Is Medical School Debt Really Manageable?

Started by WhiteCoatSyndrome
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WhiteCoatSyndrome

WhiteCoatSyndrome

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I've read quite a few threads on here concerning med school debt and have come away with mixed messages. I know that in med school (assuming I get in), I will rely almost exclusively on financial aid (mostly loans unless I'm lucky enough to earn a scholarship/grant) to pay for the total COA. I know that many if not most students are in a similar situation as mine in which they are left to pay for everything more or less on their own, so in the real world, is graduating with principle debt of >200K really manageable? I would have to think so as many people find themselves in this situation, I mean, how many 1%er's decide to go to medical school?🙄
 
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Is it manageable now? For most it is. Will it be manageable 5 years from now? For most it won't. If you are planning on taking out >$250k and don't have an alternative source of income (spouse, small business, trust fund, etc) I would not even consider med school.
 
DrRobert said:
Is it manageable now? For most it is. Will it be manageable 5 years from now? For most it won't. If you are planning on taking out >$250k and don't have an alternative source of income (spouse, small business, trust fund, etc) I would not even consider med school.
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This is pretty inaccurate. There's nothing to suggest that suddenly in 5 years the majority of medical students will find themselves incapable of managing school loans.
 
I'm actually surprised that med school tuition isn't higher. The demand is certainly there...it's not like people are going to stop going to med school if it was $75k or $100k a year. If Boomers were smart they would push for more tuition hikes to be paid over a long period of time so it would essentially be a small tax for 20 or 30 years that would pay for their healthcare and entertainment fees.
 
Sesom said:
This is actually an ignorant thing to say...
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Not really. It's ignorant to think that governmental policies will have no impact on the practical aspects of being a physician (ie, compensation). At best you can say "the future is uncertain." I do think (and hope desperately) that Doc Robert is exaggerating the difference it'll make, but it's not an uncommon philosophy for many attendings to have. I can't even begin to tell you how many preceptors I've had tell me I should quit because even after residency I'll be hard pressed to make more than 40k/yr.

In response to OP, a lot depends on what you consider to be manageable. If you're fine with living comfortably in a decent suburban home and a midsized sedan, chances are you'll be fine. I know a lot of my classmates that think that after working as hard as they did in med school and putting up with the BS it entails, anything less than a mansion and multiple luxury vehicles is unacceptable. I think if you're one of those people expecting to live lavishly you're asking for trouble. I'm not saying you'll never find yourself in a good situation financially, but the more comfortable you can be with the idea of living modestly, the easier it is to live with the burden of debt in an industry facing potentially major changes.
 
ensuii said:
Not really. It's ignorant to think that governmental policies will have no impact on the practical aspects of being a physician (ie, compensation). At best you can say "the future is uncertain." I do think (and hope desperately) that Doc Robert is exaggerating the difference it'll make, but it's not an uncommon philosophy for many attendings to have. I can't even begin to tell you how many preceptors I've had tell me I should quit because even after residency I'll be hard pressed to make more than 40k/yr.

In response to OP, a lot depends on what you consider to be manageable. If you're fine with living comfortably in a decent suburban home and a midsized sedan, chances are you'll be fine. I know a lot of my classmates that think that after working as hard as they did in med school and putting up with the BS it entails, anything less than a mansion and multiple luxury vehicles is unacceptable. I think if you're one of those people expecting to live lavishly you're asking for trouble. I'm not saying you'll never find yourself in a good situation financially, but the more comfortable you can be with the idea of living modestly, the easier it is to live with the burden of debt in an industry facing potentially major changes.
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I'm not sure if you would ever be hard pressed to make 40k/yr, but if you do work out the math after taxes and paying loan debt, for the first few years your making slightly under 70k assuming a salary of ~150k (in family practice). But that excludes doing any of those government programs that help those in family practice repay debt. You will be able to repay that debt, and for everyone that does not think they will ever be able to repay the debt, join the military they will pay it for you.
 
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It's manageable in the sense of the payments are adjusted for your level of income. There's also a program that you should look into if you're concerned over the level of debt. It's called Public Service Loan Forgiveness and you can have your debts absolved after 10 years if you work in a public or a non-profit hospital. After you're a free man, you could go into private practice and buy a small country...
 
Man, is it too much to ask just to see 10 years into the future for a few minutes to find out how much physicians will be making? It would really make my decision to apply to medical school much easier. TYIA.

Also, Praefectus, I like your tar.
 
TheWeeIceMan said:
Man, is it too much to ask just to see 10 years into the future for a few minutes to find out how much physicians will be making? It would really make my decision to apply to medical school much easier. TYIA.

