IM (Scholarship) vs Anesthesiology

[GettinAfterIt]

Hi all,

Non-traditional, incoming med-student here with a bit of a dilemma. Any advice would be greatly appreciated!

I've been offered an internal medicine, primary care scholarship from my school that will cover tuition, fees, and living expenses (+$2k per month). I'm equally interested in anesthesiology and internal medicine, as I worked with and shadowed both as a medic in the Army.

So I have two options:

Take the scholarship, specialize in internal medicine / primary care. Make $300k per year, finish residency by 35-36. No debt.

Turn down scholarship, specialize in Anesthesiology. Make $400-$600k per year. Finish residency at 36-37. $350k+ in debt.

I’ve shadowed and am equally interested in both.

Thank you and Happy New Year!

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[M&L]

wow, this is an interesting choice....

ok, first of all, - there might be something else you have not considered yet. You might fall in love with something else during med school.
You can do student loan forgiveness, and even that 350k loan will go away.

Personally, i would go for what you love. Ask them what happens if you change your mind during M3 or M4 year? will it be as simple as owning them the money? if thats the case, its fine, because than you would just own the "loan". find out exactly how binding it is.

 

[slowthai]

I just want you to consider the fact that they offered you a big scholarship for you to be locked into internal medicine. That should tell you everything


But seriously, you don't want to be locked down, ever, by your own doing or someone else's. Freedom to choose is priceless. Based on the most recent AAMC data, only ~28% of incoming students ended up choosing the same field as their initial choice when it came time to apply for the match.

 

[M&L]

agree with above. another thing - does the contract stipulate that you should have to go to a specific residency? (theirs for example), or you can choose whatever residency georgaphically? also, does it stipulate that you are required to do general internal medicine for certain number of years (and not allowed to do a fellowship)?

 

[GettinAfterIt]

agree with above. another thing - does the contract stipulate that you should have to go to a specific residency? (theirs for example), or you can choose whatever residency georgaphically? also, does it stipulate that you are required to do general internal medicine for certain number of years (and not allowed to do a fellowship)?

I just want you to consider the fact that they offered you a big scholarship for you to be locked into internal medicine. That should tell you everything


But seriously, you don't want to be locked down, ever, by your own doing or someone else's. Freedom to choose is priceless. Based on the most recent AAMC data, only ~28% of incoming students ended up choosing the same field as their initial choice when it came time to apply for the match.

So the scholarship won't technically lock me into IM. If I decide to change my mind, I have to repay the scholarship which turns into a private loan from the school. Also, I can attend any residency I'd like. The only way I would be locked into the school's residency is if I accept the 3-year accelerated IM program.

"The rate will be the Federal Direct Subsidized Loan Rate in
effect as of the date of July 2023" - Somewhere between 3-8.25%

 

[M&L]

WOOOOOW.... DONT DO IT!!!!!!! no no no no no

 

[M&L]

So the scholarship won't technically lock me into IM. If I decide to change my mind, I have to repay the scholarship which turns into a private loan from the school. Also, I can attend any residency I'd like. The only way I would be locked into the school's residency is if I accept the 3-year accelerated IM program.

do NOT do it.
So, if you take a loan from the government you qualify for loan forgiveness if you work in a certain setting for 10 years. Btw that includes residency - for example, I will do 5 year residency/fellowship, and will work for 5 more years for a university (i will work as a pathologist for the university hospital and teach, while getting paid big doctor money), and for that all my loan will magically disappears. BECAUSE IT IS A GOVERNMENT LOAN>

but if the loan is from school - it is private. it cannot be forgiven . You are scr*wed. you will HAVE to pay it off completely. WHich is also fine, but it limits your options. so DO NOT AGREE TO THAT DEAL.

Edit - i already talked to my financial advisor, and this is my legit plan that was verified by her. if you refinance government loan (so turn it into private) or if you take out school loan instead of government (that is private from the beginning), you cant do any of this.

 

[slowthai]

So the scholarship won't technically lock me into IM. If I decide to change my mind, I have to repay the scholarship which turns into a private loan from the school. Also, I can attend any residency I'd like. The only way I would be locked into the school's residency is if I accept the 3-year accelerated IM program.

So there's even a penalty for changing your mind? Do yourself a favor and remain a free agent. You don't ever want a private loan. What are the interest rates?

