Any dentists out there struggling with loans?

[Biofilm preventer]

Are there any dentists on SDN that will like to chime in on the impact that the loans are having on their life, and if they are struggling financially?

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[free99]

I think you're looking for personal anecdotes which I can't really provide, but generally speaking student loans are making an enormous impact on new graduates live. Last I heard the ADA published an average new graduate indebtedness of $285k in 2018 -- keep in mind this includes all the people with military scholarships, NHSC scholarships, and parental assistance. There are a huge number of people without any of those three that are graduating with far more than $285k in debt.

Say you're a lucky one and you come out with only $300k in debt at around 6% interest.

You don't have family in dentistry or a practice to walk into, so you get an associate job right out of school that pays you $500/day or a percentage of collections. You're exceeding your daily minimum and averaging $800/day, working 5 days a week and taking 2 weeks vacation a year. Your pre-tax take home is $200k, after taxes it goes to $130k, leaving you about $10,500/month to live on. Your 10-year standard repayment monthly payment is about $3400. Now you have $7000 a month to live on -- rent/mortgage, food, insurance (car, life, disability, home owners, etc), recreation, gifts, cell phone, clothes, etc. And you haven't even contributed to retirement accounts yet.

If your loan indebtedness is $400k, that's $4400/month. $500k, $5500/month. You can see how bleak that scenario is.

Some will say just do IDR, pay the minimum, and wait 20 or 25 years for the loan forgiveness. Invest the difference between your minimum payment and the 10-year standard repayment. Use the invested funds to pay for the eventual "tax bomb."

But there are problems with that -- if you have the devotion to not touch that "extra" money for 25 years, then you have the devotion to make the lifestyle sacrifices to pay off the loan in 10-years. I think the far more likely scenario is that you end up making allowances for yourself over time, and that difference that was supposed to be invested diligently ends up being a down payment on a tesla, or something else you can't afford.

Then there's the psychological strain of having hundreds of thousands of dollars of student loan debt in the back of your mind, constantly growing, that you're relying entirely on the federal government to forgive in 20 or 25 years. That's a long time.

So in my opinion there are only four options for people who only have acceptances to schools that will put them back $400k, 500k+
1. Don't go to dental school, choose a different profession
2. Understand and adhere to the lifestyle sacrifices that are required to pay down the debt on a 10-year standard repayment (or sooner)
3. Be laser focused on buying a general practice where your income can increase dramatically -- this is way easier said than done, I'm sure
4. Specialize after dental school, which automatically increases your income floor

 

[Cold Front]

The sad and scary part - about 6,400 pre-dents got accepted into a dental school this cycle and still have no idea what their first year tuition and cost of attendance will be for each year of DS. At best, they will know their first year cost of attendance in couple of months, the other 3 years numbers will remain unknown until they get there.

What other industries treat their customers/consumers the same way? where they will only find out the cost of what they are purchasing after they signed up, invested a lot of time and energy in it?

Pure exploitation.

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[alwaystiredandstuff]

I think you're looking for personal anecdotes which I can't really provide, but generally speaking student loans are making an enormous impact on new graduates live. Last I heard the ADA published an average new graduate indebtedness of $285k in 2018 -- keep in mind this includes all the people with military scholarships, NHSC scholarships, and parental assistance. There are a huge number of people without any of those three that are graduating with far more than $285k in debt.

Say you're a lucky one and you come out with only $300k in debt at around 6% interest.

You don't have family in dentistry or a practice to walk into, so you get an associate job right out of school that pays you $500/day or a percentage of collections. You're exceeding your daily minimum and averaging $800/day, working 5 days a week and taking 2 weeks vacation a year. Your pre-tax take home is $200k, after taxes it goes to $130k, leaving you about $10,500/month to live on. Your 10-year standard repayment monthly payment is about $3400. Now you have $7000 a month to live on -- rent/mortgage, food, insurance (car, life, disability, home owners, etc), recreation, gifts, cell phone, clothes, etc. And you haven't even contributed to retirement accounts yet.

If your loan indebtedness is $400k, that's $4400/month. $500k, $5500/month. You can see how bleak that scenario is.

Some will say just do IDR, pay the minimum, and wait 20 or 25 years for the loan forgiveness. Invest the difference between your minimum payment and the 10-year standard repayment. Use the invested funds to pay for the eventual "tax bomb."

