Is it such a crazy idea... (student loans)

[Birdnals]

Is it such a crazy idea to be aiming to pay off our student loans within 3-5 years following residency?

We hear about the "crippling, life-long" debt we're incurring by attending medical school, but does it really need to be this way? I did some basic number crunching and here's what I've come up with:

Let's say you graduate medical school with $184,000 in debt (the average in 2014). You go off and complete a residency and fellowship lasting a total of seven years. During this time, you suck, and don't pay any of the interest that accrued on your debt, leaving you with a total debt of $292,000 at the end of your training (assuming a 6.8% interest rate). Let's assume, after taxes/alimony/child support/whatever, you're brining home 200k a year. If you contributed about 10k a month to your debt, you'd have that whole massive thing paid off in 3 years and be left with 80k a year to live off of.

Now I get it that 80k a year doesn't sound like much after 11 years of training, but its only for 3 years. You'd still be much better off than you were in residency. People across the country live comfortably off of this income (or less), so why can't we adopt such a plan? Obviously, in certain geographical areas, 80k a year is gonna get stretched pretty thin, especially if there is a family involved. But besides this, what are the other pitfalls in this plan?

(By the way, if you keep up with your interest during residency, the monthly payment would drop to less than 6k a month.)

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[Brahnold Bloodaxe]

Is it such a crazy idea to be aiming to pay off our student loans within 3-5 years following residency?

We hear about the "crippling, life-long" debt we're incurring by attending medical school, but does it really need to be this way? I did some basic number crunching and here's what I've come up with:

Let's say you graduate medical school with $184,000 in debt (the average in 2014). You go off and complete a residency and fellowship lasting a total of seven years. During this time, you suck, and don't pay any of the interest that accrued on your debt, leaving you with a total debt of $292,000 at the end of your training (assuming a 6.8% interest rate). Let's assume, after taxes/alimony/child support/whatever, you're brining home 200k a year. If you contributed about 10k a month to your debt, you'd have that whole massive thing paid off in 3 years and be left with 80k a year to live off of.

Now I get it that 80k a year doesn't sound like much after 11 years of training, but its only for 3 years. You'd still be much better off than you were in residency. People across the country live comfortably off of this income (or less), so why can't we adopt such a plan? Obviously, in certain geographical areas, 80k a year is gonna get stretched pretty thin, especially if there is a family involved. But besides this, what are the other pitfalls in this plan?

(By the way, if you keep up with your interest during residency, the monthly payment would drop to less than 6k a month.)

You're absolutely right. 300k in debt isn't a big deal at all if you're making 350-500k like many specialties today. What has people concerned is that we know for a fact what our debt is going to be right now, but we have no idea what our salaries are going to be in 7-10 years when we start practicing. If it's 350k+ fine, if it's 150-250k then not so good.

 

[Birdnals]

You're absolutely right. 300k in debt isn't a big deal at all if you're making 350-500k like many specialties today. What has people concerned is that we know for a fact what our debt is going to be right now, but we have no idea what our salaries are going to be in 7-10 years when we start practicing. If it's 350k+ fine, if it's 150-250k then not so good.

Which would be all the more reason to pay it down ASAP. It doesn't seem as though this line of thinking (pay off debt ASAP) has ever been a very popular one though.

 

[67552931811]

It's really not that hard to decimate 400-500K in loans in 4-5 years while making 200K a year.

 

[Stagg737]

You're absolutely right. 300k in debt isn't a big deal at all if you're making 350-500k like many specialties today. What has people concerned is that we know for a fact what our debt is going to be right now, but we have no idea what our salaries are going to be in 7-10 years when we start practicing. If it's 350k+ fine, if it's 150-250k then not so good.

Even with a take-home of 125k after taxes and expenses, having 250k in debt isn't the end of the world if you're willing to live sparingly for 2-3 years after residency. Imo, the bigger problems are:

1. The number of hours being put in to take home that 125k.

2. The students who carry-over undergrad debt and end up north of 350-400k in debt.

3. The growing number of non-trads compared to 15-20 years ago who won't finish residency until they're 30-35, meaning that even living sparingly they wouldn't get out of debt until their late 30's or 40's.

Even then, the long-term outlook isn't that bad, it just means the days of docs being able to retire comfortably in their 50's would officially be a thing of the past.

