does medicine self-select the wealthy?

[katem]

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as various other posts have pointed out,

- the burden of med school debts is becoming increasingly overwhelming
- those who have to work in school often have lower gpa's and/or fewer e.c.s making it more difficult for them to gain acceptance
- even the cost of applying is becoming prohibitive (i'm budgeting 15-20% of my pre-tax income this year)

none of this is news to anyone, but i feel like medicine is getting to the point where it will be nearly impossible for those not from upper-middle class backgrounds to attend medical school, a situation with both vast and grave consequences.

i was just curious to hear what others had to say about whether this trend will continue, and whether there are any potential solutions to the problem.

 

[Zoobaby]

The working while in school = low gpa is a generaltiy that doesn't hold with everyone. Also, if you are accepted into med school you WILL get loans, pretty much regardless of money history.

Sure it will be a pain to pay back those loans, but with the avg salaries of full docs being as high as they are (still) it's totally doable.

It's easier if you're rich, that's true, but what isn't?

I think, if anything, medicine is less and less a profession of the already wealthy. Think about it, how many docs from poor or minority backgrounds were there as recently as 50 years ago?? Not many. I know there is more to it than that, but I think the larger trends (decades vs years) show great improvement.

 

[Random Access]

Well, there are fee waivers and such, but that helps in no way with flying out to schools for interviews, which can be the most expensive part of applying. I suppose one could apply to nearby schools, thereby reducing the need for plane fares, but that means only the more well-off can afford to go to schools that are far away from their homes.

I'm not really concerned about the burden of med school debts. I think people just like to bitch about them. With the income people will make post-residency, it's more of a non-issue. For those who might be going into underprivileged areas, there are programs that can help reduce debt in exchange for doing so, right?

As for those having to work in school, it seems like it's a matter of managing your time well. I'm not sure that having to work necessarily makes it more difficult to have a strong application. I've always found that when I stay busy, I tend to do better in classes because I have to manage my time better.
It's true that you have less time to do ECs and such, but working 8-10 hours a week would count as experience in the eyes of a med school, and if you worked in a lab, it would count as a med-related EC.

On a side note, there are those jobs in the "student health education" offices that basically consist of passing out condoms and lube that sound like they're med-related, but does anyone know what med schools really think of those jobs (so to speak)?

-RA

 

[SMW]

Originally posted by katem
- even the cost of applying is becoming prohibitive (i'm budgeting 15-20% of my pre-tax income this year)

I feel this is the biggest unfairness. It definitely helps to apply to LOTS of schools and go to LOTS of interviews -- a very expensive proposition. Last year I spent close to $10,000 on the whole process (clothes, MCAT prep, test and app fees, air/bus/taxi fares, hotels). Granted, I live in Alaska and flying anywhere from here is expensive, but it really shouldn't cost this much to have a decent shot at admission. I simply could not have afforded it, if my parents weren't footing the bill. I know decent candidates up here who didn't apply to as many schools and didn't get in anywhere, though they got a few interviews. 🙁

 

[Thundrstorm]

I can only rely on my own experience. I'm somewhere in the middle class I guess. My dad makes 6 figures, but for various reasons (that I won't go into here), my family lives in a trailer park (albeit a nice one 😉 ), I work 2 jobs during school (and worked all during high school), but I'm still in college on a full scholarship and pre-med. I think medicine preselects the dedicated, wealthy or not.

 

[agent]

I'm an example of a person doing it and im not rich.

 

[saiyagirl]

i do think the wealthy are probably overrepresented in medicine, though i admit not as much as it probably was decades ago.

however, i wonder whether the cost of applying to medical school deters OTHER qualified poorer applicants from applying (ie, yes we are making progress, but at what rate are we compared to what it could be if the costs were reduced?)

about 19% of medical students do NOT take out loans to pay for school. that's nearly 1 in 5!! think about that...nearly 1/5th of the people in med school can afford med school. doesnt that seem like a little too much to you? if anything, it certainly does not reflect the american population, or probably even the total applicant pool.

not to mention, it is so hard to get a fee waiver...you have to live in like a cardboard box or something.

my file isn't complete because i'm struggling to pay secondary fees...paycheck to paycheck...i hope a later interview doesn't hurt me too much.