But there are problems with that -- if you have the devotion to not touch that "extra" money for 25 years, then you have the devotion to make the lifestyle sacrifices to pay off the loan in 10-years. I think the far more likely scenario is that you end up making allowances for yourself over time, and that difference that was supposed to be invested diligently ends up being a down payment on a tesla, or something else you can't afford.

Then there's the psychological strain of having hundreds of thousands of dollars of student loan debt in the back of your mind, constantly growing, that you're relying entirely on the federal government to forgive in 20 or 25 years. That's a long time.

So in my opinion there are only four options for people who only have acceptances to schools that will put them back $400k, 500k+
1. Don't go to dental school, choose a different profession
2. Understand and adhere to the lifestyle sacrifices that are required to pay down the debt on a 10-year standard repayment (or sooner)
3. Be laser focused on buying a general practice where your income can increase dramatically -- this is way easier said than done, I'm sure
4. Specialize after dental school, which automatically increases your income floor

My state school waitlisted me and my other option is USC. Pray for me...

 

[Debt Free DDS]

Not anymore. It's an amazing feeling. You can read my story on the White Coat Investor's website. Freedom From Student Loan Debt: A Dentist’s Story - The White Coat Investor - Investing & Personal Finance for Doctors

Let me know if you have any questions.

 

[theleatherwalle]

I do not currently know of any dentists struggling with debt, but again i went to a public school.

Right now the dental market is at capacity, but dental schools are churning out new grads. We're going to have a real problem by 2025.

I would have serious reservations with anyone going above 300k for dental school.

 

[Cold Front]

I do not currently know of any dentists struggling with debt, but again i went to a public school.

Right now the dental market is at capacity, but dental schools are churning out new grads. We're going to have a real problem by 2025.

I would have serious reservations with anyone going above 300k for dental school.

2025 is when “today’s” pre-dents and DS applicants start to graduate. That’s really soon.

Also, I know couple of dentists in their late 50’s still paying their student loans, and few dentists who struggled with their student loans and are currently on IBR programs. A former associate was so upset with the GP associate market and it’s $180-200k a year income (because he has 2 little ones and a wife that doesn’t work) that he decided to go back to school and do an endo residency - so he can make more income, even though he would need to take out additional $300k in student loans.

There are a lot of people out there still paying their student loans at an older age and the new grads are just choosing the minimum payment options - which makes their loans go up. A lot of band aid strategies out there to manage the large debt, so I guess no one is “actually” struggling.


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[011110]

2025 is when “today’s” pre-dents and DS applicants start to graduate. That’s really soon.

Also, I know couple of dentists in their late 50’s still paying their student loans, and few dentists who struggled with their student loans and are currently on IBR programs. A former associate was so upset with the GP associate market and it’s $180-200k a year income (because he has 2 little ones and a wife that doesn’t work) that he decided to go back to school and do an endo residency - so he can make more income, even though he would need to take out additional $300k in student loans.

There are a lot of people out there still paying their student loans at an older age and the new grads are just choosing the minimum payment options - which makes their loans go up. A lot of band aid strategies out there to manage the large debt, so I guess no one is “actually” struggling.


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If your associate left a 200k a year job to go back to endo for 300k his opportunity cost is 700k minimum. Endo associates prob make 250-300k so it will take him atleast 7 years to break even, not including lost money toward retirement, interest rate, etc. May be well into your mid 40s by then...

 

[Cold Front]

If your associate left a 200k a year job to go back to endo for 300k his opportunity cost is 700k minimum. Endo associates prob make 250-300k so it will take him atleast 7 years to break even, not including lost money toward retirement, interest rate, etc. May be well into your mid 40s by then...

That’s what I told him. Not to mention feeding 3 other mouths (wife + 2 kids) during 2 years residency. So the break even is closer to 10 years if you include inflation and supporting his family.


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[ToothJockey]

2025 is when “today’s” pre-dents and DS applicants start to graduate. That’s really soon.

Also, I know couple of dentists in their late 50’s still paying their student loans, and few dentists who struggled with their student loans and are currently on IBR programs. A former associate was so upset with the GP associate market and it’s $180-200k a year income (because he has 2 little ones and a wife that doesn’t work) that he decided to go back to school and do an endo residency - so he can make more income, even though he would need to take out additional $300k in student loans.

