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top 50 isn't that bad. You'll be happy you took the full-ride in the end.
 
I've met a few people this cycle who ended up turning down full-rides at top X schools in order to attend another school. Similarly, someone I know got very generous scholarships at two schools and chose to matriculate at the "lower ranked" one (top 15 vs. top 30, so the difference wasn't big). So it does happen.
 
Full ride > top 5 unless there is something very specific at that top 5 school, such as a former CDC director or Surgeons General who's leadership you can learn from.
 
Are your friends and family in medicine or in debt 200k? If not, if not, as I expect, don't heed their unwise advice. You got into the top five and the full ride because you're either smart, hard working, or lucky. If you're any combination of the first two, the school you attending won't matter in the end and you'll be debt free and a world-class doctor.
 
ByeByeBirdy said:
Hi.

I've been a long time lurker here. I'm very thankful for the advice SDN has given me over the last few years.

I was lucky to have a very good application cycle. My medical school options came down to a top 5 research school (and $190,000 in debt), and a top 50 medical school that offered me a full ride. I ended up selecting the full ride, even though the school didn't have the flashy name.

I was pretty set on my decision, but when telling some friends/family, they seemed pretty incredulous. A lot of "Are you serious?" and "Maybe you should think a bit more?" I can understand why they feel that way, but it rattled my faith in my decision. Nonetheless, I'm going to stick to it.


I've searched through old threads and this topic has been talked about, but I didn't really hear much from people who chose one or the other (reputation or money). Does anyone have any regrets in making that decision? What do you wish you had known before? Did the opinions of close family or friends ever weigh on your choice? How do you think things would have been different for you if you took the other path?
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Most people don't realize how little your school's name matters in medicine. After all giving up an acceptance to a top 5 school in business, law, or even engineering just to save on tuition is a terrible decision, you'd be trading millions in lifetimes earnings for just a few hundred thousand in tuition. They're giving you good advice for education as they understand it. Only people who really understand our profession know that medicine is different: your pay is basically determined by which residency you get into, and your ability to land the residency of your choice is determined almost entirely by your step 1 score, your clinical grades, and your research. Your school's name isn't a non-factor, but it's pretty far down the list. A a Harvard lawyer can make an order of magnitude more than a second tier educated lawyer, but a harvard EM doctor will likely commnd the exact same hourly rate as a second tier educated EM doctor.

People also don't realize how many profesion in medicine make a very middle class (150K/year) salary, and how many doors debt can close. I ended up liking pediatrics, a field I wasn't expecting to be interested in and which I honestly couldn't have pursued if I was carryng 250K of debt on my back. You might surprise yourself by liking a poorly reimbursed field as well.

In general I think you should try and keep as many options open as possible. In this case I think that means the full ride. You made the right choice.
 
Way to stick to your choice. I've got a lot of friends (actuaries, pharmD programs) who have been accepted and are eager to judge on how I do. It's kind of frustrating hearing them be passive aggressive, but as long as you're happy is all that matters.
 
Perrotfish said:
Most people don't realize how little your school's name matters in medicine. After all giving up an acceptance to a top 5 school in business, law, or even engineering just to save on tuition is a terrible decision, you'd be trading millions in lifetimes earnings for just a few hundred thousand in tuition. They're giving you good advice for education as they understand it. Only people who really understand our profession know that medicine is different: your pay is basically determined by which residency you get into, and your ability to land the residency of your choice is determined almost entirely by your step 1 score, your clinical grades, and your research. Your school's name isn't a non-factor, but it's pretty far down the list. A a Harvard lawyer can make an order of magnitude more than a second tier educated lawyer, but a harvard EM doctor will likely commnd the exact same hourly rate as a second tier educated EM doctor.

People also don't realize how many profesion in medicine make a very middle class (150K/year) salary, and how many doors debt can close. I ended up liking pediatrics, a field I wasn't expecting to be interested in and which I honestly couldn't have pursued if I was carryng 250K of debt on my back. You might surprise yourself by liking a poorly reimbursed field as well.

In general I think you should try and keep as many options open as possible. In this case I think that means the full ride. You made the right choice.
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Ahhh, always good to hear people say awesome things on here! Beautifully stated!
 
