My 4 Year Schedule @ West Point

[GeraldMonroe]

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I think that the phrase it's far better to owe 15% of your income for 10 to 25 years is raising eyebrows.

Aren't most loans a fixed dollar amount at a given interest rate (that may be a variable rate)? Is a percentage of income arrangement a current possibility? I can see some perverse incentives in such an arragement.

Google for "Income Based Loan Repayment"

And yes, my numbers work out. If he became a specialist and made $250,000 per year (the military pays about 120) he would be ahead by nearly 100 grand per year when he is an attending, even after taking off 15%. Even if he went to Tufts medical school. The math is a little more complicated because there are various military perks you have to factor in (such as more pay as a resident) but it's pretty clear his choice is financially a losing proposition. The amount of money he loses in total depends both on what specialty he chooses and possible future changes to reimbursement. However, were he to become an orthopedic surgeon or some other highly paid specialty, he'd be behind by a couple million dollars, easily, over the 8-12 years he would owe for repayment.

Also, I'm factoring in average salaries versus military pay. Thing is, if one is willing to make sacrifices (work in a less desirable location/work more hours/take more call/do hair transplants, etc) one can make considerably more money than average as a physician. Or can work less hours and make less. In the military, you work the number of hours they tell you to work, and you're paid what Congress decides to pay you. What a deal.

And, you see, the only real reason for him to join the military now rather than later as an attending is to collect on those financial incentives. He won't be serving his country in a meaningful way until he's an attending. Yet, if those incentives stink, it's a losing proposition.

As for people yelling at me for predicting doom and gloom : again, it could work out. Maybe he'd end up a super-star like some of the anecdotal accounts given above. However, he's giving up an enormous number of choices he could make instead, and I think he's drastically lowering his probability of success and/or happiness.

 

[GeraldMonroe]

Oh, and as for perverse incentives : yes, there are some.

Currently, the optimal move appears to be to
1. Go to the medical school that gives you the maximum chance of a competitive residency, and ignore cost as a consideration.
2. Take out the max in student loans every year, even if you don't need the money. If you can think of an excuse to get the financial aid office to raise your CoA, do it.
3. Match a competitive residency and plan on a long fellowship. Start income based repayment on day 1 of residency. Try to spend at least 7-8 years in training, but make sure each additional year of training raises your future pay. Make sure the residency is run by a nonprofit hospital (nearly all of them are)
4. Take a job as an attending working for a nonprofit for a salary.
5. At the 10 year mark, apply for "public service" loan forgiveness. You'll meet all the criteria : 10 years of working for a nonprofit while making payments during income based loan repayment. While there is some question of the taxes, you probably won't have to pay income taxes on the money you are forgiven.

It depends on the situation, but the forgiveness can easily zap 300k of debt or more. You'll have paid so little actual money towards the debt it's almost like getting a 2 or 3 year full ride.

The moment the forgiveness has gone through, quit the nonprofit and go make the big bucks as a jerk running a boutique clinic.

NOTE : I'm just outlining the "optimal move" because it was amusing for me to think of how to do it. I'm not advocating gaming the system.

Keep in mind that a physician has to pay an enormous amount of taxes, since they are in the worst possible situation in terms of income taxes. (poorer people can take lots of deductions and are in a lower bracket, richer people earn their millions through long term capital gains which are taxed at 15% and play various complex games) I'm sure it's possible to figure out a way to sleep at night after doing the above, on top of a big pile of money.

 

[LizzyM]

Google for "Income Based Loan Repayment"

And yes, my numbers work out. If he became a specialist and made $250,000 per year (the military pays about 120) he would be ahead by nearly 100 grand per year when he is an attending, even after taking off 15%. Even if he went to Tufts medical school. The math is a little more complicated because there are various military perks you have to factor in (such as more pay as a resident) but it's pretty clear his choice is financially a losing proposition. The amount of money he loses in total depends both on what specialty he chooses and possible future changes to reimbursement. However, were he to become an orthopedic surgeon or some other highly paid specialty, he'd be behind by a couple million dollars, easily, over the 8-12 years he would owe for repayment.

