Nov 24, 2019
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So Im an incoming M1 and ive been accepted to a school in an area with a high cost of living. This combined with tuition makes my expected cost of attendence in the $110,000s. As someone who comes from a poor family, I will be having no financial support and will have to take out the max loans each year. If I take out maximum loans each year I expect to graduate with about $500,000 in debt.

Going into med school I knew I was going to come out with a lot of debt. I was fine with it until I started talking to some physicians who said it wouldn't be worth it to have that much debt. They werent talking about my situation specifically, just warning against excessive spending in med school. After looking through similar threads on SDN it seems that most people graduate with $300,000 and that $500,000 is too much/not worth it.

I still love medicine and want to do this, but is this really as bad as everyone makes it out to be? Unlike many of my classmates, I dont get any financial support from parents, so the only way I would ever be able to attend med school is through loans.
 
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Nov 13, 2018
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Most people shouldnt need to take out the max debt allowed. How much is tuition and rent?
 
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First, no offense, but you don’t know medicine to know if you love it or not. Unfortunately, you don’t really get to truly experience medicine until 3/4 year and residency.

Second, no it’s not with it. No chance. For a whole litany of reasons. Being on the other side, and at one time I was in your shoes, I wish I could go back and show myself the realities: I would of picked a different career path.
 

Hippocrates II

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Only worth it if you want to become a doctor, and like ^ said, you unfortunately cannot really know it until you've experienced it. So, it's a gamble, just like most of us are making. 500k in debt is steep, but you could pay that off and have a nice life if you have some decent financial sense.
 

HKSZYU

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$500k is probably more than I’d be willing to take out. It’d make me even more nervous as a DO student, since some of the really high paying specialties that could help you knock out this debt quickly (ortho, ophthalmology, derm, etc.) would be harder for you to match.

Let's say you graduate with $500k and get a primary care job paying $250k/year, which would be ~$170k take home pay after taxes. If your $500k debt is on a 10-year repayment schedule and accruing interest at 6.8%, your yearly debt repayment would be ~$5800/month, or ~$70k/year.

After debt service, you'd still be taking home $100k, which can provide for a comfortable life, so I don’t think this debt-load is a death sentence necessarily. That said, there are a lot of other paths that can provide that same amount of money without nearly the same amount of sacrifice. Not to mention the mental cost of just having that much debt hanging over your head.
 
Nov 24, 2019
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Most people shouldnt need to take out the max debt allowed. How much is tuition and rent?
Tuition is around $57,000 and rent is approx $1,300 a month. There's also a lot of "starting costs" like required kits, uniforms, tech, etc...
 
Nov 24, 2019
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$500k is probably more than I’d be willing to take out. It’d make me even more nervous as a DO student, since some of the really high paying specialties that could help you knock out this debt quickly (ortho, ophthalmology, derm, etc.) would be harder for you to match.

Let's say you graduate with $500k and get a primary care job paying $250k/year, which would be ~$170k take home pay after taxes. If your $500k debt is on a 10-year repayment schedule and accruing interest at 6.8%, your yearly debt repayment would be ~$5800/month, or ~$70k/year.

After debt service, you'd still be taking home $100k, which can provide for a comfortable life, so I don’t think this debt-load is a death sentence necessarily. That said, there are a lot of other paths that can provide that same amount of money without nearly the same amount of sacrifice. Not to mention the mental cost of just having that much debt hanging over your head.
Honestly I didn't go into medicine for the money (cliche I know). Like I said I knew I would be graduating with a lot of debt and not get paid as much (want to go into primary care). As someone who comes from a poor family, $100,000 is a lot and more than my family could ever imagine making. Is it naive to think that's more than enough for me? Maybe.

Its just frustrating that I've worked so long to start this path, and unlike most med students I now have another thing to worry about/working against me. It just seems like the hurdles I've had to jump that are attached to being a part of the lower class are never ending. This coming from a field that emphasizes diversity and inclusion.
 
May 26, 2019
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Tuition is around $57,000 and rent is approx $1,300 a month. There's also a lot of "starting costs" like required kits, uniforms, tech, etc...
My rent was close to that and I lived off of roughly 20,000 a year in med school. I’m not sure why you need to take out 53,000 a year (tuition 57,000 and your expected yearly total of 110,000...)
 