I turned down two full rides to attend the school that I will be going to but only did so because of generous need based aid. I agree with everyone else that for a difference of $190,000 you should be attending the school that gave you a full ride. As the difference becomes less than you get into the debate of how much money are you willing to pay for a top 5 school education. You won't be be any better trained than anyone else just because you went to a top 5 school. Your decision should be based on long term career goals. Private practice vs academics, research, teaching, additional degrees that you might want to pursue etc... its an individual decision and only you can decide how much money it is worth to you.
 
ByeByeBirdy said:
Hi.

I've been a long time lurker here. I'm very thankful for the advice SDN has given me over the last few years.

I was lucky to have a very good application cycle. My medical school options came down to a top 5 research school (and $190,000 in debt), and a top 50 medical school that offered me a full ride. I ended up selecting the full ride, even though the school didn't have the flashy name.

I was pretty set on my decision, but when telling some friends/family, they seemed pretty incredulous. A lot of "Are you serious?" and "Maybe you should think a bit more?" I can understand why they feel that way, but it rattled my faith in my decision. Nonetheless, I'm going to stick to it.


I've searched through old threads and this topic has been talked about, but I didn't really hear much from people who chose one or the other (reputation or money). Does anyone have any regrets in making that decision? What do you wish you had known before? Did the opinions of close family or friends ever weigh on your choice? How do you think things would have been different for you if you took the other path?
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Look at it this way:

What's better than getting accepted into a top-5 medical school?
Getting accepted, and then denying them.

Grats! Keep up the hard work. :luck:
 
I think you made the right choice. Ignore your friends and family, they won't be the one's taking on all that debt. No one will care where you went to medical school twenty years from now, or even once you match.
 
Perrotfish said:
Most people don't realize how little your school's name matters in medicine. After all giving up an acceptance to a top 5 school in business, law, or even engineering just to save on tuition is a terrible decision, you'd be trading millions in lifetimes earnings for just a few hundred thousand in tuition. They're giving you good advice for education as they understand it. Only people who really understand our profession know that medicine is different: your pay is basically determined by which residency you get into, and your ability to land the residency of your choice is determined almost entirely by your step 1 score, your clinical grades, and your research. Your school's name isn't a non-factor, but it's pretty far down the list. A a Harvard lawyer can make an order of magnitude more than a second tier educated lawyer, but a harvard EM doctor will likely commnd the exact same hourly rate as a second tier educated EM doctor.

People also don't realize how many profesion in medicine make a very middle class (150K/year) salary, and how many doors debt can close. I ended up liking pediatrics, a field I wasn't expecting to be interested in and which I honestly couldn't have pursued if I was carryng 250K of debt on my back. You might surprise yourself by liking a poorly reimbursed field as well.

In general I think you should try and keep as many options open as possible. In this case I think that means the full ride. You made the right choice.
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This is an awesome post. That is all.
 
Perrotfish said:
Most people don't realize how little your school's name matters in medicine. After all giving up an acceptance to a top 5 school in business, law, or even engineering just to save on tuition is a terrible decision, you'd be trading millions in lifetimes earnings for just a few hundred thousand in tuition. They're giving you good advice for education as they understand it. Only people who really understand our profession know that medicine is different: your pay is basically determined by which residency you get into, and your ability to land the residency of your choice is determined almost entirely by your step 1 score, your clinical grades, and your research. Your school's name isn't a non-factor, but it's pretty far down the list. A a Harvard lawyer can make an order of magnitude more than a second tier educated lawyer, but a harvard EM doctor will likely commnd the exact same hourly rate as a second tier educated EM doctor.

People also don't realize how many profesion in medicine make a very middle class (150K/year) salary, and how many doors debt can close. I ended up liking pediatrics, a field I wasn't expecting to be interested in and which I honestly couldn't have pursued if I was carryng 250K of debt on my back. You might surprise yourself by liking a poorly reimbursed field as well.

In general I think you should try and keep as many options open as possible. In this case I think that means the full ride. You made the right choice.
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👍 Let everyone else be fooled by the exterior values of life while you understand what lies beneath.
 
Perrotfish said:
Most people don't realize how little your school's name matters in medicine. After all giving up an acceptance to a top 5 school in business, law, or even engineering just to save on tuition is a terrible decision, you'd be trading millions in lifetimes earnings for just a few hundred thousand in tuition. They're giving you good advice for education as they understand it. Only people who really understand our profession know that medicine is different: your pay is basically determined by which residency you get into, and your ability to land the residency of your choice is determined almost entirely by your step 1 score, your clinical grades, and your research. Your school's name isn't a non-factor, but it's pretty far down the list. A a Harvard lawyer can make an order of magnitude more than a second tier educated lawyer, but a harvard EM doctor will likely commnd the exact same hourly rate as a second tier educated EM doctor.

