"New Doctors Awash in Debt"

[LADoc00]

Another thing to take into account is the price of dental school. Private school tuition/books/materials are above $60,000 a year, and my state schools' tuition/books/materials(the UC's) is hovering around $40,000 a year and rising. You also have to add on the cost of living and the tuition increase every year.

Correct me if I'm wrong, but medical school is usually a lot cheaper and has many more scholarships. Add on the residency requirement that some states like NY are adding, dentistry is starting to look a little more bleak these days when it comes to lifestyle/pay.

http://www.nyu.edu/dental/financialservices/tuitionfeesexpensesdds.html
http://saawww.ucsf.edu/financial/general/budget.htm

Hold it, WHAT? NYU dental is 90000+ A YEAR?! that is insane. completely insane.

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[danzman]

Hold it, WHAT? NYU dental is 90000+ A YEAR?! that is insane. completely insane.

And they will fill their class every year. Same thing for medical schools. As long as the gov will hand out student loans forever, even if tuition was a million a year at every medical school, every single spot would be taken every single year.

I have said it before, its just like trying to explain to a sixteen year old kid why, even if he had 20 grand to spend on a new car, it may be a better idea to get a nice used one for 10. They just dont get it.

It is an interesting problem, because just like we are seeing with banks the general public has good reason to keep physicians working. Thus, the entire system will not be allowed to fail, just like your nearly trillion dollars that are going in to restarting this shambled economy and keeping banks etc' from failing. In other words, there will never be a time when ALL physicians are allowed to walk away from ther practice of medicine. The difference is that the problem with physician income isn't directly felt by medical students until they are done with both medical school and their residency, just like the kid buying the 20 grand car doesn't realize what a mistake he made until he needs new tires and can't afford them. Unfortunately, the tipping point is so far away that we will be dealing with this forever. And even if tomorrow we went to a socialist state and paid for both education and medical care, would the gov step in and pay off all current student loans retroactively? I think not. It is a mess, and there is no way around it, you are going to owe money or time for much of your career if you want to practice medicine in this country.

 

[Faebinder]

Wow I'm scared... seriously.. that means after 4 years raw no bachelor loan included and no interest you will owe 360k... meaning likely you will near 500k.

MD/PHD? 600k?

They better have a neurosurgery/spine orthopedics/cardiology spot open for each of their students.

 

[Lonestar]

well, i checked my real student loan statement and its 826/month for a 167,700 dollar student loan.

I will be paying this loan for 25 yrs!!!!

I just did an electronic debit account so i do get a .25% interest reduction to 4%.

My car loan is 39K at 0.9%.

My house loan is 150K at 5%.

I currently live in an apartment at the new place that i have started work after residency. I am planning on renting a house for next 2 yrs since i am single and don't really need a house at this new location.

Things to look forward to once you are done with residency. More debt!!!!

 

[gerickson03m]

"If the American people ever allow private banks to control the issue of their money, first by inflation and then by deflation, the banks and corporations that will grow up around them, will deprive the people of their property until their children will wake up homeless on the continent their fathers conquered."
- Thomas Jefferson

This is a new form of slavery. And you really do not have a choice. you can either stay out of debt and not go to school, or you can go to school in which you have to borrow, than be a slave to the bank the rest of your life. The only way to fix this is to have a revolution and abolish the current system of government. You combine personal and national debt, current financial problems of medicare (your going to get paid less every year when adjusted for inflation), the future is not good in the USA for new medical doctors.

 

[yaah]

"If the American people ever allow private banks to control the issue of their money, first by inflation and then by deflation, the banks and corporations that will grow up around them, will deprive the people of their property until their children will wake up homeless on the continent their fathers conquered."
- Thomas Jefferson

An interesting quote considering Jefferson lived well beyond his means (although his means were quite good!) most of the last half of his life, and took out loans continuously to pay for his extravagant lifestyle. He died basically broke. So I guess he would have known!

 

[boggvir]

This is a very interesting discussion for me, as I'm about to be one of those students who is going to be over $200,000 in debt, about $270,000 counting undergrad. However, I do not see this aversion to going to medical school that people are suggesting. The average MCAT and GPA keeps going up every year, and the number of people per spot keeps increasing. The issue is that doctors still have a very cherished place in the minds of many people, and I doubt the loan number will keep them out. Even if people graduate with half a million in loans, people will just rationalize it.

Look at countries where physicians make almost no money compared to the US. In those countries, the entry into medicine is still extremely fierce. I think physicians are one profession that politicians and everyone else can keep kicking knowing there'll be an endless supply of wide-eye youngers wanting to do it no matter what. You can't do the same with nurses or other professions, because you need to entice people to choose those profesisons. No enticing is necessary to become a physician.

Anecdotally, and personally, no amount of loans would keep me out of med school. Is that the right way to go? Probably not, but the idea of being a physician is so ingrained in so many young people's psyche that it's not something that pre-meds (like me) will let go easily, and that may in fact be hurting people who are actually physicians or medical students, such as yourself. Again, it's not a logical way to go, but people are rarely logical.

I'm a non-trad and I've worked in industry (at a hospital) it's amazing how weak the doctors are compared to nurses and other professions. From personal experience, and also looking at the national stage, there doesn't seem to be a cohesive concerted push and no one seems to be willing to draw a line in the sand like many other professions have done. I'm not sure why, as physicians are educated, have resources, and perform an integral service. Surely, they should have a more powerful lobby at both the local and the national stage?

