HomeSkool's Guide to Financing Your Medical Education

[HomeSkool]

You got into medical school! Now how do you pay for it? You already sold a kidney and your grandma disinherited you after your last arrest. What options are left?

In this guide, I’ll provide a rundown of some basic options for funding medical school. This subject is very complex and my guide won’t be 100% comprehensive, but it'll be a good starting point. As you prepare to matriculate, work with your school’s financial aid office to explore these and other options. (Post-med school loan forgiveness programs are outside the scope of this guide unless I someday decide to add them as an edit.)

There are several options for funding medical school:

• Cash (your own money)
• Scholarships and grants (other people’s money)
• Loans (other people’s money that you’ll have to pay back someday)
• Service programs (everybody’s money that you pay back with years of your life)

But first things first: the Free Application for Federal Student Aid (FAFSA).

The FAFSA

My wife says if you aren't familiar with the FAFSA, you should talk to your mom because she's been filling it out for you every year. Filling it out is the first step to securing financial aid. It’s super-annoying to fill out for the first time, so you should block out like six hours and have your parents on speed dial because you’re going to need all sorts of info including their SSN, income, assets, dependents, shoe size, BMI, MELD score, and whether they know all the words to "Ice, Ice Baby". (Hopefully your mom already filled this out once for you in the past, so all you need to do is update it with last year’s tax numbers.)​

By the way, current law makes professional students “independent”, meaning their parents’ income and favorite color aren’t used when considering eligibility for federal loans. However, many schools do consider parental information when determining whether to award institutional aid.​

After you submit the FAFSA and any additional paperwork your school gives you, you'll receive an award package. This will include a letter from the Department of Education stating which loans/grants you're qualified to receive. In addition, it'll contain information on any other sources of financial aid that are being offered to you. You'll work with your financial aid office to accept the package and secure loan money. This brings us to...​

The Funding

Cash

Pretty self-explanatory. If you’re independently wealthy from your Russia-based software piracy ring, you can always cut checks directly to your school. Schools may also accept rolls of $20 bills (contact the cashier’s office to confirm).
​

Scholarships and grants

Scholarships and grants are often confused with one another, but they are different. Grants are most often from public funding sources (although they can also come from private groups and institutions) and are generally awarded on basis of need. Scholarships are more often merit-based (sometimes with a need component) and derived from non-public sources.

Too many scholarship and grant opportunities exist for me to discuss them specifically in this guide. Accepted students should research available funding sources themselves, as well as with their schools’ financial aid offices. (As part of my preparation to matriculate, my school’s financial aid office sent me a packet to fill out; later, they returned with an award package containing a mix of scholarships and grants that helped defray some of my costs.)

EDIT: @gonnif has improved this guide by contributing a list of scholarships compiled by the UC Irvine financial aid office! Scroll down or click here.

EDIT: @buckoh24 and @bigbite have also added resources, which you can access by clicking here and here.
​

Loans

Federal Loans

There are two main types of federal loans for medical students: unsubsidized Direct (Stafford) loans and Grad PLUS loans. Students with “exceptional” need may also qualify for Perkins loans. Finally, there are HRSA Primary Care loans, which I won’t discuss in this guide because it's already going to be long enough.

Unsubsidized Stafford loans (Unsubsidized Direct loans)

These are fixed-rate loans, and med students may borrow up to $40,500 each year and $224,000 in their lifetime (including any Stafford loans used to finance undergrad). Interest begins accruing when the loans are disbursed, but it doesn’t capitalize until the loans enter repayment. The loans remain in deferment as long as you’re enrolled in school at least half-time; afterward, you have a six-month grace period before repayment begins. The repayment period is 10 years. During residency, they can be put in forbearance; in this case, interest continues to accrue but payments aren’t required.

• Origination fee: 1.066%
• Interest rate: 6.00%
• Grace period: 6 months
• Repayment term: 10 years
• Limits: $40,500 annually, $224,000 lifetime (including undergrad loans)

Grad PLUS loans (Direct PLUS loans)

These are fixed-rate loans used to cover the difference between your other sources of funding and the annual cost of attending your school. The annual cost of attendance is determined by your school and includes tuition and fees, books and supplies, room and board, transportation, and personal expenses. An adverse credit history can disqualify you from these loans. Interest begins accruing when your school receives the funds and capitalizes when the loan enters repayment. The timing of repayment is identical to that of Stafford loans.

• Origination fee: 4.264%
• Interest rate: 7.00%
• Grace period: 6 months
• Repayment term: 10 years
• Limits: up to the full cost of attendance as determined by your school, minus any other financial aid received (including scholarships)

Perkins loans

These are federal loans with even more favorable terms than the two types listed above. They have the same repayment period, but a longer grace period and a lower interest rate.

• Origination fee: none
• Interest rate: 5.00%
• Grace period: 9 months
• Repayment term: 10 years
• Limits: $8,000 annually, $60,000 lifetime (including undergrad loans)

Direct consolidated loan

After graduation, you can consolidate multiple federal loans to have a single fixed-rate, fixed-payment loan. The interest rate is the weighted average of the rates of the loans being consolidated, rounded up to the nearest 0.125%. The repayment period is anywhere from 10 to 30 years depending on the amount consolidated. $60,000 or more qualifies for 30-year repayment.​

State loans

Some states offer medical school loan programs. Generally, you automatically apply for these programs by submitting your FAFSA.
​

Private loans

If you need additional funding beyond the sources listed above, you can always approach private lenders. These loans’ terms won’t be subject to the same regulations as the federal loans, but lenders tend to offer competitive repayment terms.
​

Institutional loans

Some schools also offer loans from their own monies. These are often “emergency” loans.
​

Service programs

Health Professions Scholarship Program

The most well-known public service program for medical school funding is the HPSP. The Army, Navy, and Air Force all participate in the program with some differences between the specifics (for example, the Army and Air Force offer scholarships for one to four years; the Navy only offers three- and four-year scholarships). During med school, students are commissioned O-1 reservists (i.e., Second Lieutenant for the Army and Air Force, Ensign for the Navy) and funded by their sponsoring service branch. Covered expenses include tuition, mandatory books and equipment, some fees, laptop rental, and a monthly stipend.

