thisisvj89

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All other things equal, am I likely to encounter fewer interview invites and acceptances because I am 10 years older than the straight-through applicant? It's easy to come up with reasons why, but is it something to consider before applying straight MD/PhD for a cycle?
 
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The average age range for MD/PhD applicants is probably in the 24-27 range. Very few are applying at 22. I doubt anyone will care if you're in your 30s. If you were in your 40s they might start questioning your sanity.
 
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All other things equal, am I likely to encounter fewer interview invites and acceptances because I am 10 years older than the straight-through applicant? It's easy to come up with reasons why, but is it something to consider before applying straight MD/PhD for a cycle?
Yes, you are. But are you really not going to go for what you want because your hill to climb might be a bit steeper?

If you are going to go the combined program route, you definitely want to make sure that your credentials are on par with those of the trads, and ideally better than the average MD/PhD trad applicant. I'm talking about grades and MCAT score, but also your research bona fides. You will also want to apply broadly and consider other alternatives for backup, especially if you are not a rock star candidate. Some other options are five year research MD programs, or you could do MD-only and then take a research leave (with or without getting a graduate degree). You could also consider doing a research fellowship (and even completing a PhD) after residency. If a combined program doesn't work out, then focus on getting yourself a medical school acceptance, because it's much easier to go to grad school as an MD/DO than the other way around.
 
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Seriously?
Let's say you are 40 when you apply. You're 41 when you start, 49 when you finish. Now if you're taking the "standard" MDPhD path you are looking at 3 years residency and 3 years fellowship making you 55 when you have your first "real job". Now you have to convince institutions and funding agencies to put money into you as a researcher when you only have 10-15 years of productivity left in your career. Yeah if someone applied MD PhD at 40 I'd question their sanity.
 

thisisvj89

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Yes, you are. But are you really not going to go for what you want because your hill to climb might be a bit steeper?

If you are going to go the combined program route, you definitely want to make sure that your credentials are on par with those of the trads, and ideally better than the average MD/PhD trad applicant. I'm talking about grades and MCAT score, but also your research bona fides. You will also want to apply broadly and consider other alternatives for backup, especially if you are not a rock star candidate. Some other options are five year research MD programs, or you could do MD-only and then take a research leave (with or without getting a graduate degree). You could also consider doing a research fellowship (and even completing a PhD) after residency. If a combined program doesn't work out, then focus on getting yourself a medical school acceptance, because it's much easier to go to grad school as an MD/DO than the other way around.
Thanks for the reply. You have mentioned several options I had never considered. Medical school acceptance is likely not going to be an issue today for anyone who can pull off a reasonable MCAT score. Being accepted to one of the MSTP programs or a fully funded MD/PhD program is a very different story. Being nearly 30 and considering medical school by taking out total cost of attendance loans for four years however, should make any sane individual question whether or not medical school is a good financial fit. Yes, time is money and whether straight MD or long MD/PhD, it's time or money. I understand that fully. But I'm the type of person who much prefers to owe time, not money. The below analysis is a no frills realistic assessment of the two scenarios for myself. Perhaps there is a way to pay down the $427,929 debt during the four years an MD grad has to work while the MD/PhD grad is still in training. But I doubt that. Even if with the ridiculous number of hours it would take it were possible, the MD will still not have a PhD at 44.

Beginning MD school at 32:
Tuition: $55,000/yr
Living: $25,000/yr
TCA: $80,000/yr
MD degree: $320,000 (before interest)
MD degree: $360,795 (after 4 full years of compound interest)
MD degree: $472,929 (after 4 full additional years of compound interest during residency)
---> $427,929 debt at age 40

Beginning MD/PhD program at 32:
Tuition: $55,000/yr
Living: $25,000/yr
TCA: $80,000/yr
MSTP award: $80,000/yr
MD degree: $0
PhD degree: $0
---> $0 debt at age 44
 

thisisvj89

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Let's say you are 40 when you apply. You're 41 when you start, 49 when you finish. Now if you're taking the "standard" MDPhD path you are looking at 3 years residency and 3 years fellowship making you 55 when you have your first "real job". Now you have to convince institutions and funding agencies to put money into you as a researcher when you only have 10-15 years of productivity left in your career. Yeah if someone applied MD PhD at 40 I'd question their sanity.
All true. However, do institutions and funding agencies account for your age when questioning the scientific merit of your proposal? Would there not be legal implications for such behavior?
 
