HMS (Full Loans) vs. full COA and full-tuition elsewhere?

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Mr.Blackdoc.5

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Hi,
First of all, I would say that I have had a very successful application cycle. I've been fortunate to be accepted at a number of schools and have narrowed my options to 6: HMS, CCLCM, UChicago Pritzker, Northwestern Feinberg, Mt. Sinai, as well as Mayo-Rochester. That was in large part due to the great advice I got from folks on this forum, including many of you. So thanks!

Brief background on me: I have been living in Boston the last couple of years working in an HMS-affiliated research lab, have a long-term partner here, have family here, as well as my immediate family only a couple hours drive away. When I got into HMS, I was deadset on attending due to these personal reasons as well as professional reasons (would be able to continue doing things I am doing inside/outside of the lab). HMS is need-based only, so unfortunately, I did not qualify for any FA based due to the paperwork we submitted. I felt I had a productive meeting with the FA director, so hopefully that improves, but I want to go into making this decision assuming the FA will stay the same. I will not ask my parents to contribute anything to my graduate education.

I am writing this post to hear from you all what you would do in my situation. I think my career goals are to pursue a surgical subspecialty and go into academic medicine. I would like research to be a component of my career, but it will definitely be second to being a clinician.

I've read countless posts on these sorts of dilemmas elsewhere, but I think mine may be a bit unique in that I got into "the most prestigious school in the country" that is located where I am most comfortable and where my partner is most comfortable. I worked extremely hard the last few years to get into HMS and be in this dilemma. I got zero love from any other schools in Boston. Is going to HMS worth 400k+ loans after interest? If this was not HMS, I would be taking the full COA or full-tuition hands down. I know it matters how you do where you go, not where you go. This wouldn’t be a thread if I was looking at 200k-300k of loans.

My heart is saying go to HMS despite the loans, because (assuming programs like PSLF are still out there), I will eventually pay it back, especially if I stick with my plan of pursuing a surgical subspecialty. What's the price of happiness? Medicine is going to be hard, so you might as well go where you are happy? I’ve tried thinking of where it would be hardest for me to press withdraw - hands on that is HMS.

On the other side, my head is saying go where you will have no debt, few people are in as great a position as you are. Zero debt means it is totally fine if I hate surgery and want to do primary care ,IM, etc - I can be whatever type of physician I want to be. Plus, I wouldn't have to worry about paying 1/3 of my take-home salary as an attending to pay off loans that have doubled due to interest. Would such a debt actually make me even more unhappy because I would constantly be thinking about it and not enjoying the process of becoming a physician as much? But do people even think about these sorts of things when they are so busy during medical school and training?

I've spoken with mentors who were in a similar position to me and who choose HMS and have zero regrets about the loan burden due to programs such as PSLF. I've spoken to mentors who were not in this position but would hands down choose HMS if they were in this position. They have said such things without having the personal connections to Boston that I have. When I speak to people outside medicine (eg parents), they said take the money and run - you have no idea what that will do for you in terms of flexibility, freedom, and stress, especially if I want to start a family.

Sorry if this seems like rambling. Would love to hear what you guys would do in this situation. As the three title says, I was fortunate to get full-tuition, need-based aid and/or merit scholarships that cover almost-full tuition, as well as full COA at one institution.

Thanks!

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It's a bit of a tough spot. Of the schools you have listed, all of them can help you succeed in academic medicine and surgical subspecialties. Your case is interesting because your personal reasons also draw you to Boston. Is your partner willing to move with you anywhere from those other choices?

I think you definitely can pay back 400k in loans, it's just that, do you really want to when you can go to a highly regarded medical school for free? The Harvard name will definitely open doors for you, but is it really that much better than Chicago, NW, Mayo? I don't know, it's a hard thing to justify...and I don't think I can. If you look at the students that go on from those other schools, they are highly successful in terms of getting academic matches at top places.


It might help to narrow down to Harvard vs. School offering full CoA and go from there, because as of now that's too many schools, and it's hard to advise.
 
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I'm really big into "no debt," and this is what I often advise for anyone with these type of decisions because in the long your patients will only care about what you can do to them way more than anything else.

Nonetheless, it sounds like you want to go to Harvard for a lot of good reasons. They place their students well, probably better than any other medical school in the country. Over 50,000+ vied to get into Harvard College this year to grab a piece of the apple, and only 3.43% succeeded. That's 240K minimum for a college degree with no certain path for a solid salary afterwards.

400k to fulfill a dream is totally worth it, and as an academic physician, you should get used to living with a lifetime of loans anyway.
 
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Can I ask why you dont want to ask your parents to contribute to your graduate education? I think its one thing to not want them to pay for it all but they seem to have some capacity to support you otherwise I'd expect you would have gotten some amount of aid from HMS. It sucks that you're getting penalized for it but thats life.

I agree with Bacno though; I dont think Harvard will open up 400k worth of doors relative to Mayo, Priztker, etc but as you've said your heart is pushing to HMS. For me personally, I think its easier to live with listening to the heart side of things relative to the head side of things.
 
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Congrats on a very successful cycle! It's a very difficult decision you'll have to make. I think your personal reasons for wanting to stay in Boston are really important -- having a strong support system is key to succeeding in medical school. And obviously, it's difficult to turn down Harvard.