HPSP students must spend 45 days on active duty each year. This requirement is met during officer basic training between MS-1 and MS-2; for other years, it can be waived based on the student's academic requirements. MS-3 and MS-4 students have the option to complete some clinical rotations at military hospitals, and they're on active duty during those rotations (which means more pay!).

Upon graduation, students are promoted to O-3 (i.e., Captain in the Army and Air Force, Lieutenant in the Navy) and commence active duty. Students may complete their residency as an active duty servicemember at a military site; alternatively, they may apply for a deferment so they can complete a civilian residency. Remember: the military owns your butt and doesn't have to approve a request for deferment! Military physicians do not deploy during residency. And contrary to what that one misinformed premed doofus told you, the military does not dictate your specialty. You apply for what you want.

After residency, you begin your payback period. Without going into too much detail, payback duration is either the number of years of scholarship you took or the length of your residency minus intern year (assuming a military residency), whichever is longer. If you take a two-year scholarship and do a four-year residency, for example, your payback period will be three years (four-year residency minus intern year equals three). I don't know about the Air Force and Navy (and don't care to Google it right now), but I know the Army has a minimum two-year payback requirement.
​

Uniformed Services University of the Health Sciences (USUHS)

Students who attend USUHS enjoy a tuition-free education with a military service commitment afterward. At the time of their interview, students rank the Army, Navy, Air Force, and Public Health Service, and accepted students are then assigned to one of those branches depending on the needs of each. Once they start school, students are commissioned as O-1's on active duty, and they receive full active duty pay while in school (currently about $65K for O-1's, $30K of which is tax-exempt). Upon graduating, students are advanced to O-3 and complete their residencies. By attending USUHS, students incur a seven-year active duty service obligation (ADSO); after completing the ADSO, they may elect to remain in the military or separate. Those who serve fewer than ten years on active duty after residency will remain in the Individual Ready Reserve (IRR) two to six years after separating. Those in the IRR don't have to drill or train, but they are subject to call-up by the President in event of an emergency.
​

NHSC Scholarship program

This program awards scholarships to medical (and other health professional) students in exchange for a commitment to provide care in underserved areas. It covers tuition, fees, and a living stipend. Participants repay their scholarship with a two- to four-year period providing primary care in a high-need health professional shortage area. That's really all I know about this program, though I may do more research and update this post later.​

A couple final notes

Assuming you don't run away to Canada or some other backwards country, you'll eventually have to pay back any loans. I have a couple tips to make this less painful.

How to prioritize loans

People who don't understand finance often think you should pay down the biggest loan first. This is not the best strategy (the cake is a lie). Pay down the one with the highest interest rate first, regardless of how large or small it may be.

Think of interest rates as the price tag to borrow money. If you have a 10% interest rate, the annual cost of borrowing $1 is 10¢; for a loan with a 2% interest rate, that cost is 2¢. That means each dollar in the 10% loan is five times as expensive as every dollar in the 2% loan.

Example: Suppose you borrow $1,000 at 10% and $10,000 at 2%. You don't have any mandatory payment this year, but you do have $1,000 of money that you found hidden in your freezer. You have two options:

• Option A: Put the money against the 10% loan. It's paid off and accrues no interest. The other loan accrues $200 of interest ($10,000 x 2% = $200).
• Option 2: Put the money against the 2% loan. Now the 10% loan will accrue $100 of interest ($1,000 x 10% = $100) and the 2% loan will accrue $180 of interest ($9,000 x 2% = $180). Total interest for the year is $280.

In this scenario, option A saves you money. This is true no matter what the actual numbers on your loans may be. Once more: you should always prioritize paying whichever loan has the highest interest rate.
​

Loan Consolidation

You can also consolidate many of your loans to simplify things. Suppose you get three loans from Lender A, then use Lender B to consolidate. Lender B will buy your loans from Lender A (by paying off everything you owe that lender), and now all your debt will be combined in a single loan from Lender B. It means simpler monthly payments, but more importantly, it gives you the option to change the terms of your repayment. And you don't have to consolidate all of your loans if you don't want to.

Here's a practical example of how it works:

• You have two loans with different interest rates from Lender A, and one loan from lender B. Then you decide to consolidate with Lender C.
• Lender C says, "We'll allow you to consolidate at interest rate X." X is lower than the interest rate for your loan from B, as well as one of your loans from A.
• You decide to consolidate the loan from B and the high-interest one from A.
• Now you owe Lender C money, which is accruing interest at a lower rate than it would have in the original loans. And you also owe some money to Lender A, which has an even lower interest rate than your new consolidated loan.

When consolidating, you'll be offered different terms of repayment: "A years at X interest, B years at Y interest, C years at Z interest." A longer repayment term means lower monthly payments but a higher interest rate. (Again, think of interest rate as the price tag. If you want to tie up a lender's money for ten years, they won't charge you as steep an interest rate as if you want to tie it up for thirty years.) So pick a repayment term that's aggressive so you can get a lower interest rate, but not so aggressive that the monthly payments become a hardship.​

I hope this guide is useful to you! I'm always happy to answer questions if you have them. And I'll update/modify this with new info from time to time.

Love,
HomeSkool

P.S. A big shout-out to Mrs. HomeSkool, who contributed wisdom and wit to this guide!

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[nymd22]

This is so helpful! Thank you!

