Am I an idiot for turning down a full ride to Columbia?

[hs764]

As of April 30 I have been committed to the University of Virginia, who gave me $30,000 per year in scholarships and $10,000 per year in institutional loans. I really love UVA and I think I would be a great fit there. My family lives close to Charlottesville and I really have my heart set on going there.

However, last week Columbia admitted me off of their waitlist and today they just told me that they are giving me $74,000 a year, which fully covers tuition and some living expenses. Overall I would only be paying about $60,000 total to go to school there, as opposed to $200,000 at UVA.

The issue is that I hate New York. I have been living here for the past five years and actually working at Columbia, and while I got a decent enough impression of the school on interview day, I don't like the hospital facilities and I hate the city itself. I have friends here but I've never really felt at home and I have been eagerly anticipating the opportunity to move away. That being said, Columbia is an incredibly well-renowned school with tons of resources and I'm sure I would get a wonderful education here. The hospital is in a very diverse neighborhood and I'm sure I would get to see tons of unique cases, and I would definitely have plenty of opportunity to use my medical Spanish. I just don't know if saving the extra money is worth it at a place where I don't think I'll be happy. UVA just felt right, and I can't say the same thing about Columbia.

Oh, and I have to make this decision by tomorrow. So please, any advice or personal anecdotes about these schools would be incredibly welcome.

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[BicycleGuy]

You should ask UVA to match Columbia's offer

 

[Deleted member 750603]

Go where you will be happy. If you hate your surroundings it will have a miserable time.

Considering your income potential, 140K is not a big difference for the price of happiness. Your performance will be impacted also.

 

[asrw77]

You should've emailed UVA to see if they could match the scholarship offer. It might be worth doing that now and asking Columbia for an extension on your decision

 

[IMGASMD]

Go where you will be happy. If you hate your surroundings it will have a mistakable time.

Considering your income potential, 140K is not a big difference for the price of happiness. Your performance will be impacted also.

140 is nothing to sneeze at either. It’s half of a mortgage. I second the opinion, tell UVA what you got and hear what they have to say.

 

[hs764]

You should ask UVA to match Columbia's offer

You should've emailed UVA to see if they could match the scholarship offer. It might be worth doing that now and asking Columbia for an extension on your decision

I did just email UVA's financial aid office about that. From what I remember at interview day they don't do full scholarships, but anything else they could offer me would help.

 

[deleted870424]

Yes.

 

[Deleted member 750603]

140 is nothing to sneeze at either. It’s half of a mortgage. I second the opinion, tell UVA what you got and hear what they have to say.

I'm just saying 140 is not worth my happiness/stress/worry.

If you go to Columbia your decision will be based on finances. Decide what's more important to you, finances or your lifestyle.

 

[Stagg737]

Tough decision. Don't e-mail UVA, call them and explain the situation. Worst that happens is they say they can't offer you anything else and at least you'll know you tried.

Sometimes these threads are easy decisions for outsiders, unfortunately this doesn't sound like one of them. The plus side is you got into two excellent med schools so I don't think you should be concerned there. The real question how miserable would you really be at Columbia, how much happier would you be in VA, and how much is that actually worth to you? Keep in mind that you're likely not going to have the kind of time to spend on leisure with friends and family that you did before medical school and that there will very likely be points where you are miserable wherever you decide to go. Also, $140k may not seem like a ton now, but if you have that extra money to start investing early on it can be worth 4 times that much in 30 years. So it could end up being a $600k difference, which can significantly impact your retirement plans.

If you could see yourself being pretty happy at Columbia, I'd probably go there. Between the money, prestige/name, and available resources and opportunities it sounds like it would be too good to pass up. If you really think you'd be miserable there, go with UVA. In the end none of us can really give great advice as we don't know you or your real values, but that's what I would do.

Edit: I see you already e-mailed. In that case I wouldn't call, you don't want to come off as obnoxious.

 

[Lawpy]

If UVA doesn't match the offer, I would go to Columbia hands down. Less debt matters significantly and I think you'll be okay there since there's a lot of great things to do there and the students are highly satisfied with their experience.