I don't really have an answer, but just also wanted to flag that you could consider going to Harvard then applying for external scholarships, like the PD Soros, which you could be eligible for if you or your parents are immigrants. Obviously, programs like this are extremely competitive, but HMS students have a good track record of winning them. Brown's financial aid office put out a list of scholarships like these that could be worth looking into: External Scholarships
 
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Wow, this is tough. Like the above person mentioned, what does your partner think about leaving Boston? Will they be happy moving? If they aren't willing to move, is LDR worth it? Will they be working full-time while you go to school? The total debt burden could possibly be mitigated to 200-300k while at HMS if they are willing to support you on the COL expenses for these next four years and/or you aggressively budget your expenses.

I agree with you that your personal happiness is very important. However, you are choosing between some of the top schools in the country. How much more happy will you be attending HMS over those other schools? Will you be completely miserable if you don't attend HMS? Do you think you will regret it? No matter what decision you make, I'm sure it will be the right one.
 
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I'm really big into "no debt," and this is what I often advise for anyone with these type of decisions because in the long your patients will only care about what you can do to them way more than anything else.

Nonetheless, it sounds like you want to go to Harvard for a lot of good reasons. They place their students well, probably better than any other medical school in the country. Over 50,000+ vied to get into Harvard College this year to grab a piece of the apple, and only 3.43% succeeded. That's 240K minimum for a college degree with no certain path for a solid salary afterwards.

400k to fulfill a dream is totally worth it, and as an academic physician, you should get used to living with a lifetime of loans anyway.
Hi Solitarius, Thanks for the response.
yes, totally understand patients won't care where you got your MD from, as long as you are known for giving great care.
love the "400k to fulfill a dream is totally worth it." I get things change - but I do think we ultimately want to make a life here in the Boston Area. Right now with my naivity, I think I would regret not staying here where we are comfortable. I can't say that for my other great options.
Can I ask why you dont want to ask your parents to contribute to your graduate education? I think its one thing to not want them to pay for it all but they seem to have some capacity to support you otherwise I'd expect you would have gotten some amount of aid from HMS. It sucks that you're getting penalized for it but thats life.

I agree with Bacno though; I dont think Harvard will open up 400k worth of doors relative to Mayo, Priztker, etc but as you've said your heart is pushing to HMS. For me personally, I think its easier to live with listening to the heart side of things relative to the head side of things.
Hi Zorcandpals, thanks for replying to my post.
It's funny - we were shocked by the lack of need-based aid, especially since I got it elsewhere. I don't want to go into too many details, but my parents lack the capacity to contribute to my education for a number of reasons (nearing retirement age, minimal savings, area with high taxes, etc.). Hopefully the situation will improve after they review my appeal. It does suck because I see the last names of accepted students and recognize that they come from wealthy families (1 mill+), which we are far from. But on the other side of things, there are plenty of students who are coming from households making little money at all, which we are also far from. I understand schools have limited scholarship money to give out.
Congrats on a very successful cycle! It's a very difficult decision you'll have to make. I think your personal reasons for wanting to stay in Boston are really important -- having a strong support system is key to succeeding in medical school. And obviously, it's difficult to turn down Harvard.

I don't really have an answer, but just also wanted to flag that you could consider going to Harvard then applying for external scholarships, like the PD Soros, which you could be eligible for if you or your parents are immigrants. Obviously, programs like this are extremely competitive, but HMS students have a good track record of winning them. Brown's financial aid office put out a list of scholarships like these that could be worth looking into: External Scholarships
Thank you for the advice, Mr_Unlimited! I am indeed working on applying for external scholarships. I did not see this link you provided, so I will check this site out for more. Unfortunately, I am not a candidate for the Soros since one of my parents was born in the US.
a bit of a tough spot. Of the schools you have listed, all of them can help you succeed in academic medicine and surgical subspecialties. Your case is interesting because your personal reasons also draw you to Boston. Is your partner willing to move with you anywhere from those other choices?

I think you definitely can pay back 400k in loans, it's just that, do you really want to when you can go to a highly regarded medical school for free? The Harvard name will definitely open doors for you, but is it really that much better than Chicago, NW, Mayo? I don't know, it's a hard thing to justify...and I don't think I can. If you look at the students that go on from those other schools, they are highly successful in terms of getting academic matches at top places.


It might help to narrow down to Harvard vs. School offering full CoA and go from there, because as of now that's too many schools, and it's hard to advise.
Thank you for taking the time to respond to my post, Banco.
1) Partner supports me 100% and would be willing to move. Have been with her for 5+ years and definitely plan to marry her (if I am lucky enough). But I don't want to force her to make that decision to move now if I don't have to. She is EXTREMELY close to her family, best friends with her mom and dad, siblings, etc. who are all here, and I know that moving away from that support system would be very difficult for her, especially when I will be so busy adjusting to the difficulties of med school and may not be able to focus as much on our relationship as I would like. This would be a different situation if I got accepted to schools in CT, NY, or some parts of PA that are within reasonable driving distance of Boston. I did get accepted at Mt. Sinai, but am still waiting to hear back from their financial aid office. I don't think they give much merit, so realistically, I don't see that being one of my top three options come April 15th. For full transparency, I have been waitlisted at Yale, Penn, and Columbia, but I don't want to bank on getting off a waitlist + getting a good FA package.

