MD How feasible is going into pediatrics with 260k+ debt?

[SleepingPillow]

Hello! First time in the MD forums, I am a clueless M-0 so just hoping for some advice.

I will be attending a mid-tier OOS state school as a low SES student. I was a borderline top-tier applicant and missed the cut at any of the rich schools with good financial aid. So, 260k debt it is. But anyways-

Pediatrics was the seed for my interest in going into medicine. I have been passionate about working with kids since I was like 7, and in college 1/3 of my activities involved kids. Growing up with a family income ~50k and now much less, I thought the 150k salary for pediatrics would be more than enough. However, I also need to take care of my parents (they sacrificed everything to bring us to the states) financially while making sure I live the life I imagined, which is living in somewhere like NYC for at least a few years (maybe residency) and eventually having a family of my own (and be able to not worry about $$$ constantly). I've also considered doing a NICU fellowship (I volunteered there and loved it), but that's pretty far away.

Can I actually do all of this as a pediatrician and not be miserable? I've read about refinancing loans/PSLF but am unclear on what that means for primary care, and the WCI basically discouraged primary care specialties. I know many people change their minds on a specialty in med school, but I just want to have an idea of what I would potentially get myself into. It'd help to hear this from any recent grads/anyone in similar financial situations. Thanks!

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[Wolvvs]

Hello! First time in the MD forums, I am a clueless M-0 so just hoping for some advice.

I will be attending a mid-tier OOS state school as a low SES student. I was a borderline top-tier applicant and missed the cut at any of the rich schools with good financial aid. So, 260k debt it is. But anyways-

Pediatrics was the seed for my interest in going into medicine. I have been passionate about working with kids since I was like 7, and in college 1/3 of my activities involved kids. Growing up with a family income ~50k and now much less, I thought the 150k salary for pediatrics would be more than enough. However, I also need to take care of my parents (they sacrificed everything to bring us to the states) financially while making sure I live the life I imagined, which is living in somewhere like NYC for at least a few years (maybe residency) and eventually having a family of my own (and be able to not worry about $$$ constantly). I've also considered doing a NICU fellowship (I volunteered there and loved it), but that's pretty far away.

Can I actually do all of this as a pediatrician and not be miserable? I've read about refinancing loans/PSLF but am unclear on what that means for primary care, and the WCI basically discouraged primary care specialties. I know many people change their minds on a specialty in med school, but I just want to have an idea of what I would potentially get myself into. It'd help to hear this from any recent grads/anyone in similar financial situations. Thanks!

I can't speak to the specifics of loan forgiveness or how much money a given physician in a given location makes. But I can show you what the numbers could look like each month.

For a $260K loan, on a 30 year repayment plan you're paying ~$1200-$1400 per month, on a 10 year repayment plan that's $2500-$2800 depending on the interest rate.

In NYC, $150K salary gives you approximately $8K per month after taxes (but without any other deductions like health insurance or retirement savings). I don't know how much money pediatricians make in NYC, but if it is 150K, you'd need to spend around a third of your income on loans to pay them back in a reasonable amount of time. It's not unmanageable, but it's pretty far away from not having to worry about money--especially given housing costs in NYC.

If you're able to work somewhere more rural as an attending, the salaries should be higher and housing prices should be lower.

 

[SleepingPillow]

I can't speak to the specifics of loan forgiveness or how much money a given physician in a given location makes. But I can show you what the numbers could look like each month.

For a $260K loan, on a 30 year repayment plan you're paying ~$1200-$1400 per month, on a 10 year repayment plan that's $2500-$2800 depending on the interest rate.

In NYC, $150K salary gives you approximately $8K per month after taxes (but without any other deductions like health insurance or retirement savings). I don't know how much money pediatricians make in NYC, but if it is 150K, you'd need to spend around a third of your income on loans to pay them back in a reasonable amount of time. It's not unmanageable, but it's pretty far away from not having to worry about money--especially given housing costs in NYC.

If you're able to work somewhere more rural as an attending, the salaries should be higher and housing prices should be lower.

Thank you for crunching the numbers for me! That actually doesn't sound too bad.

 

[Davidfromcali]

Can’t really give financial advice but as another med student considering peds but shying away because of the lower income, I feel you on this. Definitely a real worry considering the time and debt for a sub 200k salary.

However, NICU docs are actually compensated pretty well but it’s a very unique branch of peds that’s not for most people.

 

[SleepingPillow]

I guess I'll ask this too just to have more info, are there other non-peds specialties that do significant work with kids?

 

[Wolvvs]

I guess I'll ask this too just to have more info, are there other non-peds specialties that do significant work with kids?

A bunch of them are here: Subspecialty Descriptions – Council of Pediatric Subspecialties

Mostly peds subspecialties but there are some others too. Also, another thing to consider that's not listed at the link above is pediatric surgery and anesthesia.