 

[Gibbward]

What about NYC do you hate and what about it has made you feel not at home? If you think about it, your experience as a normal adult person with a job in NYC is going to be different from your day-to-day life as a medical student. The people you'll be interacting with is going to very different as well. Being in medical school might put you in a specific situation where you won't mind living there

 

[btuck]

Why did you stay on the waitlist at Columbia? I am not asking you this to bash you but rather you should think hard about the reason(s) you chose to stay on the waitlist. If you truely hate Columbia and love UVA, wouldn’t you have backed out of Columbia earlier?

Ask yourself that question then re evaluate

 

[hs764]

Why did you stay on the waitlist at Columbia? I am not asking you this to bash you but rather you should think hard about the reason(s) you chose to stay on the waitlist. If you truely hate Columbia and love UVA, wouldn’t you have backed out of Columbia earlier?

Ask yourself that question then re evaluate

A couple of reasons. One, I had heard from people here that Columbia was going to be giving out a lot of scholarships this year because they got a massive donation, so I was curious. Two, everyone I work with really wants me to stay here so I kind of felt like I couldn't just prematurely back out. My boss is really hell-bent on me staying here.

 

[hs764]

What about NYC do you hate and what about it has made you feel not at home? If you think about it, your experience as a normal adult person with a job in NYC is going to be different from your day-to-day life as a medical student. The people you'll be interacting with is going to very different as well. Being in medical school might put you in a specific situation where you won't mind living there

Some things definitely can be changed. I'm sick of my apartment and my neighborhood, and with this I could afford to move to a much nicer place. But a lot of things can't. I hate winters here, I really miss having a car, I miss being close to my family, I miss having lots of outdoor space and a yard and quiet. I'm just over the ****ty subway and the trash piles and the noise and the inconveniences of living in a huge, crowded city.

 

[thenucleusaccumbens]

Go where you will be happy. If you hate your surroundings it will have a miserable time.

Considering your income potential, 140K is not a big difference for the price of happiness. Your performance will be impacted also.

I'm just saying 140 is not worth my happiness/stress/worry.

If you go to Columbia your decision will be based on finances. Decide what's more important to you, finances or your lifestyle.

I agree with this. I think it's really important to go where you will be happy. If you're miserable, you probably won't do as well, maybe more likely to experience stress/burnout (already high in med school) and all that could impact your performance

 

[curbsideconsult]

140 is nothing to sneeze at either. It’s half of a mortgage.

^^ Not in the city. Unless you want to live in a 20 x 10 glorified closet/bathroom.

OP, this is a great dilemma to have. If you want the scholarship but hate the city, keep in mind that though med school is very busy there are still large chunks of time where you don't have to be there and you can go back home. I don't know what Columbia's curriculum is like, but you might also be able to do a large portion of 4th year back home by doing all your electives there. At the very least, you can do month long audition rotations back home.

I don't think you can go wrong with either decision here. $140k is a lot of money, but, as other posters have pointed out, is it worth your happiness? What does your family say regarding this situation?

Edit: to answer your question, no, I don't think you'd be an idiot for turning down a full ride to Columbia. You have very valid reasons for wanting to go to UVA and UVA is a great school too.

 

[hs764]

If there are any Columbia med students floating around here, I would love to hear your opinion. I am genuinely worried that the quality of life I will have as a student in NYC would be lower than at UVA, but I don't know that for a fact. If med school at Columbia is amazing and wonderful and you're happy all the time, I would love to know.

 

[Kingsmen2018]

Yea

 

[Deleted member 750603]

If med school at Columbia is amazing and wonderful and you're happy all the time, I would love to know.

I haven't talk to any but I promise you those people exist and they are quite happy because they like Columbia.

I also haven't talked to the ones that don't like Columbia but I can reassure you they also exist.

You're falling into a trap with your logic.

 

[YANKSBOI]

Decision sounds pretty straightforward to me.... Go to UVA because thats where your heart is set

 

[Stagg737]

A couple of reasons. One, I had heard from people here that Columbia was going to be giving out a lot of scholarships this year because they got a massive donation, so I was curious. Two, everyone I work with really wants me to stay here so I kind of felt like I couldn't just prematurely back out. My boss is really hell-bent on me staying here.

