. The DO school I have been accepted to is private and costs 52K per year. With more living expense loans to be taken out on top of that, you can imagine the staggering number I would be facing upon graduation of medical school. I am considering working as a pharmacist for a year or two and putting as big of a dent as possible in my pharmacy school loans then reapplying to medical school. The biggest reason I am scared to go that route is fear I may not get accepted to medical school again. I applied to 20 schools and only one is giving me a chance. If I turn down that offer, I am scared they will not want to accept me again two years from now, and I will have let my opportunity to become a doctor slip away. On the other hand, my 234K of undergrad/pharm debt collecting interest for 4 years (and likely more in residency) sends chills up my spine as well. While I understand pharmacy is a career many people in this country would be thankful for, it is not what I am passionate about. The job market is also TERRIBLE right now with the opening of 48 new pharmacy schools over the past ~10 years. I have work experience, decent grades and a solid resume and I am having great difficulty securing work upon graduation in the northeast. It all boils down to what is scarier, fear of future debt or not chasing my dreams. A tough one I must say. I welcome all advice and perspective on my situation. Thank you!

Edit: and no, the school I was accepted to does not allow deferment for any reasons, even financial.

Have you talked to the DO school's financial aid office? For one thing, your pharmacy school loans might be eligible for in-school deferment. I realize that's a temporary postponement, but it gets you the ability to make money doing what you are passionate about. You might have to work during breaks, apply for scholarships, and find other creative (legal :) ) ways to raise the funds, but surely your lifelong fulfillment is worth more than $250K. Yes, it might be a long time before you can afford a "doctor's lifestyle" but if this is your calling, you will always regret walking away far more than having to slog for a few years.
FWIW, unless you get instate tuition at a med school, many of them are approaching the $50k/year mark, especially the DO schools. Even if you were to reapply and get in in 2 years, you might be looking at the same or an even bigger price tag (as tuition has a tendency to increase). However, if you take this opportunity now, even if you're tight financially, nobody can take your education from you, and lenders generally offer ways to adjust loan payments to your ability to pay.
Bottom line, life has taught me that making decisions out of fear doesn't lead to good outcomes. The alternative might feel safer, but it's also pretty bleak: hunting in a tight job market for something that won't make you happy.
 
OP, could you work a few shifts a month as a pharmacist while in med school? That could significantly reduce the amount of loans you need to take out to cover things like living expenses, room & board, etc. (or pay it against your existing loans). Normally, I wouldn't recommend working during med school, but since you're a pharmacist you'll already be familiar with a lot of the physiology, biochem, neuroscience, and of course pharmacology. Also, if you're single, find roommates. That would save an enormous amount of money in rent.
 
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Take your acceptance at CCOM and run with it. You will not get another opportunity. If you had doubts about being able to start med school this early with your current debt load you shouldn't have applied in the first place.
 
This is one of those times when the military starts looking really really good.

(Nothing against those who chose to go the military route without a pre-existing mountain of student debt)

People here on SDN like to repeat the refrain that, "If you do the military isn't worth it based solely on finances, but only if you have a separate desire to serve in the military," or something to that effect. However, I think it's school dependent. You owe the same payback to the military no matter where you go to school, but you're getting a lot more from the military in return if you go to AZCOM than if you go to LECOM.
 
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So a couple people think that I will not have another chance if I do not attend this fall. Is that something you guys just suspect would happen, or do you actually know for a fact that medical schools will devalue my application, knowing I didn't attend after a previous acceptance (even if the reason was financial in nature)?
 
So a couple people think that I will not have another chance if I do not attend this fall. Is that something you guys just suspect would happen, or do you actually know for a fact that medical schools will devalue my application, knowing I didn't attend after a previous acceptance (even if the reason was financial in nature)?
@Goro
 
This is a tough decision, as 500k+ in debt is a tough burden. However, with your previous pharm experience, you should be fine on a lot of pre-clinical courses in med school. You could absolutely make time to pick up some pharm shifts at your local retail pharmacy, or what have you. This could make it possible for you to start paying down some loans while in med school...
 
Financially, it's dumb to do school later (if you will definitely go and the question is when). At that point, every year you work as a pharmacist, you are giving away the difference in salary between a doctor and a pharmacist
 
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People here on SDN like to repeat the refrain that, "If you do the military isn't worth it based solely on finances, but only if you have a separate desire to serve in the military," or something to that effect.

