Cost of Medical School

[sean]

Has anyone really given thought to the amount of debt we will have leaving medical school or is everyone ignoring that big white elephant in the corner (like I have until now)? I am not talking value for money etc... Just actual dollars, about $150,000 to be exact, to be paid back. Has anyone done any research about how long they expect to take to pay this off etc..?

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[muonwhiz]

The total costs vary according to how much is borrowed, and most lenders are willing to fashion a repayment plan that takes into account that you won't be making much $$$$ during residency. Still, it is a scary subject. Check into plans that will let you make partial or whole interest payments while you are in school, these will cut down your overall debt load considerably. I'm not happy about the prospects of that kind of debt, but apparently doctors are able to survive and pay it back!

 

[turtleboard]

Hmmm... I'm graduating with about $20,000 in debt come May 2003. My brother will probably graduate with about $140,000 when he graduates in May 2005. We'll see how things work out then.

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Tim Wu.

 

[RobbC]

I have spoken with many docs who recently completed their residency. On average, the typical student will be about $150,000 in debt...both subsidized and unsubsidized. Unfortunately, the majority of loans for students are unsubsidized, therefore interest accumulates right after med school. With compound interest in play, the average loan becomes $220,000 once you can begin the installments. With a loan that large, some docs aren't even touching the principle. TO even get to the principle, a monthly payment almost unimaginable will put you at the socioeconomic status of the average American. One of the docs mentioned to me, that at the rate he's paying now (which is quite generous), he won't be able to pay off the loan until he's about 78 (currently he's in his 40's). So, if making big bucks and having a CEO-like lifestyle is your issue, medicine is definitely not the way to go. How am I gonna handle it? It's all about early investment. Plant the seeds now, and hopefully 10 years from now, it will be a full grown tree with many fruits to harvest. Here's a website to browse if any are interested. http://www.fool.com

 

[sean]

$150,000 seems to be the magic number. I know there are some lucky souls who can attend a state school and have lower tuition but it seems that most of us will be paying about $25,000 a year, for four years, just for tuition. Like I said, I'm not worried about being rich, just about whether I will be able to pay off my loans. If I graduate on schelule I will be in my mid 40's so obviously I have a lot less working time than some of you and I accept that. What I find interesting is that there is very little discussion or information about this topic. Its almost a taboo subject. The fact is that most Do's go into primary care practice, the lowest paid specialties in the profession. Depending on where you look up the figures, average GP's make between $90-120,000 a year, a figure that is decreasing. There are lots of anecdotes out there about ie never having seen a starving doctor, or if you are going into medicine to get rich then you are in the wrong business etc... However, there seems to be very little hard factual information about real living standard expectations. For most people the amount of debt we will incurr will be equal to a house mortgage, only at a higher percentage rate.
Another part of the equation how will you make your money. Currently eveyone complains about the speed that doctors move patients through their office, often only spending a few minutes with each one. I of course vow to be different and plan to charge an hourly or half hourly rate. There is a Do close by who does this. However, he charges $220 an hour and doesn't deal with insurance. Most people can't afford this kind of money and right there my ideals get slaughtered. However, even working on the $220 hr premise, the max he can work is probably 30 hrs a week ie with scheduling etc.. Supposing he is a workaholic and only takes two weeks of total in the year. This gives him a Gross revenue of $330,000 a year. Now he has to pay for his staff, $80,000(main person $40,000, two part timers @ $20,000), his office space which is at a premium here in San Francisco, $48,000 ($4,000 mth), supplies, utilities $20,000 etc...
What does this leave him as take home pay? About $180,000. Of course these figures a very much guess work but that's all I can do. Anyway, $180,000 is a hell of a lot of money but remember, he charges $220 an hour. If he only charges half that $110 an hour he only makes $165,000 GROSS, yet he still has the same administrative needs etc..
Are you are really aware of the business side of what you are getting in to? And if not why not? Let me state again, I am not entering this profession to make lots of money. I would just like to be able to repay my financial obligations and have a reasonable standard of living. My major concern is the lack of information available about the real world situation facing new members of this profession. Comments please.

 

[fiatslug]

<font face="Verdana, Arial, Helvetica" size="2">Originally posted by turtleboard:
Hmmm... I'm graduating with about $20,000 in debt come May 2003. My brother will probably graduate with about $140,000 when he graduates in May 2005. We'll see how things work out then.

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Tim, do your parents like you a lot better than your brother?

 

[sean]

Perhaps my overly long attempt at a scenario was not very well written. Lets try it this way, has anybody thought about how they would like to run their practice? How long do you think an appointment should be, how many hours a day/week do you hope to practice? Will you practice be strictly private or do you plan to deal with HMO insurance. What kind of an income do you hope to make and also what kind of rates will you have to charge to make that income. For instance if a patient visit merits OMM I can't see how the visit can be less that one hour yet I have a tough time thinking of charging $100 hr let alone $220. Bear in mind that I am not talking residency here but future practice hopes.
Does anyone have any thoughts. Anyone who is incurring $150-200,000 in debt should have some thoughts on this.