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Beginning MD school at 32:
$427,929 debt at age 40

Beginning MD/PhD program at 32:
$0 debt at age 44
4 years attending salary = $400k plus (and probably closer to $600k+ even in FM based on the offers I've seen the seniors consider) so it's at best a wash.

MSTP programs aren't aiming to graduate MD/PhDs without debt, they want to graduate PIs that will get R01s and have their own labs.
 

esob

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Let's say you are 40 when you apply. You're 41 when you start, 49 when you finish. Now if you're taking the "standard" MDPhD path you are looking at 3 years residency and 3 years fellowship making you 55 when you have your first "real job". Now you have to convince institutions and funding agencies to put money into you as a researcher when you only have 10-15 years of productivity left in your career. Yeah if someone applied MD PhD at 40 I'd question their sanity.
Most people who are 40 aren't getting their first "real job" after med school. The whole thing that makes non-trads attractive candidates is exactly the fact that most of us have had real jobs long before we start medical school. As far as getting someone to invest money into research, that's more about the idea than researcher's age. Otherwise, NIH would just cut off funding for 50-year-old physician-scientists regardless of what age they received their PhD. Additionally, lots of people are more productive in any given 5 years of their lives than others are for their entire careers.

OP, yes, there is bias, but I would say that is only because there are limited slots and most non-trads don't have the stats to compete (metrics-wise), often for a multitude of valid reasons (like working 50 hrs per week while their counterparts were supported by their parents and were instead able to put those hrs into research lab hrs).

It could be done, but the chances are not good, especially the older you get. At the end of the day, you don't need a Ph.D. to do research anyway. Bruce Beutler is a Nobel laureate in medicine and doesn't have a Ph.D. Aside from that, if you really want one just to have one, it is entirely possible to do so after medical school. I seem to remember one of the oncologists who worked on Gleevec did that.
 
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Zoro9

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Let's say you are 40 when you apply. You're 41 when you start, 49 when you finish. Now if you're taking the "standard" MDPhD path you are looking at 3 years residency and 3 years fellowship making you 55 when you have your first "real job". Now you have to convince institutions and funding agencies to put money into you as a researcher when you only have 10-15 years of productivity left in your career. Yeah if someone applied MD PhD at 40 I'd question their sanity.
Thanks, I was just curious about applying MD in general at this age.
 

thisisvj89

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You are grossly underestimating the difficulty of getting an acceptance. You need the scored and something else these days.
To me, reasonable >= 510 MCAT + GPA >= 3.5. Data translates this to > 50% chance of acceptance to at least one MD school.
https://www.aamc.org/download/321508/data/factstablea23.pdf

Score high on the MCAT (> 515) with other qualifying resume attributes and MD/PhD doors start to open (pg 2).
https://www.aamc.org/download/321548/data/factstableb10.pdf

That being said, I agree. You probably do need something beyond the measuring stick to get into either route today. That something should probably further accentuate and verify your qualifications. We all believe we have that something or we wouldn't bother wasting money on an application.
 

thisisvj89

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4 years attending salary = $400k plus (and probably closer to $600k+ even in FM based on the offers I've seen the seniors consider) so it's at best a wash.

MSTP programs aren't aiming to graduate MD/PhDs without debt, they want to graduate PIs that will get R01s and have their own labs.
Those offers would be much more meaningful to me if a reasonable estimate on hourly wage were available. I fully understand 'that's not how it works, you're responsible for people's lives, you will work long hours'. I also suspect such lucrative offers are not without substantially increased burnout rates due to the number of accompanying hours. Not every doc works 60+ hours/wk, that's a guarantee. Many simply choose to do so for one reason (debt) or another (early retirement, etc).

Ask yourself, how many hours would you work if your medical education did not come with debt? Perhaps you would choose to pursue something more in-line with why you decided to become a doctor, rather than a reason skewed by the need to reduce debt. Not everyone needs to make $200k/yr to be satisfied. Many, myself included, need far far less.
 
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thisisvj89

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Most people who are 40 aren't getting their first "real job" after med school. The whole thing that makes non-trads attractive candidates is exactly the fact that most of us have had real jobs long before we start medical school. As far as getting someone to invest money into research, that's more about the idea than researcher's age. Otherwise, NIH would just cut off funding for 50-year-old physician-scientists regardless of what age they received their PhD. Additionally, lots of people are more productive in any given 5 years of their lives than others are for their entire careers.

