I am glad to answer any questions you have, so I'll try to cover everything that I think is important. We live in an apartment complex that has many Utah couples in it (since the med. school my hubby attends loves students from Utah), so I will share with you what all of us are doing to make it so we can have kids during medical school.
I think all of our friends have had to take out some private loans on top of the federal loans. Because of my husband's research fellowships, we have only taken out private loans once in the two years we have been out here. We mostly have used the research fellowships for necessities and the extra we have put into savings. We have a little lump of money in savings right now. If any of it is left by 4th year, we plan on using it for residency interview flights. The money that is 'extra,' that we actually have a little fun with, is the money that we get for holidays/birthdays from family. We have bought some of our tickets home, but our parent's have also payed for some of our flights, too.
We have to live on a pretty tight budget, but it is a refining experience. As a family, you learn to shop cheap. You learn to homecook, since you seldom can afford to eat out. Then, when you do get to eat out, it's extra exciting. We do get to buy some fun things, to keep us sane during the craziness. We get zoo passes, football season tickets (with our school you can sell some of the games and actually make a profit), passes to kids' science museums, etc. So we actually even have fun. Of course, my hubby doesn't get to enjoy some of those things as frequently as my daughter and I do (besides the football tickets).
We, along with almost all of our friends out here, are on Medicaid, with the medical student getting covered by school insurance instead. Some of our friends have also been on WIC, and there are also regional programs that can help cut the cost of your phone bill, etc. We do live in government subsidized apartments. They are really nice and we pay $550.00 for our apartment that has 2 bedrooms and 2 baths. It takes the edge off of the housing cost to make it very affordable. I have to admit that I was really not happy in the beginning about participating in 'welfare programs.' It hurt my pride and embarassed me. But now, I can not describe how grateful I am for these programs. They allowed us to be able to have our beautiful, healthy daughter when we felt like we needed to. I felt relieved when one of our friends told us that a medicaid person said that it was people just like us that medicaid was made for; it is for people who are diligently working on getting to the point where they can not only be independent, but also highly contributing members of society. There is no shame in using welfare programs for the right reasons, and beginning a beautiful family is at the top of the list.
As for the daycare thing being worthwhile, it depends. There definitely are many opportunities to watch kids. There are a ton of people who have found that they really like caretakers from Utah. I have had some people I know do it to bring in a little extra cash, but most people don't worry about it. I guess it is just hard to make sure that you are payed well enough for the energy and time you put into it, without mentioning the costs for damage that can be done to your house and the extra food you buy to feed the extra kids. I think it could be profitable, but you would just have to set it up wisely. I guess most of us also figure that making a doctor's salary in the end should cover the extra debt you have to go into to have a family, at least we're praying so
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Some programs are cheaper than others, which definitely helps. Look into and apply to the schools that give in-state tuition after the first year. That helps cut down the debt by thousands and thousands. Also, don't be shy to apply for scholarships, especially since there are many female specific scholarships out there. If you turn in your financial aid application early, you usually can get need-based scholarships, too. Getting those scholarships can save you thousands of dollars in the long run, as well.
Sorry this has been so long! I just want you to know all your options. I guess the moral of this reply is 'it is hard, but it is definitely worth it.'
If you have any other specific questions, feel free to ask!