How are NHSC S2S or State Loan Repayment Programs beneficial at all?

[Garett24]

I was thinking of Doing NHSC student to service program where they pay you 140k untaxed toward your loans over the course of 3 years. This sounded great.

However, one only makes a salary (form what I can find) of around 80k.

That 80k (taxed) + 40k towards loans seems like a pretty bad deal in comparison to a regular starting salay of 140k + Private practice experience...in a place one would prefer to live

Then I looked at State repayment programs serving in a rural area. Places like Illonis will pay 120k but I am also unsure of the salary?

Tl'dr all these loan repayment programs seem to be not worth it due to a low salary. It seems more practical to find a private practice job where you want and learn different kinds of dentistry. Am I missing something? Does anyone have experience or knowledge of such programs?

I am willing to relocate to a rural area to pay off my loans faster but from my current situation ( I do believe I am ignorant) I do not see the advantage of this. Thanks!

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[cooliyak]

I was thinking of Doing NHSC student to service program where they pay you 140k untaxed toward your loans over the course of 3 years. This sounded great.

However, one only makes a salary (form what I can find) of around 80k.

That 80k (taxed) + 40k towards loans seems like a pretty bad deal in comparison to a regular starting salay of 140k + Private practice experience...in a place one would prefer to live

Then I looked at State repayment programs serving in a rural area. Places like Illonis will pay 120k but I am also unsure of the salary?

Tl'dr all these loan repayment programs seem to be not worth it due to a low salary. It seems more practical to find a private practice job where you want and learn different kinds of dentistry. Am I missing something? Does anyone have experience or knowledge of such programs?

I am willing to relocate to a rural area to pay off my loans faster but from my current situation ( I do believe I am ignorant) I do not see the advantage of this. Thanks!

Maybe look in other places. 80k seems way too low. I’m making a lot more than that and I came right out of school w/o residency.
You also have to factor in the benefits from working at a NHSC active site. They usually come with life/health/malpractice/short and long term disability insurance, company match 403b/401k, and a good amount of paid vacation/holidays, etc that you would have to pay for yourself if you went into private practice.
Having said all that, it doesn’t make sense for everyone in every situation. This is the type of place I would most likely be working in anyway, so if they want to pay my loans off/pay for my school up front with a scholarship, that was a no brainer for me.

 

[doktorinprogres]

Yeah I think you need to look around some more; 80k is very low even for nonprofit/fqhc work. The LRP money is tax free which makes a big difference at the typical dentist tax-bracket. In addition, it's known to be stressful to be thrown into private practice straight out of school. FQHC's in general are more forgiving of a learning curve, won't push you as much for time/production, and may have other dentists with the time available to mentor. The benefits make a big difference as well especially if comparing to a IC situation rather than W2.

 

[Garett24]

Yeah I think you need to look around some more; 80k is very low even for nonprofit/fqhc work. The LRP money is tax free which makes a big difference at the typical dentist tax-bracket. In addition, it's known to be stressful to be thrown into private practice straight out of school. FQHC's in general are more forgiving of a learning curve, won't push you as much for time/production, and may have other dentists with the time available to mentor. The benefits make a big difference as well especially if comparing to a IC situation rather than W2.

Maybe I am wrong, but it still seems a better use of time and money to do corporate for a year (free 90 day mentor) and then build equity and establish part of a group practice as opposed to work with a state program.

In addition I have no idea where to find info like salary, it seems this little pursuit in debt alleviation is vague and there is a lack of consensus.

 

[doktorinprogres]

Maybe I am wrong, but it still seems a better use of time and money to do corporate for a year (free 90 day mentor) and then build equity and establish part of a group practice as opposed to work with a state program.

In addition I have no idea where to find info like salary, it seems this little pursuit in debt alleviation is vague and there is a lack of consensus.

It can work, if you're confident in your abilities no one will fault you for wanting to hit the ground running with PP. It's akin to betting on yourself vs taking some security. Keep in mind thought that for all those offers that say partnership opportunity down the line or what have you its just words and there's a host of reasons why partnership may never happen.

Look up "FQHC" and the state you're interested in. Then go to glassdoor punch in the name of said FQHC and look for dentist salaries. It's not going to be super accurate b/c that dentist might be a couple years in or something but it will give you an idea of what's reasonable. Then you can look up that state's LRP program. The top part of the bracket for entry level dentist is prbly 24%. 20k LRP is untaxed and is like having a 26k benefit. So let's say you get a corporate offer for 120k/yr or 500/d. That's roughly 400k production. After tax depending on state tax its 81-84k. Then you have your student loan payment to make. FQHC let's say 100k (I think this is low stil) thats like 70k after tax. Then you get your 20k+ LRP which isnt taxed. Then think about what kinda 403b match you get vs 401k match from corporate. What are the benefits like etc.

