Medical school debt, for those working in underserved/community/public health

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Hello! I'm an incoming med student interested in working with underserved populations in a lower-paying specialty. I'm considering matriculating at my dream school, instead of another school that offered a full-ride scholarship -- but would like insight on how the burden of med school debt may affect my future plans.

Can those of you who work in underserved/commmunity/public health share how the burden of paying off debt has affected your work?

And for anyone who graduated without med school debt (e.g. full-ride scholarship), how has that enabled or empowered your work?

Thanks so much 🙂
 
Hello! I'm an incoming med student interested in working with underserved populations in a lower-paying specialty. I'm considering matriculating at my dream school, instead of another school that offered a full-ride scholarship -- but would like insight on how the burden of med school debt may affect my future plans.

Can those of you who work in underserved/commmunity/public health share how the burden of paying off debt has affected your work?

And for anyone who graduated without med school debt (e.g. full-ride scholarship), how has that enabled or empowered your work?

Thanks so much 🙂

I'm a family medicine physician who has worked in a community health center since I graduated from residency. I went to a private medical school, but I received a National Health Service Corps scholarship when I was an MS3, which paid for my 3rd and 4th years of medical school.

That being said, I generally strongly encourage all students to go for the lower debt option, unless they REALLY hate that particular school or there is some geographic reason why they have to be in a specific location (their spouse lives there, they want to be near a sick family member, etc.) Being in debt can trap you in bad situations - not just educational debt, by the way. It's a fairly common joke that hospital administrators love it when physicians boast about buying a boat or a vacation home or some other extravagant purchase.

I will also say that very few people with significant medical school/PA school/NP school debt stay in a community health setting without some kind of loan forgiveness. On the flip side, almost all community health centers offer some kind of loan forgiveness option.

How much debt would you be in if you went to your dream school?
 
Please go to the school with the full scholarship. I don’t know what the "best" med school is these days, but even if I could’ve gotten in to Harvard I would take a free ride anyday.

Debt can definitely impact your life. Not just your career, but how much you can save for retirement, when and if to have kids, etc.

I’m not loosing any sleep over my debt at this point because it is what it is, but if I could go to a school with no debt I’d choose that every time. It definitely can impact multiple facets of your life.
 
I'm a family medicine physician who has worked in a community health center since I graduated from residency. I went to a private medical school, but I received a National Health Service Corps scholarship when I was an MS3, which paid for my 3rd and 4th years of medical school.

That being said, I generally strongly encourage all students to go for the lower debt option, unless they REALLY hate that particular school or there is some geographic reason why they have to be in a specific location (their spouse lives there, they want to be near a sick family member, etc.) Being in debt can trap you in bad situations - not just educational debt, by the way. It's a fairly common joke that hospital administrators love it when physicians boast about buying a boat or a vacation home or some other extravagant purchase.

I will also say that very few people with significant medical school/PA school/NP school debt stay in a community health setting without some kind of loan forgiveness. On the flip side, almost all community health centers offer some kind of loan forgiveness option.

How much debt would you be in if you went to your dream school?

Thanks so much for your insight! You're right, I shouldn't take financial security for granted. It's also encouraging to hear about options offered by community health settings; I'll educate myself more on that.

I haven't gotten my financial aid offer yet, but estimate around $200k debt.
 
I will try to give you the other side of this. If both schools are mid-tier obviously there is not a question. But top five school full price vs bottom five full scholarship, maybe there is something to think about.

What kind of condition do you have to satisfy for the scholarship? Do you have to do primary care? What if you want to switch out of it? Will YOU feel pressure to stay in a particular field (if that’s part of the condition)? What if at the end of the day, you actually want to be a, wait for it, someone who want to fix “broken bone” all day? Or someone who wants to sit in a chair, in a dark room all day? How do you know what you want to be 3,4 years from now without actually embracing all fields in medical school?

Take the extreme case of bottom five med school with a commitment to some primary care field without a chance of specializing. I will think long and hard. Top school WILL open doors. Top residency is of course even better. Will you be a better force as a specialist (which may require you to have a good academic pedigree) in some underserved area?

Have a good friend who got into one of those partial-free 7 year programs (bs/md) with the commitment to be in a primary care speciality. She choose to specialize and guess what? Pay back time. It make her doubt herself along the way.

You will not be poor as a doctor. Heck, as a new attending, our mortgage approval was an obscene amount of money. But I also agree with everyone else so far. The feeling of being debt free and not owing anything to anybody is pretty wonderful.

Just playing devils advocate and thinking it’s not as clear cut as some might think.

Edit: few words and clarification.
 
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Currently, options for loan forgiveness and the NHSC Scholarship programs make it almost guaranteed that you will not need to pay any loans accrued IF you are flexible with geographic location in where you practice. This has remained the case for a few decades now. However, the current availability of these financial resources is subject to change.

The school you attend will have some lasting impact on your career/life and is not something that you can change in the future. You can and will deal with any educational debt regardless of specialty you choose. I would recommend basing your decision on what impact this school choice could have on where you plan to be professionally in 15-30 years (as best as you can imagine this). If your future imagined self is constantly asking "what if?" with one school, I'd probably go with the other choice.
 
Debt is a form of bondage. This isn't even a decision I'd spend a minute thinking about. If you choose a primary care field after med school and accrue the debt that most med students do today, you will feel serious pain once the repayment begins. Graduating debt free from med school means that you can begin building wealth from day one. If you live frugally enough, you can achieve financial independence far sooner and achieve true freedom.

Med school is kind of over-rated anyway. The real growth and knowledge comes from a good residency program.
 
It's also encouraging to hear about options offered by community health settings; I'll educate myself more on that.

I have some experience with this with a loved one.

There are serious reasons why those jobs don't fill. One of them is that the pay is usually very low. There's no free lunch here. You might get $50k/year of loans repaid, but get paid $60k+ below market rate for your services and be exploited since you can't go practice anywhere else without huge penalties.

Don't sell yourself into indentured servitude to pay for med school.
 
Just about every medical school in the country gives you the same education. The goal is to pass boards. Residency is where you learn your craft. TAKE THE LOWER DEBT OPTION. The only concept of "tier" is in the minds of medical students. No one ever on a job interview asked me about my medical school or residency. All they care about is dings on your license, board certification and whether you have been sued. I graduated with $225K in debt and my payments are $900/month. While that doesn't really hurt me, it would be nice to use that towards some other item on my wish list.

As far as rural scholarships and "student loan repayment programs". I applied to at least 10 programs once out of school and never saw a dime. Don't bet on those being there. Take the full ride - its all the same in the end.
 
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