 

[Lawpy]

Good work! I'll try to add it to Essential SDN Wisdom when I get the time

 

[E.Hemingway]

“Interest begins accruing when the loans are disbursed, but it doesn’t capitalize until the loans enter repayment. The loans remain in deferment as long as you’re enrolled in school at least half-time; afterward, you have a six-month grace period before repayment begins.”

Could you please explain this a little more?

 

[HomeSkool]

“Interest begins accruing when the loans are disbursed, but it doesn’t capitalize until the loans enter repayment. The loans remain in deferment as long as you’re enrolled in school at least half-time; afterward, you have a six-month grace period before repayment begins.”

Could you please explain this a little more?

Sure. A couple vocab terms:

• Principal: the portion of your loan against which interest is charged
• Capitalization: when interest is added to the principal, meaning it begins to accrue interest of its own

Let's imagine a loan with the following terms

• Loan amount: $1,000
• Interest rate: 10%
• No payments required for two years
• Interest is not capitalized until repayment begins
• In this case, the loan accrues $100 of interest during year 1 (because $1,000 x 10% = $100). That interest is not added to the principal yet, so during year 2 the principal remains $1,000 and the loan accrues another $100 of interest. When repayment begins two years later, you owe a total of $1,200 (the original $1,000 you borrowed plus $100 of interest for each of the two intervening years).

Now suppose the loan has nearly identical terms, except that interest is capitalized annually.

• During year 1, the loan accrues $100 of interest. At the end of year 1, the interest is added to the principal, and the new principal amount is $1,100.
• During year 2, the loan accrues $110 of interest (because $1,100 x 10% = $110).
• When the loan enters repayment, you owe a total of $1,210.

So the part of my post that you quoted means:

• As soon as the government sends the money to your school, interest begins to accrue
• The interest is not capitalized (i.e., it's not added to the principal) until the loan enters repayment
• When you're no longer enrolled in school at least half-time, you enter a six-month grace period before repayment begins
• Once that six-month period ends, the interest is capitalized and you have to start making payments on the loan

Make sense?

 

[Robin-jay]

A big shout-out to Mrs. HomeSkool

What do you think of schools offering private loans and not federal? Is the difference in how much to you end up paying that different?

Also, are the legends true, is Mrs. HomeSkool as hawt as they say?

 

[medguy24]

Sure. A couple vocab terms:

• Principal: the portion of your loan against which interest is charged
• Capitalization: when interest is added to the principal, meaning it begins to accrue interest of its own

Let's imagine a loan with the following terms

• Loan amount: $1,000
• Interest rate: 10%
• No payments required for two years
• Interest is not capitalized until repayment begins
• In this case, the loan accrues $100 of interest during year 1 (because $1,000 x 10% = $100). That interest is not added to the principal yet, so during year 2 the principal remains $1,000 and the loan accrues another $100 of interest. When repayment begins two years later, you owe a total of $1,200 (the original $1,000 you borrowed plus $100 of interest for each of the two intervening years).

Now suppose the loan has nearly identical terms, except that interest is capitalized annually.

• During year 1, the loan accrues $100 of interest. At the end of year 1, the interest is added to the principal, and the new principal amount is $1,100.
• During year 2, the loan accrues $110 of interest (because $1,100 x 10% = $110).
• When the loan enters repayment, you owe a total of $1,110.

So the part of my post that you quoted means:

• As soon as the government sends the money to your school, interest begins to accumulate
• The interest is not capitalized (i.e., it's not added to the principal) until the loan enters repayment
• When you're no longer enrolled in school at least half-time, you enter a six-month grace period before repayment begins
• Once that six-month period ends, the interest is capitalized and you have to start making payments on the loan

Make sense?

What about during residency if you put the loans in forbearance? Does the interest capitalize during forbearance?
Thx!


Sent from my iPhone using SDN mobile

 

[fourandtwo]

So it looks like if you can pay out of pocket rather than take out loans, then you should, correct?

 

[TelemarketingEnigma]

Now suppose the loan has nearly identical terms, except that interest is capitalized annually.

• During year 1, the loan accrues $100 of interest. At the end of year 1, the interest is added to the principal, and the new principal amount is $1,100.
• During year 2, the loan accrues $110 of interest (because $1,100 x 10% = $110).
• When the loan enters repayment, you owe a total of $1,110.

This is such a great and helpful write up, thank you! A quick note: I think you have a typo here, the total should be $1,210?

 

[Crazy bruin]

Thank you, this guide is so helpful!

 

[HomeSkool]

What do you think of schools offering private loans and not federal?

(Them, not you.)

Is the difference in how much to you end up paying that different?

It can be, depending on the terms of your loans. I guess that's just the cost of going to CNU.

Also, are the legends true, is Mrs. HomeSkool as hawt as they say?

No. She's much, much hotter than the stories say. (But hey, only one of us could marry up. Might as well be me!)

What about financing your application? I'm still sitting on three maxed credit cards from the last cycle.

That's why you sold the kidney! Actually, application costs are a real concern for a lot of people. Some people's parents help, others use savings, others use credit cards, some lucky ones are able to afford it themselves. You can also look into the AAMC's Fee Assistance Program: Fee Assistance Program

What about during residency if you put the loans in forbearance? Does the interest capitalize during forbearance?

There are two ways to pause repayment during residency: deferment and forbearance. During forbearance, interest continues to accrue and is capitalized on all your loans (i.e., it acts like it's in repayment except that you don't have to make payments). During deferment, the government will pay any interest on subsidized federal loans (like subsidized Staffords from undergrad). For that reason, deferment is preferable to forbearance if you're eligible.

Also, making payments on your loans while they're in deferment/forbearance does not kick them out of that status.

So it looks like if you can pay out of pocket rather than take out loans, then you should, correct?

If you're fortunate enough to be able to do that, it's cheaper than taking out loans. Loans mean you pay the same amount plus interest.