 

[M&L]

So there's even a penalty for changing your mind? Do yourself a favor and remain a free agent. You don't ever want a private loan. What are the interest rates?

even if interest rates are ZERO i wouldnt take private loan. Because it is much easier to have government loan forgiven than you think. And locking yourself into a private loan that REQUIRES you to pay it off is ridiculous. The only exception that i would maybe consider, - if my parents were doctors with a private practice set up, and expected me to join them after fellowship, - then, sure. Private loan is fine, because if you go into private practice right after fellowship you cant have govenment loan forgiven. But for example, - i will work in university for 5 years, my loan will disappear, and then i can do whatever - including private practice if i want to .

 

[M&L]

basically, i feel like your school is trying to take financial advantage of you. Statistically, - they know that you are highly likely to change your mind during med school, and you will owe them 350+ that you will be REQUIRED to pay off. Yeah, they are very smart indeed.

 

[AlbinoHawk DO]

Take the deal. Most people end up in IM or FM anyway. Even if you're not the biggest fan of IM at the end, you can subspecialize. Worst case scenario, you go into anesthesia and have to repay. The big advantage is you will not have accumulated interest. Either way, you'll be fine

 

[GettinAfterIt]

So there's even a penalty for changing your mind? Do yourself a favor and remain a free agent. You don't ever want a private loan. What are the interest rates?

You accrue no interest while in the program. However, if you decide to opt-out, the interest rate is the current average rate of federal loans.

"The rate will be the Federal Direct Subsidized Loan Rate in
effect as of the date of July 2023" - Somewhere between 3-8.25%

 

[GettinAfterIt]

Take the deal. Most people end up in IM or FM anyway. Even if you're not the biggest fan of IM at the end, you can subspecialize. Worst case scenario, you go into anesthesia and have to repay. The big advantage is you will not have accumulated interest. Either way, you'll be fine

This is what I'm thinking. Take the deal and if I really feel the need to switch I can always pay back the loan. The interest rate seems reasonable too.

A concern of mine with gas is that I won't be actually "treating" people unless I do a fellowship. I kind of want to have my own patients.

 

[GettinAfterIt]

basically, i feel like your school is trying to take financial advantage of you. Statistically, - they know that you are highly likely to change your mind during med school, and you will owe them 350+ that you will be REQUIRED to pay off. Yeah, they are very smart indeed.

You make some great points! Thanks for the feedback. However, I read that you're able to file bankruptcy on private loans but not federal? Idk, you're right about not being able to use PSLF though.

 

[ChordaEpiphany]

You can do student loan forgiveness, and even that 350k loan will go away.

Pay attention to this OP! So many people look at the big numbers ($350-400K) and freak out, but it's a lot more complicated than that and usually the numbers end up being either small relative to overall compensation or

1) It's among the least important factors in your overall financial well-being (behind earnings, opportunity cost, COL, and whether or not you get divorced)

2) You will have options for repaying the loans as an attending, and many more opportunities will open up as you progress. For instance, some jobs offer partial or full loan repayment as a sign on bonus. Some jobs are eligible for PSLF. The jobs that aren't eligible for PSLF usually pay more than those that are. Even if you get no loan repayment, you can think of it as just $30-50K lower compensation.

Give yourself as many options as you can and assess later. Very few med students stay on their initial track. You'll make millions more over a career in a subspecialty if that's what you choose (assuming current compensation levels hold, which is a legitimately risky assumption).

If I decide to change my mind, I have to repay the scholarship which turns into a private loan from the school.

Sounds like your medical school is a educational institution that would rather be a bank. I'd skip this offer and run the numbers yourself. Even if you wind up in primary care, you won't regret having given yourself more options.

 

[GettinAfterIt]

Pay attention to this OP! So many people look at the big numbers ($350-400K) and freak out, but it's a lot more complicated than that and usually the numbers end up being either small relative to overall compensation or

1) It's among the least important factors in your overall financial well-being (behind earnings, opportunity cost, COL, and whether or not you get divorced)

2) You will have options for repaying the loans as an attending, and many more opportunities will open up as you progress. For instance, some jobs offer partial or full loan repayment as a sign on bonus. Some jobs are eligible for PSLF. The jobs that aren't eligible for PSLF usually pay more than those that are. Even if you get no loan repayment, you can think of it as just $30-50K lower compensation.

Give yourself as many options as you can and assess later. Very few med students stay on their initial track. You'll make millions more over a career in a subspecialty if that's what you choose (assuming current compensation levels hold, which is a legitimately risky assumption).

Sounds like your medical school is a educational institution that would rather be a bank. I'd skip this offer and run the numbers yourself. Even if you wind up in primary care, you won't regret having given yourself more options.

You make some very valid points, I appreciate your insight!