Accepted to Medical School, and having second thoughts.

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I wouldn't worry too much about the money. If you enter a non primary care field (likely as a MD student) your gonna be making north of 400K when its all said and done. The math gets tricky when you bring family medicine, internal medicine, and pediatrics into the picture, as they tend to make high 100's low 200Ks gross, so like low 100s after taxes.

Im going through a similar thing, but with podiatry, doubting wether or not I should go. Ultimately, you have achieved what others, like myself and a majority of DO students, only have dreamed of. You have earned this. Someone on that committee thought that you would be an excellent doctor one day. Someone in admissions thought you had what it takes to literally save lives.

You have a golden ticket the likes that most people will never get. DO students have a silver ticket, and Pod students have a bronze ticket. Sometimes, we have to take what life gives us and make it the best. Take this golden opportunity and do great works.
 
What school is an American MD school but is not in the US?? That doesn't sound familiar to me... if it's truly a foreign/Caribbean school, I would take the year off and reapply since you really didn't give the application cycle your best effort (not completing secondaries, etc).

Also, get used to med schools costing a fortune. Some are reasonable, but many are around $50k per year (and that's not counting the additional loans you'll take out for cost of living). I graduated with $380k, along with many of my classmates. (Of that, about $40k was interest I accrued during school).

Bottom line- if you do not 100% want to go to medical school, DONT DO IT. At the very least take the year off and reapply next year.

EDIT: I'm aware that PR is a US territory, just haven't heard of a medical school located in PR.

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Hakuna Matata said:
What school is an American MD school but is not in the US?? That doesn't sound familiar to me... if it's truly a foreign/Caribbean school, I would take the year off and reapply since you really didn't give the application cycle your best effort (not completing secondaries, etc).

Also, get used to med schools costing a fortune. Some are reasonable, but many are around $50k per year (and that's not counting the additional loans you'll take out for cost of living). I graduated with $380k, along with many of my classmates. (Of that, about $40k was interest I accrued during school).

Bottom line- if you do not 100% want to go to medical school, DONT DO IT. At the very least take the year off and reapply next year.


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Puerto Rico is a U.S. territory, Puerto Rican medical schools are U.S. Medical schools and as such they are accredited by the LCME.
 
Some hesitation is natural. If not tuition (at this school), you could have any number of other concerns at another. Tuition would still be a large concern at most schools, or spending 4 years in the middle of nowhere (or 4 years in a city of you love the country), or thousands of miles away from family, or the workload, etc.

On a different note, now that you're accepted, common wisdom on SDN is that you can't really reapply without a huge hit to your application. If you withdraw your acceptance, you'll have to be ok with two things: retaking the mcat (assuming you want domestic MD), and the possibility that you don't get in again. (so years of your efforts would be for naught.)

This is not to say that you need to go to medical school, but if you do want to, you should think of this as your chance. You simply can't go back in time and redo this.
 
GypsyHummus said:
I wouldn't worry too much about the money. If you enter a non primary care field (likely as a MD student) your gonna be making north of 400K when its all said and done. The math gets tricky when you bring family medicine, internal medicine, and pediatrics into the picture, as they tend to make high 100's low 200Ks gross, so like low 100s after taxes.

............

You have a golden ticket the likes that most people will never get. DO students have a silver ticket, and Pod students have a bronze ticket. Sometimes, we have to take what life gives us and make it the best. Take this golden opportunity and do great works.
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:eyebrow:
You're saying a lot of things here that have no basis in reality.

For example, internist hospitalists can routinely make 300k (depending on LOCATION)

And overall your post sugar coats the OP's bleak financial outlook. It's not a small venture. Try reading white coat investor's blog for a while and plan what your best and worse case scenarios might be. At least enter into medicine (and your debt) with both eyes open.
 
Don't not do it because of the schools tuition hike. There are a million BS money grabs that will happen throughout training and as a physician. It's reality but this one is a drop in the bucket compared to your career choice and happiness.

Just be honest with yourself, why did u apply? How do you feel in hospitals and clinics? What would be another option? Are your stats good enough to get into an American program if u apply again?

Also this isint the 70s anymore regarding medicine being basically the top career. I think medicine is a good career but there a lot of good careers. A hard working and business savvy programmer could rival a physicians lifetime income and (rarely) in some cases far exceed it. What are you good at and what can you excel at and gain satisfaction from long term?