Which would be all the more reason to pay it down ASAP. It doesn't seem as though this line of thinking (pay off debt ASAP) has ever been a very popular one though.

When you think about the time and work put into it, it's not that hard to see why. 4 years of undergrad, followed by 4 years of med school, then 3-8 years of residency/fellowship busting your butt before landing that 6-figure paycheck. After living like a student and working like a dog for 11-16 years, most people don't want to live sparingly for another 5 years. They want to enjoy their money since they "finally made it", and I can't blame them. Especially if they have a family and kids that they're supporting. Yes, they'll probably rack up another 50-15ok in debt, but for a lot of people the significant upgrade in quality of life makes it worth it.

 

[Mansamusa]

I didn't read through the other comments yet, but if you make $200K and pay $10K/month you don't have $80K left 'cause taxes

And also the student debt is more bimodal. You have people with scholarships, wealthy parents, spouses, Texans, etc. with relatively low debt and then you have the other half with much more than the average debt (which also doesn't include undergrad debt). But still, if I do a 6 yr residency and finish at 34, there is no reason I won't be paid off by 40 according to my math.


(It's also not so much crippling debt as it is an insane amount of debt. You do have to worry about buying a house, raising a family, dealing with major medical issues, retiring, etc. and it's a little crazy to think that I will have spent $500,000+ on my education by the time it is paid off)

Keep adding more: @Birdnals the "pay it off ASAP" mentality is increasing because students have a lot more debt and the interest rates are obscenely high. Older generations of docs had little motivation to pay the loans off quickly when they were at low interest rates.

 

[kbeitz]

Students always underestimate the debt burden and overestimate true earnings. They always make flawed assumptions in their math, and these assumptions always have favorable outcomes. They always assume their immediate lifestyle translates into their lifestyle ten years from now.

When you get there and start paying it off, THEN talk about how easy it is.

 

[gyngyn]

Students always underestimate the debt burden and overestimate true earnings. They always make flawed assumptions in their math, and these assumptions always have favorable outcomes. They always assume their immediate lifestyle translates into their lifestyle ten years from now.

When you get there and start paying it off, THEN talk about how easy it is.

I was free of debt in less than 4 years. NHSC, moonlighting and frugality.
Easy.

 

[Birdnals]

Students always underestimate the debt burden and overestimate true earnings. They always make flawed assumptions in their math, and these assumptions always have favorable outcomes. They always assume their immediate lifestyle translates into their lifestyle ten years from now.

When you get there and start paying it off, THEN talk about how easy it is.

The math is fairly simple and verified using a dept repayment calculator. Maybe it's easy to underestimate what it feels like to have that much debt, but it's certainly not difficult to calculate it.

What do you mean by "They always assume their immediate lifestyle translates into their lifestyle ten years from now?"

 

[gyngyn]

What do you mean by "They always assume their immediate lifestyle translates into their lifestyle ten years from now?"

I think he means that 10 years often brings additional expenses associated with normal changes in status associated with age (marriage, children, better car, house, hobbies...).

 

[PL198]

lol at inclusion of alimony/child support.

if you get divorced and have to pay for that stuff and still pay off your loans within 5 years, you're a baller

 

[halodos]

Currently, I am planning to do general surgery (+2 research), then a 2 year fellowship, which is about 9 years of training post med school.

After signing my MPN, I noticed that I qualify for IBR and PSLF, so couldn't I just work in academia or a non-profit hospital (or a VA) for 1 year and get my loans forgiven?

 

[mimelim]

Currently, I am planning to do general surgery (+2 research), then a 2 year fellowship, which is about 9 years of training post med school.

After signing my MPN, I noticed that I qualify for IBR and PSLF, so couldn't I just work in academia or a non-profit hospital (or a VA) for 1 year and get my loans forgiven?

That is my current plan, just getting to the half way point of it.

 

[Birdnals]

Currently, I am planning to do general surgery (+2 research), then a 2 year fellowship, which is about 9 years of training post med school.

After signing my MPN, I noticed that I qualify for IBR and PSLF, so couldn't I just work in academia or a non-profit hospital (or a VA) for 1 year and get my loans forgiven?

Interested in hearing more about this. How does one qualify for something like this?

