Debt worth it for low-paid specialties?

[arc5005]

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So, I'm deadset on applying to DO & MD programs; however, while visiting home this week I had a buddy of mine who is a 3rd year resident in anesthesiology telling me how it isn't worth it to go to med school for a low-salary specialty. He was almost suggesting PA as a better route and kept saying he's met PA's in the ICU making 200,000. I thought the average PA salary was 90,000??? He said, he doesn't regret going to medical school, but he says he would have regret it if he went for a primary care or other lower paid specialties. This is coming from a guy who is a 3rd generation physician.

At the moment, family med, peds endocrinology, PM&R, and EM are the specialties i'm most inclined to. Honestly, probably wouldn't mind dermatology, rad onc, or diagnostic radiology either if I were somehow to be a competitive applicant for any of them.

I'm not even really debating PA school. Perhaps as a backup if I do not get into any medical school, but I am a bit worried about the debt. I'm sure this is a common concern.

In this situation would you just go to the cheapest MD/DO program if you were to go a low-salary specialty?

 

[hopefulERdoc251]

I don't know if you should be excluding a field because of salary....

 

[arc5005]

I don't know if you should be excluding a field because of salary....

it's not really about salary... it's about debt. I'm pretty sure I'd be very comfortable with a 150-200K salary, especially if my partner is contributing to our household income. I'm worried about debt more than anything, because I have other life aspirations that require $$$ (ex: middle-class house, surrogacy, international vacations)

I'm a planner and just like to think ahead. I doubt I'll pick a medical specialty for salary. Like I said my main interests are in lower-paid salary specialties: PM&R, primary care, EM (average salary), etc...

 

[Seth Joo]

So, I'm deadset on applying to DO & MD programs; however, while visiting home this week I had a buddy of mine who is a 3rd year resident in anesthesiology telling me how it isn't worth it to go to med school for a low-salary specialty. He was almost suggesting PA as a better route and kept saying he's met PA's in the ICU making 200,000. I thought the average PA salary was 90,000??? He said, he doesn't regret going to medical school, but he says he would have regret it if he went for a primary care or other lower paid specialties. This is coming from a guy who is a 3rd generation physician.

At the moment, family med, peds endocrinology, PM&R, and EM are the specialties i'm most inclined to. Honestly, probably wouldn't mind dermatology, rad onc, or diagnostic radiology either if I were somehow to be a competitive applicant for any of them.

I'm not even really debating PA school. Perhaps as a backup if I do not get into any medical school, but I am a bit worried about the debt. I'm sure this is a common concern.

In this situation would you just go to the cheapest MD/DO program if you were to go a low-salary specialty?

Here is a word of advice, if you go to medical school do not take out private loans, just take out Federal and Direct loans, because you can get income sensitive payment after you graduate.

EM is very doable as a DO.

 

[mathnerd88]

So, I'm deadset on applying to DO & MD programs; however, while visiting home this week I had a buddy of mine who is a 3rd year resident in anesthesiology telling me how it isn't worth it to go to med school for a low-salary specialty. He was almost suggesting PA as a better route and kept saying he's met PA's in the ICU making 200,000. I thought the average PA salary was 90,000??? He said, he doesn't regret going to medical school, but he says he would have regret it if he went for a primary care or other lower paid specialties. This is coming from a guy who is a 3rd generation physician.

At the moment, family med, peds endocrinology, PM&R, and EM are the specialties i'm most inclined to. Honestly, probably wouldn't mind dermatology, rad onc, or diagnostic radiology either if I were somehow to be a competitive applicant for any of them.

I'm not even really debating PA school. Perhaps as a backup if I do not get into any medical school, but I am a bit worried about the debt. I'm sure this is a common concern.

In this situation would you just go to the cheapest MD/DO program if you were to go a low-salary specialty?

I used to think like you, but to be honest, you'll be able to live comfortably with your salary and paying off the debt, even as a PCP.

You'll always hear "anecdotes" about salaries and whatnot, but stop worrying about the debt. Just don't go to a super expensive school, and you'll pay off the debt in whichever specialty you'll choose. It may take a while to pay off the debt (5 years or more,) but you aren't going to be living in the dumps while you do, especially if you have a significant other who also works. Also, Affordable Care Act has decreased salaries for many physicians, but actually increased those who are in primary care in areas of need, because of this large gap between salaries of specialties.

Also, be realistic with yourself. If you're going to DO school you'll most likely end up in primary care. Don't count on going into more competitive residencies as your "plan to pay off this debt." If debt was an issue, then what about those thousands of graduates from DO schools who have to pay off their debt? Obviously it can be done. You have also programs that will help you pay off your debt if you decide to work for a couple of years in areas of need.

CCOM graduates have even more debt to pay off, and yet they still manage.

