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Making a decision

Discussion in 'Pre-Medical Osteopathic [ DO ]' started by yogaGirl323, 09.25.14.

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  1. yogaGirl323

    yogaGirl323

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    Hey guys, so I was talking to some of my future DO friends and I realized that making the decision of where I'm going to end up is going to be the toughest decision I've ever had to make! I have 2 acceptances so far (KCUMB & SOMA) and will be waiting on 3 more responses (AZCOM, LMU & TUCOM-CA). I feel very blessed to have options but also don't want to make the wrong decision! I will be moving with my family so the area/school system and culture of the city are already important to me, but I feel like all my potential options already have that covered. I didn't come into this process with a "first choice"
    school or my schools ranked, I was just planning on going where the wind blows. I guess I wanted to hear from y'all- what are the most important factors to you in choosing a school?
     
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  3. IslandStyle808

    IslandStyle808 Akuma residency or bust! 2+ Year Member

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    My personal reasons
    1) Best fit - How are the senior students on the tour? How are the faculty? How is the curriculum and activities? How is area, city, rural?
    2) Cost $$ - How cheap is tuition and cost of living?
    3) Rotations - How many connections do they have with hospitals and clinics? Does the school help with core rotations in far off places? How many students per attending? How are grades distributed?
    4) Board prep - How is board prep done? How much independent time is given? Is there flexibility for extra study time?
    5) Reputation and matching - How is matching for the school? Do they match frequently in far parts of the country? How well known is the school by program directors?

    There are definitely others. I think reasons one and two are by far the most important, because the others can change by the coming years. The main thing is that you feel comfortable and you see yourself that way for the next four years, at the school you choose.

    Good luck and congrats!
     
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  4. Bill Brasky

    Bill Brasky M3 who still sticks around pre-DO for some reason 2+ Year Member

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    I would put rotations up there as one of the top factors. Some DO schools don't have a lot of quality control when it comes to their core rotations, and some will send you all over the place, spending hundreds extra on gas. I also don't think you should worry too much about match lists at DO schools. There are a lot of dynamics at play due to the two different matches, so it's hard to say what is and isn't a good match just from looking at a list and ticking off names you recognize.

    The most fundamentally important thing is where you think you're going to be the happiest for four years, because happy campers do well in medical school.
     
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  5. SynapticDoctah

    SynapticDoctah 2+ Year Member

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    It depends on YOU. Going to LMU is going to be INCREDIBLY different than any of the others because it is just so rural. However, I see you're from Tennessee so that may have a role in your choice as well.

    Going to TUCOM-CA is going to be really expensive. Not only is TUCOM admission pricey, the cost of living in San Francisco area is going to be crazy. However, TUCOM would be a good choice if you want a residency in California. TUCOM and Western both have good connections with California programs.

    AZCOM and SOMA are both great schools. For cost, I would chose SOMA (just my opinion). Arizona is gonna be pretty cheap to live as well, but gets REALLY hot.

    KCUMB is a great school. I interviewed there last Monday and am hoping for my acceptance soon. It is one of my top choices. It is also closer for you than Cali and Arizona obviously. The area that KCUMB is in isn't the greatest, but as long as you aren't walking around in the hood at night, you should be good. Just be smart. Also, KC also offers you both the city and rural life. You are nice and close to downtown KC, but there are a lot of nice rural areas as well.

    Overall, it comes down to where you feel you fit in and can do your best work. Good luck!
     
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  6. Awesome Sauceome

    Awesome Sauceome SDN Gold Donor Gold Donor 2+ Year Member

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    This basically how I felt too but I would maybe put boards and rotations together in 2nd place. Cost, while still being important was not as important as rotations and board prep personally. Cost was not as much of a factor though only to a certain point... which is why I did not even bother to apply to MSU or CCOM. I just simply am not willing to pay that much, no matter how "good" the education is. So its a balance...

    I would argue happiness/general living would be up there too... maybe around 4th or 5th place.
     