How does the bolded have anything to do with your decision? Is this a research position that you would try and continue during medical school? Would you expect to get publications? If not then this should not factor into your decision as you likely won't have time to continue working during med school and it will just cause you more stress than you need in addition to the stress of being in NYC.

It sounds like the only 2 pluses about Columbia that you've stated are the finances and opportunities of the school. Both are excellent reasons to choose a school, but as someone else pointed out you have to gauge if those reasons are worth potentially feeling miserable (as it sounds like you hate large cities as much and for the same reasons I do) with the location. Any other news from UVA on the finances yet?

 

[hs764]

How does the bolded have anything to do with your decision? Is this a research position that you would try and continue during medical school? Would you expect to get publications? If not then this should not factor into your decision as you likely won't have time to continue working during med school and it will just cause you more stress than you need in addition to the stress of being in NYC.

It sounds like the only 2 pluses about Columbia that you've stated are the finances and opportunities of the school. Both are excellent reasons to choose a school, but as someone else pointed out you have to gauge if those reasons are worth potentially feeling miserable (as it sounds like you hate large cities as much and for the same reasons I do) with the location. Any other news from UVA on the finances yet?

Nope, nothing from UVA as of yet.

It is a research position, I'm not sure whether or not I would try to continue partnering with our department during medical school, but it is a position in neurology, which is my area of interest. And I have co-authored a couple of publications here so if I was looking for research opportunities, it wouldn't hurt to already have people I could go to.

 

[WedgeDawg]

I'm a Columbia 4th year medical student who was choosing between UVA and Columbia and decided on Columbia.

I've lived in Charlottesville before and am a huge fan of Cville/VA in general. I am not a city person and didn't really have a favorable opinion of NYC going into the application process. I thought I would be the type of person who would thrive in a big city. I saw myself going to school in a smaller city (think similar to New Haven, Philly, Durham, Baltimore, St. Louis - the 200k-1.5M range, not the 8.5M city that is NYC). Ultimately, I found myself deciding between UVA and Columbia and despite not being the biggest fan of NYC, I decided on Columbia for some of the reasons that you mentioned in your OP. Now, in my 4th year, I have no cause to regret my decision.

Now, you've lived in the city for several years and you even have worked at Columbia, so you're more familiar with both the city and the school than I was when I started, and thus you have a more well-formed opinion on those things than I did.

I think some of it depends on what's important to you and what your goals are. Columbia's resources, connections, and name will take you far and give you a leg up in many things, even over an also amazing school like UVA. If you want to go into academics, a surgical subspecialty, research, or anything like that, I think Columbia will help further your career over UVA. If you want to go into private practice, primary care, or don't want to make teaching/research a big part of your career and being close to your family / in a city that you like is more important, than UVA might be a better fit.

I think that in your situation, you should call the financial aid office (they're closed now, so tomorrow morning) at UVA and see if they'll match Columbia's offer.

If you want to talk more, feel free to PM me, and I can give you further details that I probably wouldn't give on the open forum here.

Overall, you can't really go /wrong/, but it's an important decision and one that you should make carefully and with sufficient thought.

 

[fdgjfg]

How much of your dislike of NYC is due to general vs. specific qualities? Do you think your negative perception is because maybe you have a long commute, have some roommates you don't care for, live in a noisy/dirty/ugly area? Or do you think you'd still hate the city even if you were in the most ideal situation possible?

I ask because I've always had a tendency to underestimate the effects of my micro-environment, and instead attribute my feelings to the city/neighborhood. At one point I hated my area/city when I was in an old building with people I didn't like, not much nature/nice landscaping, ugly architecture, etc. and then I moved no more than a couple of blocks away to a much more ideal situation and my feelings about the area completely changed. So much of perceived quality of life seems to be based on small things you don't really think about. Knowing that most of my friends who moved to NYC ended up choosing to live with like 10 people in a dumpster in Queens to save money, I can definitely imagine you being in a not-so-ideal situation as a research assistant or staff-scientist or something at Columbia.