The difference is, this guy's going to be $600-700k in debt on the day he earns his DO degree. I'm not familiar with the interest rates on PharmD loans, but 4-7 years of deferred payment and accrued interest on top of the 6.8% medical loans might dig this guy into a deeper hole than I can imagine.
 
People here on SDN like to repeat the refrain that, "If you do the military isn't worth it based solely on finances, but only if you have a separate desire to serve in the military," or something to that effect. However, I think it's school dependent. You owe the same payback to the military no matter where you go to school, but you're getting a lot more from the military in return if you go to AZCOM than if you go to LECOM.

Yep, and if you have ¼ million dollars in student debt from a previous professional degree, I think the idea of not doing the military for the money needs to be re-evaluated.
 
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The difference is, this guy's going to be $600-700k in debt on the day he earns his DO degree. I'm not familiar with the interest rates on PharmD loans, but 4-7 years of deferred payment and accrued interest on top of the 6.8% medical loans might dig this guy into a deeper hole than I can imagine.


God I know, that's what I'm scared of. The interest rates on PharmD loans are the same as medical school loans. 6.5-7%ish. Then again, the argument that someone else made about every year I work as a pharmacist is forfeiting the difference in income (between what a physician and pharmacist make) makes a lot of sense too. Difficult decision indeed. Good thing I have a few more months to decide I suppose.
 
Yep, and if you have ¼ million dollars in student debt from a previous professional degree, I think the idea of not doing the military for the money needs to be re-evaluated.

I will look into the military route more in depth. From my understanding, it seems like it may be too late to apply for that route right now..... I may be wrong though.
 
I will look into the military route more in depth. From my understanding, it seems like it may be too late to apply for that route right now..... I may be wrong though.

You may be able to do it now, and if not I think you can join after M1.

I just got a pretty tempting offer from the Air Force too. Anyone doing ACGME family med is eligible for a $77,000/year salary plus additional benefits while in civilian residency in exchange for a 4 year commitment after residency. This is in addition to the salary and benefits my residency would give me. The catch is that you can't already be an HSPE student.

If I got my top choice it would add up to $130,000 per year salary and free health care. Certainly a tempting offer.
 
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God I know, that's what I'm scared of. The interest rates on PharmD loans are the same as medical school loans. 6.5-7%ish. Then again, the argument that someone else made about every year I work as a pharmacist is forfeiting the difference in income (between what a physician and pharmacist make) makes a lot of sense too. Difficult decision indeed. Good thing I have a few more months to decide I suppose.

In my opinion, it comes down to how bad you want it.

Paying back medical loans isn't the death sentence people on here make it out to be. Live like a resident for 3-4 years while making an attending salary and your loans are officially under control. Your situation obviously isn't as cut and dry. Are you opposed to doing an HPSP scholarship? Those typically (almost always) result in a net loss of money for the physician, but in your case it might save you from crippling interest.

According to finaid.org's calculator, if you paid off $700,000 of debt in 10 years (highly unlikely) you'd be paying over $8000 per month and would accrue over $200k in interest. Paying it off in 15 years (more likely) would result in a $6200 monthly payment and almost 1/2 million in interest. As it stands, your Pharm debt would be $375,000 at the end of 7 years (minimum) earning your DO and finishing the shortest residency. It's likely you could go above $700k of total debt. Something to consider.
 
Anyone doing ACGME family med is eligible for a $77,000/year salary plus additional benefits while in civilian residency in exchange for a 4 year commitment after residency. This is in addition to the salary and benefits my residency would give me.

Crap, that's interesting. $308k would wipe out my debt and then some. Making residency salary on top of it would obviously move my financial situation in the right direction.

But I have no ambition of entering the military. In fact it intimidates me.
 
In my opinion, it comes down to how bad you want it.

Paying back medical loans isn't the death sentence people on here make it out to be. Live like a resident for 3-4 years while making an attending salary and your loans are officially under control. Your situation obviously isn't as cut and dry. Are you opposed to doing an HPSP scholarship? Those typically (almost always) result in a net loss of money for the physician, but in your case it might save you from crippling interest.

