DOs what Total debt are you graduating in 2013 with?

[Dr Dazzle]

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So point being...if you decide to do family med or primary care with 300k debt, you aren't screwed for life and can have a decent life while paying off loans.

 

[cabinbuilder]

I don't feel screwed. I have a great life.

 

[cabinbuilder]

I am well aware that life exists outside of LA. I'm simply saying that small-town living isn't for everyone and especially for those whose spouses need to be in a big city for their careers. I am currently living in a city of 100K+, but the city is in such desperate financial straits that it feels like ghetto-ass nowheresville. YMMV.

Would your spouse need to continue her career if you were making that kind of cash? I know my husband quit going to work after my residency because his $400/week really didn't matter anymore.

 

[Silent Cool]

Would your spouse need to continue her career if you were making that kind of cash? I know my husband quit going to work after my residency because his $400/week really didn't matter anymore.

Assuming your spouse works ~40hrs/wk:

Some of us expect a spouse that earns more than ~$10/hr. Sorry.

 

[Silent Cool]

Would your spouse need to continue her career if you were making that kind of cash? I know my husband quit going to work after my residency because his $400/week really didn't matter anymore.

And I would never expect my spouse to sacrifice her career for mine. Would she need to continue? Well, I should EXPECT her to continue her career because, you know, her success also matters, too. Her self-esteem matters. Her accomplishments in life matter. Her ability to strive to be the best in her chosen field and to live up to her expectations in life matter. You know--just little things in life like that....matter.

 

[cabinbuilder]

Assuming your spouse works ~40hrs/wk:

Some of us expect a spouse that earns more than ~$10/hr. Sorry.

That's cool, I get that. Circumstances just worked out that way for us. He made way more in Alaska but his job in "America" just didn't pay the same so he was more valuable at home and that works for us. I wasn't trying to play down what your wife does, we all have our lives and choices how to live in it. Good for you for supporting her career goals. My husband supported mine, he is quite bit older and doesn't need another career, so it was logical for us to let him retire once I started mine.

 

[NurWollen]

I am well aware that life exists outside of LA. I'm simply saying that small-town living isn't for everyone and especially for those whose spouses need to be in a big city for their careers. I am currently living in a city of 100K+, but the city is in such desperate financial straits that it feels like ghetto-ass nowheresville. YMMV.

I see where you're coming from about your spouse needed a place big enough to develop his/her career. I guess what I don't understand is what qualifies as a big city for most people. 100k people is bigger than the capitals of many states.

 

[deleted307836]

I think when people use the term "big city" they are usually referring to major metro areas. Dallas, Miami, Boston, etc.

 

[Bacchus]

I see where you're coming from about your spouse needed a place big enough to develop his/her career. I guess what I don't understand is what qualifies as a big city for most people. 100k people is bigger than the capitals of many states.

Coming from a township of ~3500, anything is big to me. I had to leave Philadelphia. I hated it by the time I was done with undergrad and medical school. Where I am for residency is much smaller, but sometimes I'd still consider "big." I don't need much, I guess. Just a couch after a rowdy night (which can be had anywhere). Hell, I could probably walk from downtown to the hospital and crash in the callroom if I had to 😛.

 

[michigan1212]

I think something missed in this discussion was the topic of career stability. The trade a physician learns is not one that can easily be outsourced or downsized. There are fields where jobs may pay more or have less hours/stress, but those jobs are not easy to secure or find a new one after being fired/downsized.

 

[michigan1212]

According to my calculations, I will be approximately 250k in debt when I graduate. During residency I hope to keep up with the interest and then pay the rest off in a few years.

 

[Postictal Raiden]

According to my calculations, I will be approximately 250k in debt when I graduate. During residency I hope to keep up with the interest and then pay the rest off in a few years.

As weird as it sounds, you are luck!

I'm 60K in the hole from my undergrad. My med school's COA is 80-85/year depending on the year. That will put me ~450K by the time of graduation. There's no way in hell I will be able to keep up with the interests during residency. Therefore, that number will only grow. After a 3 year residency, and while making affordable payment, I will accrue ~25K/year. That's 525K after a 3-year residency or 600K after a 6 year of residency and fellowship. Repaying that in 10 years require ~85k/year.