 

[mimelim]

Interested in hearing more about this. How does one qualify for something like this?

https://studentaid.ed.gov/sa/repay-loans/forgiveness-cancellation/public-service

I should point out that several of my months the amount shown on my bill was $0, so I paid $0. Those will still count toward my 120 months.

 

[deleted407021]

NHSC

Doesn't this kind of deal typically come with substantial risks, such as being locked into primary care and having to pay back many times what was given to you in terms of scholarship money, should you drop out?

 

[Anicetus]

What about with taxes?

 

[IslandStyle808]

I was free of debt in less than 4 years. NHSC, moonlighting and frugality.
Easy.

It's shocking to know how much one can earn moonlighting. Then again this is more plausible for non-surgical specialities as a whole (that darn 80 hour rule).

 

[gyngyn]

Doesn't this kind of deal typically come with substantial risks, such as being locked into primary care and having to pay back many times what was given to you in terms of scholarship money, should you drop out?

Worked for me. There are plenty of specialties eligible. Gyn is the only surgical field, though. I'm from the middle of nowhere so there was no adjustment necessary!

OP asked if it could be done. This is one way (of several). It was the decision that allowed me a career in academic medicine (low pay, high satisfaction). I am delighted with my choice.

 

[gyngyn]

What about with taxes?

You pay them.

 

[Tenk]

It's really not that hard to decimate 400-500K in loans in 4-5 years while making 200K a year.

Uhhh no?

200k means about 125k post state/federal tax if that. If you pay every single cent to your loan and live on the streets, have no car, no house, no kids, no spouse, and steal crackers from the nursing stations for every meal... maybe?

Realistically you would need an income of around 300-400k to pay off that much debt in 5 years and that's living pretty non-luxuriously.

 

[Tenk]

@OP:

You can easily pay off your debt early if you plan for it and live appropriately. Refinancing your loans can also be a good option to consider. I would not bet on the 10 year public service to be around in 10 years from now (at least for physicians). Nobody feels sorry for us and history has shown us that the government doesn't care about our debt burden as evidenced by decades of screwing over physician loans. So long as you make good fiscal decisions, everything will work out. My advice for anyone in med school is borrow the least amount possible because all that money comes back to haunt you with a vengeance.

 

[TBV]

The real secret is to pocket you a PA and lean more on their 80k or whatever while you funnel more into loans

 

[kbeitz]

I was free of debt in less than 4 years. NHSC, moonlighting and frugality.
Easy.

Nice. Although I agree that it can be done, I still think all of the things you mentioned are difficult to do for someone who maybe is doing only the moonlighting and frugality. Did your lifestyle change between med school and paying off loans at all (kids, house, etc)? How feasible is this plan as a PCP earning <200k, with 350k+ debt at 6.8% unsubsidized interest and no NHSC?

I'm only skeptical because I don't think this cohort of physicians out of debt matches the indebtedness of what students now will be going through (unless income grows dramatically, which it might).

 

[gyngyn]

Nice. Although I agree that it can be done, I still think all of the things you mentioned are difficult to do for someone who maybe is doing only the moonlighting and frugality. Did your lifestyle change between med school and paying off loans at all (kids, house, etc)? How feasible is this plan as a PCP earning <200k, with 350k+ debt at 6.8% unsubsidized interest and no NHSC?

I'm only skeptical because I don't think this cohort of physicians out of debt matches the indebtedness of what students now will be going through (unless income grows dramatically, which it might).

My needs are few and my lifestyle only got modestly more luxurious after medical school (no roommates, for example).

I was a PCP in the NHSC. I was offered a salary upon completion of my service that would have been consistent with pay-off in only a little more time had I not been an NHSC scholar (almost 300K). The key is going into a "less desirable" area where your specialty is in high demand. We all make trade-offs. I found service in a remote area preferable to loans.

 

[link2swim06]

Nice. Although I agree that it can be done, I still think all of the things you mentioned are difficult to do for someone who maybe is doing only the moonlighting and frugality. Did your lifestyle change between med school and paying off loans at all (kids, house, etc)? How feasible is this plan as a PCP earning <200k, with 350k+ debt at 6.8% unsubsidized interest and no NHSC?

I'm only skeptical because I don't think this cohort of physicians out of debt matches the indebtedness of what students now will be going through (unless income grows dramatically, which it might).