 

[OraclePL]

You started out fine, but dug a hole the further you got on. You can probably make that loan number work as a pediatrician. But as a pediatrician and then choosing to live in New York City and trying to help with your parents? You’re looking at a next to impossible task, unless you do student loan repayment.

Run the numbers.

For simplicity, let’s assume $8000 after-tax income. In a high cost of living area, let’s assume $3500 a month for rent. That may be too high or low depending on whether you have a family and what type of living situation you are in. $2500 a month student loan repayment.

That leaves you with $2000 a month to do everything else. Credit card bills, transportation, childcare (if applicable), and most importantly - save for retirement.

Unless you were planning on working forever, you should be saving 20% of your gross income or 25% of your net income for retirement. So at least $2000-$2500 a month. You should consider this as a vital as your food, housing, and loan repayment costs.

Once you subtract that, you have nothing left.

I think you can be a pediatrician and make this work. But you probably can’t do that and live in New York City. Unless you are willing to sacrifice some other portion of your lifestyle. There is a lot of variation in intraspecialty pay. There are pediatricians who earn over $240,000 by running efficient private practices. If you chose to live somewhere else and be one of these higher earning pediatricians, you could choose to work in your dream field. But by choosing a low paying field, and then choosing to live in a market where doctors generally get paid less and the cost of living is extremely high, you're stacking the deck against you and making it very difficult.

Now keep in mind I’m not a pediatrician, so the $150,000 salary number I’m using is the one that you had provided. There may be higher paying jobs in New York City. That changes the calculus. But this is just an example of how you should run the numbers, and never neglect retirement savings when planning your future budget.

 

[Dantes]

Where are you getting 150k from? Unless you're doing some subspecialized niche that pays less, MGMA suggests you should be able to crack at least 200 if not more in most pediatric fields.

 

[SleepingPillow]

OK so I think everyone is saying it's not a good idea to be peds and be in NYC. If I do go this route, I think I would just do residency/fellowship in the city, then move somewhere else where salaries are higher and COL is lower (especially when I would likely have a family at that age). Doing residency at top programs like NYP does provide higher salaries (70k+) as a resident along with good benefits, so that would lessen the blow of living in NYC a bit. Matching there would be difficult though of course.

 

[SleepingPillow]

That's a good plan and TBH you're in a good spot. $260k isn't too bad in today's world. You're better off than most DO/Caribbean students going 350-500k in debt mostly ending up in primary care.

You're right. Certainly not the worst problem to have and I will still be a doctor in the end.

 

[NeedSomeAdviceGuy]

As someone who wants to enter peds, and will have more debt than you, and will be living in NYC I wouldn't worry too much about it. As folks who came from lower SES backgrounds our quality of life will still be a huge improvement with our physician salary minus our debt payments (if loan forgiveness was not to be an option).

Also NYC can have pretty affordable housing options. I live in a beautiful and spacious 1900 sqft apartment with 2 other roommates in Queens. We pay 650/ea. We're close to the 7, N, W, E, R, Q, F and it only takes me about ~25 mins to get to where I need to be in Manhattan. Obviously, if you're trying to have a family and/or need to support folks that changes up the finances a lot though.

 

[SleepingPillow]

As someone who wants to enter peds, and will have more debt than you, and will be living in NYC I wouldn't worry too much about it. As folks who came from lower SES backgrounds our quality of life will still be a huge improvement with our physician salary minus our debt payments (if loan forgiveness was not to be an option).

Also NYC can have pretty affordable housing options. I live in a beautiful and spacious 1900 sqft apartment with 3 roommates in Queens. We pay 650/ea. We're close to the 7, N, W, E, R, Q, F and it only takes me about ~25 mins to get to where I need to be in Manhattan. Obviously, if you're trying to have a family and/or need to support folks that changes up the finances a lot though.

That's a pretty sweet deal in queens! Honestly, as someone who has spent most of my life in rural/suburban areas, I just want to experience NYC as a young professional for a few years. I don't think it would be the same if I waited until as an older attending. Most importantly, I am a huge Yankees fan

 

[7331poas]

As someone who wants to enter peds, and will have more debt than you, and will be living in NYC I wouldn't worry too much about it. As folks who came from lower SES backgrounds our quality of life will still be a huge improvement with our physician salary minus our debt payments (if loan forgiveness was not to be an option).

Also NYC can have pretty affordable housing options. I live in a beautiful and spacious 1900 sqft apartment with 3 roommates in Queens. We pay 650/ea. We're close to the 7, N, W, E, R, Q, F and it only takes me about ~25 mins to get to where I need to be in Manhattan. Obviously, if you're trying to have a family and/or need to support folks that changes up the finances a lot though.

Would hate to be an attending physician who needs 3 roommates...

 

[ACSurgeon]

Would hate to be an attending physician who needs 3 roommates...

I think you missed the point. It’s that this big queens apartment costs 2600/mo, which is very doable for any attending.

 

[FrkyBgStok]

I think you are worrying a little too early. The debt is non negotiable because that is the place you are going. That side is done.