I think you have a typo here, the total should be $1,210?

Fixed. Thanks! Er...I mean, you saw nothing! Nothing, I say!

 

[Catahecassa]

.

 

[CyrilFiggis]

Bravo to @HomeSkool for the guide. I used to mentor post-baccs about this stuff and he is much more clear than I am, but to just add some comments...

What do you think of schools offering private loans and not federal? Is the difference in how much to you end up paying that different?

One of the main downfalls of private loans is that they do not discharge with your death. I know that seems odd, but loans are typically a 10 year payback, but if you defer or do a 20 year repayment, it's not uncommon to think that even a traditional applicant may be paying their loans well into their 30's. If you have a spouse or family, that's a big debt to leave them.

So it looks like if you can pay out of pocket rather than take out loans, then you should, correct?

As HomeSkool said, many are unable to pay out of pocket. But if you have the means, it is wise to use that money to reduce COL loans. It can be depressing to think that your $700 rent each month is earning 6% interest.

Finally, average med school debt is creeping past $200K nationally. You are essentially taking out a mortgage on your brain. While Homeskool's guide is a good jumping off point for paying for school, it is in your best interest to understand the basics of finance and budgeting. Studies and surveys have shown financial stress as a consistent metric in resident and med student burnout. Being prepared with the knowledge can help ease the uneasiness of a debt filled future.

 

[HomeSkool]

it is in your best interest to understand the basics of finance and budgeting. Studies and surveys have shown financial stress as a consistent metric in resident and med student burnout. Being prepared with the knowledge can help ease the uneasiness of a debt filled future.

Could not agree more. Several of my colleagues have asked me to explain 401(k)/403(b) and IRA plans to them ("Hey HomeSkool, can you help me out? I just throw money at these accounts every month but I don't know what's going on there.") And I'm thinking, You're hoping to live for 20+ years on your investments after retirement. You probably ought to understand what's going on in those accounts! The number of physicians in that boat is actually rather shocking.

 

[Matthew9Thirtyfive]

Great post. You might want to add USUHS in under service programs. The commitment is different, and so are the benefits and pay.

 

[E.Hemingway]

Sure. A couple vocab terms:

• Principal: the portion of your loan against which interest is charged
• Capitalization: when interest is added to the principal, meaning it begins to accrue interest of its own

Let's imagine a loan with the following terms

• Loan amount: $1,000
• Interest rate: 10%
• No payments required for two years
• Interest is not capitalized until repayment begins
• In this case, the loan accrues $100 of interest during year 1 (because $1,000 x 10% = $100). That interest is not added to the principal yet, so during year 2 the principal remains $1,000 and the loan accrues another $100 of interest. When repayment begins two years later, you owe a total of $1,200 (the original $1,000 you borrowed plus $100 of interest for each of the two intervening years).

Now suppose the loan has nearly identical terms, except that interest is capitalized annually.

• During year 1, the loan accrues $100 of interest. At the end of year 1, the interest is added to the principal, and the new principal amount is $1,100.
• During year 2, the loan accrues $110 of interest (because $1,100 x 10% = $110).
• When the loan enters repayment, you owe a total of $1,210.

So the part of my post that you quoted means:

• As soon as the government sends the money to your school, interest begins to accrue
• The interest is not capitalized (i.e., it's not added to the principal) until the loan enters repayment
• When you're no longer enrolled in school at least half-time, you enter a six-month grace period before repayment begins
• Once that six-month period ends, the interest is capitalized and you have to start making payments on the loan

Make sense?

Yes, thank you. Great explanation.

 

[begoood95]

I have a question regarding your section on HPSP:

To me, the commitment you've outlined doesn't seem very...involved? In other words, this doesn't seem like a terrible option—at least, others have made it seem like you're committed to active duty for a time equal to the time spent in medical school (i.e., if they pay 4 years of MS, you have 4 years of active duty). Maybe I'm misunderstanding your write-up, but it doesn't seem like there is much in the way of service that is required.

The question: let's just assume I choose gensurg as my specialty, and it's a five year residency, and that HPSP payed 4 years of MS tuition. Is four years of time considered service pay back (i.e., I'm active duty), and if so, what does active duty entail? Thank you so much for your help!

 

[CyrilFiggis]

I have a question regarding your section on HPSP:

To me, the commitment you've outlined doesn't seem very...involved? In other words, this doesn't seem like a terrible option—at least, others have made it seem like you're committed to active duty for a time equal to the time spent in medical school (i.e., if they pay 4 years of MS, you have 4 years of active duty). Maybe I'm misunderstanding your write-up, but it doesn't seem like there is much in the way of service that is required.

The question: let's just assume I choose gensurg as my specialty, and it's a five year residency, and that HPSP payed 4 years of MS tuition. Is four years of time considered service pay back (i.e., I'm active duty), and if so, what does active duty entail? Thank you so much for your help!

I think you're misunderstanding. If you have the military pay for four years of med school, you'll graduate, do residency and then owe them four years (assuming your residency was shorter). You're entire life for those 4 years is service. And while they can't tell you what specialty to do, they can tell you to pack you bags and move to Germany or deploy for 18 months.

You need to look around for info on military service. There is an AMA on the front page about this and @Matthew9Thirtyfive was active duty prior to school.

Also, if you look at the long term finances of a military medicine, if you stay in for at least 10 years post-residency, you actually start to lose lifetime earning potential compared to civilian MDs.

 

[begoood95]

I think you're misunderstanding. If you have the military pay for four years of med school, you'll graduate, do residency and then owe them four years (assuming your residency was shorter). You're entire life for those 4 years is service. And while they can't tell you what specialty to do, they can tell you to pack you bags and move to Germany or deploy for 18 months.

You need to look around for info on military service. There is an AMA on the front page about this and @Matthew9Thirtyfive was active duty prior to school.