If you're going to buy a practice 0-3 yrs outta school (personally I think ppl with high debt should) then you go PP and see what you're made of. If you're not sure what your trying to do and you want a more guranteed income while learning the ropes with slightly less pressure the FQHC/LRP way isn't bad. Add in the pressure to over treat and target numbers set by a non-dentist and maybe corporate isn't what some ppl want.

Its a highly personal thing and there isn't a right answer. Maybe you find a corporate office with no pressure lots of mentors and you produce 600 your first year. That's like 180k. Maybe someone else's mom/uncle/hometown dentist has a sweet associate gig waiting. Maybe you find the group you're hoping to join right off the bat.

 

[Garett24]

It can work, if you're confident in your abilities no one will fault you for wanting to hit the ground running with PP. It's akin to betting on yourself vs taking some security. Keep in mind thought that for all those offers that say partnership opportunity down the line or what have you its just words and there's a host of reasons why partnership may never happen.

Look up "FQHC" and the state you're interested in. Then go to glassdoor punch in the name of said FQHC and look for dentist salaries. It's not going to be super accurate b/c that dentist might be a couple years in or something but it will give you an idea of what's reasonable. Then you can look up that state's LRP program. The top part of the bracket for entry level dentist is prbly 24%. 20k LRP is untaxed and is like having a 26k benefit. So let's say you get a corporate offer for 120k/yr or 500/d. That's roughly 400k production. After tax depending on state tax its 81-84k. Then you have your student loan payment to make. FQHC let's say 100k (I think this is low stil) thats like 70k after tax. Then you get your 20k+ LRP which isnt taxed. Then think about what kinda 403b match you get vs 401k match from corporate. What are the benefits like etc.

If you're going to buy a practice 0-3 yrs outta school (personally I think ppl with high debt should) then you go PP and see what you're made of. If you're not sure what your trying to do and you want a more guranteed income while learning the ropes with slightly less pressure the FQHC/LRP way isn't bad. Add in the pressure to over treat and target numbers set by a non-dentist and maybe corporate isn't what some ppl want.

Its a highly personal thing and there isn't a right answer. Maybe you find a corporate office with no pressure lots of mentors and you produce 600 your first year. That's like 180k. Maybe someone else's mom/uncle/hometown dentist has a sweet associate gig waiting. Maybe you find the group you're hoping to join right off the bat.

Excellent description- thanks

 

[lemoncurry]

I can give you an example of a Vermont FQHC: starting salary of 150k plus full benefits and every 6 months you get a check to make up the difference between your salary and 29% of your production. I'm on pace for at least 1 million in production this year.

Plus the state offers LRP of about 10k per year which is matched by the employer. You do have to apply for it and be accepted every two years or so.

 

[ysrebob]

I can give you an example of a Vermont FQHC: starting salary of 150k plus full benefits and every 6 months you get a check to make up the difference between your salary and 29% of your production. I'm on pace for at least 1 million in production this year.

Plus the state offers LRP of about 10k per year which is matched by the employer. You do have to apply for it and be accepted every two years or so.

Pretty impressive, LC! That's the opposite end of the bell curve for FQHC earnings (vs the 80k/yr OP quotes). Seems like they are paying 100-120k to start in my neck of the woods.

If it's a tossup between FQHC and corporate in financial terms, I would advocate for FQHC as a better place to start out, all else equal. Been hearing so many sour inside accounts about Corps especially in the past year or two -- just yesterday I was told by a job interviewee that the local office of a large / well known national DSO (a chain that I would have considered reputable) is holding their dentists on strict production quotas and requiring them to tx plan a certain (very aggressive) ratio of crowns to direct fills, regardless of patient needs... the hygienist was feeling uneasy about it and looking to bail out into a private office. I am sure their dentists are under mercilessly tight time constraints for procedures, too.

Just not a great way to launch your career as a trustworthy and excellent dentist. There's experience, and there's bad experience. To be fair, some private practices doubtless would push you this same way, but I'd like to imagine it's less commonplace. If you have the luxury of working your formative first year out of school as a dentist someplace that will let you do your professional and moral best, that would be awesome... then go for the maximum dollars after that if you have loans to kill. Just one guy's .02 view.