 

[arc5005]

I used to think like you, but to be honest, you'll be able to live comfortably with your salary and paying off the debt, even as a PCP.

You'll always hear "anecdotes" about salaries and whatnot, but stop worrying about the debt. Just don't go to a super expensive school, and you'll pay off the debt in whichever specialty you'll choose. It may take a while to pay off the debt (5 years or more,) but you aren't going to be living in the dumps while you do, especially if you have a significant other who also works. Also, Affordable Care Act has decreased salaries for many physicians, but actually increased those who are in primary care in areas of need, because of this large gap between salaries of specialties.

Also, be realistic with yourself. If you're going to DO school you'll most likely end up in primary care. Don't count on going into more competitive residencies as your "plan to pay off this debt." If debt was an issue, then what about those thousands of graduates from DO schools who have to pay off their debt? Obviously it can be done. You have also programs that will help you pay off your debt if you decide to work for a couple of years in areas of need.

CCOM graduates have even more debt to pay off, and yet they still manage.

Thanks. Yeah, realistically I'm mostly interested in primary care fields, PM&R, and EM. PM&R is probably my top interest as of now. It isn't considered primary care, but a lot of DOs seem to match into PM&R. How competitive is PM&R?

 

[Rekt]

Here is a word of advice, if you go to medical school do not take out private loans, just take out Federal and Direct loans, because you can get income sensitive payment after you graduate.

EM is very doable as a DO.

It's becoming considerably more competitive. I wouldn't bank on this route.

 

[samac]

Thanks. Yeah, realistically I'm mostly interested in primary care fields, PM&R, and EM. PM&R is probably my top interest as of now. It isn't considered primary care, but a lot of DOs seem to match into PM&R. How competitive is PM&R?

By the numbers our school showed us a couple weeks ago PM&R is one of the easiest specialties to get into.

 

[docycle]

Also, be realistic with yourself. If you're going to DO school you'll most likely end up in primary care

What.

How competitive is PM&R?

It's not. Like at all.

Take boards very seriously if intending to go EM. Otherwise, you could barely pass and do PCP/PM&R.

 

[DetectiveAlonzo]

There's a difference between rich and wealthy. The question isn't how much you make.. it's what you can do with what you make.

The 3rd-generation doc you talked to is butthurt (for lack of a better term) because he is used to mommy and daddy making a killing that contributed to his high-consumption lifestyle.

Now that he isn't making as much as them, or was expecting to ball straight out of residency, it's a different ballgame for him and he can't do the upkeep without working more hours for similar pay.

If you live frugally and below your means, you'd be surprised what you'll be able to do with your money.

Sure, you make more money doing business and other things... but what happens when you default on your loans? Or when the economy and sector you are in experiences a downturn?

They can take your property, but they can't take your intellect. You can pack and move.

If all else fails, go practice in a rural, underserved area and make a killing.

Yes, the debt is worth it. You can get out of debt if you live frugally. Depends if you have the willpower and integrity to put your ego aside and drive a toyota and live in an apartment for a few years rather than go get that Porsche and Louis Vuitton belt for your $300 True Religions.

 

[scoKraz4]

Also, be realistic with yourself. If you're going to DO school you'll most likely end up in primary care. Don't count on going into more competitive residencies as your "plan to pay off this debt."

Yeah if you slack off..same with MD programs. I know plenty of people who were just average students and didn't have an issue going into a whole range of specialties in DO programs. Generalizations based off of feelings are things a future doctor should shy away from.

 

[scoKraz4]

When you finish residency, live like a resident for a few years after and crush the debt.

 

[mathnerd88]

Yeah if you slack off..same with MD programs. I know plenty of people who were just average students and didn't have an issue going into a whole range of specialties in DO programs. Generalizations based off of feelings are things a future doctor should shy away from.

No...more like be prepared for the worst, and hope for the best. There's a difference. I'm not going to automatically assume I'll get into anesthesiology, make big bucks, and pay off the debt easy.

Going into a DO school closes many doors for competitive residencies, especially in academia.

An average MD applicant has a much better chance getting into a competitive residency than the top of the line DO applicant.

And also, the merger may not be helping the DO cause at all that much.

 

[scoKraz4]

No...more like be prepared for the worst, and hope for the best. There's a difference. I'm not going to automatically assume I'll get into anesthesiology, make big bucks, and pay off the debt easy.

Going into a DO school closes many doors for competitive residencies, especially in academia.

An average MD applicant has a much better chance getting into a competitive residency than the top of the line DO applicant.

And also, the merger may not be helping the DO cause at all that much.