2) You are right about HMS not opening up doors these other institutions couldn't. I know that none of these programs would prevent me from matching into my specialty of interest (CT surgery). For example, CCLCM has had multiple graduates match into Stanford, Cleveland Clinic, I6 programs. Similarly, Pritzker has had students match into the general surgery program which has a 4+3 thoracic track.

3) I think (given the information I have now), I would narrow my three choices down to HMS vs. CCLCM (five-year program though, full COA), and Pritzker (full-tuition). The caveat with the full-ride at CCLCM is that people will say it takes a year from attending salary. I think about it as a stress-free year to pursue interests I otherwise might not be able to for awhile..
 
Wow, this is tough. Like the above person mentioned, what does your partner think about leaving Boston? Will they be happy moving? If they aren't willing to move, is LDR worth it? Will they be working full-time while you go to school? The total debt burden could possibly be mitigated to 200-300k while at HMS if they are willing to support you on the COL expenses for these next four years and/or you aggressively budget your expenses.

I agree with you that your personal happiness is very important. However, you are choosing between some of the top schools in the country. How much more happy will you be attending HMS over those other schools? Will you be completely miserable if you don't attend HMS? Do you think you will regret it? No matter what decision you make, I'm sure it will be the right one.
Thanks for replying, Ligere.
Partner would be willing to leave but I don't want to ask her to do that (see my reply to Banco, above).
Partner is a nurse and is beginning NP school this year part-time. She will have some income but my dream was to take on the loan debt so she could pay off her existing loans and be debt-free. Then, when I start residency, I could aggressively pay back my loans and contribute a small portion to the household while she takes on a larger responsibility with finances. Funny thing is I have an option here that would allow both of us to pay off our debts. The stipend given at CCLCM is more than enough to get a 1-2 bedroom (Cleveland is so cheap!). But still, what price is worth being far away from your support system?

I don't think I will be happier at HMS over other schools. It's more about I will be happier staying in Boston. It's funny, I know students here who have spoken with others in similar dilemmas and recommended they NOT go to HMS.
 
This is incredible and you should choose HMS if you desire but voluntarily sinking yourself into $400k worth of debt when you have multiple full-rides elsewhere is financial suicide. I will never be in this position so I can't comprehend what's going through your mind but from a strictly objective and financial outlook, I personally would NOT choose $400k debt for HMS over a full-ride to any of the other programs you listed.
 
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That is going to be a huge loan burden after you finish such a long residency. I would take the money and match back to Boston. Should be easy to fly from Chicago to Boston or Cleveland to Boston regularly.

Not an easy call though. Just my 2 cents.
 
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i would pick HMS >> Mayo >>>>> the rest would be how I would look at it.

If I were in this situation I would pick HMS regardless of the family / social stuff. The family / social stuff is icing on the cake. I come from a very non medical family and the only name they would care about on this list would be harvard or mayo. Harvard is also the biggest name to people in medicine. Having that pedigree is worth 400k to me. The doors HMS opens is beyond belief.
 
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Thank you for taking the time to respond to my post, Banco.
1) Partner supports me 100% and would be willing to move. Have been with her for 5+ years and definitely plan to marry her (if I am lucky enough). But I don't want to force her to make that decision to move now if I don't have to. She is EXTREMELY close to her family, best friends with her mom and dad, siblings, etc. who are all here, and I know that moving away from that support system would be very difficult for her, especially when I will be so busy adjusting to the difficulties of med school and may not be able to focus as much on our relationship as I would like. This would be a different situation if I got accepted to schools in CT, NY, or some parts of PA that are within reasonable driving distance of Boston. I did get accepted at Mt. Sinai, but am still waiting to hear back from their financial aid office. I don't think they give much merit, so realistically, I don't see that being one of my top three options come April 15th. For full transparency, I have been waitlisted at Yale, Penn, and Columbia, but I don't want to bank on getting off a waitlist + getting a good FA package.

2) You are right about HMS not opening up doors these other institutions couldn't. I know that none of these programs would prevent me from matching into my specialty of interest (CT surgery). For example, CCLCM has had multiple graduates match into Stanford, Cleveland Clinic, I6 programs. Similarly, Pritzker has had students match into the general surgery program which has a 4+3 thoracic track.

3) I think (given the information I have now), I would narrow my three choices down to HMS vs. CCLCM (five-year program though, full COA), and Pritzker (full-tuition). The caveat with the full-ride at CCLCM is that people will say it takes a year from attending salary. I think about it as a stress-free year to pursue interests I otherwise might not be able to for awhile..


Maybe I'll offer you a different perspective on the partner situation. If you are committed and planning a life together, the debt will be both of yours to share. A compromise on her end would be to go to Chicago for 4 years for example, but that means you save 300k, which will make a difference in your lives going forward. Just another consideration.

Secondly, you will be able to pay off your loans if you do end up in surgery or a surgical subspecialty, but these are long residencies and that interest is going to compound.

I think often we get lost in the prestige rat race on this website and I just like to remind people to weight what's important to them and forget what others expect of them.
 
