$500,000 in debt

[thepoopologist]

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.

Take out less in loans. 500k right after med school is conservatively 600k after residency. You do not want to feel that kind of debt.

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[medgal98]

Look into the National Health Service Corps program since you’re interested in primary care. There’s a service obligation after residency but they pay your tuition, fees and give you a monthly stipend! It is worth considering.

 

[Sleepingdoc]

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.

Unfortunately, people who have not walked the walk only see the money that an attending with experience makes and try to extrapolate how "rich" doctors are and they will become... Reality sucks doesn't it.

 

[soundofwonder]

Maybe medical students can comment on this, but I read somewhere that the loans you take out in MS1 and MS2 could be saved to use for doing away rotations later (traveling costs), esp. if you're planning on going for a competitive residency. Not sue if 100k is overkill though. Please correct me if I'm wrong.

 

[Cranjis McBasketball]

Maybe medical students can comment on this, but I read somewhere that the loans you take out in MS1 and MS2 could be saved to use for doing away rotations later (traveling costs), esp. if you're planning on going for a competitive residency. Not sue if 100k is overkill though. Please correct me if I'm wrong.

That just adds more time for interest to accrue. Better to take out 50k first year and then 50k 4th year than 100k first year

 

[dial1010usa]

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.

But again don't they deduct a fee every time you borrow money? I'm not sure how much they deduct though.

 

[MedDoc305]

But again don't they deduct a fee every time you borrow money? I'm not sure how much they deduct though.

Its a percentage based on the amount you borrow so it doesn't matter how many times you do it, just the amount.

 

[Eye-eye]

It sounds like most of this has been said before, but if you really want to be a doctor, don't let the cost get you down:

1. You'll make a lot as a doc, even in primary care, compared to most jobs. If you can be frugal and are willing to live like a resident for a few years after residency, you absolutely CAN pay the debt off in reasonable time.

2. Really evaluate how much you're spending in your first semester; if you can take less in later disbursements, take less. You can always ask for an increase later in the semester if things get tight.

3. If s**t really hits the fan, you can always do PSLF. You'll be used to academia anyway by the end of residency +/- fellowship, so it shouldn't be too difficult to stick it out even if your eventual goal is private practice.

4. The advice I've always heard is don't go military for any reason other than wanting to be in the military. Your pay is much lower and they own you. They can move you, deploy you, whatever they want. But if you already want to do military, it's a no-brainer.

5. You want to be a PCP now, but that can easily change. There are a lot of fields that share a lot of elements with primary care and pay much (i.e., multiples) better, sometimes with a better lifestyle as well (more 9-5, less/no emergencies/call). If you find yourself deciding between specialties, though, go with what you love and not the $. That being said, if you really don't know what you love more, consider the one with better lifestyle and $.

6. Start listening to/reading the White Coat Investor during med school. His book(s) are a good starting place, or you can pick up a lot from passively listening to the podcast. There'll be a lot you don't understand in the beginning, but it'll start clicking after not too long, and will help you a lot in life planning regardless of your choices elsewhere. (I also recommend Paul Merriman and William Bernstein if you're getting comfortable with WCI's content, but that's for further down the road.)

7. This is your whole life we're talking about. The debt sucks, but some dedication can see it gone in not that long, and then you have a whole career you can love and be proud of, in addition to a nice income.

8. Some docs will tell you never do medicine and some will say they would never change their decision to become a doc and it's the best career anyone could ask for. In the end, your happiness comes down to you - if you want to find the negatives in the situation, medicine has an abundance. If you want to find the positives, medicine also has an abundance of those.

Good luck and a happy career and life to you no matter what you choose.