As a pediatrician, I don’t envy my surgical speciality colleagues or the cardiologists making $600k+ per year. I hope they are all crazy successful in what they want to do. I don’t envy them because I don’t want to do anything that they do. I absolutely love my job and you literally couldn’t pay me enough to work with adult patients on a regular basis.

My debt load is way higher than yours is going to be but I will make enough to pay off loans. If you get through med school truly torn between specialities, choose the one that pays more. You may also change your mind. But if you complete med school with the same desire for peds, then no amount of “financial sense” is going to change your mind. Enjoy med school, learn as much as you can, and keep an open mind.

 

[anna01106]

Pediatrics in general is chalk-full of opportunities through academic centers which are mostly non-profit and would quality you for PSLF. But your loans have qualify for PSLF, so read your loan terms carefully before signing on the line. To get PSLF you have to recertify every year (this is super important) and make payments that qualify for PSLF. Living as cheaply as possible during school, residency, and/or fellowship will help even more with chipping away at loans and not allowing interest to balloon. Definitely try to make payments during residency and fellowship which is doable under income based repayments (which quality for PSLF): you'll pay into at least 4-6 years of the current 10-year program for PSLF depending on how long your fellowship lasts.

 

[NeedSomeAdviceGuy]

A 3 bed = 650/mo each, clearly if you're an attending you can pay more... hell you could have the whole apartment for 1950, less than an above posters 3500. 20-25min away from NYP-Cornell, MSKCC, etc., two floors, 1900sq ft. You won't find many complaining.

EDIT: I miss-typed in my original post, my apartment has 3 people total including myself.



[Also personally I'd have no qualm with having roommates as an attending, communal living is best living imo]

 

[7331poas]

A 3 bed = 650/mo each, clearly if you're an attending you can pay more... hell you could have the whole apartment for 1950, less than an above posters 3500. 20-25min away from NYP-Cornell, MSKCC, etc., two floors, 1900sq ft. You won't find many complaining.

EDIT: I miss-typed in my original post, my apartment has 3 people total including myself.



[Also personally I'd have no qualm with having roommates as an attending, communal living is best living imo]

I feel bad for any person in a position where they need to spend 1950 a month for an apartment on a 150k a year salary. Peds in NYC sounds terrible to be honest.

 

[NeedSomeAdviceGuy]

I feel bad for any person in a position where they need to spend 1950 a month for an apartment on a 150k a year salary. Peds in NYC sounds terrible to be honest.

No one says they need to, I surely wouldn't. Who needs 1900sq ft to themselves? I was just making a point against how I currently live with 2 roommates and would be able to have the whole place to myself if I wanted to with only 16% of a ped low-balled attending salary, and you get the luxury of all the benefits of living in NYC has to offer. Sure you can spend less and sit on more money elsewhere, but that comes with not living in a large cultural urban center. If that's for you have at it, that's not for everybody. Peds could pay me 400k a year to live in the middle of nowhere and I'd take the 150k in the city - and please don't make the argument that with that money I could own a second house, cut my hours, etc. Most people entering peds are entering it because they love the job and want to do it, they're not trying to businessify it and make the most they can for the least amount of hours worked. And that's to be said for both parts. People enter peds because they love peds. People live in NYC because they love NYC.

You can pay 1150 or less and have 1000 sqft to yourself. Which is a lot of room imo, plus the point of living in the city is to /not/ spend all your time at home. If you were going to do that may as well live in the middle of nowhere. And yes you can find places at this price or less in NYC. They're usually located in locations expats think are "unsafe" but what they really mean is the area isn't predominately white.

 

[7331poas]

You can pay 1150 or less and have 1000 sqft to yourself. Which is a lot of room imo, plus the point of living in the city is to /not/ spend all your time at home. If you were going to do that may as well live in the middle of nowhere. And yes you can find places at this price or less in NYC. They're usually located in locations expats think are "unsafe" but what they really mean is the area isn't predominately white.

If you can actually find 1150 sqft solo apartments in NYC in decent locations then I stand corrected. I am doubtful though. Maybe true now due to depressed rental prices.

 

[LimpSpatula]

Thank you for crunching the numbers for me! That actually doesn't sound too bad.

That sounds atrocious and financially terrible. Hopefully pediatricians make more than this, but if youre gung ho about it, it would make more sense to be an NP working with them.

 

[SleepingPillow]

That sounds atrocious and financially terrible. Hopefully pediatricians make more than this, but if youre gung ho about it, it would make more sense to be an NP working with them.

I think it would be reasonable as a fresh grad out of med school when I am still in the frugal mindset, so personally I wouldn't mind doing that for a few years in residency. Also not sure why you brought up NP but that's out of the question.

 

[theendisnigh]

Hello! First time in the MD forums, I am a clueless M-0 so just hoping for some advice.