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Take the full tuition/COA scholarship, thank yourself in 20 years when you're networth is $10M+ and your future generations are set for life because you didn't spend a decade paying back 400k+ interest of student loans
 
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If you do go to HMS and take out the full COA in loans, you're looking at close to 600-700k in loans at the end of a 6-7 year residency once all of the interest is added on and capitalized. Personally, I don't think it's worth it going that much in debt when you have a completely free option.
 
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My vote is for Lerner. Outside of Harvard itself, I can hardly think of other places that would be better at enabling you to match back into Harvard. The 5th year is awesome. The only way you wouldn't be heavily considered for top 10 residencies is if you tried really, really hard to be a dud in med school. The CC Lerner students all do incredibly well in the match. I doubt you would be an exception to that.

I recently made a head vs heart decision on where to go to school (although not as prestigious and hard-core as you, lol). I ended up choosing the cheaper option, and so far I have been very at peace and happy with that decision.

You can't go wrong either way! Ultimately, it all depends on your priorities, and you're the only person who truly knows what your priorities are.
 
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Your heart seems set on HMS, but $400k is a lot of money, especially if you end up matching into a lower paying specialty. None of your other options will limit where you can go. Having said that, you will not be the first (or last) person to give up full COA scholarships to attend HMS.

The biggest benefit of attending HMS is that, being an internal candidate, you will have a much easier time matching at MGH, BWH, or BID if that is your ultimate goal. However, keep in mind that what may initially seem like a great fit may not be after starting medical school as life circumstances, relationships, and priorities may change. Similarly, what may seem like an inferior fit may end up exceeding expectations. Since there is a discordance between cost and fit, speaking in very broad strokes, there are four possible outcomes:

- Prioritizing cost, remain happy with decision at the time of graduation
- Prioritizing cost, regret decision at the time of graduation
- Prioritizing fit, regret decision at the time of graduation (due to change in circumstances)
- Prioritizing fit, remain happy with decision at the time of graduation

Among the two unfavorable outcomes, how likely are they to occur? And how much worse would one outcome be over the other? That should help guide which choice is right for you. Just my thoughts, and congratulations of your multiple excellent offers.
 
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This is incredible and you should choose HMS if you desire but voluntarily sinking yourself into $400k worth of debt when you have multiple full-rides elsewhere is financial suicide. I will never be in this position so I can't comprehend what's going through your mind but from a strictly objective and financial outlook, I personally would NOT choose $400k debt for HMS over a full-ride to any of the other programs you listed.
Thanks for replying, Ultravox Vienna. It's hard because if this was ANY other school I would take the money and run. Hard to put a price on spending time with loved ones, best friends, etc. in another city I know I would just not be as happy. We only have so much time, so why not spend it where you will be happiest? I know that money I would be saving is sort of an abstract concept for me at the moment, but so what if I have to pay 5K back a month in loans when I am bringing in 15K to the house? I'll still be living comfortably. Heck, I've been living in a high COL area on a 35K salary the last 4/5 years very happily.
That is going to be a huge loan burden after you finish such a long residency. I would take the money and match back to Boston. Should be easy to fly from Chicago to Boston or Cleveland to Boston regularly.

Not an easy call though. Just my 2 cents.
Thanks for reading the thread. I actually didn't even think about the flights. Roundtrip Cleveland to Boston is only a few hundred bucks right now. Considering the COL in Cleveland is so low, I could definitely use some of this stipend money for that... but still, it's always easier said than done doing these sorts of things. What beats being able to drive 10 mins to see your strongest support system?
i would pick HMS >> Mayo >>>>> the rest would be how I would look at it.

If I were in this situation I would pick HMS regardless of the family / social stuff. The family / social stuff is icing on the cake. I come from a very non medical family and the only name they would care about on this list would be harvard or mayo. Harvard is also the biggest name to people in medicine. Having that pedigree is worth 400k to me. The doors HMS opens is beyond belief.
Thanks for replying DNC127. What makes you so sure the pedigree is worth 400k? Personal experience during your training so far?
Maybe I'll offer you a different perspective on the partner situation. If you are committed and planning a life together, the debt will be both of yours to share. A compromise on her end would be to go to Chicago for 4 years for example, but that means you save 300k, which will make a difference in your lives going forward. Just another consideration.

Secondly, you will be able to pay off your loans if you do end up in surgery or a surgical subspecialty, but these are long residencies and that interest is going to compound.

I think often we get lost in the prestige rat race on this website and I just like to remind people to weight what's important to them and forget what others expect of them.
Thanks for the follow-up response. We've definitely thought these things through. But we are both so low maintenance, we know at the end of the day, my salary (even as a resident) and hers as an NP will allow us to live extremely comfortably. We've been living in Boston on my 35K salary for the last 4/5 years very comfortably. Even with loan repayment, our take-home pay will be at least 2X what we currently bring in.

Definitely trying to keep what's most important to me front and center. Just trying to rationally think these scenarios these through by leaning on the expertise of others who are where I want to go (already physicians) and know what a debt burden like this can do to people.
Take the full tuition/COA scholarship, thank yourself in 20 years when you're networth is $10M+ and your future generations are set for life because you didn't spend a decade paying back 400k+ interest of student loans
Thanks for replying, ArdorAyurveda. Did you have to personally make a similar decision? If not, did you have a high debt after school, and if so, what was that like paying back?
If you do go to HMS and take out the full COA in loans, you're looking at close to 600-700k in loans at the end of a 6-7 year residency once all of the interest is added on and capitalized. Personally, I don't think it's worth it going that much in debt when you have a completely free option.
I need to improve my financial literacy, but I was likely going to refinance them to pay off interest, then aggressively pay them off within my first five years of practice. It seems that would be doable since my salary:hungover:ebt ratio would be around 1:2. I know this is easier said than done, especially when I am talking about money I am yet to borrow, but that is the way I am sort of thinking about the debt.

