Residents: Economic deferment no more ...

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http://www.nasfaa.org/publications/2007/gdefermentibr091307.html


Someone needs to do something about this and I'm HIGHLY surprised that organizations didn't step in. While I know no one will actually pay $349/mn its more the principle that with the rising cost of education, people seem to forget about the graduate students and focus on the college students. Just pisses me off because many residents have a hard enough time making ends meet until they can moonlight, if they are even allowed/have enough time to.

I think its time to contact our local representatives, the sad part is this bill already passed. A resolution to extend the hardship was submitted but obviously nothing came from it (just like how nothing changed for graduate interest rates either).

/rant
 
If you can't frigging defer your loans then they might as well count residency as a job and stopping calling it training.
 
From that link:

The final conference agreement includes a change in the criteria to qualify for the economic hardship deferment that eliminates the debt-to-income pathway, which is the most common means by which medical residents obtain eligibility. The mandatory medical residency/internship deferment and forbearance will not be affected.
Click to expand...

This suggests that the changes will make it harder for residents to get these loans, but that repayment issues are not changed.

I'm no expert at this, though.
 
aProgDirector said:
From that link:



This suggests that the changes will make it harder for residents to get these loans, but that repayment issues are not changed.

I'm no expert at this, though.
Click to expand...

The way I understood it was that everyone would still get the mandatory 3 year deferment but after that it goes SOLELY to income without regard to debt:income ratio. Frankly, without that latter category no one will qualify because the income is not the issue, its paying these loans when you also have an apartment and in most cases a car payment as well.

I still recall the day when they told me I no longer qualified for the deferment and they wanted $1000/month from my $2200/month take-home. After $850 for rent and $285 for car, there wouldn't be much to live on. They suggested a roommate, or to turn off my internet (which I didn't have anyway). I suggested that we figured out another way.🙄
 
Kimberli Cox said:
The way I understood it was that everyone would still get the mandatory 3 year deferment but after that it goes SOLELY to income without regard to debt:income ratio. Frankly, without that latter category no one will qualify because the income is not the issue, its paying these loans when you also have an apartment and in most cases a car payment as well.

I still recall the day when they told me I no longer qualified for the deferment and they wanted $1000/month from my $2200/month take-home. After $850 for rent and $285 for car, there wouldn't be much to live on. They suggested a roommate, or to turn off my internet (which I didn't have anyway). I suggested that we figured out another way.🙄
Click to expand...

so what became of the issue...did you fork over $1000/month?
 
nykka3 said:
so what became of the issue...did you fork over $1000/month?
Click to expand...

Nope...went into forebearance and agreed to $350/month when I got into fellowship (and was making more). They will actually work with you to try and come up with something...I think if you agree to pay something, it gets them off your back.
 
WHAT? Is this actually going to happen?

I can't afford my $900+ monthly payment yet!

🙁
 
aProgDirector said:
From that link:



This suggests that the changes will make it harder for residents to get these loans, but that repayment issues are not changed.

I'm no expert at this, though.
Click to expand...
actually one of the financial aid officers in the FIN AID forum took a stab at that verbage ...


From what I talked to my loan provider when I deferred my husband loans, medical residency is NEVER guaranteed deferment (loan 1993 and more recent) unless you meet the debt to income ratio. That is how all loans have been calculated. If you don't meet that, you are required to have repayment which is why some residents are stuck paying their loans.

Some residents have approached their GME and filled out paperwork which I still haven't figured out to also have deferment but that doesn't fit into the debt to income which I was told is the ONLY way current residents (new graduates) can defer. This legislation eliminates that current pathway.

I am unsure how this will affect the fellowship deferment as well.
 
Kimberli Cox said:
The way I understood it was that everyone would still get the mandatory 3 year deferment but after that it goes SOLELY to income without regard to debt:income ratio. Frankly, without that latter category no one will qualify because the income is not the issue, its paying these loans when you also have an apartment and in most cases a car payment as well.

I still recall the day when they told me I no longer qualified for the deferment and they wanted $1000/month from my $2200/month take-home. After $850 for rent and $285 for car, there wouldn't be much to live on. They suggested a roommate, or to turn off my internet (which I didn't have anyway). I suggested that we figured out another way.🙄
Click to expand...