It's a tough call to make on a forum.
 
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As others before me have said, the money will work itself out: there are a ton of repayment plan options, and medical students rarely default on student loans (they have some of the lowest default rates, around 1%, meaning that most doctors find a way to repay their debt). My most recent loan statement honestly gave me palpitations, but honestly almost everyone is in the same boat so it's not like you're the only one going through this.

It is generally accepted that you have the highest chances of being accepted the first time around: I'm sorry that things came up during the application season and that you couldn't apply to as many as you may have wanted (my grandfather died right as I received all my secondaries, which set me back by at least a month in my applications, so I definitely understand). Getting in once, as others have said, does not mean you will get in again.

Personally, I would try it out. This may be a once-in-a-lifetime opportunity: imagine your regret if you decide that you do REALLY want to be a physician but can't get in on your second application. Does your school allow you to defer a year? Or to take a leave of absence? If you're really not happy with either the school or yourself after you've been there, then re-evaluate.
 
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Without going into another one of my rants about students going into debt, I'll share with you that I had the same doubts before starting medical school.
 
Look, I get where you're coming from, I myself cycle between periods of elation and imposter syndrome while awaiting matriculation.

2 things though:

1. Things are always worse in your head. The anxiety of the unknown to me is 3.0x10^8 worse than anything that actually occurs.

2. What you've just been accepted to is one of the most exclusive investment opportunities of your life and better yet, it's something that will not only benefit you financially (in the long run) but benefit those that you help.

At the end of the day, you'll be in debt. Welcome to the modern age. Nothing in life is guaranteed but someone else was willing to gamble on you, so are you willing to gamble on yourself?


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You will be a USMD, you will earn money by starting now rather than trying to apply again. Also, all USMD schools will see that you turned down an acceptance.

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A gap year at this point runs the risk that you won't be grandfathered into the public service loan forgiveness program. Are you feeling lucky to take a gamble here???
 
Also, just as others have said, the tuition is only part of the cost. Nobody talks about this on here, but I'd wager that most medical schools (certainly mine) nickle and dime you for the entirety of your time as a student there. What's sad is that a lot of my classmates aren't even aware of it, they pay their semester-ly fees without even looking at the breakdown. Your school could charge you another 3k next year and there is very little you can do, and they barely even have to justify it.

Don't forget the 3% increase in tuition almost yearly that schools try to get away with by saying "but inflation".

If your starting tuition is 50k, you can rest assured that's the best deal you'll get all 4 years. I wouldn't be surprised if it was 60k by your 4th year. I think you get where I'm going with this...
 
I have a 3.87 gpa in Bio and 4.0 for minor in psych, did research, and lots of extra curricular and shadowing, some mission trips to, good letters, but my mcat was 503. Again, i did not finish my secondaries for my state schools so i really have no idea if i would have been invited for an interview. it is what it is.
 
I had most of the same thoughts you have, and seriously considered turning it down. Im looking at almost 400k in debt. It helped to make mock budgets to see what paying that off looked like if I made 200k, 250, 300 etc. After first year I'm really glad I stuck with it.
 
I struggled with the same conflict with respect to the financial realities.

Ultimately, this is where I arrived at: based on the current financial prospects of MDs, paying back the debt will be relatively easy unless you're a glutton for punishment and want to work as a pediatrician in NYC.

If doctors end up taking a massive paycut between now and the time I'm an attending, I will consider the social contract between me and the larger society to be voided and won't worry about paying it back. There is only a certain percentage of your wages they can go after, and once you cross the threshold into trying to pay off mid-six figs of debt on a $100-200k salary it becomes better to simply surrender the 10% of your discretionary annual income in perpetuity than live like a pauper for 10 to 15 of your remaining best years as you plow 60% of your crappy salary into debt repayment.
 
NotYou20 said:
I had most of the same thoughts you have, and seriously considered turning it down. Im looking at almost 400k in debt. It helped to make mock budgets to see what paying that off looked like if I made 200k, 250, 300 etc. After first year I'm really glad I stuck with it.
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what was the turning point for you, that made you decide that you would attend ?
 
First off, congrats on that accept!