My vote is for Lerner. Outside of Harvard itself, I can hardly think of other places that would be better at enabling you to match back into Harvard. The 5th year is awesome. The only way you wouldn't be heavily considered for top 10 residencies is if you tried really, really hard to be a dud in med school. The CC Lerner students all do incredibly well in the match. I doubt you would be an exception to that.

I recently made a head vs heart decision on where to go to school (although not as prestigious and hard-core as you, lol). I ended up choosing the cheaper option, and so far I have been very at peace and happy with that decision.

You can't go wrong either way! Ultimately, it all depends on your priorities, and you're the only person who truly knows what your priorities are.
Thank you, Idahomie! Good to hear from someone who recently went through the same decision-making process. Was your support system where the "heart" decision was, though?
Your heart seems set on HMS, but $400k is a lot of money, especially if you end up matching into a lower paying specialty. None of your other options will limit where you can go. Having said that, you will not be the first (or last) person to give up full COA scholarships to attend HMS.

The biggest benefit of attending HMS is that, being an internal candidate, you will have a much easier time matching at MGH, BWH, or BID if that is your ultimate goal. However, keep in mind that what may initially seem like a great fit may not be after starting medical school as life circumstances, relationships, and priorities may change. Similarly, what may seem like an inferior fit may end up exceeding expectations. Since there is a discordance between cost and fit, speaking in very broad strokes, there are four possible outcomes:

- Prioritizing cost, remain happy with decision at the time of graduation
- Prioritizing cost, regret decision at the time of graduation
- Prioritizing fit, regret decision at the time of graduation (due to change in circumstances)
- Prioritizing fit, remain happy with decision at the time of graduation

Among the two unfavorable outcomes, how likely are they to occur? And how much worse would one outcome be over the other? That should help guide which choice is right for you. Just my thoughts, and congratulations of your multiple excellent offers.
Thanks for replying, Moko.
It's just hard, because if this was like 200K debt at HMS, this thread would not have even been made. I have spoken to plenty of people who have given up full COA but have gotten full-tuition at HMS. 100K debt is nothing in comparison to my situation. I have also spoken to people who have taken out full loans (a situation I can obviously more easily relate to), and they have zero regrets. I'm yet to speak about people who have gone to HMS on full loans and regret the situation. I have been trying to network, but of course, this is a delicate subject to broach. Would be really useful to have these conversations with HMS alumni or people who had to make similar decisions at other schools.

Definitely trying to stay cognizant that things can change. Right now we envision our future life in MA, but that could totally change once we experience another part of the country.

I think, of your four outcomes, they go (from most likely to occur to least likely to occur): 4=1 > 3 (due to debt burden) > 2. I truly don't think I would regret going to HMS and taking out this loan burden, but I understand it's hard to think of this money I have not had to pay back yet. I also do not think I would regret going to CCLCM or elsewhere once I have graduated, especially since I will have no/minimal debt. I am extremely confident I'll be able to match back to Boston if that is what I want. I just worry about missing four irreplaceable years next to our strongest support systems.
 
I personally think 400k in loans, which will end up being 500-600k after interests, is quite a bit. I come from a low SSE background so seeing those big numbers scare me. I am also choosing between HMS and another similarly ranked/prestige school with a full CoA (very generous living stipend!). While I am still waiting to receive my HMS aid, I think that unless they cover full tuition and my loans will be less than 100k , I would enroll at HMS, otherwise don't think having to pay 100k FOR ME would be worth it. I would rather have a down payment on a house or be able to support my parents while they still live.

If Boston is somewhere you would like to explore during your medical training, being a resident there is always an option. Resident salary + no debt sounds like a dream to me!

Best of luck!
 
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I personally think 400k in loans, which will end up being 500-600k after interests, is quite a bit. I come from a low SSE background so seeing those big numbers scare me. I am also choosing between HMS and another similarly ranked/prestige school with a full CoA (very generous living stipend!). While I am still waiting to receive my HMS aid, I think that unless they cover full tuition and my loans will be less than 100k , I would enroll at HMS, otherwise don't think having to pay 100k FOR ME would be worth it. I would rather have a down payment on a house or be able to support my parents before while they still live.

If Boston is somewhere you would like to explore during your medical training, being a resident there is always an option. Resident salary + no debt sounds like a dream to me!

Best of luck!
Good luck with your decision, but it doesn’t seem that you have the personal ties dilemma I do?

I know Boston very well...have worked at an HMS -affiliated research lab the last couple of years.
 
Good luck with your decision OP. If it were me, I'd take the full ride COA or tuition and just be diligent about flying back to Boston to see my support system whenever I could. They are all very prestigious institutions. It'd save you more than half a million dollars, and you'd be able to get your financial ducks in order a lot sooner (get a mortgage for a home, etc). Plus, it's only 4/5 years, not including summers. Then match back to Boston for residency and you are set.
 