I am an intern, making an intern salary, and I incredibly enough was denied a deferment--so it is NOT, as you say above mandatory. Although the salary on my contract is $50K/yr, my residency program works it so we can afford health/dental insurance without too much out of pocket expense. Unfortunately, this looks like a couple of extra hundred dollars a month on my paycheck which I really do not actually get, but disqualified me from a deferment. So, as an intern they expect me to pay $1000/month in loans. They actually told me to cancel my health insurance, which would bump my paycheck down into the deferment range. Thanks, SallieMae! Excellent idea!! 🙁
 
Bitsy3221 said:
I am an intern, making an intern salary, and I incredibly enough was denied a deferment--so it is NOT, as you say above mandatory. Although the salary on my contract is $50K/yr, my residency program works it so we can afford health/dental insurance without too much out of pocket expense. Unfortunately, this looks like a couple of extra hundred dollars a month on my paycheck which I really do not actually get, but disqualified me from a deferment. So, as an intern they expect me to pay $1000/month in loans. They actually told me to cancel my health insurance, which would bump my paycheck down into the deferment range. Thanks, SallieMae! Excellent idea!! 🙁
Click to expand...

I am in the same boat as an R1 making $54K ($44K salary + 10K housing allowance) this year in a high cost of living city. I essentially went with a forebearance and just pay the interest so it doesn't capitalize.
 
Bitsy3221 said:
I am an intern, making an intern salary, and I incredibly enough was denied a deferment--so it is NOT, as you say above mandatory. Although the salary on my contract is $50K/yr, my residency program works it so we can afford health/dental insurance without too much out of pocket expense. Unfortunately, this looks like a couple of extra hundred dollars a month on my paycheck which I really do not actually get, but disqualified me from a deferment. So, as an intern they expect me to pay $1000/month in loans. They actually told me to cancel my health insurance, which would bump my paycheck down into the deferment range. Thanks, SallieMae! Excellent idea!! 🙁
Click to expand...

DarksideAllstar said:
I am in the same boat as an R1 making $54K ($44K salary + 10K housing allowance) this year in a high cost of living city. I essentially went with a forebearance and just pay the interest so it doesn't capitalize.
Click to expand...


Ugh...I think that's all I can say to that about now...:barf:
 
Bitsy3221 said:
I am an intern, making an intern salary, and I incredibly enough was denied a deferment--so it is NOT, as you say above mandatory. Although the salary on my contract is $50K/yr, my residency program works it so we can afford health/dental insurance without too much out of pocket expense. Unfortunately, this looks like a couple of extra hundred dollars a month on my paycheck which I really do not actually get, but disqualified me from a deferment. So, as an intern they expect me to pay $1000/month in loans. They actually told me to cancel my health insurance, which would bump my paycheck down into the deferment range. Thanks, SallieMae! Excellent idea!! 🙁
Click to expand...

I got the term "mandatory" from the link Mushy provided:

"Currently, borrowers qualify for the economic hardship deferment if:

Their income does not exceed the greater of either the minimum wage rate or 100 percent of the poverty line for a family of 2; or

Their debt-to-income ratio is under 220 percent of the poverty line for a family of 2.
The final conference agreement includes a change in the criteria to qualify for the economic hardship deferment that eliminates the debt-to-income pathway, which is the most common means by which medical residents obtain eligibility. The mandatory medical residency/internship deferment and forbearance will not be affected.. "

I never thought it was mandatory either as I exceeded the debt:income ratio by 3rd year but many many SDNers argued that EVERYONE automatically got deferment for at least that long, if not longer. My problem was my debt load wasn't as high as theirs ("only" $100K) so I exceeded the debt:income ratio much earlier than those with larger debts.

But you are right...there is no mandatory deferment unless you do not exceed their ratio. I loved their idea of me getting a roommate at age 35 and to sell my car and take the bus to work. As if there was some bus trawling rural central Pennsylvania which would pick me up at 4:30 am.🙄
 
It looks like you are only supposed to pay 15% of the income above 150% on the loan. For a single resident making the average, this would be a little over $300/month.
 
Don't you love dealing with the US government? You borrow a bunch of money, and they then proceed to change the rules after the fact.
 