I will be attending a mid-tier OOS state school as a low SES student. I was a borderline top-tier applicant and missed the cut at any of the rich schools with good financial aid. So, 260k debt it is. But anyways-

Pediatrics was the seed for my interest in going into medicine. I have been passionate about working with kids since I was like 7, and in college 1/3 of my activities involved kids. Growing up with a family income ~50k and now much less, I thought the 150k salary for pediatrics would be more than enough. However, I also need to take care of my parents (they sacrificed everything to bring us to the states) financially while making sure I live the life I imagined, which is living in somewhere like NYC for at least a few years (maybe residency) and eventually having a family of my own (and be able to not worry about $$$ constantly). I've also considered doing a NICU fellowship (I volunteered there and loved it), but that's pretty far away.

Can I actually do all of this as a pediatrician and not be miserable? I've read about refinancing loans/PSLF but am unclear on what that means for primary care, and the WCI basically discouraged primary care specialties. I know many people change their minds on a specialty in med school, but I just want to have an idea of what I would potentially get myself into. It'd help to hear this from any recent grads/anyone in similar financial situations. Thanks!

I would look into stuff like the NHSC Loan Repayment Program or into contracts out of residency that offer a certain amount towards student loan repayments (these are typically in more underserved/rural areas). That would be only for a few years and you could significantly knock out some of your student loan debt. WCI may discourage primary care, but it's a finance book so it's kind of their job to do that. You'll be working in your specialty possibly into your 80's just for kicks and your student loans will be a thing of the past by then. As someone previously said, keep an open mind and do what you could see yourself doing for decades.

 

[jamaica jan sun princess]

2019(using 2018 data) MGMA 25th percentile for pediatricians is $190,000. Median is $232,00. About $10,000 to $13,000 after tax depending on filing status.

 

[Wolvvs]

2019(using 2018 data) MGMA 25th percentile for pediatricians is $190,000. Median is $232,00. About $10,000 to $13,000 after tax depending on filing status.

This is really dependent on location and salaries in NYC are usually low. In most cases it's hard to find data, but salaries for state employees are public record. I checked the salaries for a few random pediatricians at SUNY Downstate Medical Center and they were all around $150K. I don't know if that particular medical center is representative of all of NYC.

 

[NeedSomeAdviceGuy]

Can you link a 1000sqft apartment for <$1150? That's right around what I would pay here and I live in an "undesirable city"

Sure.

8139 261st St, Glen Oaks, NY 11004 | Trulia

8139 261st St, Glen Oaks, NY 11004 is a 930 sqft, Studio, 1 bath home sold in 2013. See the estimate, review home details, and search for homes nearby.

www.trulia.com

4617 Robinson St, Flushing, NY 11355 | Trulia

4617 Robinson St, Flushing, NY 11355 is a 2,880 sqft, Studio, 1 bath home sold in 2010. See the estimate, review home details, and search for homes nearby.

www.trulia.com

11221 Witthoff Ave, Jamaica, NY 11429 | Trulia

11221 Witthoff Ave, Jamaica, NY 11429 is a 1,406 sqft, 1 bed, 1 bath home sold in 2013. See the estimate, review home details, and search for homes nearby.

www.trulia.com

1752 Seward Ave, Bronx, NY 10473 | Trulia

1752 Seward Ave, Bronx, NY 10473 is a 3,680 sqft, Studio, 1 bath home sold in 2006. See the estimate, review home details, and search for homes nearby.

www.trulia.com

2044 Ford St #1F, Brooklyn, NY 11229 - See Estimated Value

2044 Ford St #1F, Brooklyn, NY 11229 is a 1,100 sqft, 1 bed, 1 bath home. See the estimate, review home details, and search for homes nearby.

www.trulia.com

etc etc, that's just from 0.05s of google searching. Plenty of more optimized deals (location to price to size) if you go digging.

Many of the best options aren't listed on sites like these, 90% of the apartments I've rented weren't listed online (usually apartments in some old landlord's house).

 

[Frogger27]

Sure.

8139 261st St, Glen Oaks, NY 11004 | Trulia

8139 261st St, Glen Oaks, NY 11004 is a 930 sqft, Studio, 1 bath home sold in 2013. See the estimate, review home details, and search for homes nearby.

www.trulia.com

4617 Robinson St, Flushing, NY 11355 | Trulia

4617 Robinson St, Flushing, NY 11355 is a 2,880 sqft, Studio, 1 bath home sold in 2010. See the estimate, review home details, and search for homes nearby.

www.trulia.com

11221 Witthoff Ave, Jamaica, NY 11429 | Trulia

11221 Witthoff Ave, Jamaica, NY 11429 is a 1,406 sqft, 1 bed, 1 bath home sold in 2013. See the estimate, review home details, and search for homes nearby.

www.trulia.com

1752 Seward Ave, Bronx, NY 10473 | Trulia

1752 Seward Ave, Bronx, NY 10473 is a 3,680 sqft, Studio, 1 bath home sold in 2006. See the estimate, review home details, and search for homes nearby.

www.trulia.com

2044 Ford St #1F, Brooklyn, NY 11229 - See Estimated Value

2044 Ford St #1F, Brooklyn, NY 11229 is a 1,100 sqft, 1 bed, 1 bath home. See the estimate, review home details, and search for homes nearby.

www.trulia.com

etc etc, that's just from 0.05s of google searching. Plenty of more optimized deals (location to price to size) if you go digging.