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Good luck with your decision, but it doesn’t seem that you have the personal ties dilemma I do?

I know Boston very well...have worked at an HMS -affiliated research lab the last couple of years.
I definitely do not, and perhaps the 400k could be worth being close to your support system. That's something else to consider. CCLCM would also let you fly to Boston whenever you want as you will have a bit of disposable income.
 
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Living in NYC and hearing everyone rat on Boston/Cambridge my whole life, I can’t imagine a better place to study and practice after seeing it this weekend on my impromptu “second look.” From a heart/instinctive feeling, I personally never have felt this way. It sounds weird but if you listen to your body and its response and the physical way you react when you tell yourself where you’re going to school and where you’ll live (and what you’ll do about money) I think that’s your best indicator. FYI I have my support in Cambridge as well and family elsewhere but close.
 
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OP - I think another way to look at this is to ask "what does my partner think about all this ?"

You mention that your "partner supports me 100% and would be willing to move." But what is her perspective when you talk at-length about the debt if you choose HMS ? What is her sense about Chicago or Cleveland for 4-5 years and then both of you "matching" back to Boston for residency/NP jobs without having the debt burden ? Would she rather stay in Boston for her family / career and is willing to take on the debt if you marry ?

It seems that if the relationship is serious enough (which it sounds like it is), then this is really a joint decision and not one that you make and she "supports" or "is willing to accept." I agree with others that you can't go wrong here with the possible exception of choosing HMS and then not matching into a competitive specialty, and thus having the debt without the high salary.

Best of luck with your decision!
 
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Gonna hijack a bit - isn't it obscene that Harvard, arguably the most famous and definitely the most well endowed university on the planet, somehow still costs 400k for medical school? Just absurd.

Get with the times and go full tuition you cowards. NYU is about to be #1 if you don't...
 
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Gonna hijack a bit - isn't it obscene that Harvard, arguably the most famous and definitely the most well endowed university on the planet, somehow still costs 400k for medical school? Just absurd.

Get with the times and go full tuition you cowards. NYU is about to be #1 if you don't...
Absolutely. Although their huge endowment is due in part to its affiliation with a large quantity of research institutions, they really need to catch up to other schools on the financial aid front. It's sad that ppl have to make this choice.
 
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Absolutely. Although their huge endowment is due in part to its affiliation with a large quantity of research institutions, they really need to catch up to other schools on the financial aid front. It's sad that ppl have to make this choice.

Ya it’s so sad people have to pay money to get a degree from the most prestigious institution in the world. Poor them. So oppressed.
 
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Ya it’s so sad people have to pay money to get a degree from the most prestigious institution in the world. Poor them. So oppressed.
Well that super prestigious institution has a history of admitting students with extremely wealthy parents, thus avoiding this problem of having to take out all loans to pay for medical school. As these schools get serious about admitting a more diverse student body, I think they'll also need to get serious about providing decent financial aid, lest they want to force their future doctors to only consider high-paying specialties.
 
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Well that super prestigious institution has a history of admitting students with extremely wealthy parents, thus avoiding this problem of having to take out all loans to pay for medical school. As these schools get serious about admitting a more diverse student body, I think they'll also need to get serious about providing decent financial aid, lest they want to force their future doctors to only consider high-paying specialties.

Most top schools already give generous need-based aid. Harvard is somewhat worse with need-based aid than its peers, but there are a number of top schools that give full rides in need-based aid for low-income students.

@OP, go to HMS. Both your heart and your brain seem pretty set on it. Many, many people are taking out more loans for worse schools / endeavors, and most people with med school loans turn out fine.
 
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What will be more stressful for you, financing your medical education or being away from your partner/family? If my partner was willing to move with me, I'd choose the money in this situation
 
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Gonna hijack a bit - isn't it obscene that Harvard, arguably the most famous and definitely the most well endowed university on the planet, somehow still costs 400k for medical school? Just absurd.

Get with the times and go full tuition you cowards. NYU is about to be #1 if you don't...

Honestly, elite medical schools are most justified in having high price tags, since even those at the bottom of their classes have nearly unlimited options in terms of specialty selection. There’s probably more reason to be concerned about the high price tags at low-tier private medical schools, where mediocre academic performance can drastically decrease the number of students’ post-graduation options.

On a separate note, medical school tuitions are set below their true market value. Any medical school could raise its tuition to $120k/year and still easily fill all of its seats. None of them want to do that, though, due to the bad press that would likely come with such a drastic change. Beyond the prestige and social status, a medical degree paves a path toward a career with the potential for good work-life balance, high pay, and excellent job security; it’s not surprising that people would be eager to take out massive government-subsidized loans to go to medical school. There’s nothing particularly “absurd” about the price being so high when more than enough people are desperate to shell out the dough.
 
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Honestly, elite medical schools are most justified in having high price tags, since even those at the bottom of their classes have nearly unlimited options in terms of specialty selection. There’s probably more reason to be concerned about the high price tags at low-tier private medical schools, where mediocre academic performance can drastically decrease the number of students’ post-graduation options.