 

[dragonfly99]

<it's amazing how weak the doctors are compared to nurses and other professions. From personal experience, and also looking at the national stage, there doesn't seem to be a cohesive concerted push and no one seems to be willing to draw a line in the sand like many other professions have done. I'm not sure why, as physicians are educated, have resources, and perform an integral service. Surely, they should have a more powerful lobby at both the local and the national stage?>

Doctors are too busy working many hours/week and the private practice docs simply do not have time to leave their practices to go lobby, etc. out of town. Also, the interests of specialist physicians are not necessarily the same as those of generalists like fp and general internal med. Increased reimbursements to procedural specialties tend to hurt those of "thinking" specialties like fp and IM, and vice versa, since there isn't an unlimited amount of money. The physicians' lobby does have a fair amount of power (I think AMA is usually listed among the top 10 or so most powerful lobbying groups in DC) but the AMA and other physician organizations don't really have the power to change antitrust laws that make it difficult or impossible for docs to negotiate against insurance companies, and since the gov't now pays for a substantial amount of medical care, they kind of have us by the balls as well. It's difficult to convince the federal gov't and general public that they can't keep cutting Medicare reimbursements when the idea of the "rich doctors driving their Mercedes cars and living in their manions" is still mighty prevalent, and in some cases still true. There are still specialists, and a few generalists, living a very very nice lifestyle and making in the 300k plus range, and as long as that is true I don't see Congress or the public "feeling our pain" any time soon.

At the state level, docs must constantly fight off incursions of other health professions (nurses, optometrists, naturopathic docs, etc.) into our scope of practice. We end up spending a lot of time defending/arguing what we are "against", leaving little time to lobby for what we are "for".

 

[dragonfly99]

<Look at countries where physicians make almost no money compared to the US. In those countries, the entry into medicine is still extremely fierce.>

Not necessarily true. From what I understand, being a physician is not a popular occupation in China - top students tend to go into things like engineering.

If you are talking about European countries w/socialized medicine, physicians in some of those countries make as much or more than some docs in the US. Reportedly a GP in the UK makes about $150k/year, comparable to what an internist here would make (and likely working a lot less) and better than many fp and pediatrics docs here for sure.

 

[dragonfly99]

I'm not trying to discourage anyone from entering medicine. I still think it's a good career. I do think one needs to realize the implications of the financial decisions one is making.

I am happy with my decision to become a doctor, but I know that I'm going to be able to pay off my loans (132k when I graduated in 2004).

Is there some way you can get through med school with <270k debt? Can you attend a cheaper med school, like your state medical school? Can your family help you out with costs?

 

[boggvir]

I'm not trying to discourage anyone from entering medicine. I still think it's a good career. I do think one needs to realize the implications of the financial decisions one is making.

I am happy with my decision to become a doctor, but I know that I'm going to be able to pay off my loans (132k when I graduated in 2004).

Is there some way you can get through med school with <270k debt? Can you attend a cheaper med school, like your state medical school? Can your family help you out with costs?

My state doesn't really have cheap med schools (no IS preference). My family is middle class, and I have to pay for my own schooling. I'm obviously going to try very hard to get through it with less than 270k debt, obviously the less debt I have the better it is, and it will be my top criteria if I am fortunate enough to be accepted to multiple schools. But unfortunately, I don't have another option. If I decide to go into primary care, I'll definitely work in an undeserved area for 4-5 years which pay help with some of the loan repayment. I'm also looking into some goverment programs where they pay your tuition, but I am not sure if they are worth it in the long run.

In any case, the main point is that as sick as it sounds, I'd do it even if it meant $400k in debt, and I suspect medical schools would still find thousands of others willing to do the same. Why do anything about costs when you have such a huge supply of students willing to pay whatever you ask?

 

[medicinesux]

In any case, the main point is that as sick as it sounds, I'd do it even if it meant $400k in debt, and I suspect medical schools would still find thousands of others willing to do the same. Why do anything about costs when you have such a huge supply of students willing to pay whatever you ask?

Well everyone has a number. I mean at some point the debt would become so great you would have be working for free for the rest of your life just to pay it off. The thing to remember is that this "debt number", whatever it may currently be, will quickly drop as you advance through your training. As a naive and idealistic 21 year old, I probably would've been willing to go into 400-500K debt too. Surely, I was willing to do and pay whatever it took to become a doctor and make the world a better place...Good grief...if I could just go back in time and smack that kid! But as you get older and the real world of American medicine begins to wear on you, idealism morphs into gritty realism. Now ten years later, if someone offered me a free ride to med school, I wouldn't take it. And that is the honest to God truth.
Medicine has taken so much from me on so many levels that I am a mere shell of my former self. I am planning my escape and dream of the day when I wake up in the morning and get to drive "by" rather than drive "to" the hospital. What a most splendid day that will be.

 

[emttim]

So here's an interesting question for those of you who are in med school or done with it. Say you had saved up enough money somehow that you didn't need loans, you just paid for it in cash (or maybe with a very small amount of loans), would you still do it?

From what I'm reading on here, it sounds like medical education is just as overpriced and atrocious as the education at a four year university. Would you be able to let go of that much money knowing you're not getting anywhere near your money's worth? Would it be worth it to buy that ticket into med school so you can be a doctor later? Would you still be concerned about the salary and state of health care or would it be a non-issue for you since you could walk away with no loan debt behind you at any point? Would you be able to with the amount of time you invested into becoming a doctor?