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  7. Stagg737

    Stagg737 2+ Year Member

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    Islandstyle FTW. If you pick a school where the curriculum, atmosphere, and city/location fit you best you'll be happy (so long as med school is actually right for you!). Cost might not seem big, but in the long run it can be huge. Going somewhere that costs 10k more per year can end up costing you 100k or more total after you figure in interest. Rotations are meh IMO. If you really want to go to a residency you'll do an audition rotation there, so match rates and locations seem more important in my mind. Besides, if you do well enough on boards you shouldn't have a problem matching somewhere you'll want to be. So pick a school that you will be happy at and where you think you'll be able to learn the most and everything else should fall into place with hard work.

    I am a MS1 at KCUMB, so I might be biased but I absolutely love it. Some days are miserable, but that will be true wherever you go. If it's not then you're probably not at the right school. I know I couldn't be happier with my choice. If you've got any questions about the school or why I chose here feel free to PM me.
     
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  8. AlbinoHawk DO

    AlbinoHawk DO Student Osteopath 2+ Year Member

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    I would take KCUMB over any of the options you listed. Much more established.
     
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  9. JimmyB123

    JimmyB123

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    Even over AZCOM and TUCOM-CA? If OP gets in
     
  10. AlbinoHawk DO

    AlbinoHawk DO Student Osteopath 2+ Year Member

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    Yes.
     
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  11. Stagg737

    Stagg737 2+ Year Member

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    Yes, I agree with albino hawk. If you're going to take tier into account I'd put KCUMB, DMU, TCOM, KCOM, and CCOM on top along with maybe one or two others. If you want to go purely off curriculum/board scores, I'd take KCUMB or TCOM for systems based or DMU for traditional. Obviously if you have a family you have other things to consider, but in terms of your career go where you will set yourself up for the best board score as that is going to be the primary factor that will determine how competitive you are as a residency applicant.
     
  12. yogaGirl323

    yogaGirl323

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    Thank you for all your input! I guess I can narrow it down to TUCOM CA, AZCOM and KCUMB. I've always wanted to live in Northern California which was my biggest motivator for applying to TUCOM CA. So far, I've liked KCUMB the most (including campus, interview day etc.) The only thing that would deter me from going to KCUMB is that Kansas City is really similar to Nashville and I was really hoping for a whole new experience such as living in the desert or mountains or something. But listening to myself think, seems like a stupid reason to not attend a school. I'm interviewing at TUCOM CA on Tuesday and I will see how I like it and how it compares to KCUMB. I'm hoping to have a decision made within a week of receiving all my final decisions to be courteous to those waiting for responses and to start planning the big move. Exciting but scary!
     
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  13. MaduNotSoff

    MaduNotSoff 2+ Year Member

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    The school's gym is the deciding factor for me. No lift, no attend.

    In all seriousness though, I would look at the quality of clinical sites, curriculum style that fits you (systems based vs. PBL for example), board scores, general vibe from students, and recent residency matches more so than the surrounding area. I agree with the other comments about going to the place that will put you in the best position to land a solid residency spot. I was impressed by KCUMB in these regards when I interviewed there earlier this month, and the gym was also on point :D
     
  14. AlteredScale

    AlteredScale Staff Member SDN Moderator 2+ Year Member

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    I knew those 100 pound dumbbells I saw on the student tour would be used by somebody! ;)
     
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  15. yogaGirl323

    yogaGirl323

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    How much more unmanageable (financially) would my life be in the future if I did choose to go somewhere like AZCOM? I've noticed it is significantly more than any of my other choices, but I guess I don't really know what that looks like for the future. My thinking is "well, whats an extra 60K in debt when I'm already at least 250K in debt". I guess I don't have a realistic grasp as to why I should have cost be the second most important thing to consider. I'm already >30K in debt and I know it's just going to keep piling on, so I guess I want to choose to ignore it until I can actually do something about it haha but that's not always the best way to handle something,
     
  16. Awesome Sauceome

    Awesome Sauceome SDN Gold Donor Gold Donor 2+ Year Member

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    For me... I know that that amount of money would be a deciding factor in what specialty I would end up in... I feel that I would be doing myself an injustice by putting myself in that position. So for instance if I got into MSU or CCOM and was tempted to go there over KCUMB, I know without a doubt that it would change my future.

