[1] The next thing to look at is how much your loan will grow during residency.
Example of above with 336k graduating in 2013 & 5yr residency.
calculator:
http://www.calculator.net/interest-calculator.html
You have a family, doing IBR with a very small payment.
Loan of $336k at 6.8% will generate interest of:
$22,848/yr
-The small monthly payments you can afford towards interest will be negligible.
Just to pay 30% of that interest you will need to pay $571/mo (that is a lot of money with a family).
After 5yr residency total interest:
$114,240.00
Total Loan balance at end of residency:
$450,240.00
Going for PSLF is good, but you never know what job options will be at graduation time.
[2] This brings me to next point. Current osteopathic students are graduating with the largest debt. This poll shows about 43% graduating with >300k.
Yet osteopathic schools keep pushing for students to go into primary care, the lowest paid field. There is a growing disconnect (as always in academia vs marketplace) of what is told to students and what the reality is.
Current numbers (and tuition increase trends) suggest that the point where going into primary care is not a financially sound decision is very close or already here.
Of course, this information is not relayed to medical students. Counseling on minimizing and repaying student loans is done during last week of medical school. This is something that should be done during first year of medical school, not when the train has left the station.
The reality of high loan amounts and 6.8% interest debt has to be looked at by students with a rational mind. Decide how you want your next 20yrs out of medical school to be.
[3] Another example:
Case-1: student graduating with 300k (6.8%) (43% of this poll is >300k)
Residency 3yrs: Loan balance at end of residency: $365k
10YR repayment schedule:
$4,096.00/mo
*lets say you are choosing to stay in a larger city (for many reasons e.g. family, friends, more fun), and can't find a PSLF job as there are many docs in these areas.
-Starting salary $160k ->monthly pay with 30% tax rate is
$9,333/mo
Monthly Salary - monthly loan payment =
$5,237/mo = ~85k/yr salary
Case-2: student graduating with 400k (6.8%) (43% of this poll is >300k)
Balance at end of residency: $487k
10YR repayment schedule:
$5,604.00/mo
-Staring salary $160k ->monthly pay
$9,333/mo
Monthly Salary - monthly loan payment =
$3,729.00 = ~60k/yr salary
Most residents make more than in Case-1 & Case-2 with moonlighting.