I realize these are a lot of questions but I really am curious to see what everyone's input is. I'm in a rather unique situation myself to be able to save up potentially 100,000 to 150,000 in a couple years (with help from my significant other) and this thread has got me thinking that maybe I should take a step back and analyze this. As with the car example, just because you can afford a 20,000 new car does not necessarily mean you should buy one.

 

[dragonfly99]

EMTtim
It would have been really nice if I had been able to save more than $8000 before going to med school...LOL! Yes, I still would have gone if I didn't have to take out loans...things would have been better because I wouldn't have had to worry about money.

If you are asking the question of whether doing medicine is worth the "opportunity cost" nobody but you can answer that question. My general answer is that if there is nothing else you would want to do, then do medicine. If there are other things that you think you'd like even close to as well as being a physician, do one of those. The reason is the hours and the many years of training, and then the hours working once you are done with training, are not good. The money is good eventually but given the debt many students will be putting themselves in, they won't be doing that great financially perhaps until they are pushing 40. Also, the crapola from the gov't, insurance companies and some patients/families, and the stresses of the large responsibilities you will have (i.e. could kill someone if you make a mistake) make medicine just a not very easy lifestyle. It IS cool, though.

 

[danzman]

So here's an interesting question for those of you who are in med school or done with it. Say you had saved up enough money somehow that you didn't need loans, you just paid for it in cash (or maybe with a very small amount of loans), would you still do it?

From what I'm reading on here, it sounds like medical education is just as overpriced and atrocious as the education at a four year university. Would you be able to let go of that much money knowing you're not getting anywhere near your money's worth? Would it be worth it to buy that ticket into med school so you can be a doctor later? Would you still be concerned about the salary and state of health care or would it be a non-issue for you since you could walk away with no loan debt behind you at any point? Would you be able to with the amount of time you invested into becoming a doctor?

One thing that does not come up much on these blogs is that there is simply no other career in America that lets as many people make as much money for so little risk as medicine. If you spend enough time talking to doctors about money they would have you believe that everyone with a bachelors degree in fine arts makes as much as they do for half the effort. And while there will always be people who open up tree trimming businesses and strike it rich, they are nowhere near the number of physicians making excellent salaries. As an example, my graduating class from high school was about 500; roughly half of them went on to college and half of that number graduated from college. That is about 125 college graduates. Of them, the vast majority graduated from local state schools in a non-science related field with between 10-20k in student loan debt. Those numbers are about par with the national averages. Three of us went to medical school, and about five went on to lower tier law schools, and another handful got MBA’s or nursing degrees. What is interesting to see, at least among my class, is how they are all living now, ten years after high school. The only ones that are truly well off had parents that gave them jobs without any college at all. They are the ones who will really have a chance to make a lot of money as they have the three ingredients to potential wealth, no debts, good starting salary, and the potential to save early. Everyone else is in the same position, living paycheck to paycheck, scared about losing their jobs at the local bank, and trying to pay off loans or buy a house. So, IMHO, unless you had someone willing to hook you up with a great job out of high school or wealthy parents, medicine is the safest and easiest career you could pick that would guarantee you a good job and little chance for unemployment. Only two other careers I can think of with even remotely similar stats are engineering and accounting and neither of them have the overall safety and security of medicine while having to work nearly as hard.

In answer to your question, one of the reasons I decided to be a doctor was because after five years of college I understood that a biochem degree was worth just as much as a philosophy degree in terms of career options and security. After looking at all the options and trying to find a better alternative I decided that medicine gave me the best of all variables related to my personal career goals, while being the choice with the least risk/most reward. And while I graduated from undergrad owing very little, I certainly couldn’t have paid for medical school without loans. Yet I think, even if I had won the lottery to the tune of about 250K, medicine would still be, by far, the safest and best career out there financially and others. Now if I had won 25 million, my answer may be different…

Your question is about the risk of the investment, and while it is a monetary risk, I think the greater risk is in time. But I do think, currently, you have the opportunity to get your moneys worth out of medical school. I would argue that there are fewer opportunities with just going to a public undergrad and getting a BA/BS (not so much the money spent, but more the time wasted.) Just look at how many people go and get their masters in English or business and cant find anything but an entry level position while owing a hundred grand.

 

[NotAProgDirector]

This interesting idea was discussed on NPR today. From an investment standpoint, a human capital contract on medical students would be "very high grade"

 

[dragonfly99]

APD,
that is very interesting. Thanks for posting. On one hand this sounds a lot like indentured servitude...but then again, there's not much difference between being an indentured servant to some "investor" for 10 years, vs. being indentured to the bank that loaned me money.

 

[emttim]

EMTtim
It would have been really nice if I had been able to save more than $8000 before going to med school...LOL! Yes, I still would have gone if I didn't have to take out loans...things would have been better because I wouldn't have had to worry about money.

If you are asking the question of whether doing medicine is worth the "opportunity cost" nobody but you can answer that question. My general answer is that if there is nothing else you would want to do, then do medicine. If there are other things that you think you'd like even close to as well as being a physician, do one of those. The reason is the hours and the many years of training, and then the hours working once you are done with training, are not good. The money is good eventually but given the debt many students will be putting themselves in, they won't be doing that great financially perhaps until they are pushing 40. Also, the crapola from the gov't, insurance companies and some patients/families, and the stresses of the large responsibilities you will have (i.e. could kill someone if you make a mistake) make medicine just a not very easy lifestyle. It IS cool, though.