 

[agent]

Originally posted by Thundrstorm
I think medicine preselects the dedicated, wealthy or not.

agreed, its just harder if you dont have the money.

but if you really want it, its available to anyone.

-----------------------------
if you build it, they will come..

 

[SMW]

My hat is off to those of you doing this on a shoestring!! Btw, my folks won't be paying for medschool. 🙁

 

[agent]

Originally posted by SMW
My hat is off to those of you doing this on a shoestring!! Btw, my folks won't be paying for medschool. 🙁

yeah honestly im a bit scared about how things will turn out.

but IMO if I stay strong, have faith, and continue to build a strong application I should be fine.

doing all of this with a family is very intimidating.

 

[Bikini Princess]

Originally posted by SMW
My hat is off to those of you doing this on a shoestring!! Btw, my folks won't be paying for medschool. 🙁

it's amazing that *anyone*'s parents pay for med school, let alone 1/5 matriculants.

I don't think there are any rewards for adcoms to select poor applicants over more affluent ones.

After all, i think med schools care most about students who can pay bills.. there's no motivation for a med school to select a poor student over a rich student, other than altruistic reasons.

on the other hand, being rich doesn't guarantee having a good gpa, or mcat. Rich people still have to work hard to get their grades, and maybe more is expected of them. also, i think wealthy people aren't swayed by the monetary reasons to go to med school, which is good because they might not be as greedy.

 

[Zoobaby]

Originally posted by saiyagirl
i do think the wealthy are probably overrepresented in medicine, though i admit not as much as it probably was decades ago.

however, i wonder whether the cost of applying to medical school deters OTHER qualified poorer applicants from applying (ie, yes we are making progress, but at what rate are we compared to what it could be if the costs were reduced?)

about 19% of medical students do NOT take out loans to pay for school. that's nearly 1 in 5!! think about that...nearly 1/5th of the people in med school can afford med school. doesnt that seem like a little too much to you? if anything, it certainly does not reflect the american population, or probably even the total applicant pool.

not to mention, it is so hard to get a fee waiver...you have to live in like a cardboard box or something.

my file isn't complete because i'm struggling to pay secondary fees...paycheck to paycheck...i hope a later interview doesn't hurt me too much.

As someone pointed out in another thread, that 19% of folks who don't take out loans include scholarships and other wheeler-dealer set-ups like the military, or commitments to working in underserved areas for a period of time. I'm not sure what % those types make, but I have to believe that the number of people who can pay for school out of pocket is much lower than 19%.

I agree, tho, the secondary fee/flying to interviews racket sucks.

 

[specialk]

LOANS.

You can get loans for anything in this country. And when you're done, you'll be able to pay it off easily. If medicine's what you wanna do, you'll have no problem realistically financing it. Like someone said earlier, practically EVERYONE gets loans.

 

[pathdr2b]

of course, visual indicators of poverty (like skin color) are important;

Please, please, please someone tell me that she didn't just say that! eek: What is a "visual indicator of poverty" and "how does this relate to skin color"?😡:

 

[relatively prime]

This is just BS. For one thing... almost everyone works during school... even if you're upper-middle class. Secondly, you can apply for the amcas fee waver... if you don't get the waver then you're not that poor. And if your parents won't pay for it... you can take out a loan. Lastly, no one worries about medical school debt. Financial aid at most schools is very fair... and once you're a doctor you're pretty much guarenteed to make at least 80K a year... more than enough to pay off your loans.

My mother grew up in the low income housing PROJECTS of NYC!! And she is now a physician... and this was 30 years ago when women weren't "meant" to be doctors! So go try to tell her that med school is for the wealthy... and see what she has to say.

My parents aren't going to be able to give me anything at all towards medical school tuition. But I'm not the least bit worried about it... because there are so so so many loans out there. They did help me with the ap fees and interviews... but if they had decided not to... I would have taken out a loan. Like the other poster said... you can get loans for anything... and with a doctor's salary you're sure to be able to pay them off.

 

[saiyagirl]

Originally posted by Zoobaby
As someone pointed out in another thread, that 19% of folks who don't take out loans include scholarships and other wheeler-dealer set-ups like the military, or commitments to working in underserved areas for a period of time. I'm not sure what % those types make, but I have to believe that the number of people who can pay for school out of pocket is much lower than 19%.