 

[KnightDoc]

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

Policy Analysis: Impact of Potential Changes to Public Service Loan Forgiveness Program | AccessLex

The Higher Education Act of 1965 (HEA), as amended, offers forgiveness of federal student loans held by borrowers who make 10 years of payments during periods in which they are employed in public service. In order for this right to forgiveness to vest, a federal loan borrower must meet the...

www.accesslex.org

While the link you posted deals with the likelihood of retroactive changes, the big thing you are missing is that you don't even enter the program until you begin repayment, NOT when you receive the loans. So, for what it's worth, any changes to the program made during the four years you are in school (plus any grace period, should you take one) would not be retroactive for you. THAT's the risk you are taking on the front end, in addition to the risk that they could retroactively change the program during the 10 years you are making payments.

The most prudent thing to assume, given how crazy high the deficit and national debt are, and how much doctors make as compared to the population as a whole, is that this program will not be available to us in its current form when we need it. Better to be pleasantly surprised if I am wrong than to be devastated to be counting on something that might not be there. Just my 2 cents!!!

 

[Mass Effect]

Was the suggestion of a service contract entirely glazed over? Eliminate the debt AND still be able to chase down your dreams - with a guaranteed job!

Yes, because service contracts suck and give more ammunition to schools to charge whatever they want. High tuition schools should be boycotted unless and only unless they're literally your ONLY option.

 

[Mass Effect]

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.

Don't fool yourself. Everyone would suffer from this debt burden.

 

[AnonymousDoctorGuyPerson]

Don't fool yourself. Everyone would suffer from this debt burden.

If you're used to living on far less the impact of the debt wouldn't be as heavy.

 

[Mass Effect]

If you're used to living on far less the impact isn't as heavy.

Trust me when I tell you that after 4 years of med school and 3+ years of residency, looking at the fact that you pay 4K a month in loans IS a big deal and WILL impact you, whether or not you think so now, especially if you plan to have a family and have a low-income spouse.

When all is said and done, the OP will likely be paying back 700K. That's the cost of a mansion in some parts of the country. And for what? The exact same education he could have gotten with 20K at some other school? Schools like this absolutely are predatory and should be boycotted.

 

[Antynamikal]

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.

Excellent advice

 

[NontradICUdoc]

That kind of crushing debt is one that you will have a hard time getting out of. If you really want to go to that school, you will need to be very, very creative.

1. Find a roommate.
2. look at craigslist or social media for people who are selling supplies
3. Consider renting your book rather than buying it. Finding it in the library.
4. You will not be going out to eat for at least 4 years.
5. no starbucks or any other non homemade coffee for at least 4 years
6. Aldis will be your best friend.

When you get to medical school, if you think you are going to go into either Family Medicine, Be a General Practitioner, Pediatrics, Geriatrics, or Ob/GYn look into the National Health Service Corps. If you are going to be doing primary care, during your fourth year there are primary care loans (be careful because if you do not go into a primary care, you will pay hefty fines).

Get on the computer and start searching and applying for scholarships. It does not matter if it is not specific to medicine, what is the worse they can say? No? well you are no worse. Check out the tylenol scholarship. Look into each state's loan repayment program.

But if you leave medical school with $500,000 in loans, you will be more than $1 million when you factor in the interest.

 

[ilikecatstoo]

Just wanted to update everyone with my situation. My first semester got pushed online so I'll be staying in my home state for the time being to save on rent. Ive also used a lot of my own money that I saved up to pay for some things now so that I wont have to spend as much loans. After some budgeting, I plan on only taking out around $85,000 instead of the $115,000 I had originally planned. If I continue like this for all 4 years my total expected loans will go down to the upper $300,000 range.

I appreciate all the advice everyone has given me, its been really helpful! I just had that mindset that I should take out all my loans and not think about it, but that's changing now.

 

[Pokedoc]

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...

The tuition for my program is 13 grand more expensive with a very similar rental cost and I don't come close to taking out that much in loans annually. That's even taking into account the fact that my loans are also supporting my wife and daughter.

Edit: Didn't see your updated reply. Glad you could work it out!