Ah, okay—that's exactly what would deter me. Thanks!

 

[HomeSkool]

Great post. You might want to add USUHS in under service programs. The commitment is different, and so are the benefits and pay.

Great point! I'll do that this evening.

I have a question regarding your section on HPSP:

To me, the commitment you've outlined doesn't seem very...involved? In other words, this doesn't seem like a terrible option—at least, others have made it seem like you're committed to active duty for a time equal to the time spent in medical school (i.e., if they pay 4 years of MS, you have 4 years of active duty). Maybe I'm misunderstanding your write-up, but it doesn't seem like there is much in the way of service that is required.

The question: let's just assume I choose gensurg as my specialty, and it's a five year residency, and that HPSP payed 4 years of MS tuition. Is four years of time considered service pay back (i.e., I'm active duty), and if so, what does active duty entail? Thank you so much for your help!

Sorry if it was unclear; I'll see if I can reword to clarify.

Residency does not count as payback time, even if it's spent on active duty. Payback begins after residency ends and is equal to the greater of your scholarship length or your residency length minus intern year (assuming you do a military residency). In the example you gave, things would go thusly:

• Four years of medical school as a reserve O-1
• Six years of gen surg residency on active duty as an O-3 (all Army gen surg residencies are six years in length and include a research year; I don't know if USN and USAF are the same, but I suspect they are)
• Five years of additional active duty payback after residency, presumably as an O-4 (you become eligible for promotion after six years of active duty, and residency counts for that)

So by the time you could exit the Army, you'd be 11 years out of medical school.

Alternatively, consider someone who takes a two-year scholarship and then does a four-year residency:

• Two years of medical school as a civilian, then two more as a reserve O-1
• Four years of residency on active duty as an O-3
• Three years of additional active duty payback, eligible for promotion at the end of the second year

That's what I did.

And while they can't tell you what specialty to do, they can tell you to pack you bags and move to Germany or deploy for 18 months.

Yep. I will say, however, that Germany is a very coveted assignment. And military physicians generally have more say in their duty station assignments than Private Joe Snuffy. (For example, when I was graduating, the Army's Consultant to the Surgeon General for Anesthesia, who was an attending in my residency program, came and said, "HomeSkool, this is the list of locations that will have open spots in July. What's your preference?") And military doctors are often allowed to "homestead", meaning they stay at one duty station for a prolonged period rather than moving every 3 years like the rest of the military.

On active duty, your days are pretty much like they would be as a doctor anywhere else, with the added wrinkle of having to do a PT test and a surprise UDS every so often. It's not like you're out drilling all the time.

Physician deployments a few years ago were a year long. Lately, they've had a lot of 9-month deployments, and I've heard of multiple cases where two physicians split the deployment halfsies. I don't know if the USN and USAF have been doing that, but the USA (acronym for US Army) has.

You need to look around for info on military service. There is an AMA on the front page about this and @Matthew9Thirtyfive was active duty prior to school.

Agreed. Check the AMA page, ask @Matthew9Thirtyfive (who can tell you more about USN) or me (I can talk about USA). The MilMed forum is also a good place for info.

Also, if you look at the long term finances of a military medicine, if you stay in for at least 10 years post-residency, you actually start to lose lifetime earning potential compared to civilian MDs.

I was on active duty for seven years, and I left about half a million dollars on the table. That's after accounting for the impacts of both the additional med school loans and the lesser civilian resident pay if I hadn't served (and it's also a function of my having chosen a very well-compensated specialty). But...

I wouldn't trade the time I spent in the Army. Not ever.

 

[buckoh24]

Bless this post

 

[buckoh24]

@HomeSkool: Here is a list of Outside Scholarships for Medical Students as compiled by the UC/Irvine Office of Financial Aid (attached PDF as well for your dancing and dinner pleasure

Outside Scholarships for Medical Students
from Office of Financial Aid, UC/Irvine Medical School
Outside Scholarships for Medical Students: Medical Students

AMWA Medical Education Scholarship (Need-Based)
Arthur N. Wilson Scholarship
Buckfire & Buckfire, P.C. Scholarship
California Community Service-Learning Program (CCSLP) Scholarship
CAMS Scholarship
Chinese American Physicians Society
Chiyo M. Hattori Scholarship
Dr. Arthur J. and Helen M. Horvart Foundation Scholarship Fund
Dr. James L. Hutchinson and Evelyn Ribbs Hutchinson Scholarship
FMMS Scholarship
Frank & Louis Groff Medical Scholarship
Gene & Marilyn Nuziard Health Care Scholarship
Health Career Scholarship
Health Professions Scholarship Program (HPSP)
Hispanic General Scholarship for Graduates
Honjo-JMSA Scholarship
Howard G. Lapsley Memorial Scholarship Fund
HSF & HACEMOS Scholarship
HSF General College Scholarships
HSF Inspiring Women Award
Japanese American Medical Association (JAMA) Scholarship
Jewish Vocational Service (JVS) Scholarship UPDATED!
Joan F. Giambalvo Memorial Scholarship Fund
Kaiser Permanente Scholarship Program
Kathern F. Gruber Scholarship Program
Medical Staff Scholarship
Medical Student Summer Fellowship Program
Minority Medical Student Award
Mitsui USA-JMSA Scholarship
Montgomery County Medical Society (MCMS) Scholarship
National Health Service Corp (NHSC) Scholarship
National Italian American Scholarship
Nippon Life-JMSA Scholarship
Nishioka-JMSA Scholarship
NMF Need-Based Scholarship Program
Nolan Scholarship
Oliver Goldsmith, M.D. Scholarship
Rebecca Lee, M.D. Scholarship
Riverside County Physicians Memorial Foundation
Rock Sleyster,M.D.Memorial Scholarship
Ruth G. White Scholarship
S. William & Martha R. Goff Educational Scholarship
Scholarship Foundation of Santa Barbara
TADAM Scholarship
The American Hellenic Educational Progressive Association Foundation Medical School Scholarship
The F. Edward Hébert Armed Forces Health Professions Scholarship Program (HPSP)
The Harvey Fellows Program
The Howard G. Lapsley Scholarship
The MacKenzie Foundation Scholarship
The Myrtle Siegfried, MD and Michael Vigilante, MD Scholarship
The Pisacano Scholars Leadership Program
Thomas Loeb, M.D. Scholarship Award
Tillman Military Scholars
Toyota Motor North America-JMSA Scholarship
Vietnamese American Medical Association Scholarship
Wellsford and Mildred Clark Medical Memorial Scholarship
William E. Dochterman Medical Student Scholarship Fund
Paul & Daisy Soros Fellowships for New Americans

