I'm planning on attending a DO school, so I calculated that I will have 380-430k in debt by the time I finish, depending on which school I attend. I, too, am very concerned about the loans and after extensive thinking and searching, I realized I have three options:
1. Join the military
2. Loans
3. Forget medicine
Since life is too short and I know that I won't be happy doing anything other than medicine, option three is ruled out. I love military medicine, and I think it would provide me with an opportunity to serve my true country, not the one that I was born in, but the one that provided me with honor and respect. However, being a husband and a father made me realize that I won't be happy being away from my family, so I put this option on hold, didn't rule it out completely. Now, I'm left with one option, loans. Knowing that in five years I'll be buried with almost half a million of educational debt is nauseating, but apparently, this is my only option.
Therefore, I came up with a plan to minimize the amount of interests I will have and reduce the repayment period (I don't want to keep paying until I'm in my fifties). My plan is to live frugally during the residency years, moonlight as much as I can, have my wife work part time. That way, my debt won't grow further. After residency, I'm planning to live in an area where the cost of living is cheap, no state income tax, and higher pay rate. For example, if I do EM (something I'm considering now, but who knows), I would live somewhere in rural Texas, SD, or even Alaska for few years; the cost of living is marginal and the pay rate is a little higher, plus no income tax. I'm also planning to work my tail off, so if the average EM physician work 36hrs/week, I will force my self to do 48 or even 60hrs/week. I know this will take a toll on myself and my family, but it's far better than the sacrifices we will endure if I go through the military route. Therefore, even if I earn as little as $100/hr (less than 67% of national average rate of EM), I would produce ~300k of income working 60hrs/week 49weeks/year. By continuing my thrifty lifestyle, I should be able to repay my entire educational debt in 3 years following residency.
Sorry for the long post, but I like to share my thoughts with you. I welcome any comments and critiques.