 

[Firkin]

Are you aware of all the options for repayment? You almost certainly will not have to actually pay all that money back, to be honest, unless you go into a high-paying specialty. Get the book "Medical Student Loans" by Ben White, available for free here: Student Loans | Ben White

IF you stick with only federal loans (and you should do so if at all possible because of the many repayment options that are built in), you can limit your monthly payment to 10% of your income that exceeds 150% of the federal poverty level. After doing this for 25 years, any remaining balance is forgiven.* Even if your monthly payment only covers the interest (or a portion of it), and the balance actually grows over time, it is still wiped clean after those 25 years of payments. Enter repayment during residency and 3/4/5 of those years are low earning years, which means you end up paying less in the long run. There are also many options for Public Service Loan Forgiveness which would wipe away your debt after only 10 years of repayment.

*Current law says that you must pay taxes on the amount of money forgiven (under PAYE and REPAYE, not public service forgiveness), as it is considered income--so that could be a big chunk due all at once on a date 29 years in the future. But the law certainly may change in the meantime.

 

[PhillyDoc24]

$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.

Respectfully - I guess that most fresh grads coming out of residence are making less than $200K in primary care. After 2-3 years, it is more realistic

 

[zNoodlez]

Respectfully - I guess that most fresh grads coming out of residence are making less than $200K in primary care. After 2-3 years, it is more realistic

Do you mind sharing some data supporting this claim?

 

[FourniersGreenGang]

Just match into Ortho and pay it off in a year. Nbd anyone can do it.

 

[ThetisAntithesis]

It seems like not every school does this but my school strongly advised to do a budget before accepting the loans offered. They also gave us a premade excel sheet to fill out for the budget. Your school SHOULD have counseled you on debt management and budgeting before borrowing knowing the amount of money you're taking out.
Truly think they do students a disservice when they don't explain some of this stuff.

 

[TragicalDrFaust]

My situation and estimated expenses are similar. I don't have economic support from my parents. Have you made a budget? If not I would recommend finding a budget worksheet online (free), which gives you a bunch of categories and you estimate your monthly or yearly spending. Then you sum it all together and that will give you a better idea of how much you really need in loans for the year. I think you'll find you don't really need $500k. Check out reddit's You Need A Budget for more resources. Like others are saying, schools overestimate expenses to make sure that everyone has access to a more than sufficient amount of loans to pay for school.

 

[Laradd]

That's the patience! You can do get your goals in your own sweat.

 

[Postictal Raiden]

June 22, 2018 12:45 PM, EDT

More than five weeks before its contract with UPS Inc. expires Aug. 1, the International Brotherhood of Teamsters and the Atlanta-based shipping giant announced late June 21 tentative agreement on a five-year contract that industry officials say could pave the way for UPS to begin Sunday delivery service.

According to information released by the Teamsters, current full-time workers will receive pay increases of $4.15 per hour during the time of the contract. The union said full-time UPS drivers now earn on average nearly $75,000 a year, or $36 an hour.

UPS, Teamsters Reach Tentative Deal on Five-Year Contract | Transport Topics

More than five weeks before its contract with UPS expires Aug. 1, the International Brotherhood of Teamsters and the Atlanta-based shipping giant announced late June 21 tentative agreement on a five-year contract that industry officials say could pave the way for UPS to begin Sunday delivery...

www.ttnews.com

Here was a comparison back in the day when UPS drivers only made $60K per year

View attachment 314688

If doctors wanted to be wealthy, they would have become UPS truck drivers

Physicians love what they do, and money is not the primary driver for joining the exclusive club of health care providers.

www.kevinmd.com

This is so dumb, I don't even know where to start...

 

[calivianya]

According to information released by the Teamsters, current full-time workers will receive pay increases of $4.15 per hour during the time of the contract. The union said full-time UPS drivers now earn on average nearly $75,000 a year, or $36 an hour.
(...)