Well, yeah I would imagine the amount that you can save up beforehand will make it a lot easier later on if it's an appreciable amount. I'm not necessarily talking about opportunity cost, I'm sure I could find plenty of other careers where the opportunity cost is more attractive, but I'm more concerned with whether it's feasible.

For instance, say if someone ends up having 250K in loans at the end of med school, last I checked on finaid.org, that would be about a $3,200 loan payment. After the loan payment, they may not be making much more than a person who makes considerably less (and who spent far less years in school to do so), and that situation will persist for 10 years. So if the person say goes to med school when they're 30, they won't even be out of residency until they're at least 37 and they're already close to 50 by the time they just pay off their loan. My main concern would be not being able to retire at a reasonable age due to not having enough money saved for retirement. Granted, I don't plan on ever fully retiring because I'd go crazy from lack of things to do, but just having the option would be nice.

I actually am going to P-school to try out being a paramedic, because as you and others have said, if there's anything else I can do and be comparatively happy with, then by all means that would make more sense. The big problem I'm noticing as I'm going through paramedic school, however, is it still leaves a lot of questions unanswered as to what we do, why we do it and how our intervention helps, and I'm the kind of person who just keeps asking why until I get a good answer. I don't like the limitation on how many medications and procedures we can do, because while I understand we don't have a controlled environment to work with, I basically feel like we're having one hand tied behind our back as far as our job goes. Additionally, part of that problem is precisely because we don't have all the diagnostic tools, labs, etc. that would be available to any physician so it makes treatment a lot more limited and potentially less accurate since we may not be able to pinpoint the problem. If I run a call on someone with abdominal pain, I'm not going to be content with just starting an IV on them and transporting. I want to provide definitive care that positively impacts my patients while maintaining a certain level of autonomy and having a depth of knowledge that allows me to know exactly why I'm doing what I am. I'm starting to realize that this is only possible as a physician.

One thing that does not come up much on these blogs is that there is simply no other career in America that lets as many people make as much money for so little risk as medicine. If you spend enough time talking to doctors about money they would have you believe that everyone with a bachelors degree in fine arts makes as much as they do for half the effort. And while there will always be people who open up tree trimming businesses and strike it rich, they are nowhere near the number of physicians making excellent salaries. As an example, my graduating class from high school was about 500; roughly half of them went on to college and half of that number graduated from college. That is about 125 college graduates. Of them, the vast majority graduated from local state schools in a non-science related field with between 10-20k in student loan debt. Those numbers are about par with the national averages. Three of us went to medical school, and about five went on to lower tier law schools, and another handful got MBA’s or nursing degrees. What is interesting to see, at least among my class, is how they are all living now, ten years after high school. The only ones that are truly well off had parents that gave them jobs without any college at all. They are the ones who will really have a chance to make a lot of money as they have the three ingredients to potential wealth, no debts, good starting salary, and the potential to save early. Everyone else is in the same position, living paycheck to paycheck, scared about losing their jobs at the local bank, and trying to pay off loans or buy a house. So, IMHO, unless you had someone willing to hook you up with a great job out of high school or wealthy parents, medicine is the safest and easiest career you could pick that would guarantee you a good job and little chance for unemployment. Only two other careers I can think of with even remotely similar stats are engineering and accounting and neither of them have the overall safety and security of medicine while having to work nearly as hard.

In answer to your question, one of the reasons I decided to be a doctor was because after five years of college I understood that a biochem degree was worth just as much as a philosophy degree in terms of career options and security. After looking at all the options and trying to find a better alternative I decided that medicine gave me the best of all variables related to my personal career goals, while being the choice with the least risk/most reward. And while I graduated from undergrad owing very little, I certainly couldn’t have paid for medical school without loans. Yet I think, even if I had won the lottery to the tune of about 250K, medicine would still be, by far, the safest and best career out there financially and others. Now if I had won 25 million, my answer may be different…

Your question is about the risk of the investment, and while it is a monetary risk, I think the greater risk is in time. But I do think, currently, you have the opportunity to get your moneys worth out of medical school. I would argue that there are fewer opportunities with just going to a public undergrad and getting a BA/BS (not so much the money spent, but more the time wasted.) Just look at how many people go and get their masters in English or business and cant find anything but an entry level position while owing a hundred grand.

Well, that's a lot more encouraging note than I usually hear from the other side of the fence. I would imagine then, if someone could pay for most of medical school in cash, it would definitely make it a lot easier to undergo the risk as far as time is concerned. I realized that about a year ago with degrees myself...a bachelor degree really doesn't get you a very high-paying or secure job, unless like you said, someone has a job setup for you when you get out into the work force. I'm only finishing my degree to have it at this point, because I can probably get a job that pays about $50,000/year as an economist, but I have zero interest in doing that and I can get a job as a paramedic in the bay at anywhere from $62,000/year starting to $68,000/year so it makes no sense to use my degree anyway. One thing that the medical director for my current ambulance company said that really sums it up quite nicely is that health care is recession-proof. I fully agree that there is no other field with as much job security as health care.

My concern isn't even really with whether the current state of being a doctor is worthit, obviously it is, since I find responses like this still quite often and the salaries are still reasonable for most specialists. The problem I see is that you kind of have to predict the future and hope that they don't socialize or nationalize health care because I would imagine that would tank the salaries of doctors by a fairly significant amount. My fear isn't really with whether I could make it through medical school but whether I would go into a profession, love it, and then watch it destroyed by some ******* in Congress and be forced to work for a salary that isn't nearly enough to ever allow me to get out of debt and have the ability to retire at some point. Hence why I'm looking at trying to save up as much as possible with a paramedic job for a couple years beforehand so I don't have to take out any loans, or at the most, $50,000 total or less since that's a manageable amount. I figure the risk and the feeling of being "trapped" would be far less if I didn't have a net worth of negative $250,000. I definitely appreciate the input though!

