240k vs 150k Tuition

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KdotLB

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If you add moving, losing family support and your wife maybe not finding a job that pays the same or being unhappy, the question becomes easier to answer.




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Go with the cheaper school. Tuition is only going to go up and the library is air conditioned and florescent in both schools.
 
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In your shoes, and speaking as someone who just had a kid (which will change both your and your wife's priorities), I'd go with the school you like more, is better ranked, has your family nearby, and lets your wife keep working the same job (assuming she's happy there).

To me, that's more than worth the extra $90k. Depending on when you have kids, it's possible your wife's job can make up a lot of that difference, unless she'd get a higher paying job at the other location. Still, don't underestimate how helpful it is to have family around when you have a busy job and a kid/kids. (Plus, a supportive family can mean your wife has the freedom to choose if she wants to go back to work part/full time vs stay at home after any kids are born, without the financial concern of daycare dictating what the two of you can and cannot do).

I generally advocate saving money, but med school is stressful, and so is being a parent. It's also stressful for spouses of med students, particularly if they are taking care of a kid. If you have more support and will be happier at the more expensive school, and if you're thinking about staying there for residency (when family support will be even more helpful), then I would personally be willing to pay the extra $90k.
 
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FYI that $90k difference will be more like $120-130 after med school and 3 years of residency when accrued interest is taken into account.

Still worth it in my mind in your particular situation (if you weren't planning on having kids soon, it would likely change my recommendation), but just keep in mind you'll be accruing interest from day 1. You may not actually accrue quite as much as I mention if the current repayment plans are still around, because your unpaid interest gets subsidized when you start making payments, but I recommend when calculate the total cost of attendance and interest accrural to assume those plans will change and you won't see any interest subsidies.
 
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Plugged it in to a calculator for you -- there are a couple out there if you google. This should give you a very rough estimate. I assumed 6% interest, 4 year forbearance period for postgrad training, and 10 year repayment.

180k becomes 220k after 4 year deferral. Monthly payment about $2500 x 10 years.

270k becomes 335k after 4 year deferral. Monthly payment about $3700 x 10 years.

If you said you were single and choosing between these schools, it would be a no brainer -- go cheaper.

Did you include cost of living in your 180k estimate? You will need to sit down with your wife and figure out what makes sense for you guys. Will depend on factors like: planning kids?, wife's job portability, wife's salary. Nonfactors are: curriculum, clinical experience, etc. Either of these places will provide you with excellent experience and similar financial outcomes. Doctors that go to expensive private schools generally don't make more or really even have better opportunities.
 
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Thank you for the insight. Having kids and being close to family will be helpful, even if my in laws don’t agree to free babysitting lol. Just the support and guidance w having a first child and the familiarity of the area will be intangible to my wife’s mental health I think. We are thinking of having a kid sometime between second and fourth year.

My wife’s job is transferable as she is a speech therapist but she has networked in the area we are in now and has many connections should she wish to transfer jobs or pick up additional hours. Moving to a new place wouldn’t likely mean she would be out of work for an extended time, just that she would lose the connections at the on-the-side PRN gigs she has. Fortunately she makes enough that we should be able to cover our cost of living completely without additional loans.

I understand opportunity differences based on school prestige aren’t relevant in private practice, but I’ve heard differently about trying to get into competitive specialties or academic Medicine. Also of note, my wife and I want to eventually end up in the Carolinas for residency. Unfortunately no Carolina school came knocking, but with us being location specific for residency, I didn’t know if a bigger name, less “regionally based” school might impact chances at residency placement in a different region of the country. It’s hard to “cast a wide net” when your partner has a specific end destination in mind.


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With regard to school prestige, after the top few it likely makes no difference. Even then it doesn't make a ton of difference. You will still get residency based on your academic performance.
Top 25 private school is not going to be significantly different from Top 40 state school in terms of your chances at a good residency, fellowship, or academic job. What makes a difference is academic performance, connections/networking, and research. Don't listen to what your premed friends are telling you. They are wrong. A middling student with average board scores at Harvard Med is not going to get a residency spot over a great student at UMass. Same goes for fellowship and academic jobs.
 
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What are the schools? Your specialty of interest?

Keep in mind that an extra 120-130k in debt as a new attending will CRIPPLE you. Especially if you have kids. Unless your wife is earning a very high income ( which as a speech therapist, she isn't), you will regret all that extra debt.
 
It is Case Western (hometown, work as nurse in home hospital already) vs Univ of Cincy.

I’m undecided but internal medicine subspecialties interest me most, thinking that I want academic clinician educator career. And as I said, wife’s desires make it fairly location specific with what we want for residency placement (southeast, love NC in particular, fam in Durham)


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U Cincinnati is on par with Case. No reason to take on the extra debt. Good luck.
 
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$220k of debt is no joke - I’m living that dream right now, and wouldn’t want to think about $330+. I would without a doubt go with the less expensive option, there’s zero chance that it’s worth it. In my opinion, going to a different center than the place where you were a nurse is also a benefit. My .02.
 
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$220k of debt is no joke - I’m living that dream right now, and wouldn’t want to think about $330+. I would without a doubt go with the less expensive option, there’s zero chance that it’s worth it. In my opinion, going to a different center than the place where you were a nurse is also a benefit. My .02.

While this may not be as applicable with the options in this thread, I did go to a school that was substantially more expensive, and I don't regret it for a second. I think my education was better, my opportunities were better, and I think I was happier.
 
While this may not be as applicable with the options in this thread, I did go to a school that was substantially more expensive, and I don't regret it for a second. I think my education was better, my opportunities were better, and I think I was happier.

How high is or will your debt burden be and how does that compare to what the cheaper option was? (If you don’t mind me asking)




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U Cincinnati is on par with Case. No reason to take on the extra debt. Good luck.

This makes the answer difficult. Case is an excellent school. The other pros of staying in Cleveland would also weight my answer in your favor. Unless you're planning on going into a long research-only career or a very-low-paying specialty, I'd say the extra 115-120k debt is totally manageable. Reading your OP, it also sounds like you're going to regret the missed opportunity, so go with your heart here. You'll be fine financially.
 
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This makes the answer difficult. Case is an excellent school. The other pros of staying in Cleveland would also weight my answer in your favor. Unless you're planning on going into a long research-only career or a very-low-paying specialty, I'd say the extra 115-120k debt is totally manageable. Reading your OP, it also sounds like you're going to regret the missed opportunity, so go with your heart here. You'll be fine financially.

Manageable? Probably. But not worth it. Cannot understand why you'd recommend taking on so much extra debt without any real advantage. Kids are expensive, and that extra 120k will be a real hardship.
 
Manageable? Probably. But not worth it. Cannot understand why you'd recommend taking on so much extra debt without any real advantage. Kids are expensive, and that extra 120k will be a real hardship.

The problem is understanding what that 120k is actually worth. Only the OP can decide that, but if it was me, I'd rather not start over socially (new city, new friends, no family support) during a particularly stressful time in my life so it'll be totally worth it to me. Better experience in med school can also translate to higher grades, better residencies, and better job placement. You should also consider that the additional 120k is also 2025+ money (so it'll need to be inflation-adjusted down), and resident and physician salaries are slowly going up year over year.
 
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