People also don't realize how many profesion in medicine make a very middle class (150K/year) salary, and how many doors debt can close. I ended up liking pediatrics, a field I wasn't expecting to be interested in and which I honestly couldn't have pursued if I was carryng 250K of debt on my back. You might surprise yourself by liking a poorly reimbursed field as well.

In general I think you should try and keep as many options open as possible. In this case I think that means the full ride. You made the right choice.
Click to expand...
150,000 is middle class? Dang you people have your standards set high..From my perspective 150k is filthy rich. 90k is upper middle class.

What's 65,000? Poverty?
 
OP, ignore people not in the profession - they know absolutely nothing about medicine. Also, my class is filled with people who turned down places like Harvard, Yale, Hopkins, etc. to come to Pritzker. Obviously it's not quite the same as your situation, but people do it. Don't worry about it. Once you start school you won't have any regrets.
 
Perrotfish said:
Most people don't realize how little your school's name matters in medicine. After all giving up an acceptance to a top 5 school in business, law, or even engineering just to save on tuition is a terrible decision, you'd be trading millions in lifetimes earnings for just a few hundred thousand in tuition. They're giving you good advice for education as they understand it. Only people who really understand our profession know that medicine is different: your pay is basically determined by which residency you get into, and your ability to land the residency of your choice is determined almost entirely by your step 1 score, your clinical grades, and your research. Your school's name isn't a non-factor, but it's pretty far down the list. A a Harvard lawyer can make an order of magnitude more than a second tier educated lawyer, but a harvard EM doctor will likely commnd the exact same hourly rate as a second tier educated EM doctor.

People also don't realize how many profesion in medicine make a very middle class (150K/year) salary, and how many doors debt can close. I ended up liking pediatrics, a field I wasn't expecting to be interested in and which I honestly couldn't have pursued if I was carryng 250K of debt on my back. You might surprise yourself by liking a poorly reimbursed field as well.

In general I think you should try and keep as many options open as possible. In this case I think that means the full ride. You made the right choice.
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This. OP stick with your guts.
 
I actually just advised my cousin to take a full ride at a non top 50 school over a top 10 school.

If you are intelligent, you can flourish at any US MD school. Even whichever one is ranked dead last. Residency programs look at personal achievement - not school achievement. If I interviewed at a single residency program that admitted to taking me because of what my school accomplished, I would have laughed and walked out.

My cousin will be debt-free after med school and super happy. Don't worry about what other people think of you - just what is best for yourself.
 
sc4s2cg said:
150,000 is middle class? Dang you people have your standards set high..From my perspective 150k is filthy rich. 90k is upper middle class.

What's 65,000? Poverty?
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Exactly what I was thinking....

You know you've made the right decision for yourself Op, congrats and enjoy the free ride into a great career 🙂
 
sc4s2cg said:
150,000 is middle class? Dang you people have your standards set high..From my perspective 150k is filthy rich. 90k is upper middle class.

What's 65,000? Poverty?
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When you have >200k in debt, then yea, 65k is poverty. 150k is pretty much middle class in most cities nowadays.
 
Got offered a full ride from large public top 25 school and had to turn down several offers from places I think I would have had a better experience (i.e. ivy league). Looking back at it, I really wish I could have gone somewhere else. Would I still make the same decision? Absolutely. I wanted to fund my entire college experience independently without going into debt and I couldn't do that elsewhere.
 
NickNaylor said:
OP, ignore people not in the profession - they know absolutely nothing about medicine. Also, my class is filled with people who turned down places like Harvard, Yale, Hopkins, etc. to come to Pritzker. Obviously it's not quite the same as your situation, but people do it. Don't worry about it. Once you start school you won't have any regrets.
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I graduated debt free. It's freeing. You made the right choice, don't look back.
190k now will be 400k by the time you're done.
 
ByeByeBirdy said:
Hi.

I've been a long time lurker here. I'm very thankful for the advice SDN has given me over the last few years.

I was lucky to have a very good application cycle. My medical school options came down to a top 5 research school (and $190,000 in debt), and a top 50 medical school that offered me a full ride. I ended up selecting the full ride, even though the school didn't have the flashy name.