The average American is not good enough at money management for any of this to be noticeable. Most of the people I know making $60-75k/year don’t have any savings at all, or very minimal savings if they do. I base this on my former RN coworkers, myself on my previous salary, and my truck driving ex husband who has exactly zero dollars in savings in his 40s, despite pulling ~$80K last year (I did his taxes). Most people have a see money -> spend money problem. You just have to look at the average credit card debt in the US to back this up.

Total lifetime earnings is absolutely meaningless if you spend every dollar you make and then some. This is true at the physician level, too, but it’s much more difficult (or much more ostentatious, I suppose) to spend a full $200k+ every year than it is to spend $60k.

Assuming $60-75k/year gives you a good but not incredible standard of living (I would say most places fit this criteria), you can pay off physician loans very quickly on a $200k+ attending salary, put a ton of money away every year after the loans are gone, and retire 10+ years early if you want to. If the UPS driver is not frugal and prioritizes a decent (not extravagant) life over saving money, he/she might have to work right up to the minute of death on a $60-75k salary.

 

[calivianya]

Invalid comparison.

If you work at UPS as a driver for 30 years you will get a pension of $4000 per month.

Frequently Asked Questions about the National Master UPS Tentative Agreement

The following are frequently asked questions from UPS members and answers to those questions. Look for more Q&As in the near future.

teamster.org

.

Very few physicians get pensions and they need to save for their retirment. Based on the 4% rule a physician would have to save $1,000,000 to generate $4000 per month.

Mortgages with your best interests in mind | Interest.com

Consider us your mortgage gurus. We’re here to get rid of the confusing lingo and convoluted processes to make the whole home buying, home refinancing experience easier than it’s ever been before.

www.interest.com

So far, they’ll get a pension. If they actually get those pensions when they retire (which they will if they retire right now, but it’s not guaranteed in the future), they’ll be in a very small minority of non-governmental workers who do. My last job offered a pension... they don’t anymore. I also had a previous job force employees into retirement if they wanted to keep their pension - anyone who continued working forfeited their eligibility, and the pension was smaller than most people’s monthly salary so most employees were willing to sacrifice it to keep working. This behavior is very common in companies and no one should count on having a pension at retirement, except for governmental workers.

You can save a million dollars in ten years as a physician if you put away $100k a year. It’s not that astronomical a hurdle unless you’re a big spender. It’s much more difficult to try to put a million dollars away on a $60k salary.

 

[calivianya]

Incorrect. The pensions are contractually guaranteed. If UPS ever went bankrupt (which is highly doubtful), then the employees are still covered by the pension benefit guaranty corporation Maximum Monthly Guarantee Tables | Pension Benefit Guaranty Corporation

Now let us look at a doctor making $250,000 per year.
Take home pay is at best $15000 per month (assuming you live in a state with no income tax).
-$3,000 mortgage payment and property taxes
-$1,000 car payment + car insurance + car registration fees
-$2,500 student loan payment ($250,000 in loans 10 year repayment fixed interest rate 3.5%)
-$600 Disability/Life Insurance
-$400 Health insurance
=7500 per month x 12 months= 90000
So you might be able to save 90,000 per year if you did buy any food, did not have any utility bills, did not have a cell phone, did not buy clothes, and never went on vacation. If you live in a state with an average income tax then you can drop take home pay to $14000 per month.
And with 500,000 in debt you can double the monthy loan payment, or do one of those 30 year payment plans at about $3700 per month (bad idea imo).

You’re putting some extravagant living in there. The mortgage at the last place I owned was $650/month, and the property taxes and my homeowner’s insurance were paid out of the escrow account (actual principal and interest was ~$400/month). When I had my Honda, my car payment was $218 with ~$50/month insurance, so both of those together can be under $1,000 instead of the $4,000 you budgeted. Not to mention I went six years with a $0 car payment after I paid the Honda off before it died and I needed something different (which I paid off in full a year and a half ago). Nobody has to have a car payment every year, unless you’re just the type that likes flashy new cars.