I would try to probe your experiences and see if your negative perception of NYC is due to problems that could be reparable. That scholarship gives you a ton of wiggle room to set yourself up in a more ideal living setting, while hardly leaving a dent in the financial gain from saving 140k. You could be living it up in a super-boujee loft and shelling out the cash to have meals prepped and delivered to your door, and still save money to go to a school that will probably serve you better in the match. However, if your feelings are strong and you know you can't "fix" them, UVA is still a very solid choice and a justified decision.

 

[hs764]

How much of your dislike of NYC is due to general vs. specific qualities? Do you think your negative perception is because maybe you have a long commute, have some roommates you don't care for, live in a noisy/dirty/ugly area? Or do you think you'd still hate the city even if you were in the most ideal situation possible?

I ask because I've always had a tendency to underestimate the effects of my micro-environment, and instead attribute my feelings to the city/neighborhood. At one point I hated my area/city when I was in an old building with people I didn't like, not much nature/nice landscaping, ugly architecture, etc. and then I moved no more than a couple of blocks away to a much more ideal situation and my feelings about the area completely changed. So much of perceived quality of life seems to be based on small things you don't really think about. Knowing that most of my friends who moved to NYC ended up choosing to live with like 10 people in a dumpster in Queens to save money, I can definitely imagine you being in a not-so-ideal situation as a research assistant or staff-scientist or something at Columbia.

I would try to probe your experiences and see if your negative perception of NYC is due to problems that could be reparable. That scholarship gives you a ton of wiggle room to set yourself up in a more ideal living setting, while hardly leaving a dent in the financial gain from saving 140k. You could be living it up in a super-boujee loft and shelling out the cash to have meals prepped and delivered to your door, and still save money to go to a school that will probably serve you better in the match.

Some of it is, some of it isn't. I truly hate the winters and the subway. Those things won't get any better no matter where I live. I'm a ten minute walk from my workplace right now, so there's no real issue of commute. However, I have both lived and worked in Washington Heights (where Columbia's medical campus is) for five years, so I am pretty sick of my surroundings. My apartment is nice, but the neighborhood isn't, and I do have roommates who I like, but still would prefer to live without. If I was able to move to an amazing one-bedroom somewhere near Central Park or something, that might help. But a lot of the things I don't like - distance from family, weather, general crowdedness, feeling trapped here without a car - that's not going to change unless I leave NYC altogether.

 

[hs764]

How does the bolded have anything to do with your decision? Is this a research position that you would try and continue during medical school? Would you expect to get publications? If not then this should not factor into your decision as you likely won't have time to continue working during med school and it will just cause you more stress than you need in addition to the stress of being in NYC.

It sounds like the only 2 pluses about Columbia that you've stated are the finances and opportunities of the school. Both are excellent reasons to choose a school, but as someone else pointed out you have to gauge if those reasons are worth potentially feeling miserable (as it sounds like you hate large cities as much and for the same reasons I do) with the location. Any other news from UVA on the finances yet?

Finally heard from UVA, they've already maxed out their aid for the year. So nothing has changed.

 

[LebronManning]

The answer to your question is yes, unfortunately. It is quite immature to not understand the importance of $140k, especially when you save that money by going to the better school.....

If you still have the ability to change it, I would.

 

[Deleted member 750603]

The answer to your question is yes, unfortunately. It is quite immature to not understand the importance of $140k, especially when you save that money by going to the better school.....

If you still have the ability to change it, I would.

Or short sighted to not understand the importance of being in a place that motivates rather than demotivates you to study for USMLE. Arguably the single most important factor that will determine your residency placement.

 

[hs764]

The answer to your question is yes, unfortunately. It is quite immature to not understand the importance of $140k, especially when you save that money by going to the better school.....

If you still have the ability to change it, I would.

I have until Monday to make the final decision, so I'm going to take the weekend to think about it. I certainly understand the importance of $140K, if I didn't I wouldn't be asking this question and would just be going to UVA regardless. Columbia is higher ranked but that doesn't necessarily mean that it is the better school for me. I feel that it isn't, and I don't know if giving up a school that I feel is a great fit is worth $140,000 in the long run. I want to have a good quality of life in addition to a good education. It's a tough call.