There are a lot of people out there still paying their student loans at an older age and the new grads are just choosing the minimum payment options - which makes their loans go up. A lot of band aid strategies out there to manage the large debt, so I guess no one is “actually” struggling.


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Did your associate only go into Endo for the money? Why not GP practice ownership instead?

To be honest, if I ever had the privelege of associating under you, I would pick your brains apart so I can learn your dental business skills and go into practice ownership. Seriously, you're like the Andy Reid of dentistry. Being part of your associate tree is like being part of Andy Reid's coaching tree lol

 

[2TH MVR]

Did your associate only go into Endo for the money? Why not GP practice ownership instead?

To be honest, if I ever had the privelege of associating under you, I would pick your brains apart so I can learn your dental business skills and go into practice ownership. Seriously, you're like the Andy Reid of dentistry. Being part of your associate tree is like being part of Andy Reid's coaching tree lol

Andy Reid is a great coach, but he never brought home the BIG one ..... until Patrick Mahomes came along. 😉

 

[Cold Front]

Did your associate only go into Endo for the money? Why not GP practice ownership instead

Yes. 100% for the money. He wasn’t a fan of running a practice, and deal with insurances and managing staff. Some people just don’t want that headache, even if it means 3-5x more income. However, I think he spoke to former classmates from DS who became endodontists, and after seeing how much they earn and how they live - that was the push he needed to go back to school and specialize. Except, those friends live in a different state, graduated from residency with less debt and specialized because they have more passion for Endo.



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[allDAT]

Most dentists who graduated with close to or more than 400k in students loans are struggling, they just won’t say it. Those who owe 500+ are almost all relying on IDR unless they specialized.

IDR is a strategy that works but does not take into account divorce. Saving for the tax bomb and finding oneself divorced 18 years later, the dentist will be screwed because half the savings will be gone.

The psychological impact of large student loans shouldn’t be understated and it does affect the way dentists practice.

 

[allDAT]

If your associate left a 200k a year job to go back to endo for 300k his opportunity cost is 700k minimum. Endo associates prob make 250-300k so it will take him atleast 7 years to break even, not including lost money toward retirement, interest rate, etc. May be well into your mid 40s by then...

Most endos make more than 300k working 3 days a week.

A minority of associates GPs break 200k working 5. Owners make more than 200k regularly but work 5-7 days a week. We just don’t identify non-clinical days as working for some odd reason (we may be the only profession that does this).

An endodontist can truely shut it down a few days a week. The raw opportunity costs don’t show the whole picture.

 

[Cold Front]

Most endos make more than 300k working 3 days a week.

Yes. Those who own their own practice do make more than 300k. What about endo associates? What’s their average income over a 20 years career? Some period of their career will be a high production years, some years they won’t - due to different employers and schedules. No dentist, let alone a specialist, makes the same income year to year - because the profession is based on what you produce, and not on a salary.



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[Big Time Hoosier]

I’ve been asked by several people via PM recently about which school I’d attend if I were them. When they present the options the schools are all $500,000 to $600,000+. In all honesty, I wouldn’t go to dental school at that debt level. I’d have probably gone to medical school.

Big Hoss

 

[ToothJockey]

Correct me if I'm wrong, but a big appeal of dentistry is that you can be a business owner, which allows you to grow your practice to limitless potentials, and have full control of your life/schedule. If you wanted to be an employee/associate, then isn't medicine a better choice logically? They get higher guaranteed salaries, generous amounts of paid time off, benefits etc...

Obviously not everyone goes into dentistry for the same reasons, so this is just my perspective, yall can disagree

 

[Big Time Hoosier]

Correct me if I'm wrong, but a big appeal of dentistry is that you can be a business owner

Which becomes much easier said than done when you owe $600,000 in student loans.

Big Hoss

 

[allDAT]

Yes. Those who own their own practice do make more than 300k. What about endo associates? What’s their average income over a 20 years career? Some period of their career will be a high production years, some years they won’t - due to different employers and schedules. No dentist, let alone a specialist, makes the same income year to year - because the profession is based on what you produce, and not on a salary.



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Endo associates I know usually net about 4K/working day. 50% collections, production of 8k per day (that’s only 5-6 RCTs + a couple consults).