According to finaid.org's calculator, if you paid off $700,000 of debt in 10 years (highly unlikely) you'd be paying over $8000 per month and would accrue over $200k in interest. Paying it off in 15 years (more likely) would result in a $6200 monthly payment and almost 1/2 million in interest. As it stands, your Pharm debt would be $375,000 at the end of 7 years (minimum) earning your DO and finishing the shortest residency. It's likely you could go above $700k of total debt. Something to consider.

Thanks for your in depth reply and going as far as to crunch a couple numbers. Appreciated. Basically going into a field such as primary care would be foolish of me unless I did the military or the other primary care scholarship (not trying to start an "it shouldn't be about the money!" war, but accruing that debt for a primary care salary seems foolish). Even in a specialty that pays more, I would have to live well below the "normal lifestyle" of a physician, which does not bother me at all. I am not sure if I am completely opposed to the military commitment. I am inclined to say that I am, given that I would be 32 upon graduation and I doubt moving all around the country will be something that fits into my life at that point. I too would be intimidated to sign my life away to the military for four years.

Edit: and also, when you say "shortest residency" I assume you are using 3 years (for FP and EM)?
 
You may be able to do it now, and if not I think you can join after M1.

I just got a pretty tempting offer from the Air Force too. Anyone doing ACGME family med is eligible for a $77,000/year salary plus additional benefits while in civilian residency in exchange for a 4 year commitment after residency. This is in addition to the salary and benefits my residency would give me. The catch is that you can't already be an HSPE student.

If I got my top choice it would add up to $130,000 per year salary and free health care. Certainly a tempting offer.

So essentially you would not get your medical school paid for, would get almost an attending's pay for your residency, and then would enter the air force for four years once you are an attending?
 
So essentially you would not get your medical school paid for, would get almost an attending's pay for your residency, and then would enter the air force for four years once you are an attending?

Yep.

My wife met a lady who's husband did the program. They were given a list of locations in need of them and they ranked them. The air force then used their rank and sent them to some Air Force installation in Wyoming. He was the only doc there for a while so he wasn't deployable. As other docs came in he had enough seniority over them that they got deployed and he never did. They still live in Wyoming now that they're out of the AirForce to my knowledge.
 
Yep.

My wife met a lady who's husband did the program. They were given a list of locations in need of them and they ranked them. The air force then used their rank and sent them to some Air Force installation in Wyoming. He was the only doc there for a while so he wasn't deployable. As other docs came in he had enough seniority over them that they got deployed and he never did. They still live in Wyoming now that they're out of the AirForce to my knowledge.

Interesting. That route sounds beneficial if you go to a cheaper medical school. Have you done the math out to see if it would be more beneficial for you to take the HPSP scholarship or not?
 
Thanks for your in depth reply and going as far as to crunch a couple numbers. Appreciated. Basically going into a field such as primary care would be foolish of me unless I did the military or the other primary care scholarship (not trying to start an "it shouldn't be about the money!" war, but accruing that debt for a primary care salary seems foolish). Even in a specialty that pays more, I would have to live well below the "normal lifestyle" of a physician, which does not bother me at all. I am not sure if I am completely opposed to the military commitment. I am inclined to say that I am, given that I would be 32 upon graduation and I doubt moving all around the country will be something that fits into my life at that point. I too would be intimidated to sign my life away to the military for four years.

Edit: and also, when you say "shortest residency" I assume you are using 3 years (for FP and EM)?

It shouldn't be solely about money, but when you're looking down the barrel of half a million dollars+ owed to the government, money becomes a large factor. This is an enormous investment on your part, don't let anybody tell you how to feel about your investment. I'm not familiar with the moving aspect of HPSP grads, so I'll let them tell you about their experiences. I sure as hell wouldn't want to move all the time either. I'm already annoyed I'll have to move for rotations, but that was something I knew when I chose the school I'm attending.

The three years I was speaking of was aimed towards primary care (FP, Peds) and in the DO world, EM is 4 years for some unknown reason. MD EM is 3 years all over the country except for LSU and Penn I believe. What I did assume in the calculations is that you wouldn't be making payments while earning a resident's wage. That complicates the math, and in your case likely wouldn't put much of a dent in the interest.
 
You may be able to do it now, and if not I think you can join after M1.