UGH #BLESS THIS WHOLE THREAD

 

[HomeSkool]

@HomeSkool: Here is a list of Outside Scholarships for Medical Students as compiled by the UC/Irvine Office of Financial Aid (attached PDF as well for your dancing and dinner pleasure

Outside Scholarships for Medical Students
from Office of Financial Aid, UC/Irvine Medical School
Outside Scholarships for Medical Students: Medical Students

AMWA Medical Education Scholarship (Need-Based)
Arthur N. Wilson Scholarship
Buckfire & Buckfire, P.C. Scholarship
California Community Service-Learning Program (CCSLP) Scholarship
CAMS Scholarship
Chinese American Physicians Society
Chiyo M. Hattori Scholarship
Dr. Arthur J. and Helen M. Horvart Foundation Scholarship Fund
Dr. James L. Hutchinson and Evelyn Ribbs Hutchinson Scholarship
FMMS Scholarship
Frank & Louis Groff Medical Scholarship
Gene & Marilyn Nuziard Health Care Scholarship
Health Career Scholarship
Health Professions Scholarship Program (HPSP)
Hispanic General Scholarship for Graduates
Honjo-JMSA Scholarship
Howard G. Lapsley Memorial Scholarship Fund
HSF & HACEMOS Scholarship
HSF General College Scholarships
HSF Inspiring Women Award
Japanese American Medical Association (JAMA) Scholarship
Jewish Vocational Service (JVS) Scholarship UPDATED!
Joan F. Giambalvo Memorial Scholarship Fund
Kaiser Permanente Scholarship Program
Kathern F. Gruber Scholarship Program
Medical Staff Scholarship
Medical Student Summer Fellowship Program
Minority Medical Student Award
Mitsui USA-JMSA Scholarship
Montgomery County Medical Society (MCMS) Scholarship
National Health Service Corp (NHSC) Scholarship
National Italian American Scholarship
Nippon Life-JMSA Scholarship
Nishioka-JMSA Scholarship
NMF Need-Based Scholarship Program
Nolan Scholarship
Oliver Goldsmith, M.D. Scholarship
Rebecca Lee, M.D. Scholarship
Riverside County Physicians Memorial Foundation
Rock Sleyster,M.D.Memorial Scholarship
Ruth G. White Scholarship
S. William & Martha R. Goff Educational Scholarship
Scholarship Foundation of Santa Barbara
TADAM Scholarship
The American Hellenic Educational Progressive Association Foundation Medical School Scholarship
The F. Edward Hébert Armed Forces Health Professions Scholarship Program (HPSP)
The Harvey Fellows Program
The Howard G. Lapsley Scholarship
The MacKenzie Foundation Scholarship
The Myrtle Siegfried, MD and Michael Vigilante, MD Scholarship
The Pisacano Scholars Leadership Program
Thomas Loeb, M.D. Scholarship Award
Tillman Military Scholars
Toyota Motor North America-JMSA Scholarship
Vietnamese American Medical Association Scholarship
Wellsford and Mildred Clark Medical Memorial Scholarship
William E. Dochterman Medical Student Scholarship Fund
Paul & Daisy Soros Fellowships for New Americans

I think you just made a lot of SDNers very, very happy.

 

[CyrilFiggis]

HomeSkool: Here is a list of Outside Scholarships for Medical Students as compiled by the UC/Irvine Office of Financial Aid (attached PDF as well for your dancing and dinner pleasure

Fun Fact: If you're a 30-something, middle class, white, male, goy, there are roughly zero scholarships for you unless you grew up in a certain state/city.

 

[Lucky Day]

Yo, @HomeSkool . I appreciate you.

 

[CloverBale]

Not to be that gal, but don't you have like 16k in bitcoin?

nah man I WISH

 

[DrDwayneJohnson]

Amazing thread. To add onto the above info: I highly recommend reading White Coat Investor by Dr. James Dahle. It's more of a personal finance piece, but I still think it's really useful.

 

[Matthew9Thirtyfive]

The question: let's just assume I choose gensurg as my specialty, and it's a five year residency, and that HPSP payed 4 years of MS tuition. Is four years of time considered service pay back (i.e., I'm active duty), and if so, what does active duty entail? Thank you so much for your help!

You pay back the four years of HPSP OR the length of your residency (not including internship)—whichever is longer. And not all residencies are the same length. For example, the Navy general surgery residency at Balboa is 6-7 years, as they require 2 dedicated research years between PGY-3 and 4 (I say 6-7 because you may be able to get away with a single Research year—maybe). So if you went there, you’d owe 5-6 years.

And active duty is not all bad. There are some frustrations, but there are frustrations anywhere. And honestly, deployment sucks. Leaving your family sucks. But for me (and many other people who are happy they are in the military), getting to do what the military does and support the guys and gals who really do the work is awesome and really makes it worth it.