Meh...your interest rate options are drastically going to change when you finish medical school. Your interest rate is going be around 3-4% if you have good credit and refinance.

Second, you have presented the most extreme option...kids, house, huge debt, and low paying (even for a PCP). This will probably be the exception more than the rule.

I have about 200K of debt. I have refinanced for a 5 year loan when I finish residency. I will owe about $40-45,000 per year. Which is going to be pretty easy given I have no house, dependents, and will make significantly more than 200K.

 

[67552931811]

Uhhh no?

200k means about 125k post state/federal tax if that. If you pay every single cent to your loan and live on the streets, have no car, no house, no kids, no spouse, and steal crackers from the nursing stations for every meal... maybe?

Realistically you would need an income of around 300-400k to pay off that much debt in 5 years and that's living pretty non-luxuriously.

? I'm speaking from first hand experience, bro.

Who pays 75 a year in taxes (on a 200K income)? Yikes.

Even given this absurd idea, if you throw 80K a year towards loans how can one not live off of 45 a year AFTER taxes? That is EASY.

 

[coldcase331]

? I'm speaking from first hand experience, bro.

Who pays 75 a year in taxes (on a 200K income)? Yikes.

More like 55k without any write offs, but don't you have to pay malpractice too?


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[TallScrubs]

To answer the original question:

1) Read some finance books. A little finance knowledge goes a long-ass way

2) It is not crazy to pay off that much debt within 5 years. It can be done without having to live like a peasant. Instead of looking at it in terms of 'I must pay it back in 5 years' look at it as 'pay as much per year as you reasonably can'

3) Refinance if you can get a good rate, which you shoulder be able to.

 

[Mr Roboto]

Uhhh no?

200k means about 125k post state/federal tax if that. If you pay every single cent to your loan and live on the streets, have no car, no house, no kids, no spouse, and steal crackers from the nursing stations for every meal... maybe?

Realistically you would need an income of around 300-400k to pay off that much debt in 5 years and that's living pretty non-luxuriously.

Sounds like you need a better CPA.

 

[Tenk]

? I'm speaking from first hand experience, bro.

Who pays 75 a year in taxes (on a 200K income)? Yikes.

Even given this absurd idea, if you throw 80K a year towards loans how can one not live off of 45 a year AFTER taxes? That is EASY.

6.7k a month towards loans is not easy on a 200k salary. My post was obviously a hyperbole, sorry if that wasn't clear. Regardless, when you add federal, state, sometimes local, sales, property, social security, Medicare, and all the other bull**** taxes, you will end up somewhere in the ballpark I listed. Add on a mortgage, some kids, insurance payments, monthly bills and you will be seriously strapped for cash.

 

[Stagg737]

Nice. Although I agree that it can be done, I still think all of the things you mentioned are difficult to do for someone who maybe is doing only the moonlighting and frugality. Did your lifestyle change between med school and paying off loans at all (kids, house, etc)? How feasible is this plan as a PCP earning <200k, with 350k+ debt at 6.8% unsubsidized interest and no NHSC?

I'm only skeptical because I don't think this cohort of physicians out of debt matches the indebtedness of what students now will be going through (unless income grows dramatically, which it might).

The first problem there is having 350k+ in debt, even with that let's do some math.

Say you make $175-180k straight out of residency (which is pretty reasonable for a PCP). I did the math a while ago, and after taxes, insurance, malpractice, etc. you would end up taking home around 125K. Unless you're trying to support a family of 5 somewhere like NYC or Cali, a family of 3-4 can live off of 50k/year pretty reasonably. Set aside 5k/year as an emergency/backup and that leaves you with around 70k/year to throw at your debt.

Now let's look at the debt itself. We'll take your 350k number, even though that's really high for most people coming out of med school. Assume you go to a 3.5 year residency and don't pay anything back during that time. It'll add 83,300k to your debt bringing your total up to 433,300 when you start making that 125k/year. Assuming you don't get any pay raises, don't pay anything off during residency, and don't receive any kind of loan forgiveness or extra funding, it'll take 6-7 years to pay off all of that debt as a PCP.

This is obviously very simplified, but assuming you're willing to work and live reasonably paying off your loans in 5 years is certainly doable. Especially if you take part in a loan forgiveness program or moonlight, which can easily take another 25k/year off your loans.

