Don’t forget that if you look at an income based repayment calculator assuming your payment’s gonna be 15% of discretionary income (most are gonna be 10% now, I think), the max you’re going to pay as a resident at $50k is maybe ~$260/month (assuming you start paying in residency bc your program qualifies you for PSLF or something) and the max you’re going to pay as an attending making ~$200k is around ~$1500/month. Doesn’t matter how much debt you take out if your loans are federal because there are controls on how much your payments are per month (assuming you use repaye, I guess). It is never going to be unaffordable.
What stops making sense at those debt levels is taking them out if the loans are private. You better be one heck of an applicant who cured cancer, or have a super rich family who can bail you out if things get rough, if you’re going to have fixed monthly payments IMO.