WOw, I really thought some of you would be tougher than that.
 
Time to have about 6 more kids!
 
HHS also wants to cut funding for graduate medical education
http://www.ama-assn.org/amednews/2007/07/09/prse0709.htm


Quite smart - cut funding for GME so that residency will have to lower resident salary to stay afloat ... enough that it falls below the 150% of the federal poverty line ... so then you qualify for deferment of your loans while in residency

yay for working 80hrs/week (or more) for $15k (total compensation, actual salary may be less) while carrying a 6-figure debt load 👍
 
Actually the 20/220 rule was dropped as of Oct 1st so now there is a gap until the new program starts in July 2009, which would be up to only 150% of the poverty level (which means hardly anyone will qualify now) for repayments are capped at 15% of your income.

PLEASE, use the contact information on the AMA site to contact your representatives. They are the ONLY one that has responded to this issue. I sent a huge email out to the AOA and got the run around on a response. I was highly disappointed. But its not until we get the word out that anything will be done.

Currently your only option as of Oct 1st is forbearance I believe unless you are 150% of poverty level, here's a memo from the AMA that explains it.
 
Oh and 150% above the poverty line?

Code: 
  [B][FONT=Arial]Family Size      Poverty Line    150%                Maximum Qualifying Monthy Income.[/B]
  [FONT=Arial]1.
  [FONT=Arial]$10,210            $15,315            [B][FONT=Arial]$1,276.[/B].
  [FONT=Arial]2.
  [FONT=Arial]$13,690            $20,535            [B][FONT=Arial]$1,711.[/B].
  [FONT=Arial]3.
  [FONT=Arial]$17,170            $25,755            [B][FONT=Arial]$2,146.[/B].
  [FONT=Arial]4.
  [FONT=Arial]$20,650            $30,975            [B][FONT=Arial]$2,581.[/B].
  [FONT=Arial]5.
  [FONT=Arial]$24,130            $36,195            [B][FONT=Arial]$3,016.[/B].
  [FONT=Arial]6                      .
  [FONT=Arial]$27610             $41,415            [B][FONT=Arial]$3,451.[/B].
  [FONT=Arial]7.
  [FONT=Arial]$31,090            $46,365            [B][FONT=Arial]$3,886.[/B].
  [FONT=Arial]8.
  [FONT=Arial]$34,570            $51,855            [B][FONT=Arial]$4,321.[/B].

*Average first-year resident stipend is $43,266 ($3606 monthly)
 
The current system is BS anyway. I owe 120K and make 44K/year and don't quality for a deferment anyway. Flat out BS. Plus I had to take out extra a year that I couldn't get as a federal loan which DOES NOT APPLY!

I hate the current system. CEO of hospitals making $$$$ off our backs while we have way more training and value.

Its an outrage and something should be done about it. Next we will have Hildabeast come in and turn us all into government employees with some idiotic bureaucrat telling us what to do.
 
The people that need to be told to speak up are the medical students. Every US medical student should speak with her/his representative.. they are the one who will be screwed the most... cause they are the one soon to be unable to defer. The current residents will not suffer as much for this cause they are partially through their residency.
 
You guys are making a case for me to stay a PA and forget med school and residency. Yuck. I hope this works out....🙁
 
I've qualified for economic hardship - but is that because my loans are more than 250K and I'm a single mom?? 😱 If I had to pay that - I'd really be in the rears considering I have to take out extra loans to pay for CHILDCARE which is never subsidized 🙄 So 45K for 80 hours a week child care which amounts to 700-800 a month + mortgage 800. plus car, plus food, plus diapers... you get my drift. This is ridiculous. WIll I be bumped out of economic hardship now?
 
Poety2 said:
I've qualified for economic hardship - but is that because my loans are more than 250K and I'm a single mom?? 😱 If I had to pay that - I'd really be in the rears considering I have to take out extra loans to pay for CHILDCARE which is never subsidized 🙄 So 45K for 80 hours a week child care which amounts to 700-800 a month + mortgage 800. plus car, plus food, plus diapers... you get my drift. This is ridiculous. WIll I be bumped out of economic hardship now?
Click to expand...

I'm guessing that if you are good for the year you can't be bumped out but as of Oct 1st, 2007 you are not eligible for the pathway you got your deferment for this year since its gone.