 

[hs764]

Or short sighted to not understand the importance of being in a place that motivates rather than demotivates you to study for USMLE. Arguably the single most important factor that will determine your residency placement.

That's a big part of my concern. I did a premed postbac program at Columbia and was pretty miserable. I was also working full-time so part of that was just being super swamped and not really having any free time to do fun things, but part of it was also just not being happy in my surroundings. So I don't know how much of that will carry over to med school. I'm worried about being tired and depressed for another four years.

 

[LebronManning]

I have until Monday to make the final decision, so I'm going to take the weekend to think about it. I certainly understand the importance of $140K, if I didn't I wouldn't be asking this question and would just be going to UVA regardless. Columbia is higher ranked but that doesn't necessarily mean that it is the better school for me. I feel that it isn't, and I don't know if giving up a school that I feel is a great fit is worth $140,000 in the long run. I want to have a good quality of life in addition to a good education. It's a tough call.

I agree with you in regards to the better fit. At the end of the day, UVA certainly won't close any doors in terms of residency matching. But in terms of quality of life, that 140K will matter a lot. Especially when it is compounding interest and maybe you decide you wanna be a surgeon or cardiologist and have to train for 7+ years.

P.S. Why the hate toward NYC???

 

[hs764]

I agree with you in regards to the better fit. At the end of the day, UVA certainly won't close any doors in terms of residency matching. But in terms of quality of life, that 140K will matter a lot. Especially when it is compounding interest and maybe you decide you wanna be a surgeon or cardiologist and have to train for 7+ years.

P.S. Why the hate toward NYC???

I'm just not a big city person. I'm from a pretty rural area of southern Virginia and I miss having greenery and mountains and lots of space. I don't mind smaller cities but NYC is just too much. It makes me feel claustrophobic. And I loathe the winters and the subway with every fiber of my being.

 

[Avada Cadaver]

Man you do you. How much is 140k worth to you? I feel like it's easy to say obviously go to Columbia because of the opportunities and affordability. However, if you go there and you're miserable you could very well underperform and not even be able to match into your desired field, rendering all the perceived opportunities moot. If however, there's any part of you that can endure for four more years and know what you want to do then go for it.

Also, idk if it's because I haven't gone through the gauntlet of medical school or anything yet, but UVA is ranked 26 and Columbia 11 (5th last year I think), is there that much of a difference in opportunities between the two? I just googled UVA's match and it seems pretty great to my untrained eyes (The Student Source).

P.S- As someone who turned down a dream school to attend a school in NYC (a city I've only visited for interviews), y'all are scaring me senseless.

 

[LebronManning]

As someone who turned down a dream school to attend a school in NYC (a city I've only visited for interviews), y'all are scaring me senseless.

If you like big cities, you will FALL IN LOVE with NYC
If you dislike big cities and like the small town feel like OP, you will HATE NYC.
There's no middle ground with NYC haha

 

[hs764]

Man you do you. How much is 140k worth to you? I feel like it's easy to say obviously go to Columbia because of the opportunities and affordability. However, if you go there and you're miserable you could very well underperform and not even be able to match into your desired field, rendering all the perceived opportunities moot. If however, there's any part of you that can endure for four more years and know what you want to do then go for it.

Also, idk if it's because I haven't gone through the gauntlet of medical school or anything yet, but UVA is ranked 26 and Columbia 11 (5th last year I think), is there that much of a difference in opportunities between the two? I just googled UVA's match and it seems pretty great to my untrained eyes (The Student Source).

P.S- As someone who turned down a dream school to attend a school in NYC (a city I've only visited for interviews), y'all are scaring me senseless.

It can be a lot of fun! I think if I was younger and less set in my ways I would enjoy it a lot more. Most people I know here love it.

UVA does have a great match list and for a small city/town, they're pretty diverse, which is important to me. But I'm interested in neuro, and Columbia is a huge neuro/psychiatry powerhouse. I don't know if turning them down would close any doors for me.