Also, Praefectus, I like your tar.
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There aren't a lot of fields out there where there's enough security to say with absolute certainty what you'll earn precisely (this is especially so in fields with higher income potential). Regardless of the upcoming changes in healthcare, it's more than likely you will be in the top 10-15% of income earners. Even with student loans, you should be living fairly comfortably depending on the lifestyle you chose to live. If you're trying to decide on whether or not to apply to medical school, I think your considerations should be based less on pay and more on whether or not you could be happy with the nature of the work and length of training.
 
DrRobert said:
So says the "pre-med" to the attending physician. I knew there was a reason I don't waste my time in this forum. All the "pre-meds" already know it all. Medicine is going to be great! Yay!
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I wouldn't put too much stock into what Dr. Robert says. By looking at his posts it's apparent he only cares about becoming wealthy. MANY of his posts are concerned with making $. If you love medicine, you can make it happen. Money does not buy happiness, as you can probably tell from his pessimistic attitude!
 
byuhusker said:
I wouldn't put too much stock into what Dr. Robert says. By looking at his posts it's apparent he only cares about becoming wealthy. MANY of his posts are concerned with making $. If you love medicine, you can make it happen. Money does not buy happiness, as you can probably tell from his pessimistic attitude!
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Um, he's an attending
 
Brachyury said:
Um, he's an attending
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I don't care who he is, his opinion is one person, one who is highly concerned with finances. I'm not saying he is wrong, just saying he cares a lot about money. And many people don't care as much about being "rich" as they do having a job they enjoy.
 
Brachyury said:
Um, he's an attending
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he is an attending....who trolls SDN premedical forums....yikes.
God help me the day I am sitting alone at the computer, after just feeding my 10 cats, and bad mouthing 20+yr old premeds on the internet with the little free time I have as an attending.

I'm not weighing in on this argument, i'm just saying, the day you learn to take an individual's opinions with a whole tube of Morton's salt, the day your life will be better.
 
I've had several attendings tell me that I should not have taken the HPSP scholarship money, that they were able to pay off ~300K of debt in under four years by living frugally and making the repayment of debt a priority.
 
byuhusker said:
I don't care who he is, his opinion is one person, one who is highly concerned with finances. I'm not saying he is wrong, just saying he cares a lot about money. And many people don't care as much about being "rich" as they do having a job they enjoy.
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notreallysure said:
he is an attending....who trolls SDN premedical forums....yikes.
God help me the day I am sitting alone at the computer, after just feeding my 10 cats, and bad mouthing 20+yr old premeds on the internet with the little free time I have as an attending.

I'm not weighing in on this argument, i'm just saying, the day you learn to take an individual's opinions with a whole tube of Morton's salt, the day your life will be better.
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...wow...although it seems like you guys aren't particularly receptive to getting advice from those who've gone through what you're about to go through, let me offer you this:

Medical training is a lengthy process and after your pre-clinical years, much of your training comes from being "on the job." Other med students, residents, and attendings will be the ones responsible for looking over your shoulder when you do your first intubation, form a differential, write a complete H&P, etc. For this reason alone, I feel like Doc Robert deserves most respect than what you've shown him.

Even if you don't agree with what he's saying, there's a way to voice your disagreement without biting the hand that feeds you and being as derisive as you two were above.

I've been lurking on these boards for a long while and I've certainly gained a lot from reading the comments of those that went down this road before me. SDN needs its attendings (especially in pre-allo?) and I hope Doc Robert wasn't driven off by you two.
 
ensuii said:
...wow...although it seems like you guys aren't particularly receptive to getting advice from those who've gone through what you're about to go through, let me offer you this:

Medical training is a lengthy process and after your pre-clinical years, much of your training comes from being "on the job." Other med students, residents, and attendings will be the ones responsible for looking over your shoulder when you do your first intubation, form a differential, write a complete H&P, etc. For this reason alone, I feel like Doc Robert deserves most respect than what you've shown him.

Even if you don't agree with what he's saying, there's a way to voice your disagreement without biting the hand that feeds you and being as derisive as you two were above.

I've been lurking on these boards for a long while and I've certainly gained a lot from reading the comments of those that went down this road before me. SDN needs its attendings (especially in pre-allo?) and I hope Doc Robert wasn't driven off by you two.
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I completely agree. 👍
Attendings are an asset to SDN pre-med, and it's necessary and refreshing to have someone post that's "been there" or at least has more insight than the typical premed.
 