 

[Matthew9Thirtyfive]

I think you're misunderstanding. If you have the military pay for four years of med school, you'll graduate, do residency and then owe them four years (assuming your residency was shorter). You're entire life for those 4 years is service. And while they can't tell you what specialty to do, they can tell you to pack you bags and move to Germany or deploy for 18 months.

It’s not all that bad. I know very few people who were given extremely short notice for a crap PCS. I myself got the shaft once on a PCS, and I got 3 hours notice on a potentially 2-month underway that they pulled me off paternity leave for once, but those things don't happen that often to the same person.

You need to look around for info on military service. There is an AMA on the front page about this and @Matthew9Thirtyfive was active duty prior to school.

Technically I’m still active duty since I’m assigned to USUHS. It’s a sweet deal.

Also, if you look at the long term finances of a military medicine, if you stay in for at least 10 years post-residency, you actually start to lose lifetime earning potential compared to civilian MDs.

This is specialty dependent. For surgical specialties and higher paying medicine subspecialties (and things like gas and EM), this is true. Taking all the benefits and financial pluses into account, you will not be far behind your civilian counterparts at the end of your commitment no matter what your specialty is.

But once your commitment is up, you will fall rapidly behind in those specialties mentioned above. But for primary care specialties, you can actually make more. In the military, your pay increases at a very constant rate, and staying on extra will give you bonuses as well.

 

[HomeSkool]

@Matthew9Thirtyfive I didn't get around to adding the USUHS stuff last night, but it's coming.

 

[calivianya]

So it looks like if you can pay out of pocket rather than take out loans, then you should, correct?

Just thought I'd add a caveat here - it depends on what else you've got going on in your life. Student loans are often the best debt - lowest interest, you can do income based repayment, etc.

If you have credit card balances accruing 20% interest, or your credit sucks so you had to get an auto loan for >10%, or have some horrendous percentage on your mortgage, and you have to pick between paying these off or paying for your education - take out student loans because the interest rates are so low and there is no forbearance/deferral for a car payment/mortgage.

Assuming no other debt, yes, it would be very wise not to take out loans at all.

 

[Lucky Day]

Just thought I'd add a caveat here - it depends on what else you've got going on in your life. Student loans are often the best debt - lowest interest, you can do income based repayment, etc.

If you have credit card balances accruing 20% interest, or your credit sucks so you had to get an auto loan for >10%, or have some horrendous percentage on your mortgage, and you have to pick between paying these off or paying for your education - take out student loans because the interest rates are so low and there is no forbearance/deferral for a car payment/mortgage.

Assuming no other debt, yes, it would be very wise not to take out loans at all.

Yeah, but let’s do real talk. The person who can pay the nearly $300k for medical school out of pocket probably isn’t worried about their CCs or finances in general.

 

[Matthew9Thirtyfive]

Yeah, but let’s do real talk. The person who can pay the nearly $300k for medical school out of pocket probably isn’t worried about their CCs or finances in general.

I agree with you in general, but I do remember seeing a post where someone was a non-trad who had saved for a while and had the money to pay cash. I’m guessing they still had to deal with finances. So it can happen, but I’m willing to bet 9 times out of 10 you’re right.

 

[freedoctor17]

I think this may be relevant here. Does anyone know exactly how the average indebtedness value on the MSAR is determined? Like if the average is 150,000 does that mean if someone who fell right at the average had 150,000 they could pay for all their med school and not worry about debt? Because calculating the amount based on total cost per year makes me expect the total debt to be closer to 300,000. Is this average given by the MSAR thrown off by people who receive full tuition scholarships or those who pay everything up front? Or do they exclude those types of people from the average? because if they don't it can be very misleading.


Edit: Cost is going to play a huge role in my decisions so just wondering which to look at. Some schools have much higher costs than others but then much lower average indebtedness and I'm not sure which to give more weight.

 

[calivianya]

I think this may be relevant here. Does anyone know exactly how the average indebtedness value on the MSAR is determined? Like if the average is 150,000 does that mean if someone who fell right at the average had 150,000 they could pay for all their med school and not worry about debt? Because calculating the amount based on total cost per year makes me expect the total debt to be closer to 300,000. Is this average given by the MSAR thrown off by people who receive full tuition scholarships or those who pay everything up front? Or do they exclude those types of people from the average? because if they don't it can be very misleading.


Edit: Cost is going to play a huge role in my decisions so just wondering which to look at. Some schools have much higher costs than others but then much lower average indebtedness and I'm not sure which to give more weight.

Some of the bigger institutions, like Harvard, have large pockets to help their students out... but they also likely have many students whose parents are Harvard alums with large pockets.

I suspect, like reading match lists, trying to read average indebtedness is a lot like trying to read tea leaves.

 

[freedoctor17]

Some of the bigger institutions, like Harvard, have large pockets to help their students out... but they also likely have many students whose parents are Harvard alums with large pockets.

I suspect, like reading match lists, trying to read average indebtedness is a lot like trying to read tea leaves.

So you think those people with large pockets who pay up front are included in the average? Because if they're not it would actually be pretty useful.

 

[calivianya]

So you think those people with large pockets who pay up front are included in the average? Because if they're not it would actually be pretty useful.

I'm assuming they are - it doesn't say average except for self pay, but I'm really just guessing here.

 

[freedoctor17]

Cost of Attendance vs. Average Indebtedness

Nevermind found this thread and they confirm that these people are included which drives the average way down. I wish there was a list of schools known for giving a ton of aid/scholarships

 

[freedoctor17]

I need to learn to use Google

https://www.usnews.com/best-graduate-schools/top-medical-schools/private-financial-aid-rankings

That's the best I could find. I'm assuming it changes year to year depending on funding but better than nothing

 

[SpoiledMilk]

✔️ Apply to medical schools
✔️ Get accepted into medical school in hometown
* Live in own house while attending medical school
* Get scholarships (if lucky) and/or take out financial aid to pay for medical school
* Graduate and get into a residency
* Sell house to pay off undergrad/medical school loans (if any) during residency
* Practice for many years
* Retire debt-free and travel

** Continue to drive same reliable car until it dies

 

[3toedsloth]

@fourandtwo
Should you use cash or loans? It's a good question that is up for debate, and it really depends on your how risk averse you are.