Also, I'm factoring in average salaries versus military pay. Thing is, if one is willing to make sacrifices (work in a less desirable location/work more hours/take more call/do hair transplants, etc) one can make considerably more money than average as a physician. Or can work less hours and make less. In the military, you work the number of hours they tell you to work, and you're paid what Congress decides to pay you. What a deal.

And, you see, the only real reason for him to join the military now rather than later as an attending is to collect on those financial incentives. He won't be serving his country in a meaningful way until he's an attending. Yet, if those incentives stink, it's a losing proposition.

As for people yelling at me for predicting doom and gloom : again, it could work out. Maybe he'd end up a super-star like some of the anecdotal accounts given above. However, he's giving up an enormous number of choices he could make instead, and I think he's drastically lowering his probability of success and/or happiness.

Again, if someone wants the college experience offered by a service academy and they want a career in the military, why should you care that they are choosing a path that is less lucrative than another path? He's made his choice and he's happy with it and his only question is how to structure his class schedule. Everything else is just silly bashing of milmed and it doesn't belong here.

And the IBLR covers only federal loans...

 

[GeraldMonroe]

Again, if someone wants the college experience offered by a service academy and they want a career in the military, why should you care that they are choosing a path that is less lucrative than another path? He's made his choice and he's happy with it and his only question is how to structure his class schedule. Everything else is just silly bashing of milmed and it doesn't belong here.

And the IBLR covers only federal loans...

Because he's giving up any choices to do anything else, and choosing 20 years in the military before spending one day as an actual service member. Do you really think that is a wise move for anyone to make? He's only happy with his choice now, before he's ever lived it.

You can pay for everything using federal loans.

 

[LizzyM]

Because he's giving up any choices to do anything else, and choosing 20 years in the military before spending one day as an actual service member. Do you really think that is a wise move for anyone to make? He's only happy with his choice now, before he's ever lived it.

You can pay for everything using federal loans.

No. As he has pointed out, he can leave after 2 years. He can serve in the military for however many years after graduation (4?) then apply to medical school as a civilian and owe no more to the Army. He has options. He may also decide that medicine is not for him and that he's going to do something different.

 

[GeraldMonroe]

No. As he has pointed out, he can leave after 2 years. He can serve in the military for however many years after graduation (4?) then apply to medical school as a civilian and owe no more to the Army. He has options. He may also decide that medicine is not for him and that he's going to do something different.

That's still a raw deal. Go to a state school, and he would owe 0 years, and a few tens of thousands of dollars.

Yes, he could leave after 2 years : but you're a medical school admin. What are you going to think about someone who dropped out of West Point to go to a state school? The perverse thing is, you'll probably think worse of him (since he must have dropped out for a reason) than if he'd done 4 years in a relatively easy major at a state school. In general, medical school admissions pass people over who over-extend themselves and fail in favor of people who don't try as hard. (if you take 22 hours a semester and manage to pull a 3.5, you look much worse than someone who did 14 hours with a 4.0.

Just like you'd probably pass him over for admissions if he ended up with a 3.2 at West Point on his crazy schedule, rather than the 3.7 he would have gotten for less work at a state school)

Perhaps I shouldn't make it so personal : "your" not responsible for how it works. Still, the game of getting into medical school isn't fair, and the optimal strategy is not to sign up for a crazy hard major with a crazy intense schedule, because you get almost no extra points if you succeed, but are severely penalized if you do "good considering how many hours you were taking".

 

[atomi]

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[atomi]

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[NeverQuit]

Oh, and as for perverse incentives : yes, there are some.

Currently, the optimal move appears to be to
1. Go to the medical school that gives you the maximum chance of a competitive residency, and ignore cost as a consideration.
2. Take out the max in student loans every year, even if you don't need the money. If you can think of an excuse to get the financial aid office to raise your CoA, do it.
3. Match a competitive residency and plan on a long fellowship. Start income based repayment on day 1 of residency. Try to spend at least 7-8 years in training, but make sure each additional year of training raises your future pay. Make sure the residency is run by a nonprofit hospital (nearly all of them are)
4. Take a job as an attending working for a nonprofit for a salary.
5. At the 10 year mark, apply for "public service" loan forgiveness. You'll meet all the criteria : 10 years of working for a nonprofit while making payments during income based loan repayment. While there is some question of the taxes, you probably won't have to pay income taxes on the money you are forgiven.