 

[LebronManning]

It can be a lot of fun! I think if I was younger and less set in my ways I would enjoy it a lot more. Most people I know here love it.

UVA does have a great match list and for a small city/town, they're pretty diverse, which is important to me. But I'm interested in neuro, and Columbia is a huge neuro/psychiatry powerhouse. I don't know if turning them down would close any doors for me.

Neurosurgery or Neurology? Columbia cannot be turned down if you want neurosurgery.

 

[hs764]

Neurosurgery or Neurology? Columbia cannot be turned down if you want neurosurgery.

Almost certainly neurology. I have no experience in surgery but I've also never had any desire for it.

 

[thenucleusaccumbens]

I'm just not a big city person. I'm from a pretty rural area of southern Virginia and I miss having greenery and mountains and lots of space. I don't mind smaller cities but NYC is just too much. It makes me feel claustrophobic. And I loathe the winters and the subway with every fiber of my being.

I have until Monday to make the final decision, so I'm going to take the weekend to think about it. I certainly understand the importance of $140K, if I didn't I wouldn't be asking this question and would just be going to UVA regardless. Columbia is higher ranked but that doesn't necessarily mean that it is the better school for me. I feel that it isn't, and I don't know if giving up a school that I feel is a great fit is worth $140,000 in the long run. I want to have a good quality of life in addition to a good education. It's a tough call.

you said you would be paying 200k to go to UVA. It's clear you feel that you would be much happier there and want to be close to your family. While it is more debt than you'd have from columbia and I don't want to minimize that, 200k is still manageable and a lot less than many people graduate with. It's not like it will be impossible to pay off. I actually know someone (in a primary care field) who paid off 300k in med school debt in a little over 2 years by "living like a resident" for a couple years after residency. Some people wouldn't want to do that and would want to graduate with as little debt as possible. Other people prefer to take on a bit more debt to be somewhere they will be happier. This is a very personal decision.

Also if you do go with UVA, I wouldn't worry much about doors being closed even if you want to pursue academic medicine or a competitive specialty. It may not be as high ranked as Columbia, but it's not like UVA isn't prestigious, it's still very highly regarded and I'm sure you'll still have plenty of research opportunities (I don't go to UVA but distinctly remember reading that Alfred Gilman did a lot of his work on G proteins there.. pretty sure that's actually where the first G protein was isolated)

 

[WedgeDawg]

Almost certainly neurology. I have no experience in surgery but I've also never had any desire for it.

Columbia is an enormous neurology powerhouse in pretty much every discipline. I can give you specifics in PM if you want.

 

[Perrotfish]

Remember that a good rule of thumb is that, whatever you borrow, you will need to earn 3x as many pretax dollars to pay that loan back (assuming a 3 year residency and a 10 year repayment plan). Whatever decision you make it's not over 140K, its over 420K. So you will work 1-2 years after residency to pay back your decision to live in Virginia during medical school.

 

[hs764]

Remember that a good rule of thumb is that, whatever you borrow, you will need to earn 3x as many pretax dollars to pay that loan back (assuming a 3 year residency and a 10 year repayment plan). Whatever decision you make it's not over 140K, its over 420K. So you will work 1-2 years after residency to pay back your decision to live in Virginia during medical school.

Only 1-2 years? I don't know how much I would be making as a neurologist, but that doesn't seem too bad.

 

[thenucleusaccumbens]

Only 1-2 years? I don't know how much I would be making as a neurologist, but that doesn't seem too bad.

For 2017 Medscape has neurologist salary at 249k, Merritt Hawkins lists avg as 305k

 

[ranson]

NYC does suck....big time but Columbia >>>>>>> UVA and I would go to Columbia despite my hatred for the city.

 

[hs764]

Columbia >>>>>>> UVA

What makes you say that? Just outright ranking or are there specific factors?

 

[fdgjfg]

Only 1-2 years? I don't know how much I would be making as a neurologist, but that doesn't seem too bad.