All new endeavors are fraught with anxiety. Just go! There have been plenty of thread in these fora about debt and how to deal with it. You're not going to be a pauper for the rest of your life.


laflame said:
Maybe its just because its summer and i know that once i matriculate things will get serious, or maybe i just need a place to talk things through, but lately i feel i have been in a tough position where i know many would be grateful.

Anyways, I recently got accepted to medical school a few months ago and lately i have been having second thoughts. The medical school is located in Puerto Rico, but it is an American allopathic school (not IMG). Due to not finishing most of my secondaries ( a lot happened during the application cycle), i was not eligible for interviews for my in state schools. Thus, i am holding my one and only acceptance. Upon acceptance i was definitely relieved to have a place to continue studying and follow my career path.

However, a couple months after i found out that tuition went up for the school by a lot, and it was this increase that began this downward spiral of doubt and rethinking. The increase in tuition brought serious concern as i began to contemplate my life after medical school, and even post residency. With tuition clocking in at 230,000 for all 4 years of medical school, I was absolutely terrified. This outrageous number did not even include cost of living such as food, transportation, books, supplies, etc. It was only tuition. This def made me second guess my decision to be a physician, especially since that debt will look to be something more like 270-300 K in debt after all 4 years depending on how much help i received from my parents, and the living expenses i acquire from living in PR. During residency the number could further increase as interest continues to accrue. I then began to think about how i would even manage paying off this debt in a reasonable amount of time, while maintaining a family, saving for retirement, a house, etc. Its as if the reality of medical school really sunk in, and now i just have this constant fear that i will be miserable during medical school, will have no time for myself and others, and that it will continue on after medical school because of the amount of debt I would be caring. I fear that I could lose myself in medical school, due to how much sacrifice, time, and energy it takes.

Its weird because before the tuition raise i was set on going, but it was that raise in number that forced me to really think about this decision and not dive in as some naive young adult. I was not thinking about my life post residency, or how to manage debt or anything. I just assumed everything would work itself out, but seriously the tuition for this school is absurd.

I am only 21 so i was headed towards the path of taking a gap year to re-think if i really want to be a physician, and re-applying if i decide i still want to. However, many say this is not smart as re-applying is no guarantee that you will get in again, especially since schools can see that i have been accepted to a school before. Physicians have advised me to go if i really want a career in medicine, but a rushed decision to attend could also cause regret. Ive heard many cases where students wished they had taken a gap year, just because they have all their life to attend medical school and be a doctor.

Any thoughts?
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laflame said:
what was the turning point for you, that made you decide that you would attend ?
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A few things. When looking at paying off debt, even if I only make 200k, I'll likely be able to pay off the debt in 5 years while still taking home more than my dad made when I was a kid. It's not great, but I'm not very materialistic so making my peace with it is preferable to bailing on a career I was (and still am) confident that I'll like. Unless your biggest motivator, by far, is $$ AND you actually can get into a different high paying career, debt shouldn't be a deciding factor imo.

Second, I reviewed why I wanted to go to med school in the first place. None of my reasons had actually changed. I spent some time reading books by docs, When Breath Becomes Air, Internal medicine, Intern, and Cutting for Stone, as well as some Atul Gawande, and again found that what they all enjoyed was what I think I'll enjoy and why I applied. I read some great threads on here where my feelings were further corroborated. By the time school started I was confident I just had a case of cold feet.

To a lesser extent but worth mentioning, if I didn't go into medicine my plan would've been travelling somewhat aimlessly for a few years. I backpacked for 4 months before school started. It was fun, but it was pretty clear the full time vagabond life wasn't for me.
 
I have some of the same anxieties, even after 8+ gap years. It's a big decision, and yes, you could feel regret. If you decide to back out though, you will need to be ok with not getting in at a future date if you choose to reapply.

From everything I have heard, the money will work itself out.

Can you ask for a deferral of one year?
 
laflame said:
Maybe its just because its summer and i know that once i matriculate things will get serious, or maybe i just need a place to talk things through, but lately i feel i have been in a tough position where i know many would be grateful.

Anyways, I recently got accepted to medical school a few months ago and lately i have been having second thoughts. The medical school is located in Puerto Rico, but it is an American allopathic school (not IMG). Due to not finishing most of my secondaries ( a lot happened during the application cycle), i was not eligible for interviews for my in state schools. Thus, i am holding my one and only acceptance. Upon acceptance i was definitely relieved to have a place to continue studying and follow my career path.

