Loan Q's: Forgiveness, refi?

[amakhosidlo]

Before I ask my questions, let my preface by saying that I'm only a pre-med, and hope I'm not out of place asking a few questions here. I just need opinions from individuals that have already traveled down the path that I hope to embark on.

After shadowing an FP for the past few months, and interning in clinics for an additional 3, I've become fairly certain that primary care is where I'd like to wind up when everything's said and done. I'm still rather concerned with the logistics of the endeavor however, and have a few questions to pose to anyone willing to answer.

My first set is regarding student loans.

1. I've seen $200k thrown around as an ballpark estimate of the debt load one incurs during their time in med. school. Is this a fairly acurate median approximation? If you started to chip away at your debt during residency, how far did you get after your three years?

2. What's a typical monthly payment on a student loan, or what do you pay? Does paying off the equivalent of a small mortgage affect your quality of life at all?

3. Follow-up loan question: Is refinancing an option? I'd imagine that established physicians qualify for much better rates than debt-laden students. If so, what types of rates do established physicians with strong credit usual recieve on their refi?

4. As far as options for reducing your debt load go, I know there are quite a few options available but am unsure exactly how they work. Take state-sponsored loan forgiveness: Are these contractually binding agreements? What sort of obligation do they entail? Are you assigned a clinic, or a regional area to practice in?

5. I've seen a number of listings that include malpractice as a benefit alongside health insurance & 401k. Is this fairly common? I know rates vary with geographic location, but is there a ballpark percentage of income I might expect to pay for coverage? What factors other than location affect your rate? Experience? Age?

6. Finally, taking into account the 'hazards' of managed care/quotas, reduced reimbursement from medicare/aid & the salary discrepancy between FM/Peds/psych and other fields, is it still worth it? (Is your job satisfaction high enough to negate or partially negate these concerns?)

Thanks in advance for your responses to any of these questions, in addition to any advice you might have.

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[deleted87716]

I've seen $200k thrown around as an ballpark estimate of the debt load one incurs during their time in med. school. Is this a fairly acurate median approximation?

The median indebtedness of family medicine residents in 2005 was $163,000 (source: http://www.aafp.org/online/en/home/aboutus/specialty/facts/26.html ).

What's a typical monthly payment on a student loan, or what do you pay?

You can estimate monthly payments here: http://www.finaid.org/calculators/loanpayments.phtml

Does paying off the equivalent of a small mortgage affect your quality of life at all?

It hasn't in my case.

Is refinancing an option?

Yes. This is known as "consolidation." Rates vary. It helps to shop around. It's not always advantageous.

As far as options for reducing your debt load go, I know there are quite a few options available but am unsure exactly how they work.

More info here: http://www.finaid.org/otheraid/medical.phtml

I've seen a number of listings that include malpractice as a benefit alongside health insurance & 401k. Is this fairly common?

Yes, although it doesn't really matter as long as you're aware of the value of each item in your total compensation package. If you don't know, ask your employer.

I know rates vary with geographic location, but is there a ballpark percentage of income I might expect to pay for coverage? What factors other than location affect your rate? Experience? Age?

All of the above. Malpractice rates are too highly variable to estimate, which is why you won't find any good figures on the Web. I could tell you what I pay, but then I'd have to kill you.

Finally, taking into account the 'hazards' of managed care/quotas, reduced reimbursement from medicare/aid & the salary discrepancy between FM/Peds/psych and other fields, is it still worth it?

It is for me. If I wanted to do something different, I'd do it.

 

[deleted77919]

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[deleted87716]

Making payments as a resident is going to be hard if you have significant debt.

Practically everyone defers during residency.