 

[peiyueng]

Don't forget about the taxes! You will be on a higher income category and subsequently pay more. Ask around and see how much does most doc pay during this tax season.

 

[electra]

I am looking into going into the Navy under a Helth Professions Scholarship. Anyone else?

 

[muonwhiz]

I'm thinking about trying loans for the first year, and then trying to get into something like health service corps or something else that will subsidize me for the rest of the way. It is a scary thought to think about debt load vs. income under managed care. Let's kick the insurers out of medical decision making, and then maybe we'll have a shot at paying off the load before we die.

 

[Medic171]

CONDIDER THIS...DEBT 120, 000= 1800/MONTH OVER 10 YEARS(FAFSA cost calculator).

SALARY AFTER RESIDENCY=120,000 TO START AVERAGE, WHICH = 10,000/MONTH

10000-1800= 8200/MONTH.

THIS IS BEFORE TAXES, BUT I THINK I CAN MANAGE TO LIVE ON AROUND 8,000 PER MONTH FOR TEN YEARS.

CAN'T YOU?

 

[mpp]

electra,

I have considered a military scholarship as well. The one thing I have been told by several people who have taken these scholarships is that be sure that you want to join the military first...the scholarship is just a benefit. Do not use the HPSP only as a means to get through medical school debt free as there is no turning back if you are unhappy being in the military. The advantages of the military scholarship are clear and any recruiter will be happy (often sickeningly happy) to explain all the wonderful details about being an officer, no malpractice suits, the large patient base, the guaranteed pay scale, opportunities for overseas travel etc. Just be sure that your first desire (apart from being a doctor) is to join the military and not to get "free tuition". Good luck what ever you choose but most importantly make an educated decision. Talk to others that are HPSP students and doctors and get the honest truth not the recruiter sales pitch.

 

[sean]

Good advice. I don't think the military is the answer for me. I was just reading back through this thread and I realize that this was not the discussion I was trying to start. Having been on the receiving end of many different types of medical treatment, from hospital visits to massage, I have also had to pay for those services. When I realized that the path to medicine was still open to an old guy like me I decided to take it swearing that I would incorporate all of the positive aspects I had experienced and change the negative ones. One of the major difficulties I had was paying $220 an hour for a DO visit. I had a health issue that needed more than one visit to take care of but I found that after the visit I couldn't afford to continue to see the doctor. That was when I tried to put together the little scenario I used earlier in the thread. My point being to see if anyone else had actually considered the actual logistics of running a private practice, how much per hour, how many hours, cost of doing business etc... It is very interesting to think that most of us just take the leap thinking it will all work out. It probably will. However, I want to know "how" this will happen, not just the bottom line salary stuff. I guess I have a problem with the kind of money we would have to charge patients to make the kind of money average doctors make. Any thoughts?

 

[Aloha Kid]

Sean,

Based upon the time, sacrafice, labor, and emotional turmoil one puts into becoming a doctor, I think it's bonefied to charge people $200 per visit. True we may make a lot of money annually, but remember the IRS takes a good portion of that away too. For example a surgeon who makes 500,000 probably well end of with only 260,000 to take home depending on deductions. Let's just not stop there. Pediatricians are some of the hardest working docotrs there are. They put in long hours and yet the average income a year is $110,000. A computer science major who went to work immediately after college has the potential to make that much. Considering the way things work out, there are a lot of easier ways to earn money. To sum it up, the amount docotrs earn are perfectly justified. Now whether or not treatment should be provided for patients who have no money, that's a different subject.

 

[Dr.No]

Does filling out the parental section in the Fafsa give you the opportunity to get more financial aid or does it matter? They told me I could fill that part later if I wanted to. Dont know if you talked about this before...................

 

[Aloha Kid]

Dr. No,

If your parents don't make much and you don't make much then filling out that part will allow you to qualify for some really awesome scholarships and loans determined by the school you go to. These scholarships are reserved for needy individuals, meaning, that parental and family support is minimal. I would suggest looking into it. If you talk to the financial aid department at you school, they can probably figure out based on your Fafsa and your parents reported income if you qualify or not. If you qualify you just might receive close to full tuition scholarships of loans based upon the condition that you go into primary care. Check it out.

 

[hagbard]

have you considered the use of a sliding scale system, based on a person's yearly income, i guess using tax information.
i haven't had any direct experience with this but have heard of chirpractors and naturopathic docs doing such a thing, massage therapists as well.
it sounds like what you are describing is a basic business plan. in massage therapy school we spent a brief amount of time making one up. it can be a very useful practice.
nice to see another old guy out there. if all goes as planned i will be in my 40's as well when i graduate.
right now i am in the pretend it isn't there relationship phase with my white elephant.
good fortune to all.