Nov 24, 2019
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My rent was close to that and I lived off of roughly 20,000 a year in med school. I’m not sure why you need to take out 53,000 a year (tuition 57,000 and your expected yearly total of 110,000...)
I'm just going off of what the school lists as their total cost of attendance. I took out max loans bc I dont know what to expect for this first year and worried about unexpected costs coming up later in the year.
 
May 26, 2019
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I'm just going off of what the school lists as their total cost of attendance. I took out max loans bc I dont know what to expect for this first year and worried about unexpected costs coming up later in the year.
O I see. That makes sense. Unless you live in Manhattan I’m positive you can live off significantly less. Hopefully that helps reduce some anxiety :)
 
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Davidfromcali

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I'm just going off of what the school lists as their total cost of attendance. I took out max loans bc I dont know what to expect for this first year and worried about unexpected costs coming up later in the year.
The schools estimated COA tends to be an over estimate. Manage your finances and you should be fine. Always try to borrow less.
 
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$500k is probably more than I’d be willing to take out. It’d make me even more nervous as a DO student, since some of the really high paying specialties that could help you knock out this debt quickly (ortho, ophthalmology, derm, etc.) would be harder for you to match.

Let's say you graduate with $500k and get a primary care job paying $250k/year, which would be ~$170k take home pay after taxes. If your $500k debt is on a 10-year repayment schedule and accruing interest at 6.8%, your yearly debt repayment would be ~$5800/month, or ~$70k/year.

After debt service, you'd still be taking home $100k, which can provide for a comfortable life, so I don’t think this debt-load is a death sentence necessarily. That said, there are a lot of other paths that can provide that same amount of money without nearly the same amount of sacrifice. Not to mention the mental cost of just having that much debt hanging over your head.
I wanted to add on to this as I've been playing with the numbers for myself. Assuming you die a lonely spinster and don't have the financial support from a spouse, your take-home on 250k is still 14k a year. If you live off 5k a month, which to me is still pretty comfortable, you'd kill that debt in 5 years. Add on to that moonlighting/locums and you can really do some damage.

Edit: this is assuming you refinance for a 3-4% interest rate.
 

DexterMorganSK

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I'm just going off of what the school lists as their total cost of attendance. I took out max loans bc I dont know what to expect for this first year and worried about unexpected costs coming up later in the year.
The COA from your program may factor in things you may not need like $$$ for laptops, textbooks, transportation, etc.

To lower the overall debt, you can share an apt, apply for work-study, apply for scholarships (both in-school ones and outside like the VA)
At the end of the day, I don't think you would need to take out 110K per year.
 

You shall know the Truth

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you are allowed to give money back within a 3 month time frame. Put a budget together and see how much everything will cost. Compass1.org and Dave ramsey have tools on their websites that will help with budget making. Live below your means and be sensible with loan money. you would be shocked at how many fritter it away on eating out every day etc.
 
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It depends on what field you want to go into. I’m 400k in debt but I’m doing ortho, so I’m not too worried about my debt. If I was doing primary care I probably would’ve done HPSP.
 
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NITRAS

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Most schools lets you borrow up to a certain amount, no questions asked. I could ask for it, and I got money within 2-3 business days.

You don’t have to ask for full COA now. You can always wait till you need it.

I'm just going off of what the school lists as their total cost of attendance. I took out max loans bc I dont know what to expect for this first year and worried about unexpected costs coming up later in the year.
 

jurassicpark

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Thanks for the advice guys! I'm going to start planning out a budget and hopefully take out less than what I have now. Just got a little overwhelmed today, but I realize it's not the end all.
I'm glad you're taking the advice on this thread seriously. Reading what you wrote in this thread, I fully sympathize. A lot of us have been in your shoes before, "I'll be a doctor," and damn the cost! Because that price tag for us was still an abstract thing, and the ends always justified the means. And it's not until you reach residency do you realize, "oh.. my.. god."

$500,000 tuition, and you didn't mention any undergrad or other educational burden is mind-boggling no if ands or buts. Can you pay it back if you decide FP/IM is the route you will take? It can be done, and done so comfortably but you will be restricted to where you practice and work more shifts, etc. Because people don't realize that the fancier larger cities often pay less, less shifts available, and much much higher cost of living. And if you want to start a family, etc.

