I'm confused??

[newdaddy]

Hello everyone!
I am so glad that this area of SDN has been started. Thanks to all of you who participate! Anyway, I'll get to my problem. I am 1 year away from applying to med school (probably DO). I am married to the most wonderful woman in the world and we have 2 kids, ages 2 and newborn. My wife doesn't work because she isn't like to make enough to justify the cost of childcare for our 2 boys. I'm sure some of you understand. Anyway, I have been working almost full time, and getting financial aid in order to make ends meet (and they are tight.) When I go to med school I obviously can't work. I have read posts about scholarships, the amount of stafford loans available, etc., but it seems that there is still a lot of individuality in loan amounts. I guess what I am asking is this: Is it possible, (all things being perfect), to get enough money through financial aid loans alone to support my family and pay tuition, etc.? How do I get the financial aid people to raise my cost of attendance? I have read some sites that make it clear that financial aid is for the student alone and dependents aren't taken into consideration. Other sites are much more hazy. Please help!? I am confused. This will obviously make a big difference whether I can do it or not. Thanks in advance!

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[commymommy]

I don't know how much this will help, but when I applied for financial aid during my MS (I am also a med school hopeful one day, and am also married to a doc) they gave me full consideration for my dependents (children). I was able to take out the maximum in stafford loans and Access loans...this helped pay for all childcare costs,etc. I don't know how this works for med school, but assume that it is similar. Try talking to the financial aid office at your own school and see what they predict?

I hope this helped a bit..

Kris

 

[newdaddy]

I have heard back from only one of the schools I contacted with regard to the above post. Western University (COMP) says that their cost of attendance per student is 16-17000 per year (living expenses.) They also said that they do not take in to consideration if a student has dependents (unless they pay childcare.) Financial aid awards are not increased for any other reason. Even if my wife took care of our kids we couldn't receive more money because the spouse of the student must be employed in order to get childcare money. Anyway, that is what one school says. Does anyone else know otherwise?

 

[Neurogirl]

Unfortunately, that is the way it is...period. I have NEVER heard of ANY medical school that was allowed to provide additional funds beyond the budget for individuals. It's not the schools fault. Federal mandates regarding stafford loans for medical education prohibit it. In fact, I was also informed that if one recieved scholarship money, stafford loans would be reduced by an equal amount. You can get extra funds for childcare, insurance and some types of medical expenses, but that's about it. A couple of my classmates with "stay at home" wives had to resort to welfare and food stamps to suppliment their loans (those with children easily qualify). One innovative wife turned their home into a daycare center so that she could continue to stay at home with the kids AND earn an income. Other people use credit cards. I suspect that many secretly accept assistance from family, but keep in mind that this type of thing is strictly prohibited and constitutes fraud (you must disclose all income when completing FA applications). I am sorry about your situation, but after 4 yrs of med school, I was NEVER able to find a way around the rules. Good Luck.

 

[k's mom]

Just thought I would vent a bit about this whole financial aid system.
I find it absolutely ridiculous that in this day and age of so-called "family values" the government refuses to acknowledge that my husband is just as responsible for my son's support as I am. The fact that we would have to get a divorce and court mandated child-support in order for him to qualify for a higher cost-of-attendance to support his son is nothing short of disgusting.
I remember as a college freshman, a group of friends sitting around and seriously talking about pairing up over the summer and getting a courthouse marriage so that we could qualify for financial aid.
The government should be ashamed of itself.

 

[commymommy]

Not only that, consider the amount of student loans that we need to take out nowadays...our degrees are more expensive than anywhere in the world, and let's face it...a bachelor's degree isn't what it used to be!!!!! Even a medical degree isn't what it used to be when you consider the investment of money and TIME...the salaries have continued to sink becuase of cost containment, and the loans continue to rise...We deluded ourselves into thinking we'd have no problem paying it off post-training, and that isn't so....we are living on a tighter leash now than during residency....