    With KCUMB I truly do feel the opportunity to go down any route... Tuition + living expenses is roughly 60K a year at KCUMB. vs 75-80K at CCOM. So thats a 60K different BEFORE interest even comes into play. Right now I feel completely open to the idea of becoming a rural family physician or really any specialty for that matter. I know that 240K will be hard as a primary care doc, but 300+K would make me feel like I am drowning. So naturally I would gun for a better paying specialty if I went to CCOM. Which at first glance seems all well and dandy, but if I am letting money decide my future, then I am not doing what I am genuinely being called to do with my life.

    Having said that, I am sure plenty of people from the more expensive schools end up in primary care and do just fine... I just know personally that that difference in money would be a part of my decision on what field I would spend my life in.
     
  17. Stagg737

    Stagg737 2+ Year Member

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    An extra 60k can end up being an extra 120k depending on how you repay your loans. Someone posted this in another thread, but I'll leave it here:

    I'm not sure how to calculate it correctly, but my understanding is that med school loans start accruing interest from the first semester. So by the time you graduate, you're looking at considerably more than the actual COA x 4. Is this correct?

    Let's take the average tuition of attending a public medical school = $49,298
    Add in fees + books + supplies + living expenses + transportation + licensure fees = $20,000 (rough estimate).
    Total cost = $70,000/year * 4years = $280,000 borrowed.

    Then lets say you choose the Forbearance option on the loan, meaning you do not have to pay into the loan during your residency since you will only be making around $45,000/year and can't afford to pay into it. If you're doing a 3-year IM residency, that's another 3 years of interest accrued. Using the current interest rate, which is fixed at 6.8%, and using the federal StudentAid website interest calculator, total interest accrued over the 7 years will be approximately $133,280.

    Total debt after residency = $413,280

    Now you're an Attending and can make payments on your loan. However, keep in mind, the loan will still accrue interest even as you pay into it. Let's say you chose the 15-year payment option. That means you must make 180 monthly payments for the next 15 years. With interest accumulating concurrently as you pay off the loan, you must pay the minimum $3,670 every month for next 15 years, and will have accrued a total of $246,890 as you did so.

    Over the 15 year period, total repayment would have been = $660,200. That's $44,000 a year for 15 years spent on just paying back your loan!


    Considering the fact that this is the shortest residency possible, and the fact that interest rates are actually higher than 6.8 percent after 40k/year (grad plus loans have an 8.6% interest rate) the amount you end up paying back is actually larger. If you do the math, then 10k less per year (240k total borrowed) would lead to 565k being borrowed in the long run. So that 40,000 dollars extra ends up being an extra 95k you end up repaying (by his math, even more in reality). That 95k means you'll either be in debt a few years longer or have to live more prudently, and who wants to do that after an extra 4 years of school and 3-7 years of residency?
     
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  18. AlteredScale

    AlteredScale Staff Member SDN Moderator 2+ Year Member

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    Wow you really got this down!
     
  19. yogaGirl323

    yogaGirl323

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    Woah.
     
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  20. nontrad78

    nontrad78 2+ Year Member

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    Though the numbers are staggering, you can still make payments during residency. Especially if you do income based repayment. This is based on your salary from previous year, so I believe that means your first year out, payments are based on $0 annual income. Combine this with public service, or other loan forgiveness programs, and you can significantly reduce the debt burden.
     
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  21. evooo8

    evooo8

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    TUCOM-CA because it is in California!
     