 

[osprey099]

Something that hasn't been brought up is the possibility of living in your parents' home/basement. I know it's not possible for everyone, but if you match at a place near home and aren't in a relationship/are relatively young, I personally think there's nothing wrong with living 3-6 years (however long residency is) in your parents' home. You can easily save at least $10k/year (depending on geography) solely from rent alone and that money can be put towards your debt.


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[Donald Juan]

Something that hasn't been brought up is the possibility of living in your parents' home/basement. I know it's not possible for everyone, but if you match at a place near home and aren't in a relationship/are relatively young, I personally think there's nothing wrong with living 3-6 years (however long residency is) in your parents' home. You can easily save at least $10k/year (depending on geography) solely from rent alone and that money can be put towards your debt.


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10k a year won't even pay my interest. Not worth living the the parents.

Seriously though, the strategies for paying off loans depends on your time and place. The current income driven plans pay off 50% of your interest that your 10% disposable income won't cover, so that alone will save someone like me with 300k in debt about 10k a year. If I work for a non-profit after 5 years of residency I can qualify for PSLF, which has now been capped, but I'm told it is based on what you signed with the master promissory note at the beginning of school, so it might benefit me to just keep paying 10% of disposable income for 5 more years, rather than living like a resident and dumping all my spare cash into trying to get them paid off in 3-4 years. Some people in the future or past may have different repayment plans, different interest rates for private consolidation, or other factors that change things drastically.

But to answer the OP: Yes, I believe the goal to financial freedom is to live like a resident after residency. Get your loans paid off however you need to; invest heavily so you have money for the future; pay off your house and cars, and buy future cars with cash. I don't want to be 60+ years old and feel like I have to take extra shifts just to make ends meat when I make more than 99% of Americans. Of course, this is all easier said than done. I'll wait until I'm there to pass judgment on anyone who went before me and how they spend their money.

 

[Red Lobster Actual]

If I work for a non-profit after 5 years of residency I can qualify for PSLF, which has now been capped,

Interesting. I remember hearing about the the 57k cap last year via POTUS' budget proposal but from what I gathered nothing ever amounted from it...anything change recently?

 

[Donald Juan]

Interesting. I remember hearing about the the 57k cap last year via POTUS' budget proposal but from what I gathered nothing ever amounted from it...anything change recently?

You're right, it actually got dropped. I guess it was still in the talks when I had financial advising and was researching into it. Good news for all.

 

[Psai]

Interesting. I remember hearing about the the 57k cap last year via POTUS' budget proposal but from what I gathered nothing ever amounted from it...anything change recently?

Lol that would have killed it. Who has only 57k in loans? That's like one year of med school

 

[Brahnold Bloodaxe]

Something that hasn't been brought up is the possibility of living in your parents' home/basement. I know it's not possible for everyone, but if you match at a place near home and aren't in a relationship/are relatively young, I personally think there's nothing wrong with living 3-6 years (however long residency is) in your parents' home. You can easily save at least $10k/year (depending on geography) solely from rent alone and that money can be put towards your debt.

Very good point. I heard it's also possible to engage in prostitution or sell your kidneys on the Israeli black market. We as future physicians have to get away from our privilege and feelings of entitlement and realize how fortunate we are to be in the position we're in. There is all this talk of debt, salary cuts, etc, but not enough talk of how much better off we are than starving kids in Africa.

 

[Psai]

Very good point. I heard it's also possible to engage in prostitution or sell your kidneys on the Israeli black market. We as future physicians have to get away from our privilege and feelings of entitlement and realize how fortunate we are to be in the position we're in. There is all this talk of debt, salary cuts, etc, but not enough talk of how much better off we are than starving kids in Africa.

This comment is so ridiculous I don't even know where to begin

 

[Brahnold Bloodaxe]

This comment is so ridiculous I don't even know where to begin

Then the comment has accomplished its mission.

 

[osprey099]

Very good point. I heard it's also possible to engage in prostitution or sell your kidneys on the Israeli black market. We as future physicians have to get away from our privilege and feelings of entitlement and realize how fortunate we are to be in the position we're in. There is all this talk of debt, salary cuts, etc, but not enough talk of how much better off we are than starving kids in Africa.

Wtf?.. I don't understand your logic. Please do explain.


