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Discussion in 'Emergency Medicine' started by aequanimitas, Jun 16, 2008.
This will basically change the GME landscape as we know it. No one will be able to afford the 7 - 10 years of Surgical sub specialties or extended fellowships.
I guess the ACGME will have to look into ways to counter this problem or else ED access to specialty care will be even more greatly affected.
The easiest solution would be to simply raise resident salaries by an amount sufficient to cover the increased burden of paying these loans early.
I now return to the magic land of unicorns, fairy dust, and people who believe Iraq has WMDs.
I agree. The ramifications are so potentially huge that I'm not sure this willl actually happen (it's still good for a year).
I mean, 200k debt, FM residency, immediate loan repayment? 200k debt, NSurg residency, 7 years forbearance?
Yeah, this is a total crock of sh!te.
I guess the government is tired of encouraging education, and would rather make sure the banks "get theirs" than make sure the next generation has the ability to learn and grow...
Idiocracy, here we come! The road is paved and we are walking it as we speak.
Someone will always be willing to take that financial hit, just to become a physician.
I posted my opinion about this in the Residency forum. There they're talking about the increase in # of med students (~30%) to match expected increases in need for physicians via the Baby Boomers. However, there hasn't been a matched increase in residency slots to train them. This may be an attempt to remove FMGs from US residentcy slots and funnel more US seniors into PMD training poisitions.
The changes in the deferral pathway may do much the same by de-incentivising (sp?) the long fellowships that result in high-paying specialists.
Sort of reducing costs on the front end (constant residency slots, no loan deferrment) and back end (fewer specialists, more cost-containing primary care).
You may be right but I for one highly doubt it's that intricately coordinated. Far more likely is that the good old government is sick of subsidizing physician education and wants to lump more of the already considerable financial responsibility onto med students/residents.
We'll survive this even if it nails us during residency, but if all current trends continue the day is coming mind you, the day is coming when becoming an MD is lifetime financial suicide for most people. I would say 10-15 years.
This is quite unfortunate but forebearance is still an option. I dont think its that big of a deal.
I think there are two interests at play in this decision:
1: Lenders are looking for other sources of revenue given the state of the credit market right now. Getting more blood out of students/doctors is one of those ways.
2: The government wants to push doctors into accepting primary care loan-forgiveness programs. Some grads may have no choice but to accept a deal a la Northern Exposure.
I agree on several points - it probably isn't coordinated, but it's not too hard to imagine that the motivations behind these changes are similar to what I described, and will end up with a similar result. And students who are also "rich doctors" (e.g. residents) make easy targets.
I also think that there will always be enough people willing to commit financial suicide to fill med schools.
The Northern Exposure route is an idea, but I've looked at various loan repayment programs and I didn't hear anything about increasing rural medicine support. I may be wrong.
But it may be a factor for me. I am deciding whether to take a year off to do research, but if residency slot competition jumps, and loan repayment becomes onerous, maybe it's not such a good decision to "put off residency" for a once-in-a-lifetime opportunity...
Well you are certainly right that there will be people willing to commit financial suicide -- our entire nation is doing that to one degree or another (I just read that avg household has like 9k in CC debt...)
Judging by your sig you're an M2. If nothing happens the econ hardship deferment will be gone in '09 so you wouldn't benefit from it anyway. In the long run of this one year one way of the other is not going to make that big of a difference.
When I was in med school in Indiana the state would pay for all of your medical school loans in exchange for a commitment to serve for 5 years in primary care in an "underserved area".
There were not a whole lot of takers on this proposal.
Same thing in Kansas. Those who took it were those that were already sold on doing primary care and staying in KS (obviously very few )
I might be mistaken . . . but doesn't this only affect the subsidized loans?
The US financial aid system is so screwed up. It's as if the government actively tries to discourage any type of meaningful educational activity.
Let's instead continue to raise the price of medical care, cut reimbursments, pay trainee physicians a pittance, and then raise the amount of loans; then do this in the face of an upcoming physician shortage and booming elderly populace. It's almost comical how short-sighted these morons are.