 

[allDAT]

Correct me if I'm wrong, but a big appeal of dentistry is that you can be a business owner, which allows you to grow your practice to limitless potentials, and have full control of your life/schedule. If you wanted to be an employee/associate, then isn't medicine a better choice logically? They get higher guaranteed salaries, generous amounts of paid time off, benefits etc...

Obviously not everyone goes into dentistry for the same reasons, so this is just my perspective, yall can disagree

Business ownership is one of the appeals but costs are problematic and the number of hats dentists have to wear to be a successful owner has become overwhelming for many. Student loans + practice loan for the net may not make sense. You have to run the numbers for each opportunity and decide for yourself.

Many older dentists just setup shop immediately after graduation or a few years of associateship, those days are over in most major metros. If someone wants to do a startup there’s a lot more planning involved than there used to be.

Finding good practices to buy is also difficult as the older guys are delaying retirement.

 

[Cold Front]

Endo associates I know usually net about 4K/working day. 50% collections, production of 8k per day (that’s only 5-6 RCTs + a couple consults).

There are general dentist associates I know who make $350k. The people we know are not averages. There was also a time I use to do 4-5 molars Endo a day, but I moved on and focused on other aspects of dentistry.


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[allDAT]

I’ve been asked by several people via PM recently about which school I’d attend if I were them. When they present the options the schools are all $500,000 to $600,000+. In all honesty, I wouldn’t go to dental school at that debt level. I’d have probably gone to medical school.

Big Hoss

I would agree. 500-600k only makes sense for OS/Perio/endo. If the plan is to be a GP I would also pass on the opportunity at that cost.

 

[Cold Front]

I would agree. 500-600k only makes sense for OS/Perio/endo. If the plan is to be a GP I would also pass on the opportunity at that cost.

True. But DS at $500k in loans, ortho/perio/Endo residency can easily add another $300k debt before compounding interest.


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[deleted903013]

True. But DS at $500k in loans, ortho/perio/Endo residency can easily add another $300k debt before compounding interest.


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and there's no guarantee you'll get into one of those residencies either.

 

[allDAT]

There are general dentist associates I know who make $350k. The people we know are not averages.


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They exist. I’ve met one associate who had a net of 400k as a GP for a few years in CA, but that was in the 90’s and he was paid 35% of collections.

These are rare exceptions and there’s quite a bit of luck involved to land a gig in a very strong practice. That luck when combined with a great skill set and a charismatic personality, can result in a great earned income. But the number of practices in the US that can support an associate producing enough to earn 300+k per year is a small fraction of the total market.

 

[allDAT]

True. But DS at $500k in loans, ortho/perio/Endo residency can easily add another $300k debt before compounding interest.


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I would not recommend spending 800-900k for a license to become anything other than an OS at this point in my career.

The surgical specialties of medicine would be more appealing at that price, especially with PSLF. Once you’ve spent that much on school, the benefits of dentistry’s work-life balance over medicine are out the window.

 

[Cold Front]

I would not recommend spending 800-900k for a license to become anything other than an OS at this point in my career.

The surgical specialties of medicine would be more appealing at that price, especially with PSLF. Once you’ve spent that much on school, the benefits of dentistry’s work-life balance over medicine are out the window.

Totally agree. People on IBR/IDR will shoot up the coming years as more new grads come out with high student loans. In 20-25 years, big tax payments will be due - many could be divorced by then, some could file bankruptcy, some might be dead.... the system is too broken for anyone to see or care about those future and upcoming crisis. The tax payers will eventually clean up the mess.


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[Debt Free DDS]

I do not currently know of any dentists struggling with debt, but again i went to a public school.

Right now the dental market is at capacity, but dental schools are churning out new grads. We're going to have a real problem by 2025.

I would have serious reservations with anyone going above 300k for dental school.

I agree that above $300k is tough. But it is doable. There are way too many graduates. However, I wonder what the affect will be with female dentists. Most classes are at least 50% female now it seems. Studies show that a lot of female dentists don't work full time and/or don't work full career length. I'm interested on the effect that will have.

 

[Cold Front]

Most classes are at least 50% female now it seems. Studies show that a lot of female dentists don't work full time and/or don't work full career length. I'm interested on the effect that will have.