There are many problems with the system, but they won't be addressed....think about it...there are actually med students here on these forums who WANT to be parted with hundreds of thousands of dollars plus interest and WANT to suffer and struggle...they actually argue than anything less would be considered WELFARE for doctors <img src="graemlins/pity.gif" border="0" alt="[Pity]" />

Our university systems have lowered their standards overall and really anyone nowadays can get a bachelor's degree...heck you can do it from your home computer and never set foot on campus...and yes, you are investing in your future, but salaries are low...in many cases, you leave undergrad studies with more debt than your potential pre-tax salaries...and there is just really something wrong with that..

Well....vent, vent, vent...

that was my rant for the week.

Kris

 

[Neurogirl]

Unfortunately, court mandated child support wouldn't make any difference in the amount of financial aid you'd qualify for. The amount is set...regardless of your personal situation.

I know I'll get flammed for saying this, but what everyone seems to be forgetting is that higher education is a privilege...not a right. To make ends meet during med school (due to circumstances beyond my control), I was forced to accumulate over $10,000 in credit card debt. Am I bitter? NO! I am grateful that the US government provided me with the opportunity to pursue my dream. Why should the government provide extra funds for those with children? As it is, they already provide extra funds for childcare, and if the spouse of the med student is working, they should be able to make it. If you can't tolerate the sacrifices you'll have to make, then maybe you don't want it badly enough. I've already given you examples of ways others in your situation have made it. It can be done.

 

[k's mom]

neurogirl-
Actually, childsupport does make a difference. You are forgetting the distinction made between the federally determined student/family contribution, and the school designated cost of attendance (COA). Federal loans are limited, but you cannot recieve any funds over your SCHOOL determined COA. That means if my husband works his rear off to secure scholarship money/loan repayment obligation service, he still cannot recieve funds over the COA.
Adjustments are almost made for health reasons. As far as schools providing child care funds, child care for two children can easily cost more than a full time salary.

 

[commymommy]

I also believe that higher education is a privilege...but not one that should cost you more than what it is worth!!!! Nowadays, the cost of getting an education is simply much more than it is worth...the plain and simple market value...$10,000 is a drop in the bucket, btw...we finished med school with about $180,000 in debt. There are people who will try and tell you that we are unusual in their debt...they would be the ones who had their parents around to pay for everything, because roughly 7 out of 10 spouses that I have met in the last 2 years have similar debt sagas! We'll be paying until we're in retirement...speaking of which..neither of us even have retirement accounts started yet...

Also if it is such an honor to get an education, then we must accept that not everyone can get one...AND the consequences of that...which means that not everyone can get a job and earn a living wage...ummmm $6/hour is not a living wage. (An interesting book to read: "Nickle and Dimed"..and many jobs even good ones don't offer health insurance...with the wonderful honor of getting a higher education will also come the burden of caring for those not as fortunate if we don't establish some type of health plan for those less fortunate....and able to be so privileged.

rant, rant, flame flame... I think I need a job or something.....

Kris

 

[commymommy]

btw neurogirl...despite the high costs of education..don't misunderstand my own desire..I recently sank nearly 50,000 into my MS for tuition, books and childcare......the desire is there...and I pulled it off...the value? the worth? questionable....

Kris

 

[Kimya]

What's the point of belittling people who are concerned about providing good care for their children by saying "if you aren't prepared to make sacrifices you don't want it bad enough". Having your spouse and children go on welfare and food stamps is asking a lot, I'm sorry. Sure, there are people who do it. There are also a lot of people who get divorced.

Providing greater support for those who have gone through the extremely competitive process and been accepted is good business. Since older applicants are being accepted more often now, that may mean with families. Medical school is especially difficult in that there is no stipend (as with many graduate programs), and the hours are a lot more fixed than in many types of other graduate programs (e.g. rotations). I don't see why those in medical school with families shouldn't be able to get more subsidized loans support.

