MS3-4/Resident Perspectives on Student Loans

[DrDrummer]

Did the thread search, didn't find anything particular to this question. If I'm re-hashing something that's brought up continually, feel free to condescendingly point me in the direction of those threads.

I'm in a position where I'm receiving interviews from many state schools here in Texas, as well as a few private schools out of state. I'm doing the calculation and finding that the total bill (no parental help here) will be ~ $300,000+ at the private schools v. half to a third of that much if I remain in Texas, where based on the data I can find, I'm pretty confident I'll get at least one admission.

I'm wondering how you guys are feeling about taking on hundreds of thousands of dollars in debt, at this point in your education? To me, from this vantage point, it seems like a no-brainer: attend any state school in TX that offers me an admission, over any private school out of state that does without massive scholarships (which I won't get). To the point that I'm considering declining interviews at the uber-expensive schools in favor of saving personal leave days and avoiding being away from my students in the school that I teach in. My mom and many pre-meds I know say it's totally insane to decline an interview without an acceptance in hand, but I'm thinking that if I only got into a school that cost $300k+, I don't even know that I'd want to go. It seems like it would make many of my goals virtually impossible-- specifically working in an underserved area and/or in primary care while retaining the flexibility to go somewhere else if life circumstances dictated.

$300,000 at 8% seems like a huge burden to take on. Obviously it's a lot more than what I'd pay in-state. So I guess what I'm asking, is there any reason that it's worth it to go to a private school for that much more money? Obviously I'm not Harvard material. I didn't even apply to any Top 20 schools. Once you go down the tiers, does the choice of state school v. out of state private become obvious, due to the financial reasons, or is there some aspect of "repayment is easier than you think" that I'm missing out on? Anyone here elect to attend a mid-tier private school over their state institution, and they're totally happy with it? (If your parents are footing the bill, you don't count. )

Any thoughts are most welcome. I'm stressing out about this due to the cognitive dissonance of wanting to decline interviews so I can teach my kids v. the seeming irrationality of doing so.

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[C5toC9]

You can schedule your in-state interviews as early as possible, and not decline your private interviews but schedule them for as late as possible.

If you hear good news from your state schools, you can cancel the private ones. If you don't or are still waiting, then you should probably attend the private ones.

 

[txprodigal]

if you get into utsw, you shouldn't think twice... top 20 school with a bill of ~15k/year

the same prob goes for baylor...

btw there's also income based repayment, so if all your loans are govt. loans... you could look into that option. technically, your total debt wouldn't matter because you would either be able to pay it off or the govt. would eventually foot the bill. but who knows if IBR will be changed/replaced...so it's a gamble

 

[DrDrummer]

but who knows if IBR will be changed/replaced...so it's a gamble

Right, that was my concern there. IBR would be a good option if I wanted to (and was blessed with the option to) go to a private school like Georgetown or Tulane that has a good public service record but a big price tag. It's just hard to anticipate what incomes will be in 10 years, and what will happen to currency values and the market for medical care. It seems like taking on less debt is always a better option unless there's an ultra-compelling income-related reason to do so, which I'm not seeing in state school v. mid/low-tier private. Does that seem logical?

 

[UserNameNeeded]

The Texas public schools, while they have been some of the cheapest in the country in general, are now graduating students with debts in excess of $170,000 and rising with 8%+ increases in tuition and fees year over year. So those figures you're seeing for $70,000-$120,000 are like 5-7 years out of date. I don't know why these schools are not updating their average indebtedness. I wonder if the students not taking out loans because of personal or family wealth are skewing the results.

 

[DrDrummer]

The Texas public schools, while they have been some of the cheapest in the country in general, are now graduating students with debts in excess of $170,000 and rising with 8%+ increases in tuition and fees year over year. So those figures you're seeing for $70,000-$120,000 are like 5-7 years out of date. I don't know why these schools are not updating their average indebtedness. I wonder if the students not taking out loans because of personal or family wealth are skewing the results.

That's interesting. I was mostly basing my figures off of the tuition rates, and then assuming that extra fees and cost of living would be comparable in different cities... e.g. rural TX < Houston < Georgetown, etc.

It's primary differences in tuition ($10k v. $36k) that lead me to believe that OOS would be so much more expensive, to a prohibitive degree.

Thank you all for your insight, I appreciate it. I guess I feel like there are more degrees of uncertainty in the economic future of medicine (I'm reading a book by Paul Starr called the Social Transformation of American Medicine right now-- maybe it's making me paranoid?), and that this probability should have some bearing on decisions I make now. I feel like the market is due for a correction, and it's going to swing in a way that lowers physician incomes. But we will see.

Anyone else read the WSJ piece by Abraham Verghese?

 

[blanche]

Right, that was my concern there. IBR would be a good option if I wanted to (and was blessed with the option to) go to a private school like Georgetown or Tulane that has a good public service record but a big price tag. It's just hard to anticipate what incomes will be in 10 years, and what will happen to currency values and the market for medical care. It seems like taking on less debt is always a better option unless there's an ultra-compelling income-related reason to do so, which I'm not seeing in state school v. mid/low-tier private. Does that seem logical?

Dr. Drummer--

I loved my 'top 20' school, I really did. However--if I had the option of a TX state school, I would have been a fool to pass that up. They are well respected institutions, and will get you where you need to be. You're right--unless there is an ultra-compelling reason not to, take the less debt path. Georgetown and Tulane are fine overall institutions, but are not medical powerhouses.

-B

 

[DrDrummer]

Dr. Drummer--

I loved my 'top 20' school, I really did. However--if I had the option of a TX state school, I would have been a fool to pass that up. They are well respected institutions, and will get you where you need to be. You're right--unless there is an ultra-compelling reason not to, take the less debt path. Georgetown and Tulane are fine overall institutions, but are not medical powerhouses.

-B

Thank you, I appreciate your candor. Perhaps I should've applied to some of those Top 20-esque places, but I'm thinking that I'll be content with never knowing how I might've done. I figure medical school anywhere is going to be intense enough, and that my boards scores & residency will determine the vast majority of my future options. Maybe that'd be different in academia, but one of the wonderful things about medicine is that it seems to be full of jobs that allow you to teach, which is what I'm interested in.