OP, yes, there is bias, but I would say that is only because there are limited slots and most non-trads don't have the stats to compete (metrics-wise), often for a multitude of valid reasons (like working 50 hrs per week while their counterparts were supported by their parents and were instead able to put those hrs into research lab hrs).

It could be done, but the chances are not good, especially the older you get. At the end of the day, you don't need a Ph.D. to do research anyway. Bruce Beutler is a Nobel laureate in medicine and doesn't have a Ph.D. Aside from that, if you really want one just to have one, it is entirely possible to do so after medical school. I seem to remember one of the oncologists who worked on Gleevec did that.
Thanks for your reply. I agree with you that the odds are unlikely if I apply with stats that are not at par or better than traditional applicants. I would not waste my money applying with sub-par stats. The measurables for MD/PhD matriculants in the most recent cycle are MCAT >= 515.6 and GPA >= 3.79.

https://www.aamc.org/download/321548/data/factstableb10.pdf

So then, do you believe I would face age-bias if applying with at-par or better MD/PhD matriculation stats?
 

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The age bias will be there no matter what you apply for.

MD/PhD is very weighted towards those who have demonstrated a continued interest and success in research. Having high scores and wanting to do research without a track record will not get you a spot in my experience.
 
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thisisvj89

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The age bias will be there no matter what you apply for.

MD/PhD is very weighted towards those who have demonstrated a continued interest and success in research. Having high scores and wanting to do research without a track record will not get you a spot in my experience.
Thank you for your reply. Proven research skills with low MCAT/GPA, not happening. High MCAT/GPA with no proven research skills, not happening. This shouldn't surprise anyone. MD/PhD, especially a full blown MSTP, represents a major cost to the funding institution. The resume of an accepted student should be expected to be exactly what the funding institution deems acceptable for the associated cost of training.

I was just wondering if I would be facing a further uphill battle because of my age, if everything else were equal. Which it never will be for those traditional students, who never were fulltime working professionals, hitting their deadlines, balancing numerous projects, dealing with peers, bosses, etc. That is what comes with the age baggage in the professional world. Life experiences will vary but as a general rule of thumb, those with greater age have at least had more opportunity to live. Whether or not they actually lived is conjecture.

Personally, I would expect age bias at the end of the day, namely for all the reasons mentioned on this forum. I just hoped to be wrong.
 

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The age bias is very depressing . I am starting to worry now, although I am not planning on MD/PhD
 

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One of the other things about the age bias (and, perhaps a valid reason) is that there is concern about older non-trads actually finishing the program. I don't have any numbers to back this up, but a trusted friend/advisor who is an MD/PhD has said on more than one occasion to me that they thought the attrition rate for the combined programs was higher for older students. If that's the case, it is unfortunate, but it would be a reason for age to be a legitimate concern for an adcom that had limited slots.
 
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You should probably ask this on the physician scientist forum. It seems like I'm the only mstp here, while they have multiple program directors on that forum.
 
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I agree with you that the odds are unlikely if I apply with stats that are not at par or better than traditional applicants. I would not waste my money applying with sub-par stats.
Ummm...n=1 but I applied to med school with a 99th centile MCAT and PhD already in hand. No red flags as far as I'm aware. I only had 1 acceptance. I mean, 1 is all you need, but even with good stats/ background I came dangerously close to not making it in. Don't underestimate this process.
 
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Age can be overcome with a strong app and scores. IMHO being very young is a steeper hill than being a bit older non trad. I just finished with a 20YO applicant (807/3.7) who seemed to receive a lot of discrimination based on his age. He did land 10 II's due to a strong app, but only 3 acceptances. He was 20 and had a baby face at that. At the interview, I believe this hurt him,
 

kraskadva

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Thanks for the reply. You have mentioned several options I had never considered. Medical school acceptance is likely not going to be an issue today for anyone who can pull off a reasonable MCAT score. Being accepted to one of the MSTP programs or a fully funded MD/PhD program is a very different story. Being nearly 30 and considering medical school by taking out total cost of attendance loans for four years however, should make any sane individual question whether or not medical school is a good financial fit. Yes, time is money and whether straight MD or long MD/PhD, it's time or money. I understand that fully. But I'm the type of person who much prefers to owe time, not money. The below analysis is a no frills realistic assessment of the two scenarios for myself. Perhaps there is a way to pay down the $427,929 debt during the four years an MD grad has to work while the MD/PhD grad is still in training. But I doubt that. Even if with the ridiculous number of hours it would take it were possible, the MD will still not have a PhD at 44.