But you will have to be realistic as heck, and frugal with your money. Every nickel you spend is a dollar you owe (not exactly, but you get the point).

As for military route, I would check out the military medicine section of SDN. But I think the general consensus is if you're doing it purely for the money, you're in for a not so good time.
 
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Grannywang

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What i did was max out my loans first year at 103k and then i was left with 13k so i reduced what i borrowed M2 and M3 year by about 10k each year(even though i cook a lot of my own meals/ being a cheapass, South Florida isn’t cheap ).
My M4 year i maxed it out again because of residency apps and since interest rates are lower this year i figured why not, I’ll return what i don’t spend before residency and the interest accrued isn’t that much in the overall picture.
 
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Schools typically overstate cost of attendance to give people a buffer or if they want to take more loans. You shouldn’t need the max amount. This is what students and faculty at schools I interviewed at said.
 

BorntobeDO?

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Do you know anyone who is a military physician? I have loved ones who are:

1- the military is going through massive cuts right now; 2-it’s EXTREMELY hard to specialize; 3- the military sees you as an officer first and a physician second; 4- they can and do tell people what fields to go into sometimes; 5- GMOs are a very real thing; 6- skill deterioration is also a real thing in specialized fields; 7- the flux of residency positions in specific fields is crazy year to year. It isn’t like the civilian world where you know University X will take X residents a year in X field. That isn’t how the military does things; 8- they own you. I think those who haven’t served really need to think hard about this one.

I mean the list goes on...

I was considering the hpsp and I talked to roughly 40 different hpsp docs one summer. I didn’t meet a single one who said they were happy they did not. They ALL advised I don’t.
They didn’t have 500k of potential debt like you would or even 300k. The problem with current attendings who used HPSP in the past like the white coat investor, is that it was a really bad financial deal 20 years ago. But for DOs now? It’s a great deal. You are guaranteed post graduate training, I know most here take that for granted, but they won’t be in a few years.

Plus the military is one of the few places where you can make your app more competitive after medical school even without research. Let’s say you want surgery, but your not a rockstar so you get a transition year and then a GMO tour. When you reapply from that tour you now have extra points added to your app for doing it and it makes you more likely to get a residency that you want. Sure you add payback time (which is the real cost) but military allows some people to get residencies they otherwise wouldn’t be able to get. So what if you made even a 100k less for a few years as an attending if you end up in a specialty you never would have otherwise. Also remember the only time you make less money than your peers is when your an attending, but it’s not like you are a poplar, the base pay is around 120k before specialty bonuses etc.

I think HPSP is a great deal, especially for primary care (which is the majority of DOs), I wish I had it instead of my standard 300k+ from my DO school.
 
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km93

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Definitely do NOT take out the max COA. I followed the advice below. I only took out a little bit at a time, when I needed it, to minimize interest. The white coat investor, bill Bernstein free pdf “If you can”, and dr wise money blog are some of my favorite resources. Create an excel spreadsheet, set a monthly budget and stick to it.

Other tips:

Live with a roommate, minimize expenses, learn how to cook. It’s way easier to live frugally at 25 than 55. I’ve never understood my classmates who take out max loans and live way outside their means during medical school.

Don’t buy the school ophthalmoscope/otoscope package - buy it for 1/2 price on eBay or from an upperclassmen.

Don’t cheap out when it comes to board prep/exams. It will be very expensive but these tests are important, so prioritize your spending to get the best result possible. Buy uworld, buy all the practice tests you need...invest in things you need to be more successful. Save money in other areas.
 

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Definitely do NOT take out the max COA. I followed the advice below. I only took out a little bit at a time, when I needed it, to minimize interest. The white coat investor, bill Bernstein free pdf “If you can”, and dr wise money blog are some of my favorite resources. Create an excel spreadsheet, set a monthly budget and stick to it.

Other tips:

Live with a roommate, minimize expenses, learn how to cook. It’s way easier to live frugally at 25 than 55. I’ve never understood my classmates who take out max loans and live way outside their means during medical school.

Don’t buy the school ophthalmoscope/otoscope package - buy it for 1/2 price on eBay or from an upperclassmen.