Either way, my personal view of pensions is the only money you are truly guaranteed to have is the money you put in your own bank account yourself. If you are willing to rely on a pension to survive in retirement, you have a higher risk tolerance than I do and we will just agree to disagree. I watched my own father lose everything when his company (textiles) went under, and his pension only ended up paying out five years’ worth of money. Is that an outlier? Maybe, but it has made my personal focus on taking care of myself instead of relying on anyone else to do it.

 

[MedDoc305]

Incorrect. The pensions are contractually guaranteed. If UPS ever went bankrupt (which is highly doubtful), then the employees are still covered by the pension benefit guaranty corporation Maximum Monthly Guarantee Tables | Pension Benefit Guaranty Corporation

Now let us look at a doctor making $250,000 per year.
Take home pay is at best $15000 per month (assuming you live in a state with no income tax).
-$3,000 mortgage payment and property taxes
-$1,000 car payment + car insurance + car registration fees
-$2,500 student loan payment ($250,000 in loans 10 year repayment fixed interest rate 3.5%)
-$600 Disability/Life Insurance
-$400 Health insurance
=7500 per month x 12 months= 90000
So you might be able to save 90,000 per year if you did buy any food, did not have any utility bills, did not have a cell phone, did not buy clothes, and never went on vacation. If you live in a state with an average income tax then you can drop take home pay to $14000 per month.
And with 500,000 in debt you can double the monthy loan payment, or do one of those 30 year payment plans at about $3700 per month (bad idea imo).

With those same numbers, excluding the student loans, a UPS driver wouldn't be able to afford it, let alone save. You're also ignoring the fact that being a UPS driver is MUCH more physically demanding than you would expect. Doing it for 30 years for a pension is debatable.

 

[Postictal Raiden]

The 4K/month pension will barely be enough to cover the costs of therapy for chronic low back pain

 

[sloh]

The 4K/month pension will barely be enough to cover the costs of therapy for chronic low back pain

Get swindled into some PRP or stem cell injections and that entire 4k goes poof!

 

[Postictal Raiden]

Incorrect. The pensions are contractually guaranteed. If UPS ever went bankrupt (which is highly doubtful), then the employees are still covered by the pension benefit guaranty corporation Maximum Monthly Guarantee Tables | Pension Benefit Guaranty Corporation

Now let us look at a doctor making $250,000 per year.
Take home pay is at best $15000 per month (assuming you live in a state with no income tax).
-$3,000 mortgage payment and property taxes
-$1,000 car payment + car insurance + car registration fees
-$2,500 student loan payment ($250,000 in loans 10 year repayment fixed interest rate 3.5%)
-$600 Disability/Life Insurance
-$400 Health insurance
=7500 per month x 12 months= 90000
So you might be able to save 90,000 per year if you did buy any food, did not have any utility bills, did not have a cell phone, did not buy clothes, and never went on vacation. If you live in a state with an average income tax then you can drop take home pay to $14000 per month.
And with 500,000 in debt you can double the monthy loan payment, or do one of those 30 year payment plans at about $3700 per month (bad idea imo).

Please stop posting this nonsense. You’re embarrassing yourself.

 

[Neopolymath]

I remember this UPS garbage being posted in 2009 on this website. Some things will never change apparently.

 

[Startingover123]

Look into the National Health Service Corps program since you’re interested in primary care. There’s a service obligation after residency but they pay your tuition, fees and give you a monthly stipend! It is worth considering.

How difficult is this program to get into?

 

[Sleepingdoc]

You’re putting some extravagant living in there. The mortgage at the last place I owned was $650/month, and the property taxes and my homeowner’s insurance were paid out of the escrow account (actual principal and interest was ~$400/month). When I had my Honda, my car payment was $218 with ~$50/month insurance, so both of those together can be under $1,000 instead of the $4,000 you budgeted. Not to mention I went six years with a $0 car payment after I paid the Honda off before it died and I needed something different (which I paid off in full a year and a half ago). Nobody has to have a car payment every year, unless you’re just the type that likes flashy new cars.