I was pretty set on my decision, but when telling some friends/family, they seemed pretty incredulous. A lot of "Are you serious?" and "Maybe you should think a bit more?" I can understand why they feel that way, but it rattled my faith in my decision. Nonetheless, I'm going to stick to it.


I've searched through old threads and this topic has been talked about, but I didn't really hear much from people who chose one or the other (reputation or money). Does anyone have any regrets in making that decision? What do you wish you had known before? Did the opinions of close family or friends ever weigh on your choice? How do you think things would have been different for you if you took the other path?
Click to expand...

Both of these things happen often. Look in the school-specific discussion forum and you'll see plenty of threads like this. Ultimately, I think it depends on a lot of factors which school you choose. I'd take a full-ride to my state school over a top five school any day (not that I have either option) because I love my state school and want to stay close to family. But you might consider debt to be the most critical factor in your own future happiness. I think the best thing to do would be to go to the school you have better feelings about. But rest assured, plenty of people choose a full ride over a top school because it will really improve your future financial situation a LOT.
 
sc4s2cg said:
150,000 is middle class? Dang you people have your standards set high..From my perspective 150k is filthy rich. 90k is upper middle class.

What's 65,000? Poverty?
Click to expand...


1) you need to adjust alll physician salaries downwards to adjust for 10 years of lost earnings and also the student debt load.

2) if you expect to need to work a full lifetime to pay off your house, pay your kids college tuition, and retire at 65 that, to me, is middle class. Even without the debt or the years lost in school I would consider 150 K to be middle class unless you are a single guy in a very cheap (rural) location.
 
notbobtrustme said:
When you have >200k in debt, then yea, 65k is poverty. 150k is pretty much middle class in most cities nowadays.
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How does anybody middle class afford a house and a car or two? Oh yeah, payments.
 
Perrotfish said:
1) you need to adjust alll physician salaries downwards to adjust for 10 years of lost earnings and also the student debt load.

2) if you expect to need to work a full lifetime to pay off your house, pay your kids college tuition, and retire at 65 that, to me, is middle class. Even without the debt or the years lost in school I would consider 150 K to be middle class unless you are a single guy in a very cheap (rural) location.
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I think that's an accurate attitude. The problem is that the bar has shifted. Most people that work in "middle class" jobs are actually making a working class salary but they don't self-identify as working class.

There's actually an interesting amount of research on the death of the "working class" identity as manufacturing has died and education has become sort of a ubiquitous prerequisite to getting any job. $150k a year is middle class when you've got $50k a year in student loan payments and live in an expensive city. Is $100k a year (after student loans) in the upper echelon of incomes? Yes. But that's because the American middle class has died.

Household incomes have stagnated over the last 30 years (adjusted for inflation). This is partly because of globalization and the expansion of the workforce due to women entering. It also has some root in the culture of ever increasing executive compensation, the growth of mechanization and the effect that technology has in creating a "winner-takes-all" environment. (For example, instead of tens of thousands of accountants making middle class salaries helping their local communities do taxes, now the average person just uses turbo-tax, and the CEO, other executives and initial investors make millions. This isn't a bad thing persay but it is a pretty widespread effect, NPR had a good episode that went through a lot of examples of this phenomenon.)

Either way, as the productivity of the American worker has doubled, salaries haven't budged. The result is an American middle class in debt, and in crisis.
 
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The full ride is definitely the way to go, although I'm not sure what the inner prestige ***** inside of me would do...
 
I turned down both during my cycle (several MSTP acceptances, most funded, top school unfunded). It's about your personal preferences. Why be miserable paying off debt for a fancy name? Or taking money from a place you can't see yourself attending over another school? Med school is intense, and personal happiness will help you during the tough times.
 
It really depends on what you want to do.

Want to match into dermatology, plastic surgery, or neurosurgery? Matching into these small, highly competitive specialties can really be helped by a Big Name medical degree and mentorship from prominent faculty. Want to be a top academic? In this area too, school prestige can help.

However, if you envision a private practice career and are not particularly set on matching into an ultracompetitive specialty, spending 190K for a big whig name is a bad choice.
 
If prestige is so important, follow the plan of Dr. 90210 - Robert Rey. He went to an ok med school - Tufts. Any med school would work here. He did his plastic surgery training at Univ of Tenn Memphis - who would want to live in Memphis (Yuck)? Then he did a very short fellowship at Harvard to have the Harvard name.