Beginning MD school at 32:
Tuition: $55,000/yr
Living: $25,000/yr
TCA: $80,000/yr
MD degree: $320,000 (before interest)
MD degree: $360,795 (after 4 full years of compound interest)
MD degree: $472,929 (after 4 full additional years of compound interest during residency)
---> $427,929 debt at age 40

Beginning MD/PhD program at 32:
Tuition: $55,000/yr
Living: $25,000/yr
TCA: $80,000/yr
MSTP award: $80,000/yr
MD degree: $0
PhD degree: $0
---> $0 debt at age 44
DO NOT apply MD/PhD for the supposed financial benefit. The 4 years of additional physician salary make up for the increased debt load and it's not worth it.

You can take this with whatever amount of salt you want, and n=1, but...
I applied MD/PhD my first app cycle at 29.
I had been swayed by some of those financial arguments and really enjoyed research to the point where I could see making a career out of it. I did not get in. This was, I am sure, mostly due to not having the stats (had done gpa reinvention, but still had low cumulative, and had good MCAT, but at the accepted MD avg, not at the accepted MSTP average, which is a couple points higher). I had years of research, but no pubs. I talked to a lot of people, most of whom were wildly (and naively) encouraging. The ones I talked to who told me not to (1- somebody in a MSTP, 2- somebody who had been in a similar position and applied without success), I didn't listen to because they were the minority. I should have.
Applying MD/PhD instead of straight MD cost me 2 years, a lot of money, and a lot of preventable stress.
While I'm certain my stats were the main thing holding me back from that, I'm also sure age played a role. The folks I talked to in, or around, MD-PhD programs all said that 26 to start was considered old. And if you dig deep enough, that's supported by the AAMC data.

If you want to do research in addition to medicine, you can do it without the PhD. The MD is more than sufficient. Don't let anyone tell you otherwise.
If you only want to do research, then don't bother with the MD at all. Straight PhD programs are also free and much easier to get into.

If you are hell bent of going the MD-PhD route, then you better have ******* pristine stats - 3.9+ gpa, whatever the current equivalent is of a 34+ MCAT, and some sort of serious research record that hopefully includes pubs, but at least has multiple posters and LORs that say you're the next best thing for science. Anything less and your age won't even matter because they'll find plenty of other reasons to not accept you.
 
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esob

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Ummm...n=1 but I applied to med school with a 99th centile MCAT and PhD already in hand. No red flags as far as I'm aware. I only had 1 acceptance. I mean, 1 is all you need, but even with good stats/ background I came dangerously close to not making it in. Don't underestimate this process.
I feel the same way. I think my app was stronger than most and, although I'm matriculating to a school I wanted to go to, I ultimately landed fewer acceptances than I think I would have if I had been 15 years younger. All of my friends that got in had poorer stats than I did plus nothing close to the life experience or volunteer experience I had. Those that had similar healthcare hours were working in civilian jobs, which is drastically different than providing medical care while being fired upon. Yet, here we are, all going to medical school. I'm happy to be going, and even if I would have been accepted to every school I applied to, I would still have chosen to matriculate to the school I am attending, but the fact that so many schools wouldn't give me the time of day even though my stats were better than their median matriculant, makes me realize I will need to crush step if I want to remain competitive for residency.
 
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thisisvj89

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DO NOT apply MD/PhD for the supposed financial benefit. The 4 years of additional physician salary make up for the increased debt load and it's not worth it.