  22. Stagg737

    Stagg737 2+ Year Member

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    If you can begin repayment in residency, do it. Especially if you have a significant other with an income. Income based repayment is better than forbearance, but it's not going to make much of a dent. For most you end up paying around $100ish/month, which basically just helps prevent ridiculous accrual of interest. There are some public service/forgiveness programs that can help a lot. However, the financial advisor here said not to rely on some of the forgiveness programs being around much longer, as too many people are being forgiven of hundreds of thousands of government dollars...

    You should be making plenty as a physician to pay 44k/year and still live decently, so paying off debt isn't a huge deal. It's just a matter of how long you want to be in debt/have to live more prudently...
     
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  23. Stagg737

    Stagg737 2+ Year Member

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    I should add I wasn't trying to scare anyone. It's a lot of money to pay, but you'll be making a lot once you finish residency, so try not to stress too much. Most of the doctors that are still in debt at 55 or 60 either didn't start med school until they were 40 or went somewhere that costs 60k+/year in tuition and then spend money as a physician like they just won the lottery after they graduate. If you really want to go somewhere that costs 60k/year because you'll be happiest there and will learn the most, then do it. If you love 2 schools and would be happy/successful at both, that's when you should seriously start looking into the costs.
     
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  24. yankees527

    yankees527 2+ Year Member

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    Question for you guy do you think going to a lecom is better than a 50k school with much better resources and everything? Im trying to decide between lecom-b and wvsom/unecom(if i get in to unecom) but im trying to justify the extra money spent which would probably be like 120k extra after 4 years
     
  25. Awesome Sauceome

    Awesome Sauceome SDN Gold Donor Gold Donor 2+ Year Member

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    That is the magical decision isnt it haha...

    The official answer is that "there is no difference in these two medical educations." As in, people go into both schools as noobs and come out as competent physicians. However, there are definitely other factors that come in to play that caused me to not apply to either LECOM OR any school that was ridiculously priced (except UNE).

    What it really comes down to:
    General happiness/feel of the school
    Possible specialties that you are interested in (maybe pick 2-3 that would be your major possibilities)
    How close any of these schools are to where you would eventually want to practice. You can technically go to residency anywhere from either of these choices, but its just that some schools will make it easier/cheaper to do audition rotations and such because of proximity.

    Personally I would not do LECOM, but that is simply because of my own bias/judgement towards their administration, general direction/mission, teaching style, lack of support for clinical years, and rumors about the school. But others have gone to the school and have ended up no worse for it.
     
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  26. AlteredScale

    AlteredScale Staff Member SDN Moderator 2+ Year Member

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    My close colleague and friend there is a current MSIII there. Here's his breakdown of LECOM-B:

    Pros:
    Very cheap
    Independency
    New(er)
    Can do core rotations "back home"

    Cons:
    Controlling administration (assigned seating)
    Somewhat weak rotations
    PBL (basically self study followed with team study)

    Best you can do is compare and contrast board scores and match lists. If the 50K school is matching their grads in competive programs more frequently then consider that.
     
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  27. nontrad78

    nontrad78 2+ Year Member

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    Appreciate your thoughts and specifics. The info on loan forgiveness is important as well. I agree that in the end, your debt should be very manageable. If you've ever worked a full time job, you've probably been on a budget much tighter than you'd ever be once you've completed residency.
     
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  28. Awesome Sauceome

    Awesome Sauceome SDN Gold Donor Gold Donor 2+ Year Member

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    Yea particularly with the rotations... everything I have heard is that they do not pay their clerkship docs which seems kind of crazy to me... If you dont pay them, how can you expect to A) keep the rotations when another med school decides to buy up those spots (heard this is an issue in the PA campus?) and B) teach to the quality that they are expected to teach... I mean docs are busy, how can a school expect for them to essentially do extra work for free...
     
  29. yankees527

    yankees527 2+ Year Member

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    such a hard decision
     
  30. AlteredScale

    AlteredScale Staff Member SDN Moderator 2+ Year Member

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    It really is, but as awesome sauceome said, medical school is medical school either way.

    Good luck with your choice!
     
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