 

[Coastie]

That economic hardship loan still exists, I just was recertified for another year in the past month....

Yes, you are right. There is the new income-based repayment plan. With the new income-based repayment plan, residents will not be going under financially, but for a lot of them I suspect the 350-400/month will not even make much of a debt in their loans, and will probably not even be enough to keep the loans from getting larger while they do residency, which is unfortunate.

There was an old economic hardship loan deferral program that was even better...for that one the gov't would pay all the interest on your subsidizes Staffords for the first 2-3 years out of med school, as long as you qualified (i.e. had a low enough salary, which most residents would).

 

[Bubb Rubb]

That economic hardship loan still exists, I just was recertified for another year in the past month....

ditto. i ended med school with 121k in loans. realistically i don't see myself repaying even interest on them until i finish residency. will it cost me more ultimately? yes. is there a greater opportunity cost to living really, really cheaply on a resident's salary vs. paying off for a few more months while living nicely on an attending's salary? i think the answer is also yes.

 

[dragonfly99]

Enjoy your economic hardship loan deferment for now, because 2009 is the last year for it. After that, you'll have to pay something on your loans, per the NEW economic hardship plan we detailed above. However, you can still do forbearance if you want...which will allow your loans to get bigger and bigger while you do residency. I definitely recommend trying to pay something on your loans while you are in residency and fellowship, if there is any way you can.

 

[Lonestar]

yeah. I had 133K in loans at the end of med school. I did 3 yrs of economic hardship deferral and 1 yr of forebearance. Now, i owe 168K in total after 4 yrs of accruing interest.

Currently, I have consolidated my loans at 4.25% interest. My first priority will be reduce this debt to around 100K within next 3 yrs. I will not be buying a house for 3 yrs as i have just started private practice. Instead will rent a house and be frugal with my money. I already have a house in the place where i did my residency and my family is living there now. So i already have house mortgage payments and i don't need to worry about another one.

My salary after extra shifts: 291K so far for the 1st yr. Another 20K in retirement and 30k in occurance malpractice. I will probably save about 100K the 1st yr for whatever I like. Bought a car for 37K at 0.9% interest for 3 yr repayment plan. Currently i am refinancing my house to a fixed 30 yr loan and will fork over 15K for downpayment to reduce the loan payment in my house. Will probably reduce my student loan amount by paying off 18K the first year. This way I am saving up for the eventual downpayment on my new bigger house in 3 yrs. Currently life is sweet as i am starting to get rid of my debt. So, my advice is hang in there; there is light at the end of the tunnel.

 

[bigpharmD]

yeah. I had 133K in loans at the end of med school. I did 3 yrs of economic hardship deferral and 1 yr of forebearance. Now, i owe 168K in total after 4 yrs of accruing interest.

Currently, I have consolidated my loans at 4.25% interest. My first priority will be reduce this debt to around 100K within next 3 yrs. I will not be buying a house for 3 yrs as i have just started private practice. Instead will rent a house and be frugal with my money. I already have a house in the place where i did my residency and my family is living there now. So i already have house mortgage payments and i don't need to worry about another one.

My salary after extra shifts: 291K so far for the 1st yr. Another 20K in retirement and 30k in occurance malpractice. I will probably save about 100K the 1st yr for whatever I like. Bought a car for 37K at 0.9% interest for 3 yr repayment plan. Currently i am refinancing my house to a fixed 30 yr loan and will fork over 15K for downpayment to reduce the loan payment in my house. Will probably reduce my student loan amount by paying off 18K the first year. This way I am saving up for the eventual downpayment on my new bigger house in 3 yrs. Currently life is sweet as i am starting to get rid of my debt. So, my advice is hang in there; there is light at the end of the tunnel.

What specialty are you??

 

[danzman]

What specialty are you??

He is a gas man.

 

[Llenroc]

The solution is simple: have your rich father write you a check. If you don't have a rich father, then get one.

[YOUTUBE]iRdd9EcXXUo[/YOUTUBE]

 

[Lonestar]

yeah, i am an anesthesiologist. Happy so far.

Simplest way is to inherit that money. This medicine business takes a lot of time and effort. On the other hand, I am about to fork over 6K for cosmetic dental work to this cosmetic dentist. Most of that money will probably go towards his yacht. Easy come, easy go. Thats life.

 

[mercaptovizadeh]

medicinesux
your graph makes it look like the attorneys are even worse shape than we are. Unless one becomes one of the higher-earning lawyers it would not be very fun to pay off 120-140k...though I guess it would be possible ultimately. I'm not sure what an average attorney (i.e. not in one of those big firms) makes.

My sister makes around 40k and works for the public defender. Her loans are 160k. Pretty much I think I'll be paying them off, which I don't mind, but the loans have practically made her life a misery, and I don't know when I'll be done with med school. Although the thought of being an IM or peds doc is appealing, I think I'll have to try one of the high paid specialties. On the other hand, I'm worried that the specialties will take a hit in reimbursement or tighten the noose on the residency spots.

I've told her to try to switch into middle/high school teaching and at least that way she'll get the vacations and a less demanding job for the same pay. But that would require yet *more* "education."