Many fields have short fellowships (1-2 years) that are relatively uncompetitive even at BIG name places. I actually know someone about to start a short fellowship at Harvard next year. He is a foreign medical graduate from a poorly known program. His resume is unimpressive. The farther you go in training in many fields - the less competitive it gets because you could otherwise be making big money instead of $55k in a fellowship.
 
Perrotfish said:
1) Even without the debt or the years lost in school I would consider 150 K to be middle class unless you are a single guy in a very cheap (rural) location.
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Read my post a few above you... 150k is NOT middle class by any stretch of the imagination.

Also, you don't need to adjust for lost earnings in those years because you already lived them. Sure you may have lived in poverty then, but not now....

If I didn't make twenty dollars yesterday, but I made sixty today, it doesn't mean I only can live like I made thirty today... It means yesterday I lived as if I had no money (because you don't) and today now that you have sixth dollars, you can live as if you had sixty dollars.

The only valid counter argument I would accept is saying debt takes some of your income. This is true, but again, when you were in residency and med school you probably were not living like a king, you were living off one dollar pot pies and seminars with free food, so your expenses are way lower to pay back.
 
MaxillofacialMN said:
Read my post a few above you... 150k is NOT middle class by any stretch of the imagination.

Also, you don't need to adjust for lost earnings in those years because you already lived them. Sure you may have lived in poverty then, but not now....

If I didn't make twenty dollars yesterday, but I made sixty today, it doesn't mean I only can live like I made thirty today... It means yesterday I lived as if I had no money (because you don't) and today now that you have sixth dollars, you can live as if you had sixty dollars.

The only valid counter argument I would accept is saying debt takes some of your income. This is true, but again, when you were in residency and med school you probably were not living like a king, you were living off one dollar pot pies and seminars with free food, so your expenses are way lower to pay back.
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This. 150K is not middle class--at all. Not making 150k until you are 50 still wouldn't change that, from the age of 150k, you no longer are middle class. I think a lot of people, particularly people that go straight from college to medicine, are very out of touch with what the rest of the country is making.
 
when people say full ride, and they meaning full tuition or an actual full ride that covers living
 
MaxillofacialMN said:
Also, you don't need to adjust for lost earnings in those years because you already lived them. Sure you may have lived in poverty then, but not now...
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Yes you do. A very large part of the wealth you make, once you're middle class, goes into savings. You accumulate equity in your home and vehicles, you make your annual contribution to your IRA, you build your kids' college funds, and of course you try to have other savings and investments on top of that. If you start earning when you're 30 you're 10 years behind the curve in terms of building up wealth towards you kids' college and retirement (wealth which would have been compounding) and you therefore need to invest a much greater portion of what you have to have enough to live at retirement. Which leaves you a lot less to actually spend.

The only valid counter argument I would accept is saying debt takes some of your income. This is true, but again, when you were in residency and med school you probably were not living like a king, you were living off one dollar pot pies and seminars with free food, so your expenses are way lower to pay bac
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Do you honestly think that living expenses are a significant part of the debt that physicians are carrying? The debt comes from the cost of the education: you can live on dirt and air, sleep under the stars at night, and you will still graduate from my school with $280,000 of student loans. That's on top of your undergraduate loans Honestly this is why so many students these days are adding 5-10K more/year in loans than they really need: the cost of education is so overwhelming that a little added luxury seems like a drop in the ocean.

As for 150K being rich, I guess its a matter of opinion. When I think of 'rich' I don't think of a modest suburban home, two non-luxury vehicles, enough money to put a couple of kids through a state college. Which is what 150K buys in most of the country. Rich is richer than that. Most of all if I need to work until I'm 65 just to own that modest home that's definitely not rich. Rich people don't need to put put up with a full working lifetime of bosses, nurses, and patients just to live. Not saying that a lot of them don't work full careers anyway, but rich has the option to retire early, at least by my definition. You can make twice the average household income and not be rich.
 
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sc4s2cg said:
150,000 is middle class? Dang you people have your standards set high..From my perspective 150k is filthy rich. 90k is upper middle class.

What's 65,000? Poverty?
Click to expand...
Filthy rich is owning a mansion, and at least one vacation home, driving whatever car you feel like on that particular day, owning a yacht, either owning your own jet or chartering a private jet whenever you want to fly to Asia, Europe, etc, shopping and buying whatever you want without batting an eye if you spend a few thousand in a day, etc. 150k is NOT filthy rich, it is most definitely upper middle class. Your perspective is not very realistic, even if 150k is more than you ever imagined earning, it is hardly "filthy rich."
 