Valvool said:
I've had several attendings tell me that I should not have taken the HPSP scholarship money, that they were able to pay off ~300K of debt in under four years by living frugally and making the repayment of debt a priority.
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Those attendings are wise. I always find it odd that on SDN people think that if you have a one time debt of $250K and a continuous income stream of $150K a year they conclude "ZOMG ZOMG ZOMG This student loan debt is insurmountable!!!1!!" whereas in the real world a family with $75K income can easily afford a $250K mortgage and stay well within affordability guidelines.
 
MT Headed said:
Those attendings are wise. I always find it odd that on SDN people think that if you have a one time debt of $250K and a continuous income stream of $150K a year they conclude "ZOMG ZOMG ZOMG This student loan debt is insurmountable!!!1!!" whereas in the real world a family with $75K income can easily afford a $250K mortgage and stay well within affordability guidelines.
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It is equivalent to the pre-meds who say "I would work for $40k a year if I could graduate with no debt!!1" when the standard of living with an income in the six figures and student loan debt of $200K+ would be a much better lifestyle than the $40K income but no debt that some pre-meds think is all the money in the world.
 
MT Headed said:
Those attendings are wise. I always find it odd that on SDN people think that if you have a one time debt of $250K and a continuous income stream of $150K a year they conclude "ZOMG ZOMG ZOMG This student loan debt is insurmountable!!!1!!" whereas in the real world a family with $75K income can easily afford a $250K mortgage and stay well within affordability guidelines.
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This
 
DrRobert said:
Is it manageable now? For most it is. Will it be manageable 5 years from now? For most it won't. If you are planning on taking out >$250k and don't have an alternative source of income (spouse, small business, trust fund, etc) I would not even consider med school.
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Posts like this make me question the validity of a given poster's association with the medical profession.
 
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ensuii said:
...wow...although it seems like you guys aren't particularly receptive to getting advice from those who've gone through what you're about to go through, let me offer you this:

Medical training is a lengthy process and after your pre-clinical years, much of your training comes from being "on the job." Other med students, residents, and attendings will be the ones responsible for looking over your shoulder when you do your first intubation, form a differential, write a complete H&P, etc. For this reason alone, I feel like Doc Robert deserves most respect than what you've shown him.

Even if you don't agree with what he's saying, there's a way to voice your disagreement without biting the hand that feeds you and being as derisive as you two were above.

I've been lurking on these boards for a long while and I've certainly gained a lot from reading the comments of those that went down this road before me. SDN needs its attendings (especially in pre-allo?) and I hope Doc Robert wasn't driven off by you two.
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There's a big difference between offering helpful advice and posting unknowable and factually incorrect information and then acting like an arrogant prick when questioned.

A 250k (higher than the average med school loan amount taken out, BTW) principal will always be manageable on current physician salaries, and literally nobody knows the full extent of the effects of Obamacare yet assuming it even comes to full fruition which seems somewhat doubtful at this time.
 
BA11 said:
There's a big difference between offering helpful advice and posting unknowable and factually incorrect information and then acting like an arrogant prick when questioned.

A 250k (higher than the average med school loan amount taken out, BTW) principal will always be manageable on current physician salaries, and literally nobody knows the full extent of the effects of Obamacare yet assuming it even comes to full fruition which seems somewhat doubtful at this time.
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+1

Though I'd also like to point out that physician income will be going down significantly with or without Obama care.
 
flatearth22 said:
I'm actually surprised that med school tuition isn't higher. The demand is certainly there...it's not like people are going to stop going to med school if it was $75k or $100k a year. If Boomers were smart they would push for more tuition hikes to be paid over a long period of time so it would essentially be a small tax for 20 or 30 years that would pay for their healthcare and entertainment fees.
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Or they could be content with Social Security which is basically what you've outlined here.
 
WhiteCoatSyndrome said:
I've read quite a few threads on here concerning med school debt and have come away with mixed messages. I know that in med school (assuming I get in), I will rely almost exclusively on financial aid (mostly loans unless I'm lucky enough to earn a scholarship/grant) to pay for the total COA. I know that many if not most students are in a similar situation as mine in which they are left to pay for everything more or less on their own, so in the real world, is graduating with principle debt of >200K really manageable? I would have to think so as many people find themselves in this situation, I mean, how many 1%er's decide to go to medical school?🙄
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I dont know if I've told you this before, but Vai is my personal god and saviour.
 
AAMC website has a really nice loan calculator set-up https://services.aamc.org/30/first/home/organizer.

For 280k in unsubsidized Stafford loans taken out during the first year, a 3 year residency, and the lowest average salary (135k, peds. btw) using forbearance, and paid over 10 yrs, you will have monthly payments of $4,800.