No one knows the effects of what the “females dominated workforce” will have on the profession, yet. Just like we don’t know the effects of $500k-$1M+ loans will have on new grads in the future. Those milestones happened very recently, within the past 2-3 years. There are a lot of theories on these boards that suggest everything will be “ok” on both, but many disagree.

I’m on the camp that warns - more female dentists means majority of the big debt will also be carried by female new grads, who on average will work less and make less income if you account for inflation and opportunity cost for hours lost to supporting a family. Servicing the big debt will eventually become a tax burden over the course of future dentists careers, and it will be normal and common to see them pay the “loan forgiveness tax” after 20-25 years of IBR/IDR repayments. That seems to be the most logical escape route out of the big student loans, while balancing other life commitments for all future dentists. It’s certainly what I would do if I were in their shoes. But then again, why choose dentistry in the first place if I know all this information in advance. Plenty of other better options out there.


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[ToothJockey]

I agree that above $300k is tough. But it is doable. There are way too many graduates. However, I wonder what the affect will be with female dentists. Most classes are at least 50% female now it seems. Studies show that a lot of female dentists don't work full time and/or don't work full career length. I'm interested on the effect that will have.

There was a study done on this by the ADA. I believe they adjusted for female dentists and their workforce habits when looking at the supply of dentists overall.

https://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0718_1.pdf?la=en

The result was that there are still going to be way too many dentists in the future even with half the workforce becoming female.

 

[P7898]

Just keep debt to $200k or less. For example, would you buy a car if every car was $500k or just take the bus? I wouldn't buy the car, I would find another way of transportation or take the bus - the same thing with career and income.

 

[Not_A_Doc]

I would not recommend spending 800-900k for a license to become anything other than an OS at this point in my career.

The surgical specialties of medicine would be more appealing at that price, especially with PSLF. Once you’ve spent that much on school, the benefits of dentistry’s work-life balance over medicine are out the window.

Why OS?

 

[allDAT]

Why OS?

Because EXT of 4 wisdom teeth with sedation is extremely lucrative and quick with very low overhead. Almost everyone has wisdom teeth, and their parents plan for and save for their EXT for their children. It also routinely gets done out of convenience (braces off, time of college, etc) as opposed to symptoms.

The other specialties are just not as lucrative, and certainly not as lucrative as quickly as OS (once you’re out of residency).

 

[jikooo]

I graduated from cali school with 600k loan.
There is endo residents and 2 ortho residents graduating from same school with 1 million loan

on the other hand, my hygienist friend makes $4-500 per day with 80K loan in bay area.

 

[Cold Front]

I graduated from cali school with 600k loan.
There is endo residents and 2 ortho residents graduating from same school with 1 million loan.

Those residents student loan monthly repayments will be equivalent to GP associate dentists monthly net income (about $10k a month after taxes).

Imagine you went to school for 10-12 years and you net 25% of your gross income (after taxes and student loans payments). Doesn’t leave much for everything else (mortgage, family, savings, auto, healthcare insurance, etc).

And this will only get worse with future tuition and fees increases every year.


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[2TH MVR]

I graduated from cali school with 600k loan.
There is endo residents and 2 ortho residents graduating from same school with 1 million loan

on the other hand, my hygienist friend makes $4-500 per day with 80K loan in bay area.

You said you graduated. How are you getting along with paying your DS debt? Associateship? DSO? Private practice? Any regrets?

 

[P7898]

Why...why....and why? Since when did people become illogical? Oh wait....

Really. If you really loved apples and wanted an apple and I told you - "pay $100 and you'll have this apple". Meanwhile the orange is only $1 and they both give you decent incomes then why would you buy that apple?

 

[pubhealthdent]

Graduated with north of $500k in student loans. Working at an FQHC making $225k this year (salaried based on 35% production from previous year). Received NHSC S2S loan repayment and state loan repayment. Planning to do PSLF. While many here scoff at working public health and doing PSLF it's worked out very well for me so far - zero stress caused by loan amount.

 

[Cold Front]

Graduated with north of $500k in student loans. Working at an FQHC making $225k this year (salaried based on 35% production from previous year). Received NHSC S2S loan repayment and state loan repayment. Planning to do PSLF. While many here scoff at working public health and doing PSLF it's worked out very well for me so far - zero stress caused by loan amount.