If you're an academic neurologist or psychiatrist, this probably isn't going to happen. Since you're in a neurology group, you should ask some of the young faculty about compensation - I'm in a similar group, and some of the younger faculty have talked to me about their financial situation (with some horror stories i.e. only making enough to keep up with interest as it accrues and not even touching the principal/interest that grew during med school or residency). As a new assistant professor, it's pretty unlikely that you crack 200k (probably will hang out around 150k), and if you want to run a lab you might not crack 100k, so 200k in loans is probably sticking around for a while (MSTP student interested in Neurology, doubts due to salary). That extra 140k at UVA will be a bigger consideration if you want academics (although there are other options available there, like NIH loan repayment grants if you stay in academics for a certain amount of time and commit to a certain amount of research time). Columbia's resources and name in the field + the low cost of attendance make it a pretty ideal situation for a future academic neurologist. If you change your mind about your career though, it matters less: private practice neuro might be able to pay it off that fast, and surgical specialities certainly would.

However, the more you post, the more it seems like you really want to go to UVA. Maybe it's just because a lot of the posters have voted for Columbia so you're trying to "balance the scale" so to speak, but most of your posts seem to be vigorously defending UVA, with very few compliments for Columbia. It kind of seems like you feel as though Columbia is sort of an inevitability that you are utterly dreading, with only cold quantitative benefits, while your gut is 100% telling you UVA, where all your warm-fuzzies are. I think this is pretty illuminating; sometimes it's hard to know how you feel, but when you analyze your reactions to people that question your decision, you can sort of see what side you're on.

So I think I might recommend just doing what you want to do and going to UVA. Premeds/med students spend so much time deferring happiness into the future (study now or do something that sucks now for benefits later, "you can match back for residency", "you can go there to work" etc.). That's a source of how you become successful, but when people just do it forever, I think it contributes to the rates of depression/suicide in the profession. You've worked really hard as a premed, and certainly earned the choice to be happy in your own life: why not do what you want to do? The 200k will take more work to pay off, and arguably better resources might help you out, but if you're absolutely sure (which it sounds like you might be) that you'll be happier at UVA, I think I would just go with it. You've only got one life, and it sounds terrible to consign four entire years of it to the domain of misery for the hope of rewards down the line. Why not spend some time in the here-and-now? And not because it might lead to better board scores and grades (which it certainly might), but because you can just enjoy your day-to-day.

 

[LebronManning]

With all that said, you can make a killing as a neurologist if you run your practice right. That goes for all specialties.

I have a family friend who’s a neurologist in Long Island NY who’s making 600k per year

 

[EnterMemberNameHere]

You don’t want to go somewhere where you think you may be miserable. You may end up happy if you go to Columbia, but it sounds like there’s a very real possibility that you will be seriously unhappy. This isn’t a research position. If you’re unhappy it will almost certainly affect your performance, which will probably affect your whole career, not to mention your mental and physical health. If you thought you’d do okay at Columbia and be pretty happy at uva, that’s onee thing, but it sounds like you KNOW you’d be happy at UVA and there are already a lot of things you know you’d dislike about being at Columbia. It seems like a lot of posters on SDN significantly underestimate the importance of having a good experience in med school and chase the prestige and money. You don’t want to be a few months into your first year and be regretting you aren’t somewhere else.

 

[Stagg737]

Here's another thing to consider, many people end up staying near where they went to med school for residency. If you get highly involved in research or with the program in general at a school, it's statistically more likely you'll stay there. So if you decide to go to Columbia there's a better chance you'd end up staying in NYC for your career where COL is going to likely be outrageous compared to if you worked pretty much anywhere else. So that financial difference may actually end up not being as meaningful depending on where you settle down and practice.

Of course, the best option financially would likely be Columbia for med school and residency then moving back to VA to practice as an attending, but who can really tell what your future will be like in 8-10 years or even in 1 or 2 (I know mine is drastically different than I thought it would be). The finances are definitely important, but so is your general contentedness. If you could be content/moderately happy, I'd say to go with Columbia (even though I loathe NYC more than you could imagine) since the financial upside is huge and it's a fantastic program (especially in your field of interest). If you legitimately think you'd be miserable there though, you should go with UVA as being miserable will not only suck, but you'll also likely perform far worse than if you're at least content and satisfied with life. No one here can really tell you what the right decision for you will be because we don't actually know you, that's my 2 cents though.

