So...I will have 0 debt entering med school next year since I went to school in state. Say med school costs 40,000 a year just for tuition. Tag on another 15,000 for room and board, 5000 for other expenses..and at a minimum I'll be spending 60,000 a year..probably more. That equates to 240,000 debt upon graduating.
Taking account of the fact that interns and residents make piss poor salaries....I figure I won't be making 6 figure until I'm 30 and done with residency.
Why do people always assume docs easily pay off 400k + in debt quickly when they don't make money until their 30? Am I missing something here!?
Yes, medical school can be an expensive proposition for many people, even those with no debt entering. I, too, had no debt entering medical school and was able to obtain a full-ride scholarship upon entry based on my prior grades and MCAT scores. While this was great, it's not going to happen to everyone. Thus, debt-load should be a consideration in terms of where you attend school.
The other thing to think about is that you have to be in an environment where you can excel in your medical studies. Getting into medical school is a battle but you have to be able to perform well in medical school or your choices for post-graduate training will be limited. Add this to having a high debt load and you can find yourself in a situation where you might not want to be. That is, paying off a huge amount of money on a salary over which you have little control based on your specialty selection. Not everyone who attends medical school is going to be even remotely competitive for a high-paying specialty.
In today's world, reimbursements to physicians are being eroded by political actions. There is also the case where you may find yourself working as a salaried individual meaning that you may not be in that six-figure salary by the time you are done with residency. Many physicians will be employees of institutions and not on a pay-per-procedure basis. This can greatly decrease what you will actually take home and apply to those six-figure loans that you have taken out.
In today's world, medicine is a gamble for those just entering. Things are changing on a yearly basis in terms of how you will actually be compensated. You need only look at the folks who trained in the 1980's and 1990's who thought that they would be making huge salaries and able to perform in the same manner as those that preceded them. Enter managed care in the form of HMOs, PPO, etc and the amount of money to be made in medicine changed. Those of us who trained with managed care are not in as much "sticker-shock" as the guys who preceded us. Those who follow us are in for a huge change in addition to the fact that you will carry far more debt than those who went before you and may be dealing with an entirely different system of reimbursement.
Finally, cost definitely needs to be part of your considerations but you also need to be educated on how you are going to be managing your debt and your educational needs. The folks who have wealthy parents or personal wealth will have a definite advantage over those who are attempting to borrow money to pay for their entire educational experience (including residency because that small compensation is not salary per se). Residency is still education and the best that you can hope for is to keep up with the interest on your huge loans or that you enter some kind of practice situation that will help reduce your debt load.
Yes, tuition has to be a consideration based more on your ability to pay on the other side of your educational process. The more money you save and have, the better shape you will find yourself in. If you are paying a huge tuition bill 20 years from now, are you really going to care much about the medical school (only 4 years) that you attended? Am I predicting doom and gloom? No, I am just saying be aware and be prepared for something (debt-load) that many students only give cursory thought to in the application process.