You can take this with whatever amount of salt you want, and n=1, but...
I applied MD/PhD my first app cycle at 29.
I had been swayed by some of those financial arguments and really enjoyed research to the point where I could see making a career out of it. I did not get in. This was, I am sure, mostly due to not having the stats (had done gpa reinvention, but still had low cumulative, and had good MCAT, but at the accepted MD avg, not at the accepted MSTP average, which is a couple points higher). I had years of research, but no pubs. I talked to a lot of people, most of whom were wildly (and naively) encouraging. The ones I talked to who told me not to (1- somebody in a MSTP, 2- somebody who had been in a similar position and applied without success), I didn't listen to because they were the minority. I should have.
Applying MD/PhD instead of straight MD cost me 2 years, a lot of money, and a lot of preventable stress.
While I'm certain my stats were the main thing holding me back from that, I'm also sure age played a role. The folks I talked to in, or around, MD-PhD programs all said that 26 to start was considered old. And if you dig deep enough, that's supported by the AAMC data.

If you want to do research in addition to medicine, you can do it without the PhD. The MD is more than sufficient. Don't let anyone tell you otherwise.
If you only want to do research, then don't bother with the MD at all. Straight PhD programs are also free and much easier to get into.

If you are hell bent of going the MD-PhD route, then you better have ******* pristine stats - 3.9+ gpa, whatever the current equivalent is of a 34+ MCAT, and some sort of serious research record that hopefully includes pubs, but at least has multiple posters and LORs that say you're the next best thing for science. Anything less and your age won't even matter because they'll find plenty of other reasons to not accept you.
Thank you for your reply. You bring up many good points but you did gloss over one of the main reasons for pursuing MD/PhD instead of simply MD + research--the money. Annual interest alone on $428k at 7% is $34k. I agree this can all be paid down in the 4 years differential between paths, but not without a) taking a job you otherwise wouldn't and/or b) working a metric ton of hours to pay down those differential years of debt and c) further delaying investing in the abysmal retirement account.

You brought up the experience of others and your own, highlighting how difficult it is to walk the MD/PhD route. I don't doubt that. At the end of the day it may not matter. Reading replies like yours and the others on this forum do lead me to believe I should not waste my time applying MD/PhD. I know full well a PhD isn't needed to be a researcher as an MD. My good friend just secured a part-time gig researching with his residency hospital while he starts his full time doc in the box. He is an MD who simply got involved in research, and published first author, during med school/residency. For me, it's always been the debt and corresponding hours required to offset it. The analysis here is tending toward mountainous debt or no doc.
 

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Thank you for your reply. You bring up many good points but you did gloss over one of the main reasons for pursuing MD/PhD instead of simply MD + research--the money. Annual interest alone on $428k at 7% is $34k. I agree this can all be paid down in the 4 years differential between paths, but not without a) taking a job you otherwise wouldn't and/or b) working a metric ton of hours to pay down those differential years of debt and c) further delaying investing in the abysmal retirement account.

You brought up the experience of others and your own, highlighting how difficult it is to walk the MD/PhD route. I don't doubt that. At the end of the day it may not matter. Reading replies like yours and the others on this forum do lead me to believe I should not waste my time applying MD/PhD. I know full well a PhD isn't needed to be a researcher as an MD. My good friend just secured a part-time gig researching with his residency hospital while he starts his full time doc in the box. He is an MD who simply got involved in research, and published first author, during med school/residency. For me, it's always been the debt and corresponding hours required to offset it. The analysis here is tending toward mountainous debt or no doc.
B1 And if you don't get in? Not getting accepted cost me another $40k just in student loans for my masters, plus the cost of another app cycle and all other expenses for the 2 years until I did get accepted to med school.
B2 That entirely depends on how you play your cards/what the political climate is at the time of graduation/what you're willing to do. It doesn't have to be awful. But recognize that the majority of physicians in this country graduate with mountains of debt and are not really struggling long term to pay it back or fund their retirement accounts. The ones I know that are, have generally just made poor financial choices along the way.

But you do you. You sound like you're gonna do it anyway. I'm just passing on the same warning that I wish I had listened to 5 years ago.
 
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thisisvj89

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B1 And if you don't get in? Not getting accepted cost me another $40k just in student loans for my masters, plus the cost of another app cycle and all other expenses for the 2 years until I did get accepted to med school.
B2 That entirely depends on how you play your cards/what the political climate is at the time of graduation/what you're willing to do. It doesn't have to be awful. But recognize that the majority of physicians in this country graduate with mountains of debt and are not really struggling long term to pay it back or fund their retirement accounts. The ones I know that are, have generally just made poor financial choices along the way.