Perrotfish said:
Most people don't realize how little your school's name matters in medicine. After all giving up an acceptance to a top 5 school in business, law, or even engineering just to save on tuition is a terrible decision, you'd be trading millions in lifetimes earnings for just a few hundred thousand in tuition. They're giving you good advice for education as they understand it. Only people who really understand our profession know that medicine is different: your pay is basically determined by which residency you get into, and your ability to land the residency of your choice is determined almost entirely by your step 1 score, your clinical grades, and your research. Your school's name isn't a non-factor, but it's pretty far down the list. A a Harvard lawyer can make an order of magnitude more than a second tier educated lawyer, but a harvard EM doctor will likely commnd the exact same hourly rate as a second tier educated EM doctor.

People also don't realize how many profesion in medicine make a very middle class (150K/year) salary, and how many doors debt can close. I ended up liking pediatrics, a field I wasn't expecting to be interested in and which I honestly couldn't have pursued if I was carryng 250K of debt on my back. You might surprise yourself by liking a poorly reimbursed field as well.

In general I think you should try and keep as many options open as possible. In this case I think that means the full ride. You made the right choice.
Click to expand...

I think it is very true that where you go for school will not ultimately change the amount of money you will earn as a physician. However, unlike lawyers or business men, how much you earn does not indicate your success as a doctor.

Very few people can give an unbiased opinion of what is the best decision, but with a brother in a top 5 med school and a sister in a top 50 med school, I can tell you that not going to a top med school will never hold you back, but it won't help either. On the other hand, going to a top medical school will place you in a completely different environment. You're surrounded by peers and faculty who generally have more drive and dedication to their career. Many of the top school's have the best match lists, and many of the school's faculties are members of academies and gone on to receive prestigious awards.

I think that its pretty obvious there are significantly more opportunities that will open up to you if you go to a top school (ie getting your training in top hospitals during rotations...etc) , but it comes at a price. But given that there is no shortage of students who want to go to the top school and are willing to pay the price, I would say that the opportunity to go to a top school is rare enough to warrant the price. That said, did you not get any fin aid from the top school?
 
JLC said:
Very few people can give an unbiased opinion of what is the best decision, but with a brother in a top 5 med school and a sister in a top 50 med school, I can tell you that not going to a top med school will never hold you back, but it won't help either. On the other hand, going to a top medical school will place you in a completely different environment. You're surrounded by peers and faculty who generally have more drive and dedication to their career. Many of the top school's have the best match lists, and many of the school's faculties are members of academies and gone on to receive prestigious awards.

I think that its pretty obvious there are significantly more opportunities that will open up to you if you go to a top school (ie getting your training in top hospitals during rotations...etc) ol?
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I actually don't think it's obvious there are more opportunities at top schools. It's pretty obvious that top schools will have the best match lists, because they recruit people who have a superhuman mastery of standardized tests, extensive research backgrounds, and engaging personalities in their interviews. I'm not sure, however, that you would see better outcomes at top schools vs lower ranked schools if you normalized for matriculant MCAT, GPA, and research experience.

You need to remember that a lot of medical school is a competition, and residency is a numbers game. Clinical grades are more or less curved (about 20% of the class gets honors) and AOA takes only the top whatever percent of the class. Now that's not a disadvantage if you happen to make AOA at a top 5 school, but I'm not sure a middle of the pack student at Harvard is doing himself any favors in the match if he could have been an AOA student with an unbroken string of honors at a midrange school.
 
I turned down a full ride at a decent school in an awesome city for a top school in a crappy city. It was the worst mistake of my life. Take the money.
 
ByeByeBirdy said:
Hi.

I've been a long time lurker here. I'm very thankful for the advice SDN has given me over the last few years.

I was lucky to have a very good application cycle. My medical school options came down to a top 5 research school (and $190,000 in debt), and a top 50 medical school that offered me a full ride. I ended up selecting the full ride, even though the school didn't have the flashy name.

I was pretty set on my decision, but when telling some friends/family, they seemed pretty incredulous. A lot of "Are you serious?" and "Maybe you should think a bit more?" I can understand why they feel that way, but it rattled my faith in my decision. Nonetheless, I'm going to stick to it.