I pray IBR/PAYE/PSLF remain an option.

 

[NurWollen]

As weird as it sounds, you are luck!

I'm 60K in the hole from my undergrad. My med school's COA is 80-85/year depending on the year. That will put me ~450K by the time of graduation. There's no way in hell I will be able to keep up with the interests during residency. Therefore, that number will only grow. After a 3 year residency, and while making affordable payment, I will accrue ~25K/year. That's 525K after a 3-year residency or 600K after a 6 year of residency and fellowship. Repaying that in 10 years require ~85k/year.

I pray IBR/PAYE/PSLF remain an option.

It's good to see someone with a realistic idea of what you're getting into while still pursuing your dream despite the insanity. I mean, you'd have to be insane to to what we're doing, and I'm still excited about it! Seven years? Half a million dollars. Might as well enjoy the ride.

It's funny how quickly debt estimates have ballooned. When I took my first prereq 5 years ago, the rough number that people through around for med student debt was ~$250,000-$300,000 range. Now people throw around half a million, and it's all too accurate. Craziness.

 

[Postictal Raiden]

It's good to see someone with a realistic idea of what you're getting into while still pursuing your dream despite the insanity. I mean, you'd have to be insane to to what we're doing, and I'm still excited about it! Seven years? Half a million dollars. Might as well enjoy the ride.

It's funny how quickly debt estimates have ballooned. When I took my first prereq 5 years ago, the rough number that people through around for med student debt was ~$250,000-$300,000 range. Now people throw around half a million, and it's all too accurate. Craziness.

It is insane. Without governmental repayment programs it makes no fiscal sense to go into too much financial loss. Despite that, I can't see myself doing something else. This is my passion. Aren't there fanatics who spends the majority of their money on customizing their cars, end of the line electronics, baseball cards, etc...? Consider me one of them. At least I'm spending this money on educating myself in a hope that one day I will be well off enough to repay all this and live decently.

 

[SurgeDO]

I think something missed in this discussion was the topic of career stability. The trade a physician learns is not one that can easily be outsourced or downsized. There are fields where jobs may pay more or have less hours/stress, but those jobs are not easy to secure or find a new one after being fired/downsized.

-primary care --> PAs and NPs
-anesthesiologists --> CRNAs
-radiologists --> literally is being outsourced
-orthopods --> podiatrists

the physician still has a nice view from his or her spot on the totem pole...but you would be naive to think you are irreplaceable.

just some food for thought.

 

[EMDO2018]

I have approximately 75 k in undergrad/grad loans.... My mom almost had a heart attack when she saw my student loan bills. I will have to make sure the feds do not send loan bills to my home address when I start med school. My mom will call me often crying.

 

[michigan1212]

-primary care --> PAs and NPs
-anesthesiologists --> CRNAs
-radiologists --> literally is being outsourced
-orthopods --> podiatrists

the physician still has a nice view from his or her spot on the totem pole...but you would be naive to think you are irreplaceable.

just some food for thought.

I was referring to stability relative to other careers. Of course you can be replaced, but as a doctor you can also go somewhere else and easily find employment. That is not always true for many professions.

 

[michigan1212]

As weird as it sounds, you are luck!

I'm 60K in the hole from my undergrad. My med school's COA is 80-85/year depending on the year. That will put me ~450K by the time of graduation. There's no way in hell I will be able to keep up with the interests during residency. Therefore, that number will only grow. After a 3 year residency, and while making affordable payment, I will accrue ~25K/year. That's 525K after a 3-year residency or 600K after a 6 year of residency and fellowship. Repaying that in 10 years require ~85k/year.

I pray IBR/PAYE/PSLF remain an option.

I should have added no undergrad debt and my spouse will be working, otherwise 75k(COA) * 4 = 300k without interest.

 

[michigan1212]

It is insane. Without governmental repayment programs it makes no fiscal sense to go into too much financial loss. Despite that, I can't see myself doing something else. This is my passion. Aren't there fanatics who spends the majority of their money on customizing their cars, end of the line electronics, baseball cards, etc...? Consider me one of them. At least I'm spending this money on educating myself in a hope that one day I will be well off enough to repay all this and live decently.