 

[Neurogirl]

momofthree,

I know that $10,000 is a drop in the bucket. That is the amount of credit card debt I accumulated (actually it is more than that). My total school debt is $215,000. <img src="graemlins/wowie.gif" border="0" alt="[Wowie]" />

Neurogirl DO, MPH

 

[commymommy]

Ouch, Neurogirl..It's a lot, isn't it!!! We really didn't consider our debt to be too bad until we got out of training....we had figured out our salary, etc and thought paying it back would be something we'd be doing for a long time, but not that it would hurt as much as it has...and truly...it is PAINFUL! We live a much less financially secure life than during residency simply because our debt load is so high. It is also true that banks are willing to give mortganges to docs even though the debt is so high...what they fail to mention is that they will offer you the homes at a much higher interest rate...We hadn't counted on paying so much in state taxes, fed taxes, social security, etc...At the end of the day, we actually pay 44% of our salary to the tax man <img src="graemlins/wowie.gif" border="0" alt="[Wowie]" /> which leaves us pretty dried up because instead of having the additional money to consider as salary, it ALL..and I mean ALL goes to pay on our loans <img src="graemlins/pity.gif" border="0" alt="[Pity]" />

BooHoo..I know ...it is just really much tougher than we ever expected. The general public still has the perception that doctors are very wealthy people...and even many pre-meds/med students have this perception as well...now that we are on the other side, I can say that in about 15 years...we will hopefully be more financially secure (just in time to finance our children's college educations)...but we will never be wealthy or near wealthy...never...we will eventually be comfortable...and we aren't alone. Unfortunately, we've met too many people in a similar situation this year.....

Right now, when my husband writes out our checks every month he doesn't think it was worth it anymore. He fights managed healthcare plans, the ever-shrinking medicare payments, has no time to spend with his patients...has frustrated patients whose insurance companies won't pay for their medications or have people with bachelor's degrees deny treatments...and then he has to spend his time fighting them...He is so disgusted by what medicine has become.....And the cost to us emotionally and financially for this was extremely high. Fortunately, my husband and I have a good marriage and a strong commitment to one another....We have made it through training and maintained our friendship and love for each other...and perhaps it even gave our marriage more character. We had many fun adventures and have been blessed with three beautiful children..it was not all bad....but I cringe when I hear these little green med student's to be demanding to pay high tuitions or telling others that they maybe don't want it enough if they are willing to question the system...I hope to meet them on the other side some day...and I WILL be full of compassion...because we were green once too.

Kris

 

[saffron]

momofthree: hey some of the things you wrote were really scary, so i am hoping you will answer a few questions for me...

i am a senior in college and have been accepted to med school (probably going to pritzker next yr). I am trying to make an informed decision about whether to actually become a physician. So, are you honestly POOR being a doctor? to qualify this term, can you answer a few specific questions (if these are too personal, feel free to not say so):

1- What kind of docs are you and your husband?

2- What was your salary (or avg. salaries of your colleagues) during residency and after training?

3- Do you think the fact that you have three kids might have something to do with your being in a tough place financially? In other words, if you only had to support yourself with only your own salary, would you still feel "poor" and "struggling to make ends meet" or would you feel like you were living a luxurious lifestyle?

4- How come your story contradicts other physicians who drive beemers, live in HUGE houses, etc? Is that just a myth? Or did they do something different than you and your husband? (I am thinking of some docs I know personally who have been in practice 5-10 yrs max and live extremely well).

Thanks in advance, and if you don't want to answer some of my questions, I totally understand...

 

[Neurogirl]

The high living docs you know probably didn't have to borrow massive amounts of loans. My loans are CURRENTLY in excess of $215,000 (the interest on the unsecured staffords is increasing daily). As a general adult neurologist (in my part of the country), I should be able to command around $150,000 to $170,000 (unless I go the pain mgmt route, in which case it will be more). If I make the above amounts, I'll take home $90,000-$100,000 (assuming a combined state and federal tax rate of 40%, (after deductions) which is really low balling it). If I choose the 10 year repayment plan, my loan payments will be $3340 a MONTH, or roughly $40,000 per year. That leaves approx $50,000-$60,000 take home pay. Now, since I don't have a DIME in savings and I plan to have a very comfy retirement, I'll need to start socking away money in investments. I've calculated that I'll need to invest around $1000 per month for retirement. That leaves about $40,000-$50,000 to live on (about double what I take home as a resident). Although that amount of money is certainly more than that made by the average person, it hardly puts me in the "wealthy" category. Once my loans are paid off I'll be VERY comfortable, but I'll NEVER be rich.