But you do you. You sound like you're gonna do it anyway. I'm just passing on the same warning that I wish I had listened to 5 years ago.
B1 need not apply for me, I work fulltime. I spent a great deal of time trying to balance the spreadsheet of debt with the income one receives as a physician. On the low end, you could be making less than $200k starting out. On the high end, well there really isn't much to be concerned with on the high end aside from the hourly rate. The fact is that starting that rat race at nearly 40 is quite different from the typical physician, who starts at around 30. $430k debt at 40 is vastly different from $430k debt at 30...

And $430k debt is low if you're taking out total cost of attendance loans for 4 full years at a reasonable tuition university. I posted a more thorough analysis on the snowball of debt acquired (compound interest) after a 4 year residency. That number was roughly $500k and was vetted by posters in that route to actually be on the low end of their reality...

Does medical school really cost $505,244?

Most of the physicians you're talking about are likely either one of two types--1) began med school at the straight-through age or 2) work a ton of hours to accommodate high retirement contributions/quickly paying down their debt. Again, both are reasonable and clearly do-able.

If $500k debt at 40 is truly what comes with beginning an MD at 32, then yes, I will continue to exhaust all other possible roads to MD. Or perhaps not pursue one.
 
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kraskadva

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Does medical school really cost $505,244?
Your numbers here are pretty accurate and DrMidlife's breakdown of the repayment options is really good.
You also say there that you're already making in the 50k range and are comfortable with that... so I'm not sure what the concern would be with continuing that level of living expenses after graduation, at least for a few years.
Most of the physicians you're talking about are likely either one of two types--1) began med school at the straight-through age or 2) work a ton of hours to accommodate high retirement contributions/quickly paying down their debt. Again, both are reasonable and clearly do-able.
Some of them are, but also all the other varieties. I've talked to a lot of physicians - trad, non-trad, workaholics, part-timers, good financial managers and bad. None of them have really struggled with repaying their loans, though what they have left over after that does vary person to person. But it's sufficient for their needs, if not all their desires, even the ones bringing in 200k or less. Some of that is the smaller loans/lower interest rates that the older generation of docs had, but there are more repayment/forgiveness options now than there were then as well.
If $500k debt at 40 is truly what comes with beginning an MD at 32, then yes, I will continue to exhaust all other possible roads to MD. Or perhaps not pursue one.
All of this comes back to the main point though... if you're doing this for the money, then you need to do something else. Knowing you're debt free won't get you through the hard times that exist throughout medical training and practice. You have to want to be there more than you want the money. Yes, it is a job, but it's one that you need some passion for or you'll just walk away when it gets too much - I know those docs too.

Nobody's gonna let you into a MD/PhD program to save you some change, you have to prove you want it regardless of the money to get in that route and out compete a bunch of trads too, which is hard (read - very, very hard) to do. There are a few 5yr funded programs (CCLCOM, RWJMS, ...etc?) that might look a bit more leniently on the age issue, but still need you to measure up and show passion for the program, not just the lack of debt.

So if you would be down with being a doc while bringing home the same functional income as you are currently, then you'll be fine, and it gets better from there. If you're not okay with that, then medicine may not be for you.
I started med school at 32, will have ~500K in principal loans at graduation and will count myself extremely lucky if I can pay it off by 50. I'm working on investments now to help make that more achievable, regardless of what specialty I go into. But even if I didn't have that Plan B, I would still be happy living off 50k a year - heck, I've been in the ~20k bracket for a decade now, so 50k sounds downright luxurious. And I am doing it because I love medicine - not the studying or the debt or the perpetual student lifestyle - but the future of getting to be a doctor.
 
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thisisvj89

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Your numbers here are pretty accurate and DrMidlife's breakdown of the repayment options is really good.
You also say there that you're already making in the 50k range and are comfortable with that... so I'm not sure what the concern would be with continuing that level of living expenses after graduation, at least for a few years.
Definitely. I wouldn't know what to do with the amount of money a typical doc makes. Unless I had the loans to go with it.
Some of them are, but also all the other varieties. I've talked to a lot of physicians - trad, non-trad, workaholics, part-timers, good financial managers and bad. None of them have really struggled with repaying their loans, though what they have left over after that does vary person to person. But it's sufficient for their needs, if not all their desires, even the ones bringing in 200k or less. Some of that is the smaller loans/lower interest rates that the older generation of docs had, but there are more repayment/forgiveness options now than there were then as well.
One of my points from the very beginning was freedom. You have so much more freedom without loans (exception HPSP). You can work as few hours as you need or take a job focusing on exactly what drives you. Add in progressively more loans and you are all but guaranteed to focus more on the salary in said job than the work when examining an offer. Or perhaps you don't and still choose the work over the salary. You would eventually work more hours than you want in order to hit the income you dictate sufficient to pay off your loans at the rate you're comfortable with.