I used this website to calculate out tax information http://www.yourmoneypage.com/withhold/il2.php

Assuming 135k annually gives you 91k after state and federal taxes (this is is Illinois with no allowances, so definitely a low ball estimate) which equates to $7580 per month.

Minus the cost of repaying loans leaves you with ~$2780 per month. Is $2780/month glamorous, not really, but it's still enough to live off of. Also, these numbers assume worst case scenario across the board; most likely annual pay will be higher and you wont be making your starting salary 5-10 years post residency. This is also assuming you want to pay off your loans straight away. There are several other options for repayment which will leave you with more take home pay, but a longer pay period and overall greater repayment.

So in answer to your question, yes it's reasonable to repay all of your loans. You might have to live within a tight budget for a few years, but you'll come out with a significantly above average salary (nationally) in one of the most stable career fields.

*I took a lot of liberties with these calculations, and a realistic loan plan would not look exactly like this. However, I think this still paints a somewhat realistic picture of the effect loan repayments will have on post graduation quality of life.
 
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TheWeeIceMan said:
Man, is it too much to ask just to see 10 years into the future for a few minutes to find out how much physicians will be making? It would really make my decision to apply to medical school much easier. TYIA.

Also, Praefectus, I like your tar.
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Thanks man, his shot from the pine on the 10th in the playoff was nasty. It was one of the best shots I've seen in my life.

Usually, salaries are higher for specialties than primary practice (ex. Cardiology vs. Pediatrics). However, don't let the numbers influence your choice; rotations during the 3rd and 4th year will expose you to a lot of fields and I'd recommend going with what feels right.
 
BenzylAcetate said:
AAMC website has a really nice loan calculator set-up https://services.aamc.org/30/first/home/organizer.

For 280k in unsubsidized Stafford loans taken out during the first year, a 3 year residency, and the lowest average salary (135k, peds. btw) using forbearance, and paid over 10 yrs, you will have monthly payments of $4,800.

I used this website to calculate out tax information http://www.yourmoneypage.com/withhold/il2.php

Assuming 135k annually gives you 91k after state and federal taxes (this is is Illinois with no withholding, so definitely a low ball estimate) which equates to $7580 per month.

Minus the cost of repaying loans leaves you with ~$2780 per month. Is $2780/month glamorous, not really, but it's still enough to live off of. Also, these numbers assume worst case scenario across the board; most likely annual pay will be higher and you wont be making your starting salary 5-10 years post residency. This is also assuming you want to pay off your loans straight away. There are several other options for repayment which will leave you with more take home pay, but a longer pay period and overall greater repayment.

So in answer to your question, yes it's reasonable to repay all of your loans. You might have to live within a tight budget for a few years, but you'll come out with a significantly above average salary (nationally) in one of the most stable career fields.

*I took a lot of liberties with these calculations, and a realistic loan plan would not look exactly like this. However, I think this still paints a somewhat realistic picture of the effect loan repayments will have on post graduation quality of life.
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Thanks for laying it out. V. helpful.
 
BenzylAcetate said:
AAMC website has a really nice loan calculator set-up https://services.aamc.org/30/first/home/organizer.

For 280k in unsubsidized Stafford loans taken out during the first year, a 3 year residency, and the lowest average salary (135k, peds. btw) using forbearance, and paid over 10 yrs, you will have monthly payments of $4,800.

I used this website to calculate out tax information http://www.yourmoneypage.com/withhold/il2.php

Assuming 135k annually gives you 91k after state and federal taxes (this is is Illinois with no withholding, so definitely a low ball estimate) which equates to $7580 per month.

Minus the cost of repaying loans leaves you with ~$2780 per month. Is $2780/month glamorous, not really, but it's still enough to live off of. Also, these numbers assume worst case scenario across the board; most likely annual pay will be higher and you wont be making your starting salary 5-10 years post residency. This is also assuming you want to pay off your loans straight away. There are several other options for repayment which will leave you with more take home pay, but a longer pay period and overall greater repayment.

So in answer to your question, yes it's reasonable to repay all of your loans. You might have to live within a tight budget for a few years, but you'll come out with a significantly above average salary (nationally) in one of the most stable career fields.

*I took a lot of liberties with these calculations, and a realistic loan plan would not look exactly like this. However, I think this still paints a somewhat realistic picture of the effect loan repayments will have on post graduation quality of life.
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Are you accounting for the interest that accrues and capitalizes while your in school and in residency? and just because the money isnt withheld doesnt mean you wont have to pay it. Borrowing 70k a year over 4 years leads to 398K in Principal balance by the end of a 5 year residecny/fellowship, and a .71 avg interest rate according to my excel sheet. Though the 4,800 number a month seems to be correct
 
poohbear12345 said:
Are you accounting for the interest that accrues and capitalizes while your in school and in residency? and just because the money isnt withheld doesnt mean you wont have to pay it. Borrowing 70k a year over 4 years leads to 398K in Principal balance by the end of a 5 year residecny/fellowship, and a .71 avg interest rate according to my excel sheet. Though the 4,800 number a month seems to be correct
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Yes, I believe the AAMC program accounts for interest accrued during school and residency. Meant allowances, not withholding; my mistake.
 