 

[saffron]

neurogirl- wow, thanks for the specific figures, it was really nice to see everything broken down like that and not just in terms of "rich" and "poor" -- which always leaves me wondering

although i agree that with those numbers, you won't be living like a pro athlete, entertainer, and maybe not even some i-bankers or CEOs, 150-170 K is nothing to balk at IMHO...

some points that i felt i had to address are:

1-aside from the loan repayments, everyone (no matter what job they have and how much they make) has to deal with the same expenses as you with MUCH LESS $ to work with. for example, my parents pay 30-40% in tax, have to save for retirement, etc. as well and make much less than that...

2-even given the conservative end of your estimated salary (150K) and taking off 40K for loans (which i admit not many other professionals have to accumulate such massive amounts) that's a base salary of

$110,000 for the next ten years
$150,000 every year you work after that

(i don't count taxes and retirement, etc. because i figure i will have to pay for that regardless of what profession i go into).

to complete the picture, can you tell me

1-the details of how many years of residency for neuro you have to do and what your salary is during those years (i am guessing 3 years and $35,000, but just double checking). more importantly, are you

2-paying off any loans during this time, or just letting the interest accumulate because you don't make enough to start paying it back yet?

3-does your loan estimate per month include this additional accrued interest?

4-finally, do friends your age in other professions make alot more than you or live better lifestyles than you?

thanks...what you have already written has been extremely helpful, if you have anything to add on top of my above questions, please tell me... i want to go into this thing informed and realistic
<img src="graemlins/wowie.gif" border="0" alt="[Wowie]" />

 

[commymommy]

Well, to answer your questions:

1. I'm not a doc, I have my MS in mol bio and am actually in a similar situation to you in that I was pre-med and am trying to decide whether or not to follow through with it once my kids are in school. My husband is an ID specialist who did 1.5 years of oncology (this lengthened our residency).


2- Salary during residency was 32,000 for PGY-1 and went up about $1200 each year through PGY-4. Fellowship salary was 38,000 and then ~39,500. This was our only source of income.

3- I think that having the children affected our expenses and thus the amount of loans and credit card debt that we took on.....this has nothing to do with a "cushy" lifestyle...we spent his years of residency having times where our child went without diapers for 5 days until payday <img src="graemlins/wowie.gif" border="0" alt="[Wowie]" /> Granted, those months of poverty were rarer, but they happened when our car broke down unexpectedly, etc, etc. Another choice that affected our taking out loans was that we felt it was important for one parent to be at home...AND my salary outside of the home wouldn't have paid for anything more than daycare anyway. We relied on the belief that our post-training salary would be higher.

As to the ~150K/year comment....dream ON!!! Certainly it depends on your specialty, but I'm here to say that the starting salaries of internists hover around 100 and specialists around 125....EVENTUALLY you will work your way up in salary, but not right off the bat. Still think that is a lot of money? Let's just go with 100 to make this simple and say 40% taxes....Take home with $5000/month. Student Loan payments, credit card payments and physician loan payments...knock of 2500-3000$$$$$$ I'm not kidding...So now you have...lets be nice and say 2500....you'll need to buy a home for tax purposes with your salary at 100...and a modest home will set you back about...well, lets be nice again...$1000 (depending on where you are living). You now have $1500: Car Payment (just one) $300 plus insurance $80 plus gas $120...You now have $1000. Factor in electricity for you home...$120, phone $50 (hey..we're talking about living cheaply)...well, you are probably getting the idea now...but figure in water, groceries...and you're out of money...I hope you don't have kids and need to pay for any incidentals!!! What set you back? That blasted loan payment...that isn't going away for a really long time.

4- Well, I think that there are people who went out and did it smarter than we did...people who took military scholarships, didn't have children during training, or chose to work while raising children...We also made two international moves (my dh is german and we lived in germany, northern Ireland, and then the US). We could have reconsidered fellowship, but I felt that supporting my husband's dreams was important....

After 5 or 10 years I do think that it is possible to be doing much better....as the loans get paid down.....We don't have a beamer..we have one car...a 1996 Chrysler Plymouth that has two major oil leaks and needs to be refilled with oil every two days. We did buy a nice home though...that is empty...and eventually we will be able to get ahead and start to relax financially...but I do believe that it will be at least ten years.