I agree, tho, the secondary fee/flying to interviews racket sucks.

true...i forgot about this. thanks 🙂 despite that though, i still have to wonder what the percentage is relative to what the number would be against the applicant pool or the american population.

and someone else said..."i think wealthy people aren't swayed by the monetary reasons to go to med school, which is good because they might not be as greedy."

i have to disagree with this. while many of wealthy applicants may do this, i must imagine that a large number might also--in an effort to maintain their lifestyle--be attracted to medicine for monetary reasons.

to be sure, poor applicants may be plenty greedy too since they did not have money to burn...but i also imagine there are many once-poor doctors who are more likely to be altruistic with their money because they know what it is like not to have any. (or perhaps be more willing to recieve a lower salary by working in lower-income/poorer areas, etc...this still is probably better than where they were before, you know what i mean?)

 

[pathdr2b]

For one thing... almost everyone works during school... even if you're upper-middle class.

Overall, statement well said!! BUT there is a huge difference between working to pay on your credit card bills and working to earn income to eat or buy books. Better yet, how about having to choose between eating or buying books as I had to do!

PS- I chose to eat and checked the books out from the library until the next payday.😉

 

[TroutBum]

pathdr2b--

I'm guessing (hoping) that this comment just came out wrong. I would guess that what he/she is trying to say is that, statistically speaking, there are many more people of color who are financially struggling than white people. I don't think anybody would deny that. At least that's how I read into it.


quote:
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of course, visual indicators of poverty (like skin color) are important;
--------------------------------------------------------------------------------

Please, please, please someone tell me that she didn't just say that! eek: What is a "visual indicator of poverty" and "how does this relate to skin color"?:

 

[DW]

Originally posted by relatively prime
This is just BS. For one thing... almost everyone works during school... even if you're upper-middle class.

mostly agreed as usual RP, but for this small comment, you obviously have NOT seen the BMW laden campus at my undergrad

my next door neighbor my freshman year had a 5K a month allowance from his parents. he actually ran out of money a couple times trust me, he wasn't an outlier......

 

[SMW]

Wow! 😱 Calm down, RP! No one is saying med school is for the wealthy. But I didn't work during college and know lots of people who didn't. The AMCAS waiver is so hard to get as to be of help to very few applicants. When your mother got into medschool, it probably wasn't the norm for people to apply to 15+ schools and fly all over the country interviewing for a realistic shot at admission. Most people can't get loans to pay for interviewing costs. No one is saying there's injustice here on a par with, say, the Taliban's treatment of women, but there does seem to be a slight advantage to being well-off, if not necessarily rich. That doesn't mean that some poor folks don't get in.

And I agree, that "visual indicators of poverty" comment was quite disturbing! 😱

 

[DW]

smw, you're truely the voice of reason on SDN 🙂

yeah, the med school admissions process is a completely different game these days. when my boss was applying to harvard 30 some years ago, among the whopping 3 schools she had to apply to with her 2 Cs in O chem, they covered all her travel and lodging expenses, so she wouldn't have to tack that onto the 2K a year for med school tuiton. every time she tells this, i want to hurt someone 🙄

 

[Zoobaby]

Originally posted by DW


harvard
3 schools she had to apply to
with her 2 Cs in O chem
they covered all her travel and lodging expenses
2K a year for med school tuiton

😡 😡 😡

 

[pocwana]

Originally posted by SMW
Most people can't get loans to pay for interviewing costs.

it does suck to not have money or parents to give you money, to be in debt, and try applying to med school, but the key is LOANS. i've been working to pay for a lot of it, but what really came in handy was that i took out basically the max i could in loans during undergrad and saved some of it so that i could use it during the interview process. phew, it's come in handy! if you're not in the wealthy category, it's totally feasible to become a doctor, you just have to be willing to take out LOANS and be in debt, probably for a couple of decades, before everything is squared away. but that's just it, eventually, you'll be out of debt and able to buy both books and food 😉

 

[isidella]

Originally posted by relatively prime
Secondly, you can apply for the amcas fee waver... if you don't get the waver then you're not that poor. And if your parents won't pay for it... you can take out a loan.

I did not get the waiver and I am poorer than dirt. "Working poor." Amcas does not take previous debt or cost of living into consideration.