 

[hs764]

If you're an academic neurologist or psychiatrist, this probably isn't going to happen. Since you're in a neurology group, you should ask some of the young faculty about compensation - I'm in a similar group, and some of the younger faculty have talked to me about their financial situation (with some horror stories i.e. only making enough to keep up with interest as it accrues and not even touching the principal/interest that grew during med school or residency). As a new assistant professor, it's pretty unlikely that you crack 200k (probably will hang out around 150k), and if you want to run a lab you might not crack 100k, so 200k in loans is probably sticking around for a while (MSTP student interested in Neurology, doubts due to salary). That extra 140k at UVA will be a bigger consideration if you want academics (although there are other options available there, like NIH loan repayment grants if you stay in academics for a certain amount of time and commit to a certain amount of research time). Columbia's resources and name in the field + the low cost of attendance make it a pretty ideal situation for a future academic neurologist. If you change your mind about your career though, it matters less: private practice neuro might be able to pay it off that fast, and surgical specialities certainly would.

I think I would like to teach eventually, but my plan right now is to practice for a while and not go into academia for several years at least. I don't know yet whether I'd prefer to be in a public or private setting, but I do plan on being a clinician for a while. I think I'd make more money that way but I'm sure it'll depend on where I live and what type of practice I'm in.

Here's another thing to consider, many people end up staying near where they went to med school for residency. If you get highly involved in research or with the program in general at a school, it's statistically more likely you'll stay there. So if you decide to go to Columbia there's a better chance you'd end up staying in NYC for your career where COL is going to likely be outrageous compared to if you worked pretty much anywhere else. So that financial difference may actually end up not being as meaningful depending on where you settle down and practice.

Of course, the best option financially would likely be Columbia for med school and residency then moving back to VA to practice as an attending, but who can really tell what your future will be like in 8-10 years or even in 1 or 2 (I know mine is drastically different than I thought it would be). The finances are definitely important, but so is your general contentedness. If you could be content/moderately happy, I'd say to go with Columbia (even though I loathe NYC more than you could imagine) since the financial upside is huge and it's a fantastic program (especially in your field of interest). If you legitimately think you'd be miserable there though, you should go with UVA as being miserable will not only suck, but you'll also likely perform far worse than if you're at least content and satisfied with life. No one here can really tell you what the right decision for you will be because we don't actually know you, that's my 2 cents though.

Unless something drastically changes with my personality, I'm like 99% sure I won't want to stay here for residency. I'm really hoping to end up somewhere back in the southeast at a place like Vanderbilt, Duke, or Emory. Those were all my top choices for med school along with UVA, but the money just didn't end up working out. From the info they gave me on interview day, about 25% of Columbia med school grads end up doing residency at Columbia and about 50% end up doing it somewhere in New York state. I don't know if that's by choice or by circumstance, but I definitely don't want to go to med school here if that's going to make it more unlikely for me to be able to get a residency back in the southeast.

 

[Stagg737]

Unless something drastically changes with my personality, I'm like 99% sure I won't want to stay here for residency. I'm really hoping to end up somewhere back in the southeast at a place like Vanderbilt, Duke, or Emory. Those were all my top choices for med school along with UVA, but the money just didn't end up working out. From the info they gave me on interview day, about 25% of Columbia med school grads end up doing residency at Columbia and about 50% end up doing it somewhere in New York state. I don't know if that's by choice or by circumstance, but I definitely don't want to go to med school here if that's going to make it more unlikely for me to be able to get a residency back in the southeast.

I don't think it would necessarily hurt your chances for obtaining a residency in the south, just increase your chances of staying there. Other than the tippy top programs, there's geographic bias almost everywhere and almost every program will favor their own medical students if those students have shown that they're up to snuff. The stats they gave you are probably a little of both choice and circumstance. I also don't think a degree from Columbia is going to hinder your chances of matching in the SE unless you end up with crappy stats and a bad applicant which will hurt you no matter where you get your degree. Just trying to point out some trends which you seem to already have recognized.