I didn't read through this thread, but people should be thinking about and worried about loans. It's easy to dismiss loans as not a big deal because 1) every takes them so the amount of debt you're taking on, which can be insane in many cases compared to the average person, is normalized because of who your peers are and 2) it seems like imaginary money because you rarely see most of it and don't have to actually start repaying it until many years down the line.
When you start paying it down, though, it does have an impact on your life. For example, my wife and I are in the process of buying a home and my student loan debt has an impact on our ability to secure a mortgage and the kinds of homes we can look at. It's another few hundred bucks a month that comes out of our budget that we don't have available for things we'd like to be able to buy now. I'm repaying my loans with IBR so the proportion of the payments to our income is actually fairly small, but it will become significant later on and be there for many years to come. And I have a relatively small amount of debt compared to many of the people that I read about here.
So, yes, loans are part of the game, and it's unlikely that you will escape them entirely unless you're independently wealthy, your parents are wealthy, or you manage to get scholarships to pay for the entirety of your education (unlikely). This being an unescapable reality, the best thing you can do is work to take on the smallest amount of debt you possibly can so that you have less to pay further down the line. The whole idea of "paying your loans off as soon as possible once you're an attending" is a nice idea but difficult to execute in practice as I've found by talking with attendings. For people that are married or maybe with children, it can be a long sell to get your family on board to agree to continue living with a resident's lifestyle for years after you're making good money. It's the smart thing to do, sure - no one would deny that - but the smart thing to do can be difficult when other people are along for the ride with you. You may not want to be married, buy a house/condo/apartment, or have kids now, but you will be at a different place in your life when it comes time to pay your loans and may want those things. But by that time the damage is done, so to speak.
Loans aren't the end of the world, but they can and will impact your life down the road. Being aware of that and trying to understand what that impact will be to the best of your ability and given the relatively limited knowledge you have when making these big financial decisions is the best you can do. Some people are focused on going to their "dream school" that costs double what another perfectly fine school does, so for them the cost is irrelevant (though they may regret that decision in the future). Others are more flexible and are able to prioritize the financial realities of debt over the desire to go to school A. You need to figure out what's important to you and be realistic when thinking about the cost of the decisions you're making now.