Either way, my personal view of pensions is the only money you are truly guaranteed to have is the money you put in your own bank account yourself. If you are willing to rely on a pension to survive in retirement, you have a higher risk tolerance than I do and we will just agree to disagree. I watched my own father lose everything when his company (textiles) went under, and his pension only ended up paying out five years’ worth of money. Is that an outlier? Maybe, but it has made my personal focus on taking care of myself instead of relying on anyone else to do it.

To each their own but... but in the city I live in, which I would say would be any major city in the US, you cant even get an apartment where you would get mugged in your white coat while walking to your car for 650$. A one bedroom apartment in a decent place, would cost around 1200$... Its great that you can live that way, but everyone has their own view of what lavish and meagre living is.

Again to each their own... 250k is a decent amount of money, dont get me wrong but after you are attending- lets say you are married, have kids, you have student loans, home, other commitments, you would be surprised how much you would be saving each month.

 

[NavynurseATL]

You can always call up a military recruiter or consider service contracts

Absolutely. For practicing MDs the Navy gives upwards of 225k in bonus AND 250k in loan repayments. I tell people all the time "you can do anything part-time for 3 years to be debt free"

 

[NavynurseATL]

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.

The Navy has some great opportunities you might want to look into.

 

[MDMechEngr]

Absolutely. For practicing MDs the Navy gives upwards of 225k in bonus AND 250k in loan repayments. I tell people all the time "you can do anything part-time for 3 years to be debt free"

If any one goes this route, they need to look at the Army and AF first b/c I heard the commitment is less than what the Navy requires as pay back. This comming from a NAVY brat. I opted not to go this route and took out loans. Also turned down a really early interview invite from the Uniform Services med school.

 

[NavynurseATL]

If any one goes this route, they need to look at the Army and AF first b/c I heard the commitment is less than what the Navy requires as pay back. This comming from a NAVY brat. I opted not to go this route and took out loans. Also turned down a really early interview invite from the Uniform Services med school.

Typically the commitments are standard across the board. But if you do not take any incentive its 3 years. If you do take the monthly stipend the committment in return is 6mos for every year you take the stipend (basically 2year for every year). This all depends on the what year you come into the TMS program. I spoke with a Critical Care doctor just yesterday who is in the TMS program, he finishes fellowship in 5 months and his committment back to the RESERVES (not active duty) will be 4 years and he also received the loan repayment. Also you have to take into perspective your work ethic and the reason for joining. You can look at like "I can help serve my country for 4-5 years as a Reservist and have a little extra money in my pocket monthly and get a bulk if not all of my loans paid off" OR take out loans. Either way you have to take into perspective what will be right for you and your family. I am happy to help with any questions.

 

[MDMechEngr]

Typically the commitments are standard across the board. But if you do not take any incentive its 3 years. If you do take the monthly stipend the committment in return is 6mos for every year you take the stipend (basically 2year for every year). This all depends on the what year you come into the TMS program. I spoke with a Critical Care doctor just yesterday who is in the TMS program, he finishes fellowship in 5 months and his committment back to the RESERVES (not active duty) will be 4 years and he also received the loan repayment. Also you have to take into perspective your work ethic and the reason for joining. You can look at like "I can help serve my country for 4-5 years as a Reservist and have a little extra money in my pocket monthly and get a bulk if not all of my loans paid off" OR take out loans. Either way you have to take into perspective what will be right for you and your family. I am happy to help with any questions.

Can you comment on GMO requirements for Navy vs. AF/Army? how is the Navy different than the other 2 services.

 

[kamat paramedic]

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.

I am with you on this one. Many med students I know don't have to work during medical school and grew up in large houses and stay at home moms that really supported and pushed them. My family doesn't have money and my parents are retired. It is so disheartening that the financial debt looming over the poorer students (except those who worked their ass off to get into mdphd and it's paid for) is another reason for gap among physicians. The stress, lower quality of living (gotta save all the time) and limitations to fellowships due to debt really divides.