 

[mercaptovizadeh]

<Look at countries where physicians make almost no money compared to the US. In those countries, the entry into medicine is still extremely fierce.>

Not necessarily true. From what I understand, being a physician is not a popular occupation in China - top students tend to go into things like engineering.

If you are talking about European countries w/socialized medicine, physicians in some of those countries make as much or more than some docs in the US. Reportedly a GP in the UK makes about $150k/year, comparable to what an internist here would make (and likely working a lot less) and better than many fp and pediatrics docs here for sure.

Cost of living in much of the more appealing parts of the UK (the south and east especially) is likely comparable to the most expensive places in the US. London is almost certainly more expensive than any US city.

 

[meister]

This **** is on my mind constantly and I'm a lowly M1. I am already $100k in debt counting undergrad. The worst part is that I'm trying to raise a family at the same time and it is just soul-crushing to see the debt pile up knowing it's going to be a ****ing decade before I can start to make a dent in this. And if I take out $70k/year, I'll be right at $300k by the time I'm done. There is absolutely no way I'll be a primary care doc, and that makes me sad that I have to just ignore that possibility.

$300k in debt (estimate after interest accrual) at 6.8% is like $2000/mo. What the **** kind of system do we have here?

No way I'm ever having my kids pay for their schooling. Maybe a little bit to teach them how to manage some debt, but this is ridiculous.

 

[CaptainXRT]

I am on economic hardship deferment. I still get these interest statements saying how much money I continue to lose. It's depressing. I realize that if I were to pay off my med school loans (on a 10 year plan) my monthly payments would leave me with $150/month left over. My loan payments pretty much equal my take-home pay as a resident. I see my colleagues from high school and college buying houses and starting families and realize that i am going into my 30s still living in the cheapest apartment I can find, don't go out to restaurants, or take vacations, etc. Does anybody else feel as stressed out by their loans as I do?

 

[dragonfly99]

captainXRT,
a little bit.
I get where you are coming to.
I'm 30-something, going into fellowship, and still living in a kinda cheap apartment and not really taking real vacations, have never bought a house, etc. It does suck but you'll make it.

I suggest trying to pay some or all of the interest on your loans from your resident salary. Then you don't have to watch the principle on the loans getting bigger...and bigger...and bigger.

Also, once you get 2-3 or more years into residency you can start moonlighting occasionally, which gives you some extra money to play with.

 

[CaptainXRT]

captainXRT,
a little bit.
I get where you are coming to.
I'm 30-something, going into fellowship, and still living in a kinda cheap apartment and not really taking real vacations, have never bought a house, etc. It does suck but you'll make it.

I suggest trying to pay some or all of the interest on your loans from your resident salary. Then you don't have to watch the principle on the loans getting bigger...and bigger...and bigger.

Also, once you get 2-3 or more years into residency you can start moonlighting occasionally, which gives you some extra money to play with.

I'm trying to pay off some of the highest interest loans (at 7%), but can't afford to pay off any more. And the rest of the loans (from the first 3 years of med school) continue to balloon away. I just hope the whole 'medicare crisis' and incoming socialized medicine doesn't leave us unable to pay things off when we finally finish training. And I'd love to be able to afford to have kids before I'm sterile

 

[medicinesux]

Great article put out by Forbes magazine just this week exposing the "education bubble":

http://www.forbes.com/leadership/forbes/2009/0202/060.html

"an unfolding education hoax on the middle class that’s just as insidious, and nearly as sweeping, as the housing debacle. The ingredients are strikingly similar, too: Misguided easy-money policies that are encouraging the masses to go into debt; a self-serving establishment trading in half-truths that exaggerate the value of its product; plus a Wall Street money machine dabbling in outright fraud as it foists unaffordable debt on the most vulnerable marks.”

Hmmm, kind of sounds a little like my first posting on this thread a little less than a month ago?

 

[bigpharmD]

This **** is on my mind constantly and I'm a lowly M1. I am already $100k in debt counting undergrad. The worst part is that I'm trying to raise a family at the same time and it is just soul-crushing to see the debt pile up knowing it's going to be a ****ing decade before I can start to make a dent in this. And if I take out $70k/year, I'll be right at $300k by the time I'm done. There is absolutely no way I'll be a primary care doc, and that makes me sad that I have to just ignore that possibility.

$300k in debt (estimate after interest accrual) at 6.8% is like $2000/mo. What the **** kind of system do we have here?

No way I'm ever having my kids pay for their schooling. Maybe a little bit to teach them how to manage some debt, but this is ridiculous.

Man as a pharmD thinking of going back you guys make me think hard about it. I already have close to 100 grand in loans from private pharm school. I just dont know if all that money is worth it...

 

[medicinesux]

And from last night's 20/20 in case you missed it:

[youtube]V122ICNS8_0[/youtube]

 

[danzman]

And from last night's 20/20 in case you missed it:

[youtube]V122ICNS8_0[/youtube]

I think this also reinforces what I commented about earlier. There are few safer investments than a career in medicine, but if you go to college believing that a BA in fine arts will guarantee you a great job, you are poorly informed. Overall, I think there are too many people attempting to get college degrees that are of a devalued status. How many people do you know of who spent 80grand to get a degree in elementary education? We will always need people to teach little kids, but 80 grand is nuts. The same can be said for more than half the degrees granted by colleges, if you don’t want to teach that very same subject at a college, there are no other jobs available to you. I read a report yesterday that said that 9 of the top 10 jobs today are in science or math related fields, it is getting to the point where unless you want to study a science or math based subject, you would be better off never going to college or finding the cheapest one. Even then, there are no guarantees, I personally know five people who graduated with biology degrees that are essentially worthless to them now. If I ever have kids, and if they want to go to college, they will need a pretty good argument to get me to pay for anything other than engineering, medicine, or actuary/accounting.