I could be totally upside down on this but I think burnout rates would drop precipitously if docs didn't feel obligated to work so many hours. Not the extra hours that are required in order to keep your patients safe. The hours they feel they need to stay afloat because of their massive, massive, loans or lavish lifestyle, or both. I know not all docs live lavishly but that's not because they can't.
All of this comes back to the main point though... if you're doing this for the money, then you need to do something else.
I couldn't agree more, no one should get into medicine for the money. Like you mentioned, I'm more than happy with what we'll call my current, 50k. What I'm talking about is being able to make ends meet with 500k+ loans at 40 yrs old and not working so many hours that I burn out. Or dramatically increase my risk of failing the work/life/family balance.
So if you would be down with being a doc while bringing home the same functional income as you are currently, then you'll be fine, and it gets better from there. If you're not okay with that, then medicine may not be for you.
I started med school at 32, will have ~500K in principal loans at graduation and will count myself extremely lucky if I can pay it off by 50. I'm working on investments now to help make that more achievable, regardless of what specialty I go into. But even if I didn't have that Plan B, I would still be happy living off 50k a year - heck, I've been in the ~20k bracket for a decade now, so 50k sounds downright luxurious. And I am doing it because I love medicine - not the studying or the debt or the perpetual student lifestyle - but the future of getting to be a doctor.
You actually sound financially a lot like the me of the future, if I stay the MD course. Call it what you like but MD/PhD would be a way to circumvent the financial headache.

The 'if' in the room is whether I could produce an app of caliber required by a fully funded MD/PhD program. That is difficult of course and I don't mean to minimize that fact. Potential age-related stigma would add to this difficulty, hens my initial post here. All this money tangent is valid but for me, only adds to the value provided by the MD/PhD.
 

kraskadva

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I could be totally upside down on this but I think burnout rates would drop precipitously if docs didn't feel obligated to work so many hours. Not the extra hours that are required in order to keep your patients safe. The hours they feel they need to stay afloat because of their massive, massive, loans or lavish lifestyle, or both. I know not all docs live lavishly but that's not because they can't
For the docs I've talked to, the underlying reasons for stress/burn out that I've heard mentioned are never about loans. Yes, they exist, yes, they're paying them - but you bring this up and it's usually a hand-flap kinda dismissal. What they did get tied in knots about is most often the administrative BS they have to navigate, and financial issues/overwork they mention is usually secondary to say, a spouse with a serious shopping habit, or kids in fancy schools, or wanting to get a new house/car/whatever that is just outside the budget. Never student loans.
You could argue that if they weren't paying those loans, they'd have the money for those other things, and you'd be right, but everybody just sees it as the cost of doing business and doesn't get too stressed about it.
The 'if' in the room is whether I could produce an app of caliber required by a fully funded MD/PhD program. That is difficult of course and I don't mean to minimize that fact. Potential age-related stigma would add to this difficulty, hens my initial post here. All this money tangent is valid but for me, only adds to the value provided by the MD/PhD.
Yes, and the point of my first response as well. It's hard to get in to a fully funded program anyway (as I explained to somebody else here 50 YO PhD working in Biotech/Pharma wants to go to Med School) and any whiff in your app of you wanting to to it for the money rather than the pure love of medicine/science is swift rejection. When compounding that with the exceedingly high level stats needed for MD-PhD and the very real age discrimination that exists in that pool, your odds of getting into one of those programs drop from very low to infinitesimal.
So would it be a nice bonus to walk out debt free after 8 years? Hell yeah.
Is it anything you can count on? Hell no.
So if you're going to apply,
1- you need to apply to straight MD/DO programs as well. And more of them than MD-PhD programs.
2- you should do so in the expectation that you will not get accepted into one of the MD-PhD programs and that, if accepted at all, you would graduate with the full debt load. Anything else is a bonus.