Benefits of loans: Taking loans allows you to keep your current investments. Governmental student loans are forgiven on death. You still have a security net (assuming you wouldn't if you spent a significant portion of your net worth on tuition/living expenses).
Cost of taking loans: Interest and origination fees.

If your assets are projected to make 7%+ returns, then it makes more sense to take loans. If you have a family, and if the amount of tuition is a very significant portion of your net worth, it may also make sense to take loans so that if you die (sorry, morbid...), your medical education expenses are forgiven. On the other hand, if they are in more conservative investments (why at your age you'd do this.. I don't know...), then it makes sense to use cash.

 

[freedoctor17]

I always warn acceptees that no school is required to produce financial aid offers prior to the April 30th single acceptance deadline. Indeed, why should a school invest work in producing FA analysis before they know you will attend? You may have to make an acceptance decision without any FA information. Additionally, some schools do not award internal institutional scholarships until after the April 30th deadline for the same reason. At larger, more prominent schools, with successful alumni, grateful patients and their families, and well off donors, these can be substantial.

If I'm fortunate enough to get accepted into multiple schools ideally id go to the one I liked best, but when it comes down to it if the cost is significantly cheaper at one I'd take that over risking not getting anything at a school who won't release the financial aid until after the April 30th date (which I'm glad you mentioned because I wasn't aware of that). I won't go into the reasoning but cost for me is probably a much larger deciding factor than for most other applicants.

 

[fourandtwo]

@fourandtwo
Should you use cash or loans? It's a good question that is up for debate, and it really depends on your how risk averse you are.

Benefits of loans: Taking loans allows you to keep your current investments. Governmental student loans are forgiven on death. You still have a security net (assuming you wouldn't if you spent a significant portion of your net worth on tuition/living expenses).
Cost of taking loans: Interest and origination fees.

If your assets are projected to make 7%+ returns, then it makes more sense to take loans. If you have a family, and if the amount of tuition is a very significant portion of your net worth, it may also make sense to take loans so that if you die (sorry, morbid...), your medical education expenses are forgiven. On the other hand, if they are in more conservative investments (why at your age you'd do this.. I don't know...), then it makes sense to use cash.

Thank you! This makes sense and helps with my decision making

 

[dl426]

My rule of thumb that at $100,000 difference in debt, it becomes a significant factor. That has to do with how the debt is capitalized and payback as a percentage of future income

I am debating between two schools currently: State School (COA $58k) and Georgetown (COA $91k). Multiply these by 4 and that comes out to a difference of $132,000.

It seems like a no brainer, right? The issue: the State School has an extremely strong focus on rural family practice. I may be interested in this, but I also like internal medicine, derm, and psych. I want to have the opportunity to explore my interests, and I want to have the chance to do research (there is no M1 summer break at State School to leave and do research elsewhere).

@gonnif @HomeSkool What suggestions do you have for me, given the circumstances? Does the money still outweigh the difference in opportunities?

 

[freedoctor17]

I am debating between two schools currently: University of Minnesota Duluth (COA $58k) and Georgetown (COA $91k). Multiply these by 4 and that comes out to a difference of $132,000.

It seems like a no brainer, right? The issue: the Duluth campus of UMN has an extremely strong focus on rural family practice. I may be interested in this, but I also like internal medicine, derm, and psych. I want to have the opportunity to explore my interests, and I want to have the chance to do research (there is no M1 summer break at Duluth to leave and do research elsewhere).

What suggestions do you have for me, given the circumstances? Does the money still outweigh the difference in opportunities?

Notice he said "significant factor" and not only factor. You should still consider all that extra stuff you care about as long as they're actually relevant (I've heard that no school will really prevent you from pursuing an interest, though some may be better prepared for it than others). My scenario is different so I've been discussing it via pm but if I could choose while ignoring cost I would (I still need to apply so I'm getting ahead of myself).

 

[HomeSkool]

$155K difference

All of which capitalizes at graduation and begins accruing 7% annual interest. Assuming annual compounding and a 3-year residency during which you don't pay the interest, that becomes $190K. 4-year residency, $203K. And remember: that's just the difference between the two schools.

 

[Goro]

Actually, it is much worse. How debt is capitalized for medical school is
1) each year is a separate loan
2) it is simple interest on each year
3) all that is typically rolled over into a single loan after graduation.

Therefore, if you were to borrow all of COA for each year at say 7% interest (I do not know what current loan rates are), after 4 years you would have
$58K a year = $272K total; $91K a year = $427K , or $155K difference (see below)
View attachment 227802

 

[freedoctor17]

wow before financing my medical education I need to figure out how to finance my secondaries . Have been saving up money for the application cycle and didn't realize the average secondary was around $100, thought it was closer to 60 ... luckily I got a whole semester to continue saving up.

 

[Robin-jay]

wow before financing my medical education I need to figure out how to finance my secondaries . Have been saving up money for the application cycle and didn't realize the average secondary was around $100, thought it was closer to 60 ... luckily I got a whole semester to continue saving up.

I'd say the average across all my secondaries was probably closer to 70 than 100.

 

[E.Hemingway]

I'd say the average across all my secondaries was probably closer to 70 than 100.

wow before financing my medical education I need to figure out how to finance my secondaries . Have been saving up money for the application cycle and didn't realize the average secondary was around $100, thought it was closer to 60 ... luckily I got a whole semester to continue saving up.

Just as a counterpoint, I believe my average was just over $100 / secondary