On a separate note, medical school tuitions are set below their true market value. Any medical school could raise its tuition to $120k/year and still easily fill all of its seats. None of them want to do that, though, due to the bad press that would likely come with such a drastic change. Beyond the prestige and social status, a medical degree paves a path toward a career with the potential for good work-life balance, high pay, and excellent job security; it’s not surprising that people would be eager to take out massive government-subsidized loans to go to medical school. There’s nothing particularly “absurd” about the price being so high when more than enough people are desperate to shell out the dough.

I'm speaking on principle, not a capitalistic stance. I find it crazy that undergraduate and graduate education so disgustingly expensive in this country when it isn't in many peer nations. (Germany for example).
 
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OP, for most people this would be an easy decision to take the money and not look back. The only reason anyone would pay a 400k difference for a similar education is either 1) they come from a rich/privileged background where money doesn't matter (which is not your case), 2) they just really, really, really want to go to Harvard or 3) they values social/family/location factors that make the price tag worth it.

I'm changing my vote to Harvard. It sounds like you're really going to regret it if you don't go. Living your life with regret isn't worth any amount of money. It's not what I would do in your situation, but what is best for me or anyone else here is not what is best for you. Only you can figure out what 'best' is.
 
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Food for thought in no particular order:
1. 50% of marriages today end in divorce, many in the first five years.
2. Kids cost a lot of money and time (would one of you forgo salary to care for them?) if still together, it isn’t unreasonable that you’ll have kids while you are in residency. Eats into disposable income, and lets debt compound as you pay $8k a year just for IBR (income based repayment).
3. 400k debt is quite massive and not the real debt burden due to interest prior to repayment. You REALLY need to the numbers to understand the magnitude to factor into your decision. Assume 5% interest for everything in his example. After four years, you’ll owe $440k, as you enter residency for seven+ years and you refinance into an IBR loan loan, with IBR of say $8k/yr, interest will accrue an additional $16k/yr beyond this amount so after 7yrs of residency, your debt is now at least $550,000 despite already paying $56k. Now take that an use a mortgage calculator for another refinance. 30yr Term = $3000/mo and 20yr Term= $3600/mo. This is all on top of your everyday living expenses , and other loans for home and cars etc. and you would pay this pretty much until retirement u less you pay off at accelerated rate. An alternate way of looking at this would be to see what the opportunity cost is for investment. Say you accelerated repayment and you paid it off in five years, imagine taking that $600k worth of repayment payments and investing it for 20 years in a mutual fund averaging 8% returns (goal for many long term investments), after 20 years, you would then have $2.8M !!!
4. Four years in another city isn’t a long time and can be fun. Realize it isn’t in a vacuum for four years!! Flights are like $200. And driving from Cleveland (640miles) isn’t bad for a long weekend either. Plus as a nurse/NP, it is decently likely that your partner will do many days (7) on and many days (7) off service. She could fly home every other off service 20 times a year for visiting and the cost would be negligible compared to the debt of HMS
5. Building on your partners schedule, could she stay in Boston, live at her families house and visit you each off-service stretch? Again only 4K-$5k/yr in flight cost and she keeps the closeness to her family.
6. Just commit on budgeting flying to Boston 4-8 time a year, some weekend and some longer stays for visits. Again, over four years, this is tiny cost comparatively.
7. Ask for a meeting (call) with the Dean of Admissions. Negotiate with him and indicate your financial predicament. Notice I didn’t say Fin Aid office. Not all, but many schools do modify their offers.
8. Waitlist movement is quite prevalent especially at top schools. To me, given the current choices which I expect to change anyway due to WL movement, choose Cleveland or Chicago whichever you liked better. In fact, Releasing HMS acceptance is a key cog to start a cascade!
9. Remember, you might have a similar decision even If you get into Penn/Yale/Columbia acceptance off WL, the travel time from NYC or Penn isn’t really better to Boston than arriving early and taking a 1-2hr flight from Cleveland /Chicago to Boston. At which point you should still compare offers.
10. If you plug in a high paying attending salary of $400k, realize that after taxes, you likely net no more than $267K to service the above debt. Then assume 2 car payments and a mortgage for a home of at least the same amount, plus property taxes and insurance, and children college fund ($400k goal each in 18yrs) as the expected big ticket items.
 