First, anesthesia isn't that competitive. Being a DO might close doors to the most competitive MD residencies (as it would for most MD's anyway) and certain med specialties like derm/optho/etc unless you have a great connection and the application.
Besides that if you work hard you can match into whatever in the DO match. You are right that an average MD candidate could get that spot over a competitive DO for an MD residency, but you will still match somewhere and make the same amount of money, or more depending on location, and do the same thing. If prestige is your thing then it will be more of an uphill battle. I work with DO doctors now that are ortho's/urologists/anasthesia/EM..they just worked hard to get where they are, as you should anyway going into this profession.

 

[IslandStyle808]

Thanks. Yeah, realistically I'm mostly interested in primary care fields, PM&R, and EM. PM&R is probably my top interest as of now. It isn't considered primary care, but a lot of DOs seem to match into PM&R. How competitive is PM&R?

PM&R seems to be mildly competitive and is probably the most DO friendly field. You can do fellowships to increase your salary if it concerns you a lot.

 

[NonTrad16]

If you're going to graduate with 600k in debt (undergrad, med school, partner, etc) then you have a real burden regardless of specialty. If you have 200k debt, you'll be in a much different place. Where do you expect to be?

I think pursuing medicine with the interest/intent for a less-competitive area is preferable to banking on a high paying one to finance the adventure, since your chances at PM&R or FM are more favorable then the more competitive ones (speaking generally). Assuming you're not up to your eyeballs in debt, it seems likely that you should be able to manage if you pursue PM&R, FM, EM, etc. It'll be a matter of budgeting and understanding you can't afford everything on your list immediately upon graduation.

It's also worth recognizing much things can change in 8-10+ years (when you'd be finishing residency). What's competitive now can change, and it will be interesting to see how the merger affects residency placement once it goes into full effect. Additionally, compensation for each area will continue to change. All in all, we're all trying to head down this road, so most people here will probably say you can have a good standard of living as a physician.

 

[docycle]

When you finish residency, live like a resident for a few years after and crush the debt.

So....no mansion parties?

No...more like be prepared for the worst, and hope for the best. There's a difference. I'm not going to automatically assume I'll get into anesthesiology, make big bucks, and pay off the debt easy.

Lol especially with a hungry CRNA group rolling 20 deep and twice as cheap coming to a state near you.

It's fiiiiiiine. We'll be fiiiiiiiiine.

Going into a DO school closes many doors for competitive residencies, especially in academia.

Many != majority. The market offers a supply greater than that amount which is restricted.

An average MD applicant has a much better chance getting into a competitive residency than the top of the line DO applicant.

And also, the merger may not be helping the DO cause at all that much.

It isn't at all. I'm assuming the former ACGME board can't stop laughing about how they totally robbed the AOA blind while making them think they got an awesome deal.

Some winter reading for you all: http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

 

[cliquesh]

I don't think medical school is worth it if you anticipate a lot of debt, especially if you only want to do primary care. If you LOVE medicine, it might be worth it, but there is no way to know that until you're in practice.

 

[PathoTurnUp1865]

So....no mansion parties?



Lol especially with a hungry CRNA group rolling 20 deep and twice as cheap coming to a state near you.

It's fiiiiiiine. We'll be fiiiiiiiiine.



Many != majority. The market offers a supply greater than that amount which is restricted.



It isn't at all. I'm assuming the former ACGME board can't stop laughing about how they totally robbed the AOA blind while making them think they got an awesome deal.

Some winter reading for you all: http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

I don't think it will be as gloomy as you think. Maybe it depends on what region you're in. I don't see my region being affected too much, over half of my medical school matches allo anyways.

 

[arc5005]

If you're going to graduate with 600k in debt (undergrad, med school, partner, etc) then you have a real burden regardless of specialty. If you have 200k debt, you'll be in a much different place. Where do you expect to be?

I think pursuing medicine with the interest/intent for a less-competitive area is preferable to banking on a high paying one to finance the adventure, since your chances at PM&R or FM are more favorable then the more competitive ones (speaking generally). Assuming you're not up to your eyeballs in debt, it seems likely that you should be able to manage if you pursue PM&R, FM, EM, etc. It'll be a matter of budgeting and understanding you can't afford everything on your list immediately upon graduation.

It's also worth recognizing much things can change in 8-10+ years (when you'd be finishing residency). What's competitive now can change, and it will be interesting to see how the merger affects residency placement once it goes into full effect. Additionally, compensation for each area will continue to change. All in all, we're all trying to head down this road, so most people here will probably say you can have a good standard of living as a physician.

I'm not really sure how much debt I'll be in after med school...I have a feeling I'll be around 300K? I don't know what the average is. My partner should be in the range of 65-80K salary (probably on the lower end) w/ zero debt. However, partners can change...so I don't want to base it off my s/o.

 

[docycle]

I don't think it will be as gloomy as you think. Maybe it depends on what region you're in. I don't see my region being affected too much, over half of my medical school matches allo anyways.

I don't think it's that bad really. But I don't really care since I'd be fine to go PCP.