Parents death=2 funerals=severe debt=bad credit=no loans

I am reading a lot of really sweeping assumptions.

I am paying for my applications by working full time with two part-time jobs and selling off sentimental items, piece by piece. The last one, my mother's hand painted tea service.

I don't think medicine just selects the wealthy, it selects the resourceful.

 

[DW]

okay, i'm going to have to drop a little public service annoucement.

in response to the "oh, just take out a loan" comment, its NOT that simple for all you kiddies out there. yes, borrowing money for the process is an acceptable way to get funds to get into med school, but if you think getting money is always like the context of a 6 percent subsidized stafford loan, without any appreciable credit history or income, you've potentially got another thing coming.

if you take out the several Gs to apply from the types that tend to give out loans indiscriminately to young people, predatory lenders, you could be paying out the wazzoo in interest, and if you dont get in, you'll be saddled with possibly double the anticipated debt. as much as you'd like to go to medical school, there such things like "liens against your property" or "garnishment of wages" which will more or less kill your opportunities for financing on medical school later on. if you need to take out a loan, yes by all means try, but TREAD WITH CAUTION: there are companies that make a living f*cking over poor students like you. i know a handful of people that will be glad to give you their nightmarish first hand experiences 😳

 

[pocwana]

of course, if it can be avoided, i would not recommend bank loans/credit card debt. these, i have fortunately been able to avoid. but if you can, take out a couple thousand more in school loans that will be low interest, maybe even no interest during school, and deferred during med school as well. obviously, this is not an option for those people out of school and unable to take out school loans, but it's something for those ugrads to consider. just make sure you do set it aside and keep it aside, preferrable gaining interest.

 

[relatively prime]

Look... I'm not saying that having money doesn't make it easier... but not having money far from makes it impossible. Having money always helps... no matter what you're doing. I just don't want people to read this and think they can't go to medical school because they are not from the upper middle class... or to use their economic situation as an excuse for not achieving.

Yes, taking out loans isn't that easy... but neither is geting a 29+ on the MCAT. However, the people who really want to be doctors.... they manage... they do it.

If you have a lot of past debt... you really have to ask yourself why you have that debt. If you went to some fancy private university that cost you $40K a year when you could have gone to your local state university that would have only cost you $10K... well that was your decision. And if you bought a car when you could have bought a bike... well... you see what I'm saying... I understand that some people are in debt for reasons they couldn't have forseen or controled (i.e. funerals)... however, I haven't met a significant number of these people.

Unfairness in inherent in the design of the world... however, we're fortunate to live in a country were nearly anything is reasonably possible if you really want it... even for the middle class (which, why the way... makes up like 90% of the population)

If we lived in a communist society were everyone had the same amount of money... we'd probably all complain that some people are born smarter than other... and if they found a way to make everyone equally as smart... we'd probably complain that some people had nicer parents than other... and if they raised all children by government trained mechanical robots we'd probably complain that our robot was not as shiney as our neighbors...

 

[jwin]

i am wondering for those of you in this post who have said that it is easy to pay back loans have talked to a person whose parents cannot contribute to med school tuition and is trying to pay off their loans post residency. many private schools regardless of your state of need make you loan out all of your tuition and living costs. my friends who are going to tufts and pritzker this year are receiving around 55,000 dollars in loans. multiply this figure by 4 and tack on an average undergraduate debt, pray that your loans are subsidized, and you are looking at 250,000 dollars when you are finishing your residency. a person is likely 24yrs old+4 yrs med school+4yrs residency=32 years old. this is a time many people would agree is good to start a family, and a must for many women to start having a children if they intend to do so. 250K does not mean you owe 250K, this is the pre interest figure, you are looking at a figure that is likely much larger and closer to 300K. if you were able to pay back, what i think is a rather sizable figure of 50K a year, assuming a staring salary of 125K that would be a take home of around 80K. this leaves the young hot shot doctor with a whopping living salary of 30K. this sort of payment plan would pay off the loans in 5 years now making the doctor 37 years old by the time he or she is worth a positive amount of money. if this sounds easy to you guys, then your minds work in very interesting ways.

 

[Random Access]

Well the standard payment time is 10 years for the undergrad loans. I'd imagine the med loan is similar?