Many of the best options aren't listed on sites like these, 90% of the apartments I've rented weren't listed online (usually apartments in some old landlord's house).

These apartments are hideous

 

[LimpSpatula]

I think it would be reasonable as a fresh grad out of med school when I am still in the frugal mindset, so personally I wouldn't mind doing that for a few years in residency. Also not sure why you brought up NP but that's out of the question.

I brought up NP because it would make more financial sense to pursue that route if the end result is 150k salary and 260k debt.

 

[brownman23]

Living in NYC for residency will be 100% do-able. Your salary will be adjusted for the higher cost of living. You should be able to max out our Roth IRA, save for an emergency fund, and still have plenty left over to enjoy the perks of NYC.

Living in NYC as an attending pediatrician who needs to pay off a $260K debt, support parents, and not "worry about $$$ constantly" will be extremely tough, if not impossible. If living in NYC as an attending is a goal, becoming a pediatric surgeon or pediatric anesthesiologist will be more financially sound.

However, it doesn't seem like you want to live in NYC forever. I'd recommend you try your best to match at a NYC residency to scratch the itch of living in NYC, and move somewhere else for attending life.

 

[Gilakend]

You could do try to do a residency in NYC, then move someone rural/higher paying and pay off loans aggresively. If you didn't match in NYC for residency, live there after paying off your loans. Or live in the tri-state area and go to the city whenever you want. It is fairly easy to do all of the things you want to do on a doctors salary if you don't spend like crazy. You might not be able to do all of them at the exact same time, so it just takes planning.

 

[7331poas]

Sure.
Many of the best options aren't listed on sites like these, 90% of the apartments I've rented weren't listed online (usually apartments in some old landlord's house).

Holy cow. Could only get through 3 of them because they were so bad. Depressing

 

[NeedSomeAdviceGuy]

They look like 300-450 sqft tops. The descriptions (area) are wrong, and some are just basements so you'll be living with other people. $1100 in my area gets you 2-3 bedrooms with granite counter tops

That's cool, but you don't get to live in NYC

As I said, the point of living in NYC is not to lounge around your apartment all day. If that's you, then yeah NYC has nothing to offer you.

Holy cow. Could only get through 3 of them because they were so bad. Depressing

Looks like how I grew up

These apartments are hideous

Look fine to me?


And as I said, the best apartments are unlisted, rented out by someone who owns the home. Most expats don't find those places.

 

[Thesimplelifeofamyloid]

These apartments are hideous

I was simply pointing out the obvious and I wasn't trying to make fun. But tbh I'd rather avoid cockroaches and rats and have my own backyard + be able to leave my doors unlocked without worrying about crime. Plus, being a doctor in my neck of the woods you're literally treated like royalty (and we $400k+ car dealerships, Michelin star restaurants - so it's not some place in the middle of nowhere).

And if these "hidden gems" were so good I'm sure they post them online and bump up the price to above market value. Nobody leaves free money on the table. IMO, these "hidden gems" you speak of don't exist or its 10 guys squeezed into a 2 bedroom like sardines for $1k/month

With the difference in salary I will make here I can fly out to a different urban city each weekend, rent a hotel, eat fancy dinners and still come out $50k+ ahead of a NYC or big city salary.

Just curious. Post an apartment that is more your style

 

[jamaica jan sun princess]

 

[deleted941485]

Sure.

8139 261st St, Glen Oaks, NY 11004 | Trulia

8139 261st St, Glen Oaks, NY 11004 is a 930 sqft, Studio, 1 bath home sold in 2013. See the estimate, review home details, and search for homes nearby.

www.trulia.com

4617 Robinson St, Flushing, NY 11355 | Trulia

4617 Robinson St, Flushing, NY 11355 is a 2,880 sqft, Studio, 1 bath home sold in 2010. See the estimate, review home details, and search for homes nearby.

www.trulia.com

11221 Witthoff Ave, Jamaica, NY 11429 | Trulia

11221 Witthoff Ave, Jamaica, NY 11429 is a 1,406 sqft, 1 bed, 1 bath home sold in 2013. See the estimate, review home details, and search for homes nearby.

www.trulia.com

1752 Seward Ave, Bronx, NY 10473 | Trulia

1752 Seward Ave, Bronx, NY 10473 is a 3,680 sqft, Studio, 1 bath home sold in 2006. See the estimate, review home details, and search for homes nearby.

www.trulia.com

2044 Ford St #1F, Brooklyn, NY 11229 - See Estimated Value

2044 Ford St #1F, Brooklyn, NY 11229 is a 1,100 sqft, 1 bed, 1 bath home. See the estimate, review home details, and search for homes nearby.

www.trulia.com

etc etc, that's just from 0.05s of google searching. Plenty of more optimized deals (location to price to size) if you go digging.