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Food for thought in no particular order:
1. 50% of marriages today end in divorce, many in the first five years.
2. Kids cost a lot of money and time (would one of you forgo salary to care for them?) if still together, it isn’t unreasonable that you’ll have kids while you are in residency. Eats into disposable income, and lets debt compound as you pay $8k a year just for IBR (income based repayment).
3. 400k debt is quite massive and not the real debt burden due to interest prior to repayment. You REALLY need to the numbers to understand the magnitude to factor into your decision. Assume 5% interest for everything in his example. After four years, you’ll owe $440k, as you enter residency for seven+ years and you refinance into an IBR loan loan, with IBR of say $8k/yr, interest will accrue an additional $16k/yr beyond this amount so after 7yrs of residency, your debt is now at least $550,000 despite already paying $56k. Now take that an use a mortgage calculator for another refinance. 30yr Term = $3000/mo and 20yr Term= $3600/mo. This is all on top of your everyday living expenses , and other loans for home and cars etc. and you would pay this pretty much until retirement u less you pay off at accelerated rate. An alternate way of looking at this would be to see what the opportunity cost is for investment. Say you accelerated repayment and you paid it off in five years, imagine taking that $600k worth of repayment payments and investing it for 20 years in a mutual fund averaging 8% returns (goal for many long term investments), after 20 years, you would then have $2.8M !!!
4. Four years in another city isn’t a long time and can be fun. Realize it isn’t in a vacuum for four years!! Flights are like $200. And driving from Cleveland (640miles) isn’t bad for a long weekend either. Plus as a nurse/NP, it is decently likely that your partner will do many days (7) on and many days (7) off service. She could fly home every other off service 20 times a year for visiting and the cost would be negligible compared to the debt of HMS
5. Building on your partners schedule, could she stay in Boston, live at her families house and visit you each off-service stretch? Again only 4K-$5k/yr in flight cost and she keeps the closeness to her family.
6. Just commit on budgeting flying to Boston 4-8 time a year, some weekend and some longer stays for visits. Again, over four years, this is tiny cost comparatively.
7. Ask for a meeting (call) with the Dean of Admissions. Negotiate with him and indicate your financial predicament. Notice I didn’t say Fin Aid office. Not all, but many schools do modify their offers.
8. Waitlist movement is quite prevalent especially at top schools. To me, given the current choices which I expect to change anyway due to WL movement, choose Cleveland or Chicago whichever you liked better. In fact, Releasing HMS acceptance is a key cog to start a cascade!
9. Remember, you might have a similar decision even If you get into Penn/Yale/Columbia acceptance off WL, the travel time from NYC or Penn isn’t really better to Boston than arriving early and taking a 1-2hr flight from Cleveland /Chicago to Boston. At which point you should still compare offers.
10. If you plug in a high paying attending salary of $400k, realize that after taxes, you likely net no more than $267K to service the above debt. Then assume 2 car payments and a mortgage for a home of at least the same amount, plus property taxes and insurance, and children college fund ($400k goal each in 18yrs) as the expected big ticket items.
if medicine doesn’t workout for you, accounting and life planning seems to be perfect for you because that was very well thought out
 
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if medicine doesn’t workout for you, accounting and life planning seems to be perfect for you because that was very well thought out
Thank you.
I’m over 50 years old and hope my life experiences can benefit others. Many of the young people on this site use too broad brush stokes to over estimate how far high income goes as life and family goes on.
 
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Thank you.
I’m over 50 years old and hope my life experiences can benefit others. Many of the young people on this site use too broad brush stokes to over estimate how far high income goes as life and family goes on.
May be you should update your signature to say parent of 2019-2020 MD applicant.
 
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Pretty rough spot to be in. A few factors to take into account:
1. All the places you're looking at do well for getting you into academic medicine. HMS has a slight leg up, but don't think it's huge
2. The boost of HMS is more the doctor+ opportunities than the clinical ones. Yes the 3 home hospitals is awesome, but most people I know who turned down big money elsewhere did so for the basic science, MBA, policy or tech opportunities. It's hard to justify that kinda debt load for reasons of academic medicine
3. There are ways to cut down the debt burden while being here (can apply to be a resident tutor at the undergrad for room and board, HMS kids do pretty well with scholarships if they hustle, there are lucrative side hustles depending on your background, etc...)
4. The people who are often least stoked on HMS are future surgeons. I think something between the low emphasis on anatomy and the inefficiency of flipped classrooms can be rather irksome. Mayo actually seems like the ideal environment for pre-surgery folks
5. Congrats. It's weirdly stressful to have so many options, but just pick one and don't look back. You can be immensely successful anywhere you go.
 
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Hi all,
Quick update - I ended up choosing HMS. This was one of the most difficult decisions I have ever had to make, but now I feel so relieved. Hopefully, a sign that in 15 years upon reflecting on this decision, I can be happy with my choice.

I've worked very hard towards this goal. Not just getting into medical school, but having the option to go to a school where my partner and I would be most comfortable. It didn't sit right that the sole reason I was considering turning HMS down was the money. I never went into this process hoping to go to the cheapest "good" school, and yes, I know I would succeed at any of the phenomenal institutions I was fortunate to be accepted at. But now was not the time for me to compromise on a goal I have worked so hard towards because of a financial aid package. If money is an issue in the future, then I can make those sorts of decisions then (eg working in a more rural areal).

I know myself better than anyone, and I am confident that I will be able to pay back whatever debt I owe in a timely manner while still living comfortably. In the interim, I will try to mitigate that debt by applying for outside scholarships, minimizing cost of living expenses, etc. I know many of you may disagree with this decision, but I think dilemmas like these are very personal, as debt affects people in different ways. I appreciate all your feedback, as well as the feedback I received from several of my mentors, current HMS students, and HMS alumni who were in identical situations. Not a single person I spoke to said they regret their decision of going to HMS, and these folks were interested or are attending physicians in a variety of specialties as well as primary care. I don't think that is a coincidence.

One noteworthy conversation I had with a user on here was that they were rejected from HMS post-interview. They did end up getting a full COA to another T10, but they told me they did not realize how upset they were that they couldn't stay near their support system until they no longer had the chance - which is when they realized they would have paid whatever was needed to attend HMS and stay in the Boston area where their support system was. I know my happiness and the happiness of my partner is invaluable, especially when I am going to begin this very rigorous training path. You can't put a price on that, and I strongly believe that HMS will give me the best chance to thrive inside and outside of the classroom.

Take care,
Black doc
 
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