Good for you.

However, the problem of $500k+ in student loans itself still remains and can’t be justified by using Public Health Service position as a escape hatch. That’s the excuse schools would like to tell their students to increase their tuition and fees every year.


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[Biofilm preventer]

Graduated with north of $500k in student loans. Working at an FQHC making $225k this year (salaried based on 35% production from previous year). Received NHSC S2S loan repayment and state loan repayment. Planning to do PSLF. While many here scoff at working public health and doing PSLF it's worked out very well for me so far - zero stress caused by loan amount.

how long ago did you graduate? Can you tell us more about your employment such as location and hours please

 

[pubhealthdent]

how long ago did you graduate? Can you tell us more about your employment such as location and hours please

Graduated 2018. Working in rural central Wisconsin, 8-5 M-F, opportunity to work less is available but less hours = no loan repayment.

 

[theleatherwalle]

You sound like you're doing your loan repayment right.

I am waiting to hear a few horror stories of kids who went to USC and are stuck in SoCal making 100k a year.

 

[Cold Front]

I am waiting to hear a few horror stories of kids who went to USC and are stuck in SoCal making 100k a year.

The silent majority with big student loans will never speak up and share their stories. They are already terrified of the dilemma they got themselves into.



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[Big Time Hoosier]

The silent majority with big student loans will never speak up and share their stories. They are already terrified of the dilemma they got themselves into.



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They be like...

Big Hoss

 

[ryancord]

I am working public health with 600k in loans. Pursuing PSLF. So far so good. Have 6.5 years left. Fed loan Servicing has been very transparent in the PSLF process and I make sure to follow all the rules to a “T”.
Crossing my fingers

 

[deleted972255]

I wonder when this dental school student debt bubble will burst? It needs to happen, there needs to be a reckoning.

 

[SDFBlaque]

I am working public health with 600k in loans. Pursuing PSLF. So far so good. Have 6.5 years left. Fed loan Servicing has been very transparent in the PSLF process and I make sure to follow all the rules to a “T”.
Crossing my fingers

Same here. My expensive undergraduate liberal arts college and private dental school = $600k in loans. In my situation I wouldn't dare get a practice loan, huge mortgage, or take on any additional debt. So I decided to work in public health. Currently w/ IHS guaranteed salary +180K and all the benefits, 4 days/wk, low stress (great decision considering the current covid-19 situation). Only 2yrs into PSLF so hopefully congress and future administrations don't get rid of it. Sharing to provide hope to those in a similar situation. I made the decision to do what needs to be done to be debt free w/o killing myself. Biggest sacrifice is living in the middle of nowhere but it fits my personality and I save a ton not eating out. My plan is to let the govt pay itself back and properly plan my exit strategy after 10yrs in public health. With this type of debt just have to consider all options. You can aggressively payback or make minimum payments rest of your life or be somewhere in between. Or consider looking into Commission Corps, Army/Air Force/Navy/Reserves/Natl Guard that all have SLRP & Bonuses, NHSC, IHS, State SLRP etc. There are pros and cons to all scenarios just have to figure out your financial goals and what's best for your family.

Side note: Has anyone heard of residents qualifying for or taking advantage of State SLRP while in residency as many training sites are a FQHC with high HPSA scores?? That would be a better option instead of forbearance/deferment.

 

[P7898]

Why are soo many people on this thread in $600k? Did you guys know what you were getting yourselves into? Not trying to bash anyone just wanted to hear your thoughts process.

 

[Big Time Hoosier]

Why are soo many people on this thread in $600k? Did you guys know what you were getting yourselves into? Not trying to bash anyone just wanted to hear your thoughts process.

If I remember correctly, 1/3 of graduates from private schools owe $400,000 or more.

Big Hoss

 

[ryancord]

Why are soo many people on this thread in $600k? Did you guys know what you were getting yourselves into? Not trying to bash anyone just wanted to hear your thoughts process.

My loans after dental school were $430k. However, with IDR payments the unpaid interest is capitalized and increases the loan balance. That is how I have nearly $600k in debt. Students in dental school today with a $600k price tag will see a significantly higher balance upon graduation as some of the loans accumulate interest during dental school. Then if they are doing IDR payments, they will hit $1 mil in no time.
To anybody considering dental school simply for the financial benefits....learn to code.