Many of the best options aren't listed on sites like these, 90% of the apartments I've rented weren't listed online (usually apartments in some old landlord's house).

Dude I lived in better apartments as a resident than this! I did not have a roommate and it was in the northeast. These same places in Manhattan would be double the price and half as large,

 

[Frogger27]

Just curious. Post an apartment that is more your style

The Jeffrey | Gallery

www.thejeffrey.com

Sure, here is a apartment building in a normal Midwest city (Columbus). Nice modern finishes, granite countertops, massive gym. In one of the best areas for a young professional with tons of bars and restaurants within walking distance.

830 sq 1 bedroom apartment is 1200.

My sibling lives in a 450 sq 1br in NYC (east village) and pays ~3300/month and my SO lives in a 300 sq studio in Chelsea and pays 1700 for a horrible apartment. I couldn’t fathom living in a place like this as a resident, let alone as an attending. I get the point of living in NYC is not to be in your apartment, but you are going to be so busy during residency it’s really nice to come home to a nice apartment that isn’t a shoebox/horrible. Plus, if you aren’t in your apartment you are most likely out spending money on food, bars, entertainment, etc. That gets pricey quick in NYC

OP, you can make it work as a resident with what you’ve described you’d be okay with. But there is no way it would work as an attending given your debt load and other expenses

 

[calivianya]

I know you’re saying stay for residency and then leave NYC - but have you considered the opposite?

Where I’m rotating doesn’t have a peds program, but the IM residents here have told me because it’s so underserved that the hospital is offering student loan repayment bonuses for *residents,* not just attendings. I have no idea how much it is because that’s a really personal question to ask. I’m sure there are some places that do this in peds as well. So if you can even get your residency program to put a decent chunk down on your loans, plus start PSLF, you’d be in a better position to come back to NYC later.

I don’t know if there’s difficulty getting into the NYC market after you’ve been out, though.

 

[NeedSomeAdviceGuy]

I was simply pointing out the obvious and I wasn't trying to make fun. But tbh I'd rather avoid cockroaches and rats and have my own backyard + be able to leave my doors unlocked without worrying about crime. Plus, being a doctor in my neck of the woods you're literally treated like royalty (and we $400k+ car dealerships, Michelin star restaurants - so it's not some place in the middle of nowhere).

And if these "hidden gems" were so good I'm sure they post them online and bump up the price to above market value. Nobody leaves free money on the table. IMO, these "hidden gems" you speak of don't exist or its 10 guys squeezed into a 2 bedroom like sardines for $1k/month

With the difference in salary I will make here I can fly out to a different urban city each weekend, rent a hotel, eat fancy dinners and still come out $50k+ ahead of a NYC or big city salary.

Bruh. I've never had a problem with cockroaches, rats OR crime.... lots of assumptions there. I said the neighborhoods I live in are cheaper because they happen to not be predominantly white, don't conflate that with crime. They're hidden gems because they're old folks who own these homes, and just want a nice resident. And those places I speak of are as described. My last apartment, for example, was 1100sqft, 2bd, 1ba, 1400/mo, walking distance from Astoria.

And that's nice, you can come and do the touristy things of NY. That ain't my vibe. Like I said, if that's yours have at it. The things I like to do in NYC are daily things, not eat at "Michelin star restaurants" or whatever that is. And the last thing I want is to be treated like royalty lol

The Jeffrey | Gallery

www.thejeffrey.com

Sure, here is a apartment building in a normal Midwest city (Columbus). Nice modern finishes, granite countertops, massive gym. In one of the best areas for a young professional with tons of bars and restaurants within walking distance.

830 sq 1 bedroom apartment is 1200.

My sibling lives in a 450 sq 1br in NYC (east village) and pays ~3300/month and my SO lives in a 300 sq studio in Chelsea and pays 1700 for a horrible apartment. I couldn’t fathom living in a place like this as a resident, let alone as an attending. I get the point of living in NYC is not to be in your apartment, but you are going to be so busy during residency it’s really nice to come home to a nice apartment that isn’t a shoebox/horrible. Plus, if you aren’t in your apartment you are most likely out spending money on food, bars, entertainment, etc. That gets pricey quick in NYC

OP, you can make it work as a resident with what you’ve described you’d be okay with. But there is no way it would work as an attending given your debt load and other expenses

You can't compare the price you're paying to that, I already made the point of living in the actual affordable areas of NY. Your sibling lives in THE VILLAGE lmao. Like.. one of the most expensive places in NYC. I don't think any New Yorker even lives there anymore, or any of those places you listed. And you'll notice you only listed Manhattan places. That ain't all of NYC. Plenty of far more affordable, accessible, beautiful places in spots like Queens. Is NYC expensive? Of course it is. Is it as expensive as people say? Nah. Expats all wanna live in the village or SoHo.