 

[Raggaman]

I am on economic hardship deferment. I still get these interest statements saying how much money I continue to lose. It's depressing. I realize that if I were to pay off my med school loans (on a 10 year plan) my monthly payments would leave me with $150/month left over. My loan payments pretty much equal my take-home pay as a resident. I see my colleagues from high school and college buying houses and starting families and realize that i am going into my 30s still living in the cheapest apartment I can find, don't go out to restaurants, or take vacations, etc. Does anybody else feel as stressed out by their loans as I do?

As a 4th yr in med school, I live in a tiny apartment that has bums with shopping carts outside. The best restaurants I have been to recently (past 5 yrs) are due to drug reps. The only "vacations" I take are residency interviews or playing computer games. Recently I calculated my take home pay during residency and subtracted some of the loan monthly payments I plan to make. Thats when it dawned on me that I will be living in the exact same condition that as I am now- well into my 30s! Not to say that I am starving or anything, but I am a little over this student life. Especially when all my friends from undergrad have already bought homes and have stable jobs.
Thats it! I was done comparing up- now I only compare myself to the bum standing in the parking lot. Atleast I have a roof over my head and can buy as much frozen pizza as I want

 

[locketeer]

I find this discussion very true to reality...


As one just entering medical school next fall(and taking out loans), my only comforts for the future are:
-anticipated love of the field
-lack of excess greed on my part
-if physician salaries fall below some threshold, they'll have nowhere to go but up (IE, I'll be able to eat Ramen if nothing else)

 

[Llenroc]

A while back I met Ward Connerly, the guy who leads initiatives against affirmative action. He told us that colleges are and "edu-cartel" that keep insisting that people need more and more education, even though not everyone needs to go to college. A lot of folks who are in college right now might be better served by going to a technical school or the like.

And a college degree has cheapened over the years. It's hard to get a serious job as a scientist with just a bachelor's degree, you need a PhD now. Back in the 1960's, the average college graduate had an IQ of 130. Today it's something like 105, because so many people are going to college.

 

[Miami_med]

The artificially elevated supply of college grads doesn't increase the demand for services that are enhanced by college degrees. It simply devalues the degree, as everyone has one. It's getting a little sick, because the extended training length for everything is seriously cutting into the time that people could actually be productive.

 

[BlondeDocteur]

I agree-- and one thing that really angers me is the devaluing of the trades. 30 years ago being a Master Carpenter was something people were really proud of-- it required skill, years of experience and expertise (and was remunerated accordingly). Now people firmly believe that being a master carpenter is much worse than having a communications degree from the regional branch of your state university (or worse-- a no-name private college), with its income potential of $21,000 and the educational debt of $40K.

Not everyone should own a home. Not everyone should go to college. Don't let the tastes and choices of a few dictate what's right for the entire human race.

As an aside, though, it is lovely that everyone who wants to go, and has the smarts to make it through, can do so nowadays. Both of my grandfathers dropped out of school (one in 8th grade, one in 10th) to help feed their large families during the Depression. One told me-- at every graduation of mine, high school through graduate school-- that he used to run behind the barn and cry every time the school bus drove by, he wanted to go so badly.

I think the pendulum has swung too far in the other direction, though, and the predatory lending of educational loan companies certainly hasn't helped.

 

[dragonfly99]

I agree that the skilled trades, as well as technical schools, should not be devalued.

Perhaps there are too many folks in college currently, but I'm not totally convinced of that. I DO think that college tuition has gotten way too inflated (ditto for grad school and professional schools). The issue in my mind is "value for the money" which is not entirely dependent on the salary you'll make when you are done. There is an inherent value in education that cannot be measured in dollars alone. I'm not sure I agree that college should only be for the 130+ IQ people...there is value in having an educated society. I think my "useless" (so called by several of you) biology degree from a liberal arts college (one of those "no name private colleges" also mentioned by one of you) is worth far more than what I paid for it. However, my tuition was 13k, 1/2 of which was paid by a scholarship. Not sure I'd say the same if I was paying the 20k+ per year tuition that same college is now charging. I certainly agree that the large number of people with BA and BS degrees in recent years has eroded the value of having a college degree (financially speaking). I also agree that folks should think twice before dropping 80k or more to get something like an art of elementary education degree...whenever one takes out any type of loan, educational or otherwise, it's important to think about what you'll need to do to repay it. Colleges need to be more responsible in how they spend students' tuition money, and students need to be better consumers (i.e. don't necessarily go for the biggest name or most expensive school, but the one that offers value for the money and that is the best fit FOR YOU).

 

[Substance]

University enrollment should be decided by merit and intellectual ability, not by the size of one's parents pocketbook, nor by race or gender.

Over the years, university tuition has risen astronomically, and everyone under the sun can go provided they have the cash. Aside from the few scholarships offered to exceptional high school graduates, university admittance is primarily based on ability to pay. As such, the overabundance of university graduates has devalued bachelors degrees - in the job market, a bachelors degree is as good as a high school diploma was 30 years ago.

I agree with the previous poster who said that too many people are going to university, and many do not belong there. University has gone from a place of higher learning to another hurdle to be competitive in the job market, thus illustrated by the lower average IQ of the university graduate.