So we have a few months to push something through Congress. Anyone related to some important peeps in DC? 😀
 
Actually, my sister-in-law is on staff with David Wu, D-Oregon (Senate). Although she mostly does the financial stuff in his office she does have his ear. I'll forward this on to her and who knows where it may go....
🙂
Lisa
 
Has anybody drafted a form letter we can mail to our legislators? As fun as it is to gripe about this on SDN, we need to actually do something pro-active. Where is AMSA??
 
My loan status was supposed to be in "deferrment" until January 2008. With the new changes, has my "current deferrment status" expired as of October 2007?
 
Flopotomist said:
Has anybody drafted a form letter we can mail to our legislators? As fun as it is to gripe about this on SDN, we need to actually do something pro-active. Where is AMSA??
Click to expand...
No, someone should post a draft and we can edit it. It be nice if AMA or someone did something like this. Many people have been asking for it. Kinda sad if you think about it, no one has time to draft a letter anymore.
 
This bill may particularly hurt residents in fields which require longer periods of training, such as general surgery.
 
I just spoke with my account representative at Great Lakes (the company servicing my loan). She actually had relatively good news. I can get a forebearance until my residency is done. And I can do it over the phone when I'm closer to the end of my deferment period.

Interest would start accruing on my Subsidized Stafford Loan, but that is a small percentage of my loan compared to my Unsubsidized and Private loans that are already accruing interest.

She also stated that no interest capitalization would occur until the end of the forebearance period. (Which jibes with what's on the website.)

I e-mailed my Senators and Rep through my state medical association website, but in the meantime forebearance is my best option, and probably for a lot of other residents as well.
 
InductionAgent said:
I just spoke with my account representative at Great Lakes (the company servicing my loan). She actually had relatively good news. I can get a forebearance until my residency is done. And I can do it over the phone when I'm closer to the end of my deferment period.

Interest would start accruing on my Subsidized Stafford Loan, but that is a small percentage of my loan compared to my Unsubsidized and Private loans that are already accruing interest.

She also stated that no interest capitalization would occur until the end of the forebearance period. (Which jibes with what's on the website.)

I e-mailed my Senators and Rep through my state medical association website, but in the meantime forebearance is my best option, and probably for a lot of other residents as well.
Click to expand...

I'm glad to hear about the interest capitalization, but I wonder if that will be the norm. Usually your interest is capitalized in forebearance per specifications on the gov't website and in definition of what forebearance is.

Glad to hear people are working on this though!
 
I am going to research this more and write Congress. I currently am going to graduate with approximately $275,000 in student loan debt so making payments in residency is going to break me. They pay us so little in residency for the hours worked...but to ask us to make full repayment on our loans during residency is just insane. They should either pay us a full salary during residency (which is never going to happen) or make it a mandatory loan deferment through residency training. As a future hopeful urologist, it'll be 5 long years of residency. What the heck am I going to do in year 4? Live in a cardboard box while I make $2250 loan payments? sheesh. Pass the mac and cheese please.
 
The TMA (Texas medical assoc) has this automated, but editable letter that can be sent to your local/state representatives once you input your zipcode. This only works for Tx zipcodes, but the letter they send would make a good template to work off of (see below).

Also...here's the website:
http://capwiz.com/tma1/issues/alert/?alertid=10408956&type=CO&show_alert=1



"I am a medical student/resident physician who lives in your district. I am very concerned that recent congressional action will make it almost impossible for many newly graduated physicians to repay their huge medical school loans. But you have an upcoming opportunity to reverse that.

Please use the Higher Education Act Reauthorization to restore the “20/220 rule,” which was eliminated as part of the recently passed College Cost Reduction Act. Please expand the definition of economic hardship deferment to include resident physicians. In the meantime, please delay the elimination of the 20/220 rule until at least July 1, 2009, when a new — but nowhere near as extensive — loan repayment program begins.

The 20/220 rule allowed students to defer payment without accruing interest on subsidized loans for up to three years if their debt burden was greater than 20 percent of their income and their income minus their debt burden was not greater than 220 percent of the federal poverty level.

