md vs. md/phd

[1Path]

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The only ones offered now are for 2 years at 35k/year each for a total of 70k, which is pretty much nothing.

Unless things have changed drastically in the 2 years since I left the NIH, I don't beleive this is true. In fact, I had a friend with an MD/PhD who did her residency at NIH, that was able to get her loans paid off at 35K/year for the ENTIRE length of her residency program.

 

[Neuronix]

As far as I'm aware, this is the best repayment option you can get, which is IMO, pretty sad. As always, feel free to prove me wrong--I'd like to know if there are more/better options. You are right that you can get more paid off (75% instead of 50%) if you work at the NIH for 3 years as opposed to the max of 2 elsewhere. Again, this caps at $70k (or $105k at the NIH), which is nothing compared to ridiculous sums like $250k that many med school graduates face.

http://www.lrp.nih.gov/about/extramural/particip.htm

In exchange for a two-year (or three-year for the Intramural General Research LRP) commitment to your research career, the NIH will repay your educational loan debt at the rate of 25% annually, up to a maximum of $35,000 per year. You will receive the maximum annual disbursement only if your repayable debt remains equal to or greater than $140,000 over your LRP contract. The NIH Loan Repayment Programs (LRP) payment projections are based on the repayable debt calculated at the start of an LRP contract. Repayable debt is a participant's total eligible student loan debt (principal plus existing accrued interest) at the beginning of an LRP contract, less participant obligation (which is 10 percent of a participant's base institutional salary), plus estimated future interest on a participant's eligible loans through the end of the LRP contract.

 

[oldbearprofessor]

You can apply for a renewal after the first 2 years. These are reviewed with original applications and are evaluated based on accomplishments during the initial time period.

Participants may apply to continue their Extramural Loan Repayment Program participation. Renewal contracts are issued for one or two year periods and are based upon the same criteria as the initial contract. Additionally, a demonstration of research accomplishments during the previous contract is required. Progress toward development as an independent investigator is a major factor in renewal of Extramural Loan Repayment Program support. Renewal applications are competitively reviewed and the submission of a renewal application does not assure the award of benefits.

As far as I'm aware, this is the best repayment option you can get, which is IMO, pretty sad. As always, feel free to prove me wrong--I'd like to know if there are more/better options. You are right that you can get more paid off (75% instead of 50%) if you work at the NIH for 3 years as opposed to the max of 2 elsewhere. Again, this caps at $70k (or $105k at the NIH), which is nothing compared to ridiculous sums like $250k that many med school graduates face.

http://www.lrp.nih.gov/about/extramural/particip.htm

In exchange for a two-year (or three-year for the Intramural General Research LRP) commitment to your research career, the NIH will repay your educational loan debt at the rate of 25% annually, up to a maximum of $35,000 per year. You will receive the maximum annual disbursement only if your repayable debt remains equal to or greater than $140,000 over your LRP contract. The NIH Loan Repayment Programs (LRP) payment projections are based on the repayable debt calculated at the start of an LRP contract. Repayable debt is a participant's total eligible student loan debt (principal plus existing accrued interest) at the beginning of an LRP contract, less participant obligation (which is 10 percent of a participant's base institutional salary), plus estimated future interest on a participant's eligible loans through the end of the LRP contract.

 

[Neuronix]

Thanks for pointing that out obp, the rules of the LRP are fairly complicated, but I guess I will summarize what I understand of it.

-- The program will pay only 25% of your outstanding debt per year, to a maximum of $35,000/year. This is recalculated yearly. So if you started at $140,000, you will only get $26,250 in your second year. If you started at $250,000, you'll need >7 years of funding to pay off your debt. If you do get a competitive renewal they will take that up to 50% of your outstanding debt per year, but only to a maximum again of $35k/year.
-- You still have to make payments on your loans based on your salary.
-- You apply in two year shots, so after two years you'll have to reapply.
-- You can apply for these programs only under a few guises:

"Loan Repayments for Clinical Research
Loan Repayments for Pediatric Research
Loan Repayments for Health Disparities Research
Loan Repayments for Clinical Researchers from Disadvantaged Backgrounds
Loan Repayments for Contraception and Infertility Research"

So if you want to do research outside of these narrow areas, you're out of luck. All this summed up and it still seems like the MD/PhD is a much better idea if you're serious about doing research. My soapbox of the day is that the LRP seems like a bad deal to me for several reasons.

First, what are the funding rates like for these competitive applications? The people in my lab can't even get their little Kirchstein grants funded these days. Second, for those with high debt loads the LRP may not even get them down to half of their initial debt. Third, only certain types of research by clinicians are being rewarded.

I think this is ridiculous. If the NIH was serious about producing physician-scientists, you would think the LRP would be much better than this. I mean look at the money available to the MSTPs, yet physicians who decide later they want a basic science career only have this half hearted option. This makes no sense to me. Wouldn't a physician switching into a basic science pathway be more serious about doing basic science than someone fresh out of college starting medical school? Yet, after medical school, physicians have limited and competitive repayment options.

This is a somewhat touchy topic for me because some IM residents once brought the third year medical students (me included) to lunch to try to talk to us about going into IM and doing research. They told us how we shouldn't worry about our debt load since IM and particularly research in IM doesn't pay well, as there are repayment programs out there. When I actually asked them the details of these repayment programs, nobody had a clue, not even the attendings.

 

[1Path]

"Loan Repayments for Clinical Research
Loan Repayments for Pediatric Research
Loan Repayments for Health Disparities Research
Loan Repayments for Clinical Researchers from Disadvantaged Backgrounds
Loan Repayments for Contraception and Infertility Research"

So if you want to do research outside of these narrow areas, you're out of luck.

I'm curious as to why you think these are limited areas? I personally think clinical research is VERY broad. Keep in mind, that clinical research doesn't mean "lack of bench" research. It should probably be classified as translational research.