I also fail to see the value a BA with a GPA of 2.7 brings to one's resume or skill set. These individuals would be better off learning a trade. I know of plenty of guys I went to high school with who have eschewed university for a welding course, and are now making six-figures on the Alberta oil sands. My BA friends are working at call-centers making 11 bucks an hour. Go figure.

As it stands, the devaluing of university education, combined with the very unfavorable opportunity cost for all but the most coveted professional degrees, will likely result in a student-loan repayment crisis, not unlike the current mortgage crisis.

Universities have to tighten their enrollment standards and offer more financial aid for gifted students if a university education is going to mean anything in the future. This will not likely happen as student tuition payments are very lucrative for universities.

As for Dragonfly's post stating that an education society is a better society - I agree completely! However, this level of education should be granted to all students at a secondary school level. The tools needed to appraise problems and situations logically is missing from the general high school curriculum in all but the most coveted private institutions, and this needs to change. Specialized knowledge such as that offered by a university education does not need to be available to everyone.

 

[BlondeDocteur]

Dragonfly, my point about the "no-name" private schools is precisely indexed to value for money. The vast majority of the 3000+ private 4-yr colleges in the US cannot justify their tuition when compared to their state universities and community colleges. In my opinion, for what it's worth, there are less than 50 (probably less than 30) private colleges where the extra tuition is worth it in terms of educational opportunities (intensive seminars with leading scholars, excellent facilities and labs, research opportunities in all fields), career networking (good alumni networks, internships, scholarships, institutional exchanges) and name recognition (which, like it or not, really does open doors).

Since the choice of where to attend college is solely in the hands of 17-year olds, who are completely divorced from financial reality, you often end up with a degree which provides none of the above-named advantages, a high debt burden, and the inability to pay it back whatsoever. And worse, many people correlate tuition with quality-- there are lots of small private colleges who had to *raise* tuition in order to increase enrollment, since people figured if they were charging the same as Yale, they must be just as good.

 

[dragonfly99]

I disagree that there are less than 50 good private colleges around...lots more than that. Just because a lot of them don't have the "name" recognition of Harvard or Columbia or even Williams does not mean they don't offer a great education. The "name" of a college or university doesn't tell it all about the quality of education you'll get there...not by a long shot.

But I agree w/some of the above posts predicting there may be a coming financial crisis having to do with some folks not being able to repay their loans. I think what is even more likely is that people will be paying off their loans, but then not saving for retirement or their OWN kids' college tuitions, because they'll be paying off their own college loans for 20-30 years or something...

 

[Miami_med]

The deep dark secret is that I know some master plumbers, carpenters, etc... Most of them actually do really well. These careers are there, and the pay is there. The problem really starts in the public middle/high schools where they lead you to believe that everyone who doesn't go to college is doomed to begging under the overpass. The education fiat starts young.

The local carpenters union used to hire apprentices at $10/hr with no training back when I considered it as a career track (the same time period when you would be paying tuition for college). They had free workshops and on the job training for the next four years, after which you were considered a journeyman and given ~$40k/year + overtime at union wages. Overtime for some was another 20 or 30 grand. This was after four years of paid training. Not a bad gig. Roofers start as high as like $18/hr + overtime. Commercial truck drivers often make pretty good money as well. I know numerous small business general contractors and specialty contractors that are making money that rivals the salaries of employed primary care docs.

 

[Pghboy18]

From the premed point of view, it really bothers me that the new trend for medical schools is supposedly to emphasize primary care, especially among some of the new allopathic schools opening up. These supposed bastions of primary care education still charge the same 40k/yr that has become standard at many allopathic and osteopathic schools.

I'm interested in primary care, but I'm not interested in putting off buying house, having a family, or taking out more loans to pay for the above. If you want to be a primary care school, how about figuring out a way to reduce tuition so some of your students might actually be able to choose it as a career path?

 

[Llenroc]

From the premed point of view, it really bothers me that the new trend for medical schools is supposedly to emphasize primary care, especially among some of the new allopathic schools opening up. These supposed bastions of primary care education still charge the same 40k/yr that has become standard at many allopathic and osteopathic schools.

I'm interested in primary care, but I'm not interested in putting off buying house, having a family, or taking out more loans to pay for the above. If you want to be a primary care school, how about figuring out a way to reduce tuition so some of your students might actually be able to choose it as a career path?

"Primary care" this and that is just a catchy buzz phrase. Just like "technology" and "patient care". There's nothing wrong with going into primary care, but the schools like to push it hard. For a school to say "we promote primary care" has no meaning in my mind, just like if a politician says "I'm in favor of education".

 

[BlondeDocteur]

There's more to it than that. State-funded medical schools have an overt mission to provide health care for the population of their state (part of being a land grant university). Most of the rural US counts as underserved for all medical specialties, particularly primary care.

 

[pgg]

If I ever have kids, and if they want to go to college, they will need a pretty good argument to get me to pay for anything other than engineering, medicine, or actuary/accounting.

I have to disagree with that. I'll pay for my kids to go to college for whatever field they want, provided they don't party & booze it up so much that they flunk out. There are many benefits to a university education that go beyond the knowledge or skills that are explicitly taught. And when they finish, debt free, they'll have a significant advantage for the rest of their lives.

The problem isn't the non-math/science degree that leads to a low paying job; it's the crushing debt and the fact that Joe Borrower ends up paying 2-3x the actual cost of the education by the time he's done. If you pay cash for your kids' education, you pay less, and they don't graduate as financial cripples. If you're in the enviable position of being able to give that to your kids, why wouldn't you?