Elimination of the 20/220 rule is a major disincentive for the best and brightest students to enter the medical profession. Residents earn an average of only $43,266 per year and carry an average debt of $130,571, making residency a difficult time to make monthly payments on our student loans."
 
A deferment is simply a way to get you to pay more money out of your pocket by way of interests. Now tell me who else besides physicians, will fight for their rights to loose money. The sensible thing to do is to ask for a pay raise to offset the burden

IMO, they need to scrap the entire deferment deal, and make the entire enchilada due immediately. Maybe that ought to make those of you who think there is nothing wrong with making less than nurses, Pas, and janitors think twice and start being proactive instead of being sheepishly reactive.

BTW, for those of you that think you will soon escape to the promised land beyond residency where milk and honey flows, let me be the first to tell you that all these weird things you are seeing the government throw your way is not without method. If you are not being asked to pay for universal healthcare, you are being screwed on student loans, or outright being accused of making too much money.

It’s just like boxing; they will throw a few jabs to see what kind of chin you have. They now know you don’t have much of a chin, next move is to land a haymaker flush to your jaw, and I am curious to see if your knees hold up.
 
mshheaddoc said:
I'm glad to hear about the interest capitalization, but I wonder if that will be the norm. Usually your interest is capitalized in forebearance per specifications on the gov't website and in definition of what forebearance is.

Glad to hear people are working on this though!
Click to expand...

There is interest capitalization, but not until the end of the forebearance period. So what I plan to do is maintain forebearance until a few months post-residency. During those first few months, I will use my additional income to pay off my interest on higher-interest rate loans. This will prevent it from being capitalized when I enter the repayment stage.

The granting of forebearance is up to the discretion of the lender. However, if you go with a reputable lender who has been in the business many years and plans to stay in it, it's a reasonably sure thing. If a lender stops granting forebearance during residency, word will get to the financial aid offices, and they will not acquire new business.
 
I just got this email back from my sister-in-law regarding this issue:


I don't know a lot about HR 2669 except that I believe it was folded into the Higher Education Act which passed the House. I believe the bill was fairly recently signed into law by the President. I don't know the particulars but can ask about the outcome of HR 2669 and the deferrment of student loans, but I will check into it. I know it's important to you.

Anyway, interesting to note it was tacked onto something else as is so often done in politics. I like that Texas has a form letter as someone mentioned above.

Will keep watching on this issue...oh well, I'm going to apply anyway and see what happens. Residency for me is still several years down the pike....
 
It's interesting that the president won't sign a health care bill that will help children get access to healthcare (and will save money in the longrun), but will sign a bill that will require residents to repay their loans when they are not in a position to do so. 😕
 
I dont have the money to pay the 800 dollars monthly bill that my loan company is asking for!!! Im a PGY-1.
 
TweetyPie said:
I haven't read through all the previous posts in this thread. So I'm not sure if anything has been said to the contrary, but from what I've gathered and the experience I'm having with my lender currently, the phrase in bold is not correct.

It seems you may be getting two forbearance situations confused. From what I gather the forbearance request for when you are working a regular job with a regular salary is the only forbearance that is discretionary.

Other than that, there is what's called a "Mandatory Medical Residency Forbearance Request", which appears to be guaranteed by the Higher Education Act, HEA 428 (c)(3)(a)(i)(I); section 682.211 (i) and (g), and a requirement by the lenders to grant.

Here are some references to this source:

www.med.ufl.edu/oea/finaid/forms/2006-finaid-forbearance.pdf

http://www.slcsloanhelp.com/forbearance%20-%20mandatory.htm

I called my lender and made sure I used the word mandatory, they sent me the form, and I'll be FAXing in on Monday.
Click to expand...

Ouch... doesn't cover fellowships post residency... that blows.
 
Faebinder said:
Ouch... doesn't cover fellowships post residency... that blows.
Click to expand...

I think that it really is questionable as to whether there really should be a system where the government subsidizes loan interest into infinity so that people can oversaturate the post-residency fellowship market anyway.
 
Richie Truxillo said:
I am going to research this more and write Congress. I currently am going to graduate with approximately $275,000 in student loan debt so making payments in residency is going to break me. They pay us so little in residency for the hours worked...but to ask us to make full repayment on our loans during residency is just insane. They should either pay us a full salary during residency (which is never going to happen) or make it a mandatory loan deferment through residency training. As a future hopeful urologist, it'll be 5 long years of residency. What the heck am I going to do in year 4? Live in a cardboard box while I make $2250 loan payments? sheesh. Pass the mac and cheese please.
Click to expand...