I just got a pretty tempting offer from the Air Force too. Anyone doing ACGME family med is eligible for a $77,000/year salary plus additional benefits while in civilian residency in exchange for a 4 year commitment after residency. This is in addition to the salary and benefits my residency would give me. The catch is that you can't already be an HSPE student.

If I got my top choice it would add up to $130,000 per year salary and free health care. Certainly a tempting offer.

Wow. That would be tempting. The downside is you're probably going to make less as a family med attending in the military than you would as a civilian. But you could make up for that by knocking out a huge amount of student loans during residency, instead of accumulating interest.
 
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Do the FAP. You'll get ~70K a year to train wherever you want in whatever you want. Then once your training is done you pay back your time as an attending in whatever you trained in (1 year pay back for every year of $ you accept. I believe the minimal is 4 years). Much more flexible option than the HPSP and you don't have to worry about not getting the speciality you want (for a whole litany of political reasons).

It's something that I'm highly considering if I end up matching into a lower paying speciality.

This may be the same exact program that @SLC is talking about?
 
It shouldn't be solely about money, but when you're looking down the barrel of half a million dollars+ owed to the government, money becomes a large factor. This is an enormous investment on your part, don't let anybody tell you how to feel about your investment. I'm not familiar with the moving aspect of HPSP grads, so I'll let them tell you about their experiences. I sure as hell wouldn't want to move all the time either. I'm already annoyed I'll have to move for rotations, but that was something I knew when I chose the school I'm attending.

The three years I was speaking of was aimed towards primary care (FP, Peds) and in the DO world, EM is 4 years for some unknown reason. MD EM is 3 years all over the country except for LSU and Penn I believe. What I did assume in the calculations is that you wouldn't be making payments while earning a resident's wage. That complicates the math, and in your case likely wouldn't put much of a dent in the interest.

Unless you match into an EM ACGME residency I would assume, then you could do a 3 year residency as a D.O, no? The EM residency at Central Maine Medical Center is 3 years and accepts D.O. students I believe. The only reason I know that is because the school I was accepted to (UNE) is right near there.
 
Unless you match into an EM ACGME residency I would assume, then you could do a 3 year residency as a D.O, no? The EM residency at Central Maine Medical Center is 3 years and accepts D.O. students I believe. The only reason I know that is because the school I was accepted to (UNE) is right near there.

As you are probably aware, DO's can enter either AOA (DO) or ACGME (MD) residencies. I am unaware of any AOA 3 year EM residencies. So yes, you could do a 3 year EM residency as a DO so long as it is ACGME. This is my plan.
 
I have a pharmacist in my class that works part time and pays for school that way. Granted I am at lecom where it is cheaper
 
You may be able to do it now, and if not I think you can join after M1.

I just got a pretty tempting offer from the Air Force too. Anyone doing ACGME family med is eligible for a $77,000/year salary plus additional benefits while in civilian residency in exchange for a 4 year commitment after residency. This is in addition to the salary and benefits my residency would give me. The catch is that you can't already be an HSPE student.

If I got my top choice it would add up to $130,000 per year salary and free health care. Certainly a tempting offer.

Is this FAP?
 
I have a pharmacist in my class that works part time and pays for school that way. Granted I am at lecom where it is cheaper

Nice, I wonder how many hours part time was for him.... That's awesome though, if I attend I'll definitely have to consider picking up some hours somewhere.
 
Op how much do you even think you would be able to put towards loans if you postponed? Interest alone on 234k of debt would be around 16k a year, so you would have to contribute much more than this to even hit a dent in your principal. Just go with he acceptance you have, the prospect of a much larger paycheck in the future (not to just chase the money) will be infinitely more worthy than anything you could contribute in the short term.
 
People forget that every year you postpone your start date is essentially costing you one year of an attending salary.


So you would be sacrificing ~180k dollars per year to eliminate 16k per year of interest from accruing.
 
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OP, apply for deferment of Pharm loans if you can. Also, apply for every possible scholarship, grants or aid you can get while in med school. Go to med school now if you're going to ever do it.

The idea of having $700-$800k in debt might be crazy to you, but at very least you have PAYE/PSLF/plain old IBR to deal with it. It's not an impossible feat, you'll just have to live like a pharmacist while working as a doc if you want to make any headway on your loans (assuming you really prefer the work, that should be worth it). It's doable, especially if you're planning to work for at least 20-30 yrs as a physician.