However, a couple months after i found out that tuition went up for the school by a lot, and it was this increase that began this downward spiral of doubt and rethinking. The increase in tuition brought serious concern as i began to contemplate my life after medical school, and even post residency. With tuition clocking in at 230,000 for all 4 years of medical school, I was absolutely terrified. This outrageous number did not even include cost of living such as food, transportation, books, supplies, etc. It was only tuition. This def made me second guess my decision to be a physician, especially since that debt will look to be something more like 270-300 K in debt after all 4 years depending on how much help i received from my parents, and the living expenses i acquire from living in PR. During residency the number could further increase as interest continues to accrue. I then began to think about how i would even manage paying off this debt in a reasonable amount of time, while maintaining a family, saving for retirement, a house, etc. Its as if the reality of medical school really sunk in, and now i just have this constant fear that i will be miserable during medical school, will have no time for myself and others, and that it will continue on after medical school because of the amount of debt I would be caring. I fear that I could lose myself in medical school, due to how much sacrifice, time, and energy it takes.

Its weird because before the tuition raise i was set on going, but it was that raise in number that forced me to really think about this decision and not dive in as some naive young adult. I was not thinking about my life post residency, or how to manage debt or anything. I just assumed everything would work itself out, but seriously the tuition for this school is absurd.

I am only 21 so i was headed towards the path of taking a gap year to re-think if i really want to be a physician, and re-applying if i decide i still want to. However, many say this is not smart as re-applying is no guarantee that you will get in again, especially since schools can see that i have been accepted to a school before. Physicians have advised me to go if i really want a career in medicine, but a rushed decision to attend could also cause regret. Ive heard many cases where students wished they had taken a gap year, just because they have all their life to attend medical school and be a doctor.

Any thoughts?
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1.) This dates way back to pre-Allo so I feel @LizzyM @Goro and @gyngyn are the ones to answer this for you but last time I had this question, I came away with the assumption that declining a US MD acceptance is a red-flag and that many people drop out post-interview day at their safeties they no longer want to attend to avoid this specific scenario.

2.) Went to PR for a week's vacation. PR is a decent area to live at a reasonable cost. It's not NYC/SF/etc. for living costs nor is it Caribbean quality of life which I've heard is abysmal. A walk down the street was just like one in my home neighborhood.

3.) When you say "due to not finishing your secondaries" for IS schools and then go on to talk about an "outrageous" tuition it just rubs me the wrong way. If tuition was a big enough issue to reject an acceptance it should have been a big enough issue to figure out a way to turn in more secondaries. More importantly, your rationale probably won't get any respect from AdComms looking at your application.

So what do you do? I'd say go to medical school now. You've been accepted to a credible US MD school (some people forget PR is US territory) and you actually for their profile given your stats. Estimating conservatively, you may 200K as an attending for an extra year vs. 25K*4 and lets conservatively estimate interest causes the difference to double. All in all, both paths break even. BUT, this assumes you get in the following year. The Plan B that I endorse is taking the gap year but then applying next year with lots of DO schools. To the best of my knowledge the admissions processes still don't share information (@Goro ) so you'd be safe with DO schools even if all MD schools don't bite.
 
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Backtothebasics8 said:
1.) This dates way back to Allo so I feel @LizzyM @Goro and @gyngyn are the ones to answer this for you but last time I had this question, I came away with the assumption that declining a US MD acceptance is a red-flag and that many people drop out post-interview day at their safeties they no longer want to attend.

2.) Went to PR for a week's vacation. PR is a decent area to live at a reasonable cost. It's not NYC/SF/etc. for living costs nor is it Caribbean quality of life which I've heard is abysmal. A walk down the street was just like one in my home neighborhood.

3.) Don't take this as an attack. When you say "due to not finishing your secondaries" and then go on to talk about an "outrageous" tuition it just demonstrates bad judgment. In my opinion, if tuition was a big enough issue to reject an acceptance it should have been a big enough issue to figure out a way to turn in more secondaries. More importantly, your rationale probably won't get any respect from AdComms looking at your application.