This is not to be discouraging..it is reality...unless you arrange for a primary care scholarship or some kind of student loan repayment program you will have the kind of debt that neurogirl and I are talking about, and it will be a challenge to get out of that debt....

Just some thoughts....

Kris

 

[commymommy]

[bold]finally, do friends your age in other professions make alot more than you or live better lifestyles than you? [/bold]

Yes...all I can say is GO DENTISTRY! Our friends who are dentists are doing well..as are our friend who is an attorney and two friends who went into banking......some of them won't have the same "earning potential", but they have the avantage of not having spent 7 years in residency/fellowship earning 30-39K with no retirement and few benefits...They got out of school and started working...paying into a 401K, etc, etc...they have SAVINGS, take VACATIONS...holy moly...what I'd give for a vacation

Kris

 

[saffron]

momofthree- thanks for your answers...i was a little confused about the financial difficulties b/c i thought both you and your husband were docs...but with 3 kids and 1 salary, your situation makes a lot more sense...

im not downplaying your hardship at all, but just to put things in perspective, my parents also raised 3 kids with 1 income (ALOT lower than your husband's)- they came to this country as foreigners about 15 years ago...anyway, both my brother and i are at private, top 15 universities (combination of scholarships and parent's help) and my sister is still young...SO while it's definitely not a cushy life, it IS possible, because i saw my parents handle it growing up...

by the way, my dad went to a top foreign school (its known to be more selective than Harvard), works harder than most doctors i know, and is smarter than i could ever hope to be (and im not exactly dumb )...so most doctors in this country don't have it THAT bad, believe me

BUT i def. understand your frustration when comparing to more affluent friends.

Oh, the 150K figure i didn't dream up, i was using neurogirl's estimate...

one last thing- what did you mean by 'buying a house for tax purposes' -- what advantages are there to owning a house? (of course it's much nicer and probably needed with 3 kids, but i mean in terms of legalities?)...thanks again

 

[commymommy]

Well, I'm not trying to downplay the salary at all, and the rags to riches stories that come along...my own father grew up with parents who only had an 8th grade education and went on to become a pilot...and now makes more than my husband will ever be able to earn and is restriced by the FAA by how many hours he can work.

The bottom line in medicine is that it is much more difficult to make the same money that was made many years ago thanks to HMO's and other managed care plans, medicare, the increasing population of elderly and the uninsured. Our healthcare system is experiencing some difficulties.

My husband went to one of the top med schools in germany, where he also did research in one of the top labs on neuroblastoma...so....I share your experience in many ways...and if we can, we will do anything to afford our own children top educations...though it does come at a price of personal sacrifice. The times are also diff. than 15 years ago...I don't think 30,000 buys nearly what it used to....

But many doctors DO have it bad, and the rate of physicians defaulting on student loans is at a high....Everyone's experience is different, and it sounds like your parents made some sacrifices to get you to where you are in your life...and I hope that they will continue to help you as you pursue your med school dream so that you can maintain minimum debt. It helps to have a family that is behind you.

To look for salaries, here is a good link:

It is the Medical Student Resource Page at

http:// www. studentdoc.com/july_surv.html

I separated the ?? and the www. from the rest so that it would show up...for some reason, the link didn't take...

When you purchase a home, you can deduct the interest that you pay at tax time...this can be quite significant, especially the first few years...when you are paying rent, you can't do that. So if you are paying $750 rent ...even $1000 for an apt. big enough for a family of 5, you can't take off any interest...if you have purchased a home, you will get some of that interest back.

 

[Neurogirl]

The starting salary I mentioned is not a "dream", but reality...based on my knowledge of the market in my area. $150,000-170,000 is not an inflated figure. Where I live, neurologists are in great demand and do very well. The average wait for new patients is 3 months! I'm only a pgy-1 and I've already been recruited by one local specialist. When it comes to physican income, it all depends on your specialty and which part of the country you're in. Like everything else in life, it's all about supply and demand. Look at the salary survey you posted...why do you think each specialty has such a broad range of reported salaries.