Don’t cheap out when it comes to board prep/exams. It will be very expensive but these tests are important, so prioritize your spending to get the best result possible. Buy uworld, buy all the practice tests you need...invest in things you need to be more successful. Save money in other areas.
As a CPA I must say this is great advice. Be as frugal as you can be regarding personal stuff but do invest in academics.
 

Mad Jack

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First, no offense, but you don’t know medicine to know if you love it or not. Unfortunately, you don’t really get to truly experience medicine until 3/4 year and residency.

Second, no it’s not with it. No chance. For a whole litany of reasons. Being on the other side, and at one time I was in your shoes, I wish I could go back and show myself the realities: I would of picked a different career path.
It's not that bad
 

Mad Jack

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They didn’t have 500k of potential debt like you would or even 300k. The problem with current attendings who used HPSP in the past like the white coat investor, is that it was a really bad financial deal 20 years ago. But for DOs now? It’s a great deal. You are guaranteed post graduate training, I know most here take that for granted, but they won’t be in a few years.

Plus the military is one of the few places where you can make your app more competitive after medical school even without research. Let’s say you want surgery, but your not a rockstar so you get a transition year and then a GMO tour. When you reapply from that tour you now have extra points added to your app for doing it and it makes you more likely to get a residency that you want. Sure you add payback time (which is the real cost) but military allows some people to get residencies they otherwise wouldn’t be able to get. So what if you made even a 100k less for a few years as an attending if you end up in a specialty you never would have otherwise. Also remember the only time you make less money than your peers is when your an attending, but it’s not like you are a poplar, the base pay is around 120k before specialty bonuses etc.

I think HPSP is a great deal, especially for primary care (which is the majority of DOs), I wish I had it instead of my standard 300k+ from my DO school.
Knew a guy that landed ophtho right out of my DO school in the military- they also don't discriminate based on degree
 

NITRAS

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Don’t buy an Otoscope or ophthalmoscope. Honestly I use it more to look in my wife’s or kids’ ears.

Military medicine is its own beast. I wouldn’t joint unless you were gung how about joining the military. The training is going to be very different. An example, the nearby active duty military hospital has no cardiology coverage, so they turf over every BS positive troponin. Their patient population is going to be much healthier than your average university hospital. And, at the end of the day, you are there to serve the needs of the Military, they are not there to serve your needs.

At the end of the day, $500k in debt will cause you to make painful decisions. An internist can make $400k/year after a couple years of practice. It won’t be in major metropolitan areas and it won’t be 4.5 days a week w/o call. But three or four years of making $400k, and you can pay it off. It isn’t nearly as “easy” as you think it is, but it can be done.
 

Deecee2DO

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I didnt go into medicine for the money but I can tell you this-If medicine didnt pay well Im not sure I would have wanted to make the sacrifice of the years in training. At least when you get out youre well compensated for the stress and non-stop working during training that was endured for 10+ years of your life. Medicine is awesome for many reasons and I still think you can get those figures down if you manage your money well during school. The avg salary if you include all specialties (not sure what you want to go into) is over 300K which is plenty enough to pay off your debt if you live modestly during your training
 
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Just do the math based on average salaries. 500k after you’re done with residency can mean many things. If you do residency at a non for profit hospital, maybe you qualify for pslf and have your loans waived after 10 years (although I think they’re removing this, im not too sure). So u do a 5 year residency let’s say, then for another 5 years working at a non for profit you’ll have loans waived.

Or let’s say you have interest of 7 percent on 500k. Every year that’s 35k. If you want to pay that in 10 years, that’s roughly 850 k loans total accounting for interest. Now the math is an estimate because certain monies have been piling interest more than others etc. 850k in 10 years comes to 7k a month. That’s Farily steep, but you can definetly do it.
 

calivianya

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I’m going to take out about the same amount, for several reasons that I could not have anticipated before matriculating.

I would still do this anyway, though. Tbh, the grass really isn’t much greener at other jobs and I wonder if people who regret doing this have actually worked many other careers. The lowest-paid full time job I’ve worked was at $22k/year - really ugly, and at that level you really have to hope nothing breaks if you like things like eating and having electricity. Regardless of how much your loans are going to be, I don’t know any physicians that have to worry about putting food on the table or whether they’re going to get their electricity turned off and not have air conditioning in the middle of the summer.