 

[Redpancreas]

Hello! First time in the MD forums, I am a clueless M-0 so just hoping for some advice.

I will be attending a mid-tier OOS state school as a low SES student. I was a borderline top-tier applicant and missed the cut at any of the rich schools with good financial aid. So, 260k debt it is. But anyways-

Pediatrics was the seed for my interest in going into medicine. I have been passionate about working with kids since I was like 7, and in college 1/3 of my activities involved kids. Growing up with a family income ~50k and now much less, I thought the 150k salary for pediatrics would be more than enough. However, I also need to take care of my parents (they sacrificed everything to bring us to the states) financially while making sure I live the life I imagined, which is living in somewhere like NYC for at least a few years (maybe residency) and eventually having a family of my own (and be able to not worry about $$$ constantly). I've also considered doing a NICU fellowship (I volunteered there and loved it), but that's pretty far away.

Can I actually do all of this as a pediatrician and not be miserable? I've read about refinancing loans/PSLF but am unclear on what that means for primary care, and the WCI basically discouraged primary care specialties. I know many people change their minds on a specialty in med school, but I just want to have an idea of what I would potentially get myself into. It'd help to hear this from any recent grads/anyone in similar financial situations. Thanks!

I think this thread brings up an important point. For the sake of that point, let’s assume your proclivity for Peds is maintained and you match. You have to realize there are far worse things you can do to yourself than a few hundred thousands dollars worth of debt. There are unhappy marriages and people who have unfulfilling careers and those are the real people I feel sorry for because those things can last a lifetime. Being in an unfulfilling career for the next thirty-fourthy years just so you can pay off your debt a decade quicker than others is not worth it. Like you’ve mentioned, there’s PSLF which would actually break down the repayment into very small amounts. Additionally, be judicious with how you spend your money in medical school and residency. A lot of people have the “what’s another $1000 here or there” and that’s fine when it comes to interviews and stuff but try to budget smart when it comes to things like housing, groceries, etc. and you can actually pay off a good chunk of your loans if you budget aggressively in residency.

The part about your parents is understandable. I can see the urgency there to support them for all they’ve likely done for you but you have to put your dreams first as it’s what they’d indirectly want to. They’re not going anywhere (god forbid) and you will have time to help them in the future.

 

[sylvester500]

Hello! First time in the MD forums, I am a clueless M-0 so just hoping for some advice.

I will be attending a mid-tier OOS state school as a low SES student. I was a borderline top-tier applicant and missed the cut at any of the rich schools with good financial aid. So, 260k debt it is. But anyways-

Pediatrics was the seed for my interest in going into medicine. I have been passionate about working with kids since I was like 7, and in college 1/3 of my activities involved kids. Growing up with a family income ~50k and now much less, I thought the 150k salary for pediatrics would be more than enough. However, I also need to take care of my parents (they sacrificed everything to bring us to the states) financially while making sure I live the life I imagined, which is living in somewhere like NYC for at least a few years (maybe residency) and eventually having a family of my own (and be able to not worry about $$$ constantly). I've also considered doing a NICU fellowship (I volunteered there and loved it), but that's pretty far away.

Can I actually do all of this as a pediatrician and not be miserable? I've read about refinancing loans/PSLF but am unclear on what that means for primary care, and the WCI basically discouraged primary care specialties. I know many people change their minds on a specialty in med school, but I just want to have an idea of what I would potentially get myself into. It'd help to hear this from any recent grads/anyone in similar financial situations. Thanks!

I'm also an incoming M1 looking at tons of debt, much more than you (~350k principle at the end of M4).

You ever look into military support? There are several options. HPSP is probably not a good idea for you, however, because peds isn't a critical wartime specialty. You could look into the financial assistance program, which provides ~2100 per month during residency + 45k per year. Actually a huge payoff. Do this for a peds residency and you'd have a 4-yr service obligation, but your debt would be paid off completely.

Check out: Medicine + The Military

 

[physicsnerd42]

Why limit yourself to Peds? There are pediatric-based subspecialties that will pay much more than any Peds subspecialty and you still won’t have to take care of adults long term. I’m trained in Peds, anesthesia and Peds anesthesia. I had thought about doing PICU vs Peds anesthesia but I clinically prefer Peds anesthesia. Peds anesthesia also pays ~ twice as much as PICU at any given institution.

I have many friends who did anesthesia after peds and know no one who did the opposite. If you want to take care of children and have the ability to make enough money to live comfortably with your amount of debt, don’t limit yourself to just think about peds and its subspecialties.