 

[Calizboosted76]

At this point I feel that you have gotten a bunch of great info, however I am going to beat this dead horse.

So I have a wife and kid, I am looking at about $360,000 after medical school (granted COL is relatively cheap from what I have seen and heard for the area of my school). I can appreciate the fact that you are from a low SES (so am I). I do not see you needing to take out that much with it only being yourself. The only reason that I am taking out as much as I plan to is because of childcare.


I think you will be just fine!

 

[unexpectedcomplications]

Even in primary care FM/IM, you will pay off all those loans in 3 years if you are open to working out in the sticks. Who knows, you might grow to love the area. Medicine is a profession where geography hugely affects salaries.

 

[AzBasRad]

OP, I feel you. I will have around $450K debt between my spouse (non-medicine) and myself after I graduate.

However, recognize physician's salary can vary widely based on location and practice structure. See post below about a PMR doc making > 700K/year after graduating residency in 2019.

Doximity physicians' salary

https://c8y.doxcdn.com/image/upload/Press%20Blog/Research%20Reports/compensation-report-2020.pdf

forums.studentdoctor.net

If you are passionate about medicine, do well academically in medical school and don't look back. Live frugally, learn the about financial aspects of medicine that are often ignored in medical school, and be flexible about your future practice location.

 

[Airborne Flt Doc]

It is soooo worth it ! You will get help paying back your student loans if you join the right organization and many pay over 200,000 loan repay over 4-5 years; plus you will make at least 300,000 a year working one job. Yes the Air National Guard in your local area can help pay back too without active duty commitment ( 25,000/yr residency stipend, 90k bonuses, etc. )

 

[ASGD1983]

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.

So unlike you just considering it, I'm actually in situation that I'm facing $520k debt very soon (I'm a 4th year DO). I don't want to name the school, but it's most expensive one in western usa. I had no choice, as I it was the only school that I was accepted, but it's not a bad school, just very expensive.

So here's my situation and how real numbers look. First of all, as soon as I graduate, I refinance my current loan. Currently I am on 6.6% to 7.5% (each year had different apr). There are about dozen of firms specializing on med. refinancing. If you go with fixed apr it's going to be 2% to 4.9%. Assuming you have good credit and you'll get into residency - risks for lender are very low, so you'll be able to get about 3% to 3.5% on $520k (one guy who is in residency already got apr fixed for 1.9% but that's because his loan is less - about $370k). Next thing is to forget about 10 year and go for 15 years. That will allow you to live comfortably (folks in our situation shouldn't go for 10 years with that much debt). In that case it'll come to $3717 per month or $3591 (if you'll get 3% apr). I'm still going to figure out how to defer payments while in residency, but let's say going into IM after residency (only 3 years yay!) you'll get about $12k monthly clean (after taxes), so you can pay off your loan monthly and live on $8200. That been said in 15 years you'll be free and the rest of your working life you'll get full salary. However, keep in mind you'll get bonuses each year - about $20k (after taxes). That alone makes it $9800 that you'll get to your account after taxes and after loan repayment - it's your money to use. And finally you can take 1 extra shift per month and that will yield about $1k (after taxes) making your clean net monthly $11k. And trust me you'll be forced to take extra shifts anyway lol (even if you don't want to) just because that is a norm nowadays in almost every IM location (people get sick, people ask you to cover etc). So don't worry about it right now, just do your thing.

P.S. And this is based on IM hospitalist job with $240k yearly and I took $96k for taxes (which as you probably guessed is a worst case scenario - a single not married person in a highest tax rate state, but in reality you might not pay that much taxes, well unless current administration will raise taxes lol). If you can get into some specialty - then as you understand things will be even better.

P.P.S. Just wanted to state that this scenario is the worst case scenario for someone like me (non US citizen) with private loans - who can't use loan forgiveness program or income based driven repayment etc. If you have federal loans - your life is much easier and there are options you can explore. Basically with federal loans you shouldn't even worry about it.