Also important to remember that the people who continue to carry debt after years and years of practice are usually doing it because they choose to, because they’ve made enough to pay it off many times over already. I know some higher income people who choose to not pay off their house, and not pay off their student loans, just because you can deduct interest from both on your taxes every year. If you think nothing‘s ever going to happen to you and you’re invincible, why not use the loans and mortgage as an excuse to pay less taxes?

Personally, I’d rather be debt free and skip the deductions, but that’s just me.
 
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El-Rami

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I would honestly sell my soul to pay off 500k debt, and it wouldn't deter me from becoming a primary care doc, either. Becoming a hospitalist is a dream career, IMO. Nice hours, nice lifestyle, pretty chill job, and you do a lot of cool stuff. People may suggest finance as an alternative career due to the potential to earn a crazy amount of money (essentially limitless ceiling), but to be frank most people aren't capable of being that successful in the business world. It's like becoming the President of the US. Sure, it's possible, but is it realistic for the average person? No.

Maybe you could contact some hospitals in rural areas and see if they would be willing to pay for the cost of part of your education in return for you working there. There's also the military and VA.

Don't take out the full COA. Maybe take out full COA for the first semester to see how much you actually NEED, but like other said, I am pretty sure that you can just take out part of the full estimated COA and then request more funds with financial aid anytime you need to. My understanding is that you can only borrow up to full COA.

Also, work your butt off to get into the top 10% of your class in order to be competitive for various merit scholarships. Schools generally also have scholarships for URM students (female, POC, LGBT). There are loans that could be taken out if you are interested in primary care, rural practice programs, etc.
 

Cranjis McBasketball

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I would honestly sell my soul to pay off 500k debt, and it wouldn't deter me from becoming a primary care doc, either. Becoming a hospitalist is a dream career, IMO. Nice hours, nice lifestyle, pretty chill job, and you do a lot of cool stuff. People may suggest finance as an alternative career due to the potential to earn a crazy amount of money (essentially limitless ceiling), but to be frank most people aren't capable of being that successful in the business world. It's like becoming the President of the US. Sure, it's possible, but is it realistic for the average person? No.

Maybe you could contact some hospitals in rural areas and see if they would be willing to pay for the cost of part of your education in return for you working there. There's also the military and VA.

Don't take out the full COA. Maybe take out full COA for the first semester to see how much you actually NEED, but like other said, I am pretty sure that you can just take out part of the full estimated COA and then request more funds with financial aid anytime you need to. My understanding is that you can only borrow up to full COA.

Also, work your butt off to get into the top 10% of your class in order to be competitive for various merit scholarships. Schools generally also have scholarships for URM students (female, POC, LGBT). There are loans that could be taken out if you are interested in primary care, rural practice programs, etc.
Are you a medical student or attending? Because if not, I had the same thinking of "its a dream job and I'd sell my soul to be a family doc" but even after only 2 years I'm already wondering if the sacrifice was worth it haha. Of course, I am a husband and father and also not a brainiac so I probably study a lot more and work a lot harder than the average student so that could also be a reason. Its a long and tough road
 

Espressso

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I'm just going off of what the school lists as their total cost of attendance. I took out max loans bc I dont know what to expect for this first year and worried about unexpected costs coming up later in the year.
You really need to sit down one evening with that document the school provides and recalculate based on your life. Yes there are some silly costs in the first year like scrubs and otoscope etc etc. But the budget the school gives you is always maxed out to the extreme. Often you don't need to. My school listed one of the budget items like $200/month on clothes or something ridiculous like that. If you blindly follow their budget you'll be $500k in debt. But you often don't need to.
 

samac

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I’m going to go against the grain here.
If you’re someone who’s willing to work in the middle of nowhere you’ll be fine. many rural hospitals offer loan repayment options along with competitive salaries. If you’re willing to do that for 5 years and continue to live like a resident you’d be able to knock that debt out.
I wish I could tell you PSLF was a good option, but there’s no telling where it’ll be in 14 years when you could make use of it. I’m starting on that path now with the understanding I could lose it.
Good luck!
 