I've searched through old threads and this topic has been talked about, but I didn't really hear much from people who chose one or the other (reputation or money). Does anyone have any regrets in making that decision? What do you wish you had known before? Did the opinions of close family or friends ever weigh on your choice? How do you think things would have been different for you if you took the other path?
Click to expand...

All I got to say is amazing job dude 👍 , way to stand by your guns. I feel that for the applicant (especially one like you that attended a top UG institution), the usual tendency is for the applicant to want to go with the big name, and doesn't think reasonably. I have heard from multiple med students and residents that where you go for med school is pretty minimal and that debt is haunting (and can many sometimes even force you out of a specialty you love because you're so worried about the debt). I think going with the full-ride is a great decision...
 
MaxillofacialMN said:
Read my post a few above you... 150k is NOT middle class by any stretch of the imagination.

Also, you don't need to adjust for lost earnings in those years because you already lived them. Sure you may have lived in poverty then, but not now....

If I didn't make twenty dollars yesterday, but I made sixty today, it doesn't mean I only can live like I made thirty today... It means yesterday I lived as if I had no money (because you don't) and today now that you have sixth dollars, you can live as if you had sixty dollars.

The only valid counter argument I would accept is saying debt takes some of your income. This is true, but again, when you were in residency and med school you probably were not living like a king, you were living off one dollar pot pies and seminars with free food, so your expenses are way lower to pay back.
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I agree that saying a $150k salary is "middle class" is disingenuous, but depending on your situation that high income may very well produce a middle class lifestyle due to the costs required to earn that $150k. Remove ~25-30% of your income for taxes, another 10-15% for savings, and another significant portion for loan repayments (maybe 5-10%), and you're left with a pretty solid middle class income. This definitely screams of "first world problems," but I think Perrot makes a good point about physician finances that many pre-meds either choose to ignore or are ignorant about.
 
Perrotfish said:
Yes you do. A very large part of the wealth you make, once you're middle class, goes into savings. You accumulate equity in your home and vehicles, you make your annual contribution to your IRA, you build your kids' college funds, and of course you try to have other savings and investments on top of that. If you start earning when you're 30 you're 10 years behind the curve in terms of building up wealth towards you kids' college and retirement (wealth which would have been compounding) and you therefore need to invest a much greater portion of what you have to have enough to live at retirement. Which leaves you a lot less to actually spend.


Do you honestly think that living expenses are a significant part of the debt that physicians are carrying? The debt comes from the cost of the education: you can live on dirt and air, sleep under the stars at night, and you will still graduate from my school with $280,000 of student loans. That's on top of your undergraduate loans Honestly this is why so many students these days are adding 5-10K more/year in loans than they really need: the cost of education is so overwhelming that a little added luxury seems like a drop in the ocean.

As for 150K being rich, I guess its a matter of opinion. When I think of 'rich' I don't think of a modest suburban home, two non-luxury vehicles, enough money to put a couple of kids through a state college. Which is what 150K buys in most of the country. Rich is richer than that. Most of all if I need to work until I'm 65 just to own that modest home that's definitely not rich. Rich people don't need to put put up with a full working lifetime of bosses, nurses, and patients just to live. Not saying that a lot of them don't work full careers anyway, but rich has the option to retire early, at least by my definition. You can make twice the average household income and not be rich.
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How many friends do you have that started a college fund for their children at age 20? Or 25? It'd say maybe 10%, and I think that is being generous, so to compare med students to the rest of the population who has supposedly been building up a nest egg since they were 20 is a little absurd IMO.

I'm not suggesting 150k is rich or "filthy rich" or anything like that, but rather that only 12% of people/families In the USA have incomes higher than 150k...
 
MaxillofacialMN said:
How many friends do you have that started a college fund for their children at age 20? Or 25? It'd say maybe 10%, and I think that is being generous, so to compare med students to the rest of the population who has supposedly been building up a nest egg since they were 20 is a little absurd IMO.
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Most of my friends who are engineers, earning around 60K out of college, started building equity in a home and contributing to their IRA right out of college. When you get a real salary you start saving and building equity. If you look at the effects of compound interest it really doesn't take much in the way of savings, at an early age, to make a big difference in your savings at retirement. If you're making money in college you should be saving too, if only by contributing a grand a year to your IRA. You are right that the first few years after people get a salary it seems like a lot of people do tend to buy 'stuff', like cars, electronics, and furniture before they really start building equity and savings, but that lag in between salary and savings seems to be common with physicians as well, so that's not really an advantage.