 

[Prncssbuttercup]

I am an FM doc in a rural area with 500k in debt.

I love my job. I don’t regret it for one second.

I qualify for NHSC money, and got 100k for doing suboxone treatment in a rural area, AND I qualify for PSLF.
If I continue doing suboxone therapies I can reapply for my NHSC money every year until I am done paying or they’re forgiven.

I make decent money, and given my IDR plan I don’t starve with 5 kids.

 

[Firkin]

So unlike you just considering it, I'm actually in situation that I'm facing $520k debt very soon (I'm a 4th year DO). I don't want to name the school, but it's most expensive one in western usa. I had no choice, as I it was the only school that I was accepted, but it's not a bad school, just very expensive.

So here's my situation and how real numbers look. First of all, as soon as I graduate, I refinance my current loan. Currently I am on 6.6% to 7.5% (each year had different apr). There are about dozen of firms specializing on med. refinancing. If you go with fixed apr it's going to be 2% to 4.9%. Assuming you have good credit and you'll get into residency - risks for lender are very low, so you'll be able to get about 3% to 3.5% on $520k (one guy who is in residency already got apr fixed for 1.9% but that's because his loan is less - about $370k). next thing is to forget about 10 year and go for 15 years. That will allow you to live comfortably (folks in our situation shouldn't go for 10 years with that much debt). In that case it'll come to $3717 per month or $3591 (if you'll get 3% apr). I'm still going to figure out how to defer payments while in residency, but let's say going into IM after residency (only 3 years yay!) you'll get about $12k monthly clean (after taxes), so you can pay off your loan monthly and live on $8200. That been said in 15 years you'll be free and the rest of your working life you'll get full salary. However, keep in mind you'll get bonuses each year - about $20k (after taxes). That alone makes it $9800 that you'll get to your account after taxes and after loan repayment - it's your money to use. And finally you can take 1 extra shift per month and that will yield about $1k (after taxes) making your clean net monthly $11k. And trust me you'll be forced to take extra shifts anyway lol (even if you don't want to) just because that is a norm nowadays in almost every IM location (people get sick, people ask you to cover etc). So don't worry about it right now, just do your thing.

P.S. And this is based on IM hospitalist job with $240k yearly and I took $96k for taxes (which as you probably guessed is a worst case scenario, in reality you might not pay that much taxes, well unless current administration will raise taxes lol) - which is very very average. If you can get into some specialty - then as you understand things will be even better.

This all sounds like you have a well-thought-out plan to shoot yourself in the foot as soon as you get out of school. Refinance? Are your loans federal or private? The only situation in which your plan makes financial sense is if every bit of your loan debt (or the vast majority of it) is from private loans. With your stated planned income, a person who had that much in federal loans would simply enroll in an income-driven repayment program and have a huge portion of that money forgiven. You have also taken 40% off the top in taxes, and that is very unlikely--even in the states with the highest income taxes you wouldn't approach $96,000 in taxes. Your payment on an income-driven repayment plan would be more in the range of $1200-1800 per month, or less...followed by outright forgiveness of hundreds of thousands of dollars. If you DO have that much in private loans, then...ouch. That sucks. But I don't want people who might stumble across this to think that your scenario is the only option. Read Ben White's Medical Student Loans for plenty of info about repayment options and planning: Student Loans | Ben White

 

[Prncssbuttercup]

I make decent money, have kids and claim 1. My taxes were 50k last year and I live in a high tax state.
Just for reference.

NEVER EVER refinance your student loans into private loans. You will no longer qualify for any loan forgiveness and they still won’t be forgiven in bankruptcy.

If they are already private loans that don’t qualify for NHSC or PSLF then fine, but if they do... those are better options.

 

[Prncssbuttercup]

Also, if you’re on FB please join the physician finance and the PSLF-Eligible physicians groups.

You will get great financial advice in there