Think about things like HPSP and FAP, but I don't know how that'll affect your pharm loans. I still think you should only join if you have an interest in the military though.
 
People forget that every year you postpone your start date is essentially costing you one year of an attending salary.


So you would be sacrificing ~180k dollars per year to eliminate 16k per year of interest from accruing.

It's not that simple. Your case is implying he would make $0 as a pharmacist.
 
It's not that simple. Your case is implying he would make $0 as a pharmacist.
Even the highest possible starting salary for a pharm isnt close as starting salary for an attending.
 
And yes ... Do not go military unless you are ready to devote a good part of your life to being in the military. Whoever is suggesting it for financial reasons is a ********
 
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And yes ... Do not go military unless you are ready to devote a good part of your life to being in the military. Whoever is suggesting it for financial reasons is a ********

Classy!

Anyone who calls someone mentally handicapped as a slur instantly loses any and all credibility with me. It's a dickish thing to do and looks way worse on the person saying it than the person being insulted.
 
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Classy!

Anyone who calls someone mentally handicapped as a slur instantly loses any and all credibility with me. It's a dickish thing to do and looks way worse on the person saying it than the person being insulted.


Damn. Im really gonna miss your credibility.

Also, note the asterisks. I could have typed spittard. You're actually the one who brought up mentally handicapped people. So actually, its you who are being insulting.
 
Even the highest possible starting salary for a pharm isnt close as starting salary for an attending.

Color me shocked.

My point still stands. Try to be a little less of an ass to everyone and we'll all be happier.
 
Damn. Im really gonna miss your credibility.

Also, note the asterisks. I could have typed spittard. You're actually the one who brought up mentally handicapped people. So actually, its you who are being insulting.

Ha ha, spittard? Give us a definition and a link to the definition and we'll consider whether your comment was anything less than distasteful.
 
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If i were in your position, I would never leave the pharm program
who cares about pursuing your dream.. you are 1-2 years away from earning 100k+ and an easy lifestyle. You can find a way to turn that $ + time you will have towards something else that you arepassionate about.... (ie start a hospital somehwere in the 3rd world or start a charity that gives pharm products to the needy etc. etc. etc. )

Find a job somewhere in the country as a pharmacist..
are you telling me you cannot find a job anywhere even if you hustle your butt off and work hard at it?


You need to have the mentality that carribean med grads have... which is to hustle your *** off and work and don't ever give up. Look for jobs ruthelessly... maybe you will have to live somewhere else for a few years, but after you can continue looking for jobs in the northeast and eventually you will find one


When you are doing residency and are in 700k debt, you will be asking yourself why you incurred all this debt.
 
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Color me shocked.

My point still stands. Try to be a little less of an ass to everyone and we'll all be happier.



It actually doesnt stand.

Every year you spend earning less than an attending salary is financially costly.

It doesnt really matter if you are a pharmacist, or a fry cook. If you are trying to be a doctor in the end, the most financially smart way to do it is to attend medical school at the earliest age possible.

There are reasons to delay your start date. This is not one of them.
 
If i were in your position, I would never leave the pharm program
who cares about pursuing your dream.. you are 1-2 years away from earning 100k+ and an easy lifestyle. You can find a way to turn that $ + time you will have towards something else that you arepassionate about.... (ie start a hospital somehwere in the 3rd world or start a charity that gives pharm products to the needy etc. etc. etc. )

Find a job somewhere in the country as a pharmacist..
are you telling me you cannot find a job anywhere even if you hustle your butt off and work hard at it?


You need to have the mentality that carribean med grads have... which is to hustle your *** off and work and don't ever give up. Look for jobs ruthelessly... maybe you will have to live somewhere else for a few years, but after you can continue looking for jobs in the northeast and eventually you will find one


When you are doing residency and are in 700k debt, you will be asking yourself why you incurred all this debt.


Ignore this entire post.
 
Ha ha, spittard? Give us a definition and a link to the definition and we'll consider whether your comment was anything less than distasteful.


Who is "us"? There is only enough room on that high horse for one person at a time
 
Nevermind
 
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