I'm not suggesting 150k is rich or "filthy rich" or anything like that, but rather that only 12% of people/families In the USA have incomes higher than 150k..
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Again, it's not the percentage that have a higher total salary, its the percentage that have a higher lifetime earnings after both taxes and debt payments.

Also, personally, I think you should be compared to people in the same region with the same number of dependants rather than the nation as a whole. The way our system of medical care is set up physicians tend to cluster around tertiary care centers in urban areas. The low cost of living in rural flyover country drags down the average for national earnings, and makes 150K look like more than it really is. Someone earning 150K with no dependents in rural Mississippi IS rich. You can buy a mansion and retire early. For that matter someone earning 35K out there is middle class, you can own your home and build equity and savings towards retirement. On the other hand someone who has two kids in the suburb of a major city (most medical subspecialists) is very definitely middle class, barely buying a modest home, and 35K would barely cover the cost of housing a family, much less feeding them and saving anything.

NickNaylor said:
I agree that saying a $150k salary is "middle class" is disingenuous, but depending on your situation that high income may very well produce a middle class lifestyle due to the costs required to earn that $150k. Remove ~25-30% of your income for taxes, another 10-15% for savings, and another significant portion for loan repayments (maybe 5-10%), and you're left with a pretty solid middle class income. This definitely screams of "first world problems," but I think Perrot makes a good point about physician finances that many pre-meds either choose to ignore or are ignorant about.
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I was never arguing that 150K/year is anything to whine about, just that its low enough that the cost of your education is going to affect how you live and what you can provide for your children and your community. Its low enough that you want to attend the cheapest school that you can.
 
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Perrotfish said:
I was never arguing that 150K/year is anything to whine about, just that its low enough that the cost of your education is going to affect how you live and what you can provide for your children and your community. Its low enough that you want to attend the cheapest school that you can.
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I know, I'm totally with you - I just made the note that externally this looks like a ridiculous argument ("oh no, I'm taking home $75k instead of $150k!") to those that don't understand exactly what you're talking about (i.e., many on this board).
 
NickNaylor said:
I agree that saying a $150k salary is "middle class" is disingenuous, but depending on your situation that high income may very well produce a middle class lifestyle due to the costs required to earn that $150k. Remove ~25-30% of your income for taxes, another 10-15% for savings, and another significant portion for loan repayments (maybe 5-10%), and you're left with a pretty solid middle class income. This definitely screams of "first world problems," but I think Perrot makes a good point about physician finances that many pre-meds either choose to ignore or are ignorant about.
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Why do people on SDN always want to compare a physicians salary after taxes and savings to other salaries that are before taxes and savings taken out?
The truly middle class making 30-60,000 a year is having taxes taken out too and need to save for their retirement IF they can even manage to.

a $150,000 salary doing IBR payments will end up with about $75,000 POST Tax and POST loan payments. This is NOT the same as only making $60,000 gross.
 
galaxyx said:
Why do people on SDN always want to compare a physicians salary after taxes and savings to other salaries that are before taxes and savings taken out?
The truly middle class making 30-60,000 a year is having taxes taken out too and need to save for their retirement IF they can even manage to.

a $150,000 salary doing IBR payments will end up with about $75,000 POST Tax and POST loan payments. This is NOT the same as only making $60,000 gross.
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I agree.
 
galaxyx said:
Why do people on SDN always want to compare a physicians salary after taxes and savings to other salaries that are before taxes and savings taken out?
The truly middle class making 30-60,000 a year is having taxes taken out too and need to save for their retirement IF they can even manage to.
.
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Because our tax system is very, very progressive. A person making 30K/year has almost no taxes taken from their income. Actually someone that makes 30K likely qualifies for government subsidized housing, food, and medical care, so they have a five figure net income from the government. On the other hand a big chunk of that 150K goes to the tax man. People forget that as your income rises each dollar you earn contributes less and less to what you pay, while you assume a greater and greater responsibility for your expenses..
 
You're kidding right? Do you believe that teachers live in subsidized housing, get food stamps, and are qualified for medicaid? In 43 states the starting salary for a teacher is at or below $35000. (I chose $35,000 because that's close to the delination between the 15% and 25% tax rates in this country.)

You should probably turn off the Fox News Channel.
 
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