So what do you do? I'd say go to medical school now. You've been accepted to a credible US MD school (some people forget PR is US territory). Estimating conservatively, you may 200K as an attending for an extra year vs. 25K*4 and lets conservatively estimate interest causes the difference to double. All in all, both paths break even. BUT, this assumes you get in the following year. The Plan B that I endorse is taking the gap year but then applying next year with lots of DO schools. To the best of my knowledge the admissions processes still don't share information (@Goro ) so you'd be safe with DO schools even if all MD schools don't bite.
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I believe AACOMAS is starting to ask if you've been accepted to another school.
 
GypsyHummus said:
I wouldn't worry too much about the money. If you enter a non primary care field (likely as a MD student) your gonna be making north of 400K when its all said and done. The math gets tricky when you bring family medicine, internal medicine, and pediatrics into the picture, as they tend to make high 100's low 200Ks gross, so like low 100s after taxes.

Im going through a similar thing, but with podiatry, doubting wether or not I should go. Ultimately, you have achieved what others, like myself and a majority of DO students, only have dreamed of. You have earned this. Someone on that committee thought that you would be an excellent doctor one day. Someone in admissions thought you had what it takes to literally save lives.

You have a golden ticket the likes that most people will never get. DO students have a silver ticket, and Pod students have a bronze ticket. Sometimes, we have to take what life gives us and make it the best. Take this golden opportunity and do great works.
Click to expand...

The only fields where I'd say 400K is a reasonable bet is Surgical Subspecialties like Orthopedics, Urology, ENT, Plastics, Rad Onc, and possibly Derm as well. Others include fields that at PGY6+, in rural areas, or not the typical situation. IM/Family/Peds are definitely not the only ones.
 
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Cardio, Gas (although not sure with all the CRNAs running around anymore), ophthalmology, and others make 400K+

Backtothebasics8 said:
The only fields where I'd say 400K is a reasonable bet is Surgical Subspecialties like Orthopedics, Urology, ENT, Plastics, Rad Onc, and possibly Derm as well. Others include fields that at PGY6+, in rural areas, or not the typical situation. IM/Family/Peds are definitely not the only ones.
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I know it might sound unrealistic but I truly believe that medicine is not something you decide based on the financial rewards.

Whatever field you go into, you will have the means to repay whatever loans.

You will still live a comfortable life.

However, do you truly enjoy medicine? Otherwise, it will be misery. And your talents can be taken elsewhere where you can invest your time and actually make real bank.
 
I don't know too much about medical school, but i'd be willing to bet that even if you wait another year, you wouldn't be saving that much more. The question is, are you willing to give up a year and potential rejection next year for that chance? In the end, only you can decide if it's worth it.

p.s.
Many of my dental school friends are going to be 350k+ debt when they graduate. They think it's worth it, not because it's good money (because it really isn't if you factor in the debt), but because they'll be spending the rest of their life doing what they love, and helping people the way they think is right. Personally, i'd jump at a chance to go to dental school at 250k. Considering that I'm expecting to my tuition at LEAST around 300k+ (if I maltriculate), your cost doesn't seem that bad.
 
GypsyHummus said:
Cardio, Gas (although not sure with all the CRNAs running around anymore), ophthalmology, and others make 400K+
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Ophthalmology isn't a safe bet for 400K without a fellowship and if they're lucrative you bet they're competitive especially when you're already among a group scoring 240+ on Step 1 on average. Cards is PGY-6 and they don't usually make 400K on average unless they're interventional which takes 2 additional years if you want to do stuff besides peripheral. Anesthesiology usually goes around 350k from what I've heard. GI is also under 400K on average.

Other specialties making less than 400K are all IM subspecialties, Emergency, PM&R, Radiology, General Surgery, OB/GYN, Psychiatry and many more.

Most importantly, the assumption that OP won't one of the things that >50% of medical students do is just a plain bad assumption.
 
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Hey, so I was a similar situation as you. I was doing undergrad in the USA and was getting deeply into debt. I always knew that I wanted to get into medicine reason why doing undergrad seemed almost like a waste of time (knowing that in most other countries undergrad doesn't exist...you go straight into what you want to study).

