"New Doctors Awash in Debt"

[dragonfly99]

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?

Quoted for truth.
However, I think that all the colleges and universities (including the Harvard/Stanford/Columbia types) need to exert some tuition control. They could provide a great education and not need to chart 30k a year tuition...

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[danzman]

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?

You are obviously correct that people should be able to choose their own educational path, and if I ever have children I will, of course, encourage them to find what makes them happy and to do what interests them. What I should have said was that I would want my kids to have at least some idea of what they were interested in before they go off to a private university and take three semesters of basket weaving while drinking on Dad’s dime. One of the best things I did was to take a year off of school before I started college. I worked as a car mechanic and loved it. I was able to work part time on cars to pay for my undergrad throughout my entire college career. Also, my first semester was at a local community college that gave me a tuition fee waiver scholarship. This really let me get my feet wet and see what college was like for next to nothing.

I can only speak from my personal experience but I had a ton of friends who went off to big schools and drank themselves silly and failed out. Also, most people that I know who did actually graduate bounced around to two or three schools, lost a bunch of credits, and graduated in five or six years. If I was paying the bill for that at a school that cost 60 grand a year I would be furious, especially if they wanted to study art history (again, nothing wrong with art, hell I love art… but you see where this is going.) I am all for an education, I think it is one of the most important things that humans can do for themselves. Even if all I ever did was work on cars for the rest of my life, I would still value my education immensely. College gave me a chance to study philosophy, business, humanities, and literature, along with all of my pre-med stuff and no matter what happens to you, no one can take away your education. It’s just like I said earlier about the 16 year old kid and a car; people just don’t properly evaluate their situations and balance needs with their wants effectively enough when they are 18. They make choices that can get them into huge amounts of debt with little to no foresight. And colleges are not in the business of providing education, they are in