I'll be in the same boat next year, I have $250k+....but on top of that my husband also owes med school loans (not sure how much, maybe $100-150k) AND we have a one year old. we're going to have to live in a homeless shelter or worse, move in with my parents 😱😱
 
mshheaddoc said:
Actually the 20/220 rule was dropped as of Oct 1st so now there is a gap until the new program starts in July 2009, which would be up to only 150% of the poverty level (which means hardly anyone will qualify now) for repayments are capped at 15% of your income.

PLEASE, use the contact information on the AMA site to contact your representatives. They are the ONLY one that has responded to this issue. I sent a huge email out to the AOA and got the run around on a response. I was highly disappointed. But its not until we get the word out that anything will be done.

Currently your only option as of Oct 1st is forbearance I believe unless you are 150% of poverty level, here's a memo from the AMA that explains it.
Click to expand...

This needs to be made into a forum so other SDNers can start noticing and contacting representatives. i.e., i don't think this topic is getting enough notice
 
TweetyPie said:
Again, if you are in residency you don't have to make any payments. You will no longer be qualified for a no-payment deferment but you can request the "mandatory" forbearance.

This will make your loans more expensive in the long run but at least you won't be grappling with the ~$349 payment as per the new 15/150 rule associated with the Economic Hardship Deferment.
Click to expand...
But that is part of the issue ... school is already EXPENSIVE enough as it is and this is putting MORE economic stress into fields that are already struggling in some cases.

Mandatory forebearance is great and all but if that doesn't account for fellowship and now the interest will be capitalizing on the $34,000+ that wasn't so is that fair to the professions? Not really.

And I've tried to get the word out by posting announcements at the top of the medical/pre-medical forum but I'm limited to what I can do in the ways of "cross-posting" as people tend to complain.
 
Miami_med said:
I think that it really is questionable as to whether there really should be a system where the government subsidizes loan interest into infinity so that people can oversaturate the post-residency fellowship market anyway.
Click to expand...



Tell you what... lets do as you say and make it harder for people to get fellowships than it already is... and when you are old enough to need a cardiologist or a GI doc or even your a regular rheumatologist (yes all these are fellowship trained docs) and cant find any.. we'll know how to blame.
 
while i feel for you guys, i almost wish i could be in your position. i have $170,000 of student loans ($150k + $20k interest), all private, so deferment is not so much the issue. i am able to defer only 4 years of residency - but the whole time i've been in medical school, i'm paying 8.0-8.5% interest in these loans. by the time i finish 3 years of IM, it'll be around $200,000. if i do a 2-3 year fellowship, $250,000+. sucks. i want to do infectious diseases for a fellowship, but is it worth it (with no added income for extra training)?
 
Faebinder said:
Tell you what... lets do as you say and make it harder for people to get fellowships than it already is... and when you are old enough to need a cardiologist or a GI doc or even your a regular rheumatologist (yes all these are fellowship trained docs) and cant find any.. we'll know how to blame.
Click to expand...

All of the competative fellowship spots will fill regardless of this, and if there isn't enough demand for a specialty to make doing the fellowship lucrative enough to entice people to do it, then the taxpayer shouldn't have to pay. Frankly, the current system is ludicrously long, and expecting people to defer loans into their mid-30s while taking low pay fellowships is a ridiculous system. A change in the background economics of the system might be the only way to force the system to change. There's no reason that fellowships couldn't routinely be attached to some amount of generalist work in the core specialty that funds the fellowship work, allowing the fellow to NOT accrue interest for another billion years. Remember that these things work both ways, and part of the reason that people are willing to take more debt is these deferment processes. That in turn drives up demand at higher prices for education and lower remuneration for positions. This LOWERS everyone's respective take home pay in the profession.

Look, I'm as angry as anyone. It has nothing to do with automatice forebearance during fellowships. It has to do with the fact that we all borrowed with a certain understanding, and they simply changed the rules AFTER the money was borrowed. That's the problem.
 
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