Even if you have $500k debt after you're done things are still likely to be better than many others. You may only have 60-90k after loan payments, but that still puts your salary way above most others in this country. I could live comfortably on $50k and having a career I enjoy.

 

[Postictal Raiden]

Even if you have $500k debt after you're done things are still likely to be better than many others. You may only have 60-90k after loan payments, but that still puts your salary way above most others in this country. I could live comfortably on $50k and having a career I enjoy.

So could I. Currently my wife, son and I live decently on less than 35K/year (before taxes) in SoCal. 60K post tax money is double what I earn now.

 

[Postictal Raiden]

I should have added no undergrad debt and my spouse will be working, otherwise 75k(COA) * 4 = 300k without interest.

My wife is currently in the process of obtaining her degree in Social Work (the field is in high demand). Eventually she'll be able to work and supplement my income. There's a light at the end of the tunnel.

 

[Back 5]

I'll owe ~ 500k after med school, combined with my previous loans.

Make > $450k and sing a "whoa is me" song? Give me a break people. Get some perspective.

 

[NurWollen]

I'll owe ~ 500k after med school, combined with my previous loans.

Make > $450k and sing a "whoa is me" song? Give me a break people. Get some perspective.

I see what you're saying, but most of us aren't going to be making that much.

Still, you have a point. We'll all be earning for more than the verge American, even when you account for loan repayments.

Plus, as IbnAlfanis said, there are and hopefully still will be programs like IBR, PAYE, and PSLF.

 

[sazerac]

As weird as it sounds, you are luck!

I'm 60K in the hole from my undergrad. My med school's COA is 80-85/year depending on the year. That will put me ~450K by the time of graduation. There's no way in hell I will be able to keep up with the interests during residency. Therefore, that number will only grow. After a 3 year residency, and while making affordable payment, I will accrue ~25K/year. That's 525K after a 3-year residency or 600K after a 6 year of residency and fellowship. Repaying that in 10 years require ~85k/year.

I pray IBR/PAYE/PSLF remain an option.

The interest payments alone on your student debt will be about $40,000 a year.

The Pay As You Earn system ties your loan payments to your income, setting it at 10% of your discretionary income (actual income minus some living wages). If you earn an income of $350,000 as an attending (which is statistically not very likely, sorry, $250,000 is much more likely), your loan payments will be around $30,000 a year.

Your loan payments will not even cover the interest on your student loans.

Your student loans will continue to grow, through undergrad, through medical school, through residency, and through your career as an attending. Your student loans will grow each and every year of your existence, until they are forgiven through some sort of forgiveness program that may or may not exist someday, or until you die.

You will never pay off your student loans. Ever. You won't even keep up with them. That is the reality of medical student candidates in 2013.

 

[NurWollen]

The interest payments alone on your student debt will be about $40,000 a year.

The Pay As You Earn system ties your loan payments to your income, setting it at 10% of your discretionary income (actual income minus some living wages). If you earn an income of $350,000 as an attending (which is statistically not very likely, sorry, $250,000 is much more likely), your loan payments will be around $30,000 a year.

Your loan payments will not even cover the interest on your student loans.

Your student loans will continue to grow, through undergrad, through medical school, through residency, and through your career as an attending. Your student loans will grow each and every year of your existence, until they are forgiven through some sort of forgiveness program that may or may not exist someday, or until you die.

You will never pay off your student loans. Ever. You won't even keep up with them. That is the reality of medical student candidates in 2013.

Do we have any specific reason to believe that PSLF, etc. won't be around in the future, other than the fact that the government is fickle and untrustworthy? The idea that they may be done away with keeps getting thrown around SDN, but have there been any actual proposals to end them?

 

[Dr Dazzle]

Do we have any specific reason to believe that PSLF, etc. won't be around in the future, other than the fact that the government is fickle and untrustworthy? The idea that they may be done away with keeps getting thrown around SDN, but have there been any actual proposals to end them?

Do all professional students in dentistry etc get these same loans?

 

[NurWollen]

Do all professional students in dentistry etc get these same loans?

AFAIK, yes. Dental school is often more expensive than med school. IBR, PAYE, ICR, PSLF aren't even specific to the health professions.

 

[TheWeeIceMan]

Do we have any specific reason to believe that PSLF, etc. won't be around in the future, other than the fact that the government is fickle and untrustworthy? The idea that they may be done away with keeps getting thrown around SDN, but have there been any actual proposals to end them?