It depends on the situation, but the forgiveness can easily zap 300k of debt or more. You'll have paid so little actual money towards the debt it's almost like getting a 2 or 3 year full ride.

The moment the forgiveness has gone through, quit the nonprofit and go make the big bucks as a jerk running a boutique clinic.

NOTE : I'm just outlining the "optimal move" because it was amusing for me to think of how to do it. I'm not advocating gaming the system.

Keep in mind that a physician has to pay an enormous amount of taxes, since they are in the worst possible situation in terms of income taxes. (poorer people can take lots of deductions and are in a lower bracket, richer people earn their millions through long term capital gains which are taxed at 15% and play various complex games) I'm sure it's possible to figure out a way to sleep at night after doing the above, on top of a big pile of money.

This simply is not about money. If you think/have interest in being a physician because of the monetary incentives (or even more ludicrous-- an army doctor which we all know make piles of cash ) then you're doing it for the wrong reasons.

 

[LizzyM]

Yes, he could leave after 2 years : but you're a medical school admin. What are you going to think about someone who dropped out of West Point to go to a state school?

I think I saw an applicant last year who fit that description. I didn't downgrade his application fbecause of the transfer just as I wouldn not downgrade someone who chose to transfer because a school was not a good fit or because career goals had changed (someone who leaves an engineering school for a college of arts & sciences, for example).

There is no one perfect route to medical school and optimizing one's lifetime income is not the only consideration for many people who aspire to a career in medicine.

 

[starfishprime]

This simply is not about money. If you think/have interest in being a physician because of the monetary incentives (or even more ludicrous-- an army doctor which we all know make piles of cash ) then you're doing it for the wrong reasons.

OK Mr. Big-High-School-Senior, what the hell do you know about being a physician anyway?

 

[DeadCactus]

All pre-medical students dedicate themselves to 10 years of training without spending one day as a doctor. Is that really a wise move?

If you don't understand the difference between a decade of education during which you can leave on a whim (no worse off than some debt) and a legal obligation to serve 14-20 years in the military (under severe legal, professional, and personal penalties); you really have no business in this discussion...

Edit:
GMs point is simple; if your goal is to be a physician, a military academy is not the route of least resistance in any sense of the phrase. It's a completely accurate statement.

If the added risk is worth the potential added reward, go for it. It's not the wrong route to go, just not the most expedient.

 

[BoxerCar12]

"looks like a manageable schedule
But could you take Analytical Chemistry during one of the 2012-2013 semesters? It seems like a bit much to have organic + analytical chem, along with microbio and new research. "

I just did Orgo+ Analytical chem +physics+ new research at USMA, it wasn't too bad. Our support system is pretty outstanding in the science department. So is our Pre-Med staff.

Future cadet: PM me and we can talk about this if you want.

 

[GeraldMonroe]

All pre-medical students dedicate themselves to 10 years of training without spending one day as a doctor. Is that really a wise move?

There's a 100 different kinds of doctor you can end up being (including perfectly respectable non-clinical jobs), you can work as many or as few hours as you want (you could work 6 months of the year doing locum tens or 100/hours week taking tons of call) and there's thousands of places you could potentially work at.

Contrast this to being a military physician : you have to be one of the specialties the military has enough openings in, or you'll end up wasting years as a GMO. You may still end up wasting years as a GMO no matter what you do. The perverse thing is, you could owe 8 years, do 4 GMO years, decide to do a residency...and end up owing more years from time added on from the military residency. You have to work where the military decides to make you work - they assign you places. You can bargain with your superiors for desirable assignments sometimes, but you have to give something up to get them. And you'll not be allowed to stay at one place your whole career, they want to move you around. (that sounds better than it is. If you've got the perfect gig in a good location, you're not going to want to move)

Basically, you have only a tiny fraction of the flexibility you would have in the civilian world.