I've already accumulated over $100k in my undergraduate loans and own my own home and vehicle (read an additional $100k). Now consider my wife's debt, nearing $200k in her undergraduate and graduate loans combined, and the fact that she'll be making $30-50k a year when she graduates (hind-sight is always 20-20). We're part of a growing trend of an increasingly economically disadvantaged cohort of incoming med students. Needless to say, I'm looking at all of my options as I hope to enter med school this summer. It's very frightening regardless of the many positive and negative things mentioned above. Nevertheless, I felt the following two options needed a little elaboration for those of you leaning on them as potential solutions to your future indebtedness.

For those interested in the Public Service Loan Forgiveness programs, please keep in mind that most, though not all, only repay primary care, OBGYN, and psychiatry specialties. Those wishing to pursue subspecialties or surgical specialties still do not have nearly as many repayment options as the aforementioned specialties. Each state has its own rules and may have additional programs. I recommend you look at them all if you're worried about the debt. Also be advised that the positions are limited. You will have to apply and compete with other grads. I'd post a bunch of links for you, but don't have the time. Feel free to PM me if interested. I've done a ton of research and would be happy to help fellow indebted students.


For those looking into HPSP, please be aware that your health may preclude you from receiving the scholarship. I just found that out the other day. Something as simple as high blood pressure, your weight, or an inability to run a mile within a certain time limit for any reason can nix your eligibility. They Navy and Air Force seem to have more lax standards regarding health than the Army, though. Also pay attention to the fact that you're required to apply to the military residency match, ranking two specialties. If you fail to match both, then and only then can you apply to the NRMP (normal match). The military match is awesome in some respects (i.e., better chance for matching to competitive specialties since you're competing with far less grads), but lacks in other respects (e.g., limited specialties by branch, much more limited in potential hospitals).

Another facet not yet mentioned, is that many private and academic recruiters also offer loan repayment programs or sign-on bonuses as part of their wooing/advertising process, but wait to explain them during your interview. If any attendings are still lurking, they'd be much better suited to discuss that aspect.

I hope this helped someone.
 
Looked at his position, which is obvious, He only cares about getting rich. Many people worry about his position the dollar. If you love the drugs, you can do this. Costs less time to browse the Internet!
 
On a flight, I met and chatted with a husband-wife doctor-doctor couple with nearly $1 million in combined student loans. Their combined income was about $400K. I was frightened but they weren't really bothered.
 
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Chrome19 said:
On a flight, I met and chatted with a husband-wife doctor-doctor couple with nearly $1 million in combined student loans. Their combined income was about $400K. I was frightened but they weren't really bothered.
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Wow--I would imagine if they got $1 Million in loans--they must have really borrowed excessively while living up a glamorous lifestyle.

I have never seen a total CoA over 100k per year?
 
LaughingMan said:
Wow--I would imagine if they got $1 Million in loans--they must have really borrowed excessively while living up a glamorous lifestyle.

I have never seen a total CoA over 100k per year?
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It included loans from college, masters, and med school.
 
LaughingMan said:
Wow--I would imagine if they got $1 Million in loans--they must have really borrowed excessively while living up a glamorous lifestyle.

I have never seen a total CoA over 100k per year?
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They exist, University of Illinois SOM out of state tuition is an example. As long as the gov't is willing to provide the loans, and the students are willing to take them med schools can continue to raise the tuition.

Its kinda like the concept of a monopoly or oligopoly in economics. There are high barriers to entry and a greater demand then supply. The medical schools are price setters. The price can continue to go up, shrinking the consumer surplus and increasing the consumer surplus. When it becomes more profitable to provide education than to receive the education (think of certain college majors where a majority of the graduates go into teaching) then you know your in the bottom of a classic pyramid scheme. Dont think we are there yet.
 
Do not fear, Americans! Even in my socialistic hellhole of a country (Canada) no physician makes $40k a year unless they're working like 1 or 2 days a week. Same with other US-like but still evilly socialistic hellholes like the UK. True, physician compensation in the US is higher than in most of those countries, but you won't be making secretary-pay even if you did go all out and hit the single government payer road 😉
 
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