In any case, no one said it was easy to pay back loans. Just that it's possible with the income you have. After you pay it back, even if it takes you 10 years, you'll be rolling in the dough.

-RA

 

[jwin]

being 42 and still paying back student loans does not appeal to many, hence my accelerated time table
as for rolling in the dough, at 42 years old, having not saved for your children's college education (assuming you would not make your kids pay for loans after seeing what a pain your own loans are), having no money for a down payment on a home (assuming some day you wish to own the roof over your head), and having no saving or money towards retirement, I would not exactly classify one's financial situation as "rolling in the dough"

 

[DW]

well said jwin. a 10 year repay on 150K debt with taxes, insurance, etc, wont get you on "lifestyles of the rich and famous" on an internist salary.

RP, the counterpoints were not to complain about the state of affairs. just to shed a little realistic light on the situation, thats all, before people start running to take out money from those sketchy ads in the paper.

 

[relatively prime]

Originally posted by DW


RP, the counterpoints were not to complain about the state of affairs. just to shed a little realistic light on the situation, thats all, before people start running to take out money from those sketchy ads in the paper.

Yeah yeah... I know. 🙂 I kinda went off on a tagent... sorry. BTW... to all those who don't have all the money at their feet to apply... I hold you in very high regard. Just in case it seems that I don't have a lot of respect for people who have to do this on a strict budget... believe me I DO. I just don't want anyone to get the idea in their head that they can't apply because they are not upper-middle class. I believe medical schools do take into light the fact that some students have to work during school (to pay basic expenses... not just to get those jeans from the Gap)... and if they don't then they really should. But I believe most of them do.

 

[paean]

There are a number of students at my school who haven't taken out loans, aren't doing an Army/NHSC type deal and don't get money from their family. How? They worked before coming to school, saved up money, and have a spouse/partner who works. Just another think to think about when you get depressed that you have to take out loans and your classmates seem wealthy.

Anyone who can't afford the application costs can always graduate, take a year or two off, and save up enough to get through the application process. I did that, paying for about 8,000 out of my total application cost of about 10,000 out of my income. (My parents helped me with about 1000, and I saved the first 1000 of my total cost from my senior year Stafford loans.) I lived like a poor student, except for flying all over the country, but it worked.

AMCAS waivers are hard to get, but FYI, if you didn't get one, you can call the admissions office and ask if they will give you one for the secondary, and sometimes they do.

I think more of the disparity has to do with opportunities earlier in life for persons who grow up poor. Once you make it through undergrad, you have options, and should be able to make it work financially.

In terms of not looking as good if you have to work during college, I took 6 years to graduate from Berkeley, and worked part-time through most of it. My work experiences were as valuable as many applicant's volunteer experiences, and some schools took me more seriously because I worked, while others seemed to focus more on the fact that I was rarely full time. So it really depends if working will be an asset or a hinderance.

 

[lady bug]

paeann it cost you 10K for the application process?!! I think thats the largest amount I've ever heard someone spend on applications! 😱 😱 😱 😱

 

[relatively prime]

Originally posted by lady bug
paeann it cost you 10K for the application process?!! I think thats the largest amount I've ever heard someone spend on applications! 😱 😱 😱 😱

There is absolutely no reason why the application process should cost anyone more than $5000...

 

[katem]

you all have made a lot of good points.

when i started the thread, i wasn't trying to say that there was no way for someone without much money to attend med school (sorry about the dbl negative). i just think committing to 18-20 years of near-poverty (8 yrs training + 10-12 years loan payback) might be a bit daunting, even if you will have a good income after that. as others have said, those years are the prime years for trying to buy a home, save for kids' college, invest for retirement, etc.

and i am concerned that the profession will lose out on a lot of potentially fabulous doctors who are turned off by the challenges of financing medical school.


on a completely separate note, good luck to all the august MCATers!

 

[Andrew_Doan]

If medicine selected for the wealthy, then I would not have ever made it. My parents were immigrants and made less than $10 per hour.

Borrow now, and then pay later. $150,000-$200,000 debt will be paid off. It's a sound investment considering the job and salary security. I also found different routes to pay for my medical education. I pursued the MSTP and then the Navy. There are many ways to pay for medical school asides from student loans.