I haven't seen any proposals to end these programs but we also haven't seen what happens when these loans start getting forgiven. The general public already thinks that physicians make too much money. I'd imagine that when people with six figure incomes start discharging massive amounts of loans, there could likely be enough negative press to push the government to at least start restricting who can have there loans forgiven.

 

[Postictal Raiden]

The interest payments alone on your student debt will be about $40,000 a year.

The Pay As You Earn system ties your loan payments to your income, setting it at 10% of your discretionary income (actual income minus some living wages). If you earn an income of $350,000 as an attending (which is statistically not very likely, sorry, $250,000 is much more likely), your loan payments will be around $30,000 a year.

Your loan payments will not even cover the interest on your student loans.

Your student loans will continue to grow, through undergrad, through medical school, through residency, and through your career as an attending. Your student loans will grow each and every year of your existence, until they are forgiven through some sort of forgiveness program that may or may not exist someday, or until you die.

You will never pay off your student loans. Ever. You won't even keep up with them. That is the reality of medical student candidates in 2013.

If I earn 350K/year, which I think it will be very likely (350K in 2024 is ~230K in 2013 money), I will pay off the entire loan balance in 5 years. I calculated that after a 6 year residency, the loan amount will balloon to 600K. Paying it off in 5 years means that I will pay ~145K/year. If I earn 350K, I will be taking home ~245K after state and federal taxes. Subtracting the 145K loan repayment will leave me 100K. 100K in 2024 will have the same purchase power as 65K in today's money (if we assume 2-3% inflation a year).

Of course the plan above will only happen in case of the disappearance of governmental repayment programs, which is very unlikely to happen. Yes, the general public is aware of physician salaries and may not be happy with it, but they are not going to do anything about it. The public is also aware of Congressmen earnings, public education administrators, public lawyers, etc... I don't think there is a reason to exclude physicians from repayment assistant programs just because the general public know they make six figures. What I think may happen is that the government steps in and put and end to the ever increasing tuition.

 

[TheWeeIceMan]

If I earn 350K/year, which I think it will be very likely (350K in 2024 is ~230K in 2013 money), I will pay off the entire loan balance in 5 years. I calculated that after a 6 year residency, the loan amount will balloon to 600K. Paying it off in 5 years means that I will pay ~145K/year. If I earn 350K, I will be taking home ~245K after state and federal taxes. Subtracting the 145K loan repayment will leave me 100K. 100K in 2024 will have the same purchase power as 65K in today's money (if we assume 2-3% inflation a year).

Of course the plan above will only happen in case of the disappearance of governmental repayment programs, which is very unlikely to happen. Yes, the general public is aware of physician salaries and may not be happy with it, but they are not going to do anything about it. The public is also aware of Congressmen earnings, public education administrators, public lawyers, etc... I don't think there is a reason to exclude physicians from repayment assistant programs just because the general public know they make six figures. What I think may happen is that the government steps in and put and end to the ever increasing tuition.

All of which earn considerably less than physicians. Also, I kind of doubt the govenment will step in and stop tuition increases, especially considering that it would cause them to lose revenue (and it's probably not even legal).

Wasn't this type of situation what made student loans non-discharable in bankruptcy? High earners were filing bankruptcy to get rid of student loans, government gets wind and changes the bankruptcy code. Serious question, I really don't know.

Also, and kind of off topic, but I can't envision that you could predict how much money you'll make in 2024 by using simple inflation. At least, not with the way physician compensation is currently set up and will change in the future.

 

[Postictal Raiden]

All of which earn considerably less than physicians. Also, I kind of doubt the govenment will step in and stop tuition increases, especially considering that it would cause them to lose revenue (and it's probably not even legal).

Wasn't this type of situation what made student loans non-discharable in bankruptcy? High earners were filing bankruptcy to get rid of student loans, government gets wind and changes the bankruptcy code. Serious question, I really don't know.

Also, and kind of off topic, but I can't envision that you could predict how much money you'll make in 2024 by using simple inflation. At least, not with the way physician compensation is currently set up and will change in the future.

Congressmen and school district administrators make considerably less than physicians? Think again.