 

[Fiddlergirl]

GeraldMonroe, please stop. You've made your opinion clear, and I don't see why a medical student feels the need to degrade the personal choices of a high school senior. No one is forcing you into the military. Those of who have made this choice already know about the "pros and cons" and we decided to do it anyway. It's also becoming obvious that you have a limited amount of information on the medical establishment in the military. For example, you don't seem to realize that a military medical student has the chance to match into a civilian residency if the specialty they want to purse doesn't have a military residency. If you feel the need to continue this argument, I suggest you pursue it in the military medicine forum in the allopathic section of the website.

 

[BoxerCar12]

Geraldmonroe,

You obviously have no idea what you are talking about, so why don't you stop looking like an idiot.

 

[GeraldMonroe]

I'm here not because I want to degrade this young man's accomplishment. I'm here because I want to stop someone from making possibly the biggest mistake of their lifetime.
Signing away 20 years and nearly all control of your life is a big mistake, by definition. It really doesn't matter what they are offering. Every attending on the military medicine forums on this site agrees with me. I suggest that the OP go and inquire there about this.

 

[dr milky]

NQ, sorry I’m late to the party:
First, you might want to reconsider taking an overload during your freshman year. Even if it seems possible at the end of the fall semester, keep in mind that upperclassmen tend to come back from Christmas break “recharged.”

Second, you will want to give yourself time to prepare for the MCAT. That means, soldier, drill. Make sure you have time to take practice tests and review basic concepts of all the sciences. It won’t help to be fluent in AChem but hazy on those pesky time, speed, distance problems from physics. A good way to handle the MCAT might be to schedule it at the end of your 4 week summer leave period after 2/c or even 3/c year.

Third, consider scheduling your research during firstie year. A solid GPA will get you into more schools than a mediocre GPA with research. Plus, if you do during your senior year, you will still be able to talk about it at your interviews.

Fourth, if you find yourself drawn to anything else (flying helicopters, driving tanks) while at USMA, do it. You can always come back and apply to medical school, and five years of real world leadership experience will only help your application. I’ll never forget watching the Blue Angel airshow (VIP seating of course…RHIP) with two of my mentors, one a vascular surgeon and the other a plastic surgeon (both very wealthy) and they each turned to me and said, “Man you sure are doing it the right way.”

Finally, don’t worry about missing out on the mindless hedonism that is often referred to, reverently, as the “true college experience.” Even at USMA you’ll have the opportunity to drink beer and hit on chicks. You’ll also have the chance to do some things that money can’t buy.

BEAT ARMY

 

[Narmerguy]

The military isn't all it cracks itself up to be. Congrats on making it to West Point and remember who you'll be working for when you make some of your plans. It matters.

A also, why do people on this site feel the need to turn every freaking thing into an an acronym? WP? Really? Just type West Point.

 

[m015094]

NeverQuit,

First off, check out this link. You may have seen it already, but it may answer some of your questions about course loads. Also, don't worry too much about this right now. You'll be able to sit down with your advisor and USMA's pre-med advisor once you start.

I believe Dr. Milky makes a good point about pursuing your desires and then going back to med school later in life. I entered USNA thinking I was going to become one of the 15 people chosen for a med school spot - but it didn't work out. Instead I got to fly planes off carriers for 8 years - something I never would have had the chance to do if I went to med school directly out of a service academy. Of course I'm older, but I don't regret it for one second as I enter med school in 2 months.

Best of luck with whatever you decide to do.

GO NAVY, BEAT ARMY!

 

[dr milky]

The military isn't all it cracks itself up to be.

That point has been made abundantly clear on this thread.

Fortunately, we have an all-volunteer force in this country, but it wasn't that long ago that this country had a draft. Even doctors were conscripted, and recent reports indicate that if the draft returns, it will probably be targeted to health care workers. Enjoy your freedom.

 

[nick_carraway]

I entered USNA thinking I was going to become one of the 15 people chosen for a med school spot - but it didn't work out. Instead I got to fly planes off carriers for 8 years - something I never would have had the chance to do if I went to med school directly out of a service academy. Of course I'm older, but I don't regret it for one second as I enter med school in 2 months.

How do you get to become a Naval aviator and not get picked for med school? Crazy world!