 

[Philosopher Jagger]

I’m a Peds PGY1 basically in your exact scenario, plus some private undergrad debt. I know this may sound like little consolation, but it works out. Try PSLF, “pay” your loans as if they won’t be forgiven, depositing that money into a side fund for if they aren’t. Keep this account untouched for any reason. Let $100-200,000 build up in it.

you’re gonna have to live within your means. If your means don’t allow for this, you may consider something other than Peds. It takes commitment

 

[Thesimplelifeofamyloid]

I’m a Peds PGY1 basically in your exact scenario, plus some private undergrad debt. I know this may sound like little consolation, but it works out. Try PSLF, “pay” your loans as if they won’t be forgiven, depositing that money into a side fund for if they aren’t. Keep this account untouched for any reason. Let $100-200,000 build up in it.

you’re gonna have to live within your means. If your means don’t allow for this, you may consider something other than Peds. It takes commitment

Or you can become a social media star and make millions for your opponent organizing a fake fight

 

[Thesimplelifeofamyloid]

Reminds me of the youtuber TheStriveToFit (an EM doc in NYC). Her apartment looks so cramped and outdated. She has to put the microwave and air fryer on top of the fridge, and take out mini-appliances as needed. No space to meal prep, and she has to move around her table everytime she needs some space for other things. No dedicated study space. I'd go crazy in there.

I have all of my mini appliances on the countertop 24/7 cuz I use them daily, my living room is like a mini office and the other half for entertainment and my bedroom is only for relaxing, and I'm probably paying 25% what she's paying.

Resident or attending? Please say attending isn't living like that.

 

[ibnalkamil1990]

Resident or attending? Please say attending isn't living like that.

She's a resident and living with her boyfriend I believe but I wouldn't be surprised if she/or others continue living like that for a few years as they pay down their debts.

My friends starting residency this year are all buying homes/condos and I should be able to do the same even with my $350k+ debt if I match my desired program. They allow lots of moonlighting (can double your salary), but even without it I'd be fine.

 

[Thesimplelifeofamyloid]

She's a resident and living with her boyfriend I believe but I wouldn't be surprised if she/or others continue living like that for a few years as they pay down their debts.

My friends starting residency this year are all buying homes/condos and I should be able to do the same even with my $350k+ debt if I match my desired program. They allow lots of moonlighting (can double your salary), but even without it I'd be fine.

I always was told that you have to be careful with moonlighting. My school always gives the example of a rads intern moonlighting in the ER. It isn't a good idea for obvious reasons. Who's taking the liability? If you're working 80 hr/week, you're now going to take an extra 20? Dicey stuff.

 

[January]

I can't speak to the specifics of loan forgiveness or how much money a given physician in a given location makes. But I can show you what the numbers could look like each month.

For a $260K loan, on a 30 year repayment plan you're paying ~$1200-$1400 per month, on a 10 year repayment plan that's $2500-$2800 depending on the interest rate.

In NYC, $150K salary gives you approximately $8K per month after taxes (but without any other deductions like health insurance or retirement savings). I don't know how much money pediatricians make in NYC, but if it is 150K, you'd need to spend around a third of your income on loans to pay them back in a reasonable amount of time. It's not unmanageable, but it's pretty far away from not having to worry about money--especially given housing costs in NYC.

If you're able to work somewhere more rural as an attending, the salaries should be higher and housing prices should be lower.

NO

 

[January]

I can't speak to the specifics of loan forgiveness or how much money a given physician in a given location makes. But I can show you what the numbers could look like each month.

For a $260K loan, on a 30 year repayment plan you're paying ~$1200-$1400 per month, on a 10 year repayment plan that's $2500-$2800 depending on the interest rate.

In NYC, $150K salary gives you approximately $8K per month after taxes (but without any other deductions like health insurance or retirement savings). I don't know how much money pediatricians make in NYC, but if it is 150K, you'd need to spend around a third of your income on loans to pay them back in a reasonable amount of time. It's not unmanageable, but it's pretty far away from not having to worry about money--especially given housing costs in NYC.

If you're able to work somewhere more rural as an attending, the salaries should be higher and housing prices should be lower.

NO not realistic unless you go into pedi specialty like neuro/endocrine etc. Not specialty like adolescent or behavioral

 

[Lawpy]

Reminds me of the youtuber TheStriveToFit (an EM doc in NYC). Her apartment looks so cramped and outdated. She has to put the microwave and air fryer on top of the fridge, and take out mini-appliances as needed. No space to meal prep, and she has to move around her table everytime she needs some space for other things. No dedicated study space. I'd go crazy in there.

I have all of my mini appliances on the countertop 24/7 cuz I use them daily, my living room is like a mini office and the other half for entertainment and my bedroom is only for relaxing, and I'm probably paying 25% what she's paying.

I still have no idea why people are willing to spend so much money living in crappy congested apartments just because of city life but maybe i just don't understand the city life well (that and the housing market boom)

 

[Frogger27]

I always was told that you have to be careful with moonlighting. My school always gives the example of a rads intern moonlighting in the ER. It isn't a good idea for obvious reasons. Who's taking the liability? If you're working 80 hr/week, you're now going to take an extra 20? Dicey stuff.

My ortho program allows moonlighting... Most of the residents do it once they are upper level and have more time.... 2k/weekend to take home hand call. Easily double their salary this way.