No one knows what the future holds, but going off past historical trends, one can make such predictions. Do your really think physician incomes will stay static for the next 10 years? Do you really think the 200K hospitalist job will pay 200K (with a purchase power of ~130K) in 2024?

Aside from few specialties that paid near seven figures in the past (Radiology, CT surgery, Cardiology), physician salaries have been continually increasing over the years.

All this are speculations. No one knows what's going to happen. I choose to stay optimistic that physician salaries, aside from some specialties, will remain at the same levels where they are today (~3x the average income in the country) and that loan repayment plans will still be an option.

 

[TheWeeIceMan]

Congressmen and school district administrators make considerably less than physicians? Think again.

No one knows what the future holds, but going off past historical trends, one can make such predictions. Do your really think physician incomes will stay static for the next 10 years? Do you really think the 200K hospitalist job will pay 200K (with a purchase power of ~130K) in 2024?

Aside from few specialties that paid near seven figures in the past (Radiology, CT surgery, Cardiology), physician salaries have been continually increasing over the years.

All this are speculations. No one knows what's going to happen. I choose to stay optimistic that physician salaries, aside from some specialties, will remain at the same levels where they are today (~3x the average income in the country) and that loan repayment plans will still be an option.

The average congressman makes like 170k and school admins make around an average of 100k (though there is certainly variance). Not sure why this matters though, since most congressman/school admins aren't looking to take advantage of student loan repayment plans.

No, I don't think physician salaries will stagnate, but I suppose I am less optimistic than you are that they will keep up with inflation.

 

[Postictal Raiden]

The average congressman makes like 170k and school admins make around an average of 100k (though there is certainly variance). Not sure why this matters though, since most congressman/school admins aren't looking to take advantage of student loan repayment plans.

No, I don't think physician salaries will stagnate, but I suppose I am less optimistic than you are that they will keep up with inflation.

Then for all our sake, let's hope I'm right 😉

 

[TheWeeIceMan]

Then for all our sake, let's hope I'm right 😉

Haha, yeah, I really do hope you're the one that's right about this one.

 

[sazerac]

Do we have any specific reason to believe that PSLF, etc. won't be around in the future, other than the fact that the government is fickle and untrustworthy? The idea that they may be done away with keeps getting thrown around SDN, but have there been any actual proposals to end them?

Well, if you like your loan forgiveness program, you can keep your loan forgiveness program, as they say.

Period.

 

[Dr Dazzle]

Well, if you like your loan forgiveness program, you can keep your loan forgiveness program, as they say.

Period.

So really the only reason to not max out your loans right now and enjoy life is the possible scenario that loan forgiveness could diminish and the fairly reasonable 10 year repayment plan will not exist.

A surgeon I shadowed was lamenting his $400 k income and said it literally disappeared after paying life, malpractice insurance and his loan repayment. He couldn't understand how primary care physicians survived with the similar debt load.

 

[NurWollen]

Well, if you like your loan forgiveness program, you can keep your loan forgiveness program, as they say.

Period.

That made my day.

 

[NurWollen]

The average congressman makes like 170k and school admins make around an average of 100k (though there is certainly variance). Not sure why this matters though, since most congressman/school admins aren't looking to take advantage of student loan repayment plans.

No, I don't think physician salaries will stagnate, but I suppose I am less optimistic than you are that they will keep up with inflation.

Well said.

All we can do is work hard and hope for the best. Good financial planning would help too.

 

[p30doc]

The idea that they may be done away with keeps getting thrown around SDN, but have there been any actual proposals to end them?

Yes I believe it was last year there was a proposal in congress to get rid of the PSLF program. It did not get enough support to pass the vote. It was one of the "entitlements" targeted.

 

[Silent Cool]

So really the only reason to not max out your loans right now and enjoy life is the possible scenario that loan forgiveness could diminish and the fairly reasonable 10 year repayment plan will not exist.

A surgeon I shadowed was lamenting his $400 k income and said it literally disappeared after paying life, malpractice insurance and his loan repayment. He couldn't understand how primary care physicians survived with the similar debt load.

You should NEVER max out your loans if you don't need to. Always borrow the minimum possible.

By the way, I assume that surgeon was an independent contractor? What field of surgery was he in? What was his loan balance? What state?

thanx
😎