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Like others have said it sounds like you can probably take out less than the full COA which would be preferable. You also have to understand that you probably aren’t going to be making full payments under the standard repayment plan. Most people I know with significant debt are doing one of the income based repayments like PAYE or REPAYE which is capped at 10% of your income adjusted for poverty level, for 20 or 25 years. Those payments are also eligible for PSLF, which forgives your loans after 10 years if you work for a qualified employer. There’s also HPSP, etc. So you have options to look into!
 

Bacchus

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You will not die poor as a PCP if that’s the route you take. I fully admit I’m probably pie in the sky at this point for PSLF but I’ll have about 4 years left this coming fall. If I wasn’t pursuing that, and wasn’t doing other things with my income, I’d likely doing rough calculations have a 1/3 to half my Med school loans paid off. Financials are in my post history.
 

AnonymousDoctorGuyPerson

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I’m going to go against the grain here.
If you’re someone who’s willing to work in the middle of nowhere you’ll be fine. many rural hospitals offer loan repayment options along with competitive salaries. If you’re willing to do that for 5 years and continue to live like a resident you’d be able to knock that debt out.
I wish I could tell you PSLF was a good option, but there’s no telling where it’ll be in 14 years when you could make use of it. I’m starting on that path now with the understanding I could lose it.
Good luck!
Arent the terms of PSLF in the MPN signed when receiving federal loans? While there is lots of gloom-and-doom about PSLF being capped or outright abolished, I think it'd be rather difficult to retroactively remove those who signed a legally binding document. I could be wrong though!

EDIT: Found something about it here, I guess like everything it's not clearcut
 

DO2015CA

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You’ll just have to decide what is worth it to you. We come with a large debt burden but even a lowly pediatrician can pay off 500k debt right now. You won’t be balling but you can pay off your debt aggressively then live a good life
 
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FutureDoctor5000

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You’ll just have to decide what is worth it to you. We come with a large debt burden but even a lowly pediatrician can pay off 500k debt right now. You won’t be balling but you can pay off your debt aggressively then live a good life
Also location matters a lot, I know several Peds who make well north of 400k..
 
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Attending Physician
You’ll just have to decide what is worth it to you. We come with a large debt burden but even a lowly pediatrician can pay off 500k debt right now. You won’t be balling but you can pay off your debt aggressively then live a good life
Eh... Depends on your definition of “ballin’”
 

AnonymousDoctorGuyPerson

2+ Year Member
May 19, 2017
531
1,514
If you love medicine and can't imagine doing anything else then it's 100% worth it. Yeah, you'll be tied to your debt longer than others, but it's not like you'll be on the streets. I'm coming into med school with ~250k debt and will probably graduate with ~400k so I understand your pain.

I'm only an M0 but to give some perspective I live in NYC and I spend no more than ~18k a year on all my expenses (rent, utilities, loans, going out, etc) and enjoy myself quite a bit with money left over to pay down some private student debt I have. As an attending, you'll be in an even better position than this. What could muddle this is if you plan on having children and also have a low-income spouse, then it could get dicey.

I think the only people who would suffer from this debt burden as an attending would be people who grew up in high-income households that may be accustomed to a certain lifestyle, though most people who grew up this way don't end up 500k in the hole from med school anyways.
 
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Trogghunter

10+ Year Member
Nov 16, 2009
850
264
Status
Attending Physician
Live with room mates, get an easy job, and invest your extra money into some growth stocks.
 
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Reactions: zNoodlez

bighoss77

2+ Year Member
Nov 20, 2016
5
15
You need to refund some of the loan you've withdrawn, especially as a big portion of what you've withdrawn has to be Grad Plus loans which have high interest. In the future you need to be strategic about withdrawing loans. Being scared by that $500k amount you are projecting is the right attitude to have. $500k debt at graduation can easily turn into $1 million dollars over the life of the loans. Your minimum payments would be massive. I think you can realistically get your loan amount closer to $350k.

Too many med students have a cavalier attitude about debt. I have classmates taking out the full loan amount just because, or doing absolutely *****ic stuff like leasing new cars and buying houses only to have to move for rotations. High debt burden cripples your ability to save for retirement especially if you have other big expenses like childcare. Living like a resident longer than you need to sucks and you will likely have to make other compromises with your career and quality of life in order to maximize income.

Start learning about personal finance now and thinking about strategies of minimizing debt and start planning for how you want to approach loan repayment.
 
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