Considering all these options I decided that I was going to study medicine and not get into insane debt. Thus I decided to move to Argentina to study medicine. Here medicine is tuition free and of high quality. The medical school is 7 years during which you complete whatever you would have done in undergrad + the med school content. In addition, you have contact with patients from the first day as a student. Honestly, it was the best decision I have ever made. I am now finishing med school and I feel ready to be a doctor. Now I am not writing this post to convince you to come to Argentina. I am writing this post in order for you to have a clear notion that the education system in the US is severely flawed and many times out of reach for anybody not upper class (unless you are willing to get into debt and have years taken in order to pay it off). Because of this severe flaw, you might want to take advantage of other paths less traveled.

However, do know that if you study in another country you won't have as much preparation for the steps and thus it will become a harder step. In addition, and very logically, the US favors its own students. All this makes the process of returning to work in the US harder, yet not impossible.

Everything has its advantages and disadvantages, just be aware that you have more options if you truly want to be a doctor that go outside the limits of USA certified schools.

As for the gap year, I think it's a brilliant idea. I wish I would have taken a gap year to really assess where and if I wanted to study and also if I was ready to go in. I only really became convinced that medicine was the right choice I made into the 3rd year of med school, having been convinced before would have spared me a lot of emotional uncertainty. There is not shame in deciding that you need to mature a little more before med school since it literally consumes everything. Again, I wish i would have taken a gap year since it would have put everything into perspective and give me time to enjoy and be a kid before the MASSIVE responsibility that is medical school.

Whatever it is that you choose, you will do great. Just weigh your options and make an educated decision.
Best of luck.
 
Dude, y'all are fine. I'm more worried about the pharm and dental students debt to income ratio. I mean, pharmacy has like 250k in debt and they barley break 100k/year after taxes.

Entadus said:
:eyebrow:
You're saying a lot of things here that have no basis in reality.

For example, internist hospitalists can routinely make 300k (depending on LOCATION)

And overall your post sugar coats the OP's bleak financial outlook. It's not a small venture. Try reading white coat investor's blog for a while and plan what your best and worse case scenarios might be. At least enter into medicine (and your debt) with both eyes open.
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Med student 18 said:
Hey, so I was a similar situation as you. I was doing undergrad in the USA and was getting deeply into debt. I always knew that I wanted to get into medicine reason why doing undergrad seemed almost like a waste of time (knowing that in most other countries undergrad doesn't exist...you go straight into what you want to study).

Considering all these options I decided that I was going to study medicine and not get into insane debt. Thus I decided to move to Argentina to study medicine. Here medicine is tuition free and of high quality. The medical school is 7 years during which you complete whatever you would have done in undergrad + the med school content. In addition, you have contact with patients from the first day as a student. Honestly, it was the best decision I have ever made. I am now finishing med school and I feel ready to be a doctor. Now I am not writing this post to convince you to come to Argentina. I am writing this post in order for you to have a clear notion that the education system in the US is severely flawed and many times out of reach for anybody not upper class (unless you are willing to get into debt and have years taken in order to pay it off). Because of this severe flaw, you might want to take advantage of other paths less traveled.

However, do know that if you study in another country you won't have as much preparation for the steps and thus it will become a harder step. In addition, and very logically, the US favors its own students. All this makes the process of returning to work in the US harder, yet not impossible.

Everything has its advantages and disadvantages, just be aware that you have more options if you truly want to be a doctor that go outside the limits of USA certified schools.

As for the gap year, I think it's a brilliant idea. I wish I would have taken a gap year to really assess where and if I wanted to study and also if I was ready to go in. I only really became convinced that medicine was the right choice I made into the 3rd year of med school, having been convinced before would have spared me a lot of emotional uncertainty. There is not shame in deciding that you need to mature a little more before med school since it literally consumes everything. Again, I wish i would have taken a gap year since it would have put everything into perspective and give me time to enjoy and be a kid before the MASSIVE responsibility that is medical school.

Whatever it is that you choose, you will do great. Just weigh your options and make an educated decision.
Best of luck.
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We have very little information regarding the success of US IMG's who attended South American medical schools. There were an insufficient number to be included in the only NRMP publication on the topic. If OP hopes to work in the US, attending a US medical school (including a Puerto Rican school) confers a considerable advantage.

We do have some information regarding non-US IMG's: 43 applicants from Columbia matched into a preferred specialty, 37 did not; 35 from Peru matched, 29 did not; 50 from Venezuela matched, 32 did not.
 
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