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[Brahnold Bloodaxe]

Wtf?.. I don't understand your logic. Please do explain.


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I was poking fun at your idea that living with your parents until your early to mid thirties is a reasonable action for med students to take to pay off debt. Not sure how much clearer I could have made it. I thought the kidney selling and allusion to starving Africans would have made the sarcasm obvious enough.

 

[TheFutureFatMan]

Wtf?.. I don't understand your logic. Please do explain.


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Lol lighten up.

 

[Bancrofti]

People always say that you don't factor in a family, but how expensive is a kid really? Say I wanted to have a kid during residency, is it really going to hurt my pockets that much? I feel like all they need is diapers and food. That can't be more than $1500/year, right? I guess if you have to pay someone to watch your kids though, that's where the financial burden can come in to play, but anyone know how much that is? And is my logic correct in that if you were to have family watch your kid(s) or somehow got a cheap baby sitter, then they really aren't that expensive until they get significantly older?

 

[vernhart]

I was poking fun at your idea that living with your parents until your early to mid thirties is a reasonable action for med students to take to pay off debt. Not sure how much clearer I could have made it. I thought the kidney selling and allusion to starving Africans would have made the sarcasm obvious enough.

You have to act like you're speaking to Spok on here, no literary devices allowed! I think the main point is, yes we could do all of these things but why should we have to after the amount of our lives we commit to this profession? Our very nature betrays us at times. We are so stoic by the end of it all that any extra burden is taken without question. Until we decide enough is enough, the world will just keep piling it on. No we don't have it nearly the worst but that doesn't mean our struggles don't matter at all-there is always someone who has it worse (his point with the allusion to starving kids in Africa). From what I've seen we are some of the most eager to endure whatever fate the public/administration decides. Just because others have greater struggles why should ours have any less value? At a certain point we have to begin to think of ourselves; we have to stop thinking of our happiness and our patients' are mutually exclusive. Seems the profession is split between those who are giving to a fault, and those that are incredibly ego-centric. While I will choose the former any day, neither is healthy when too extreme.

 

[futuremdforme]

People always say that you don't factor in a family, but how expensive is a kid really? Say I wanted to have a kid during residency, is it really going to hurt my pockets that much? I feel like all they need is diapers and food. That can't be more than $1500/year, right? I guess if you have to pay someone to watch your kids though, that's where the financial burden can come in to play, but anyone know how much that is? And is my logic correct in that if you were to have family watch your kid(s) or somehow got a cheap baby sitter, then they really aren't that expensive until they get significantly older?

Car seat, crib, diaper table, clothes... and how are you going to get a cheap babysitter if you don't have family around?

I'm not saying don't have kids but you probably don't want to get the discount babysitter...

 

[Stagg737]

People always say that you don't factor in a family, but how expensive is a kid really? Say I wanted to have a kid during residency, is it really going to hurt my pockets that much? I feel like all they need is diapers and food. That can't be more than $1500/year, right? I guess if you have to pay someone to watch your kids though, that's where the financial burden can come in to play, but anyone know how much that is? And is my logic correct in that if you were to have family watch your kid(s) or somehow got a cheap baby sitter, then they really aren't that expensive until they get significantly older?

$1,500??? That's not even close. There's food, diapers, clothing, crib, blankets, stroller, car seat (can't legally leave the hospital without one), medical care, babysitter/nanny, toys, etc. Here's an article that gives a more in-depth look. Says the average family spends $12k on a child during their first year alone:http://www.parenting.com/article/the-cost-of-raising-a-baby

 

[Brahnold Bloodaxe]

You have to act like you're speaking to Spok on here, no literary devices allowed!

Yeah, I've noticed this about a subset of the posters on SDN. They're so uptight, I'm surprised they can even pass stool.

 

[osprey099]

I was poking fun at your idea that living with your parents until your early to mid thirties is a reasonable action for med students to take to pay off debt. Not sure how much clearer I could have made it. I thought the kidney selling and allusion to starving Africans would have made the sarcasm obvious enough.

I was just suggesting an option. And IRRC, I did mention that it's not for everyone. If you graduate medical school at the age of 25, there's no shame in living with you parents for the latter half of your 20s especially if you aren't yet in a serious relationship or have a family of your own yet IMO.


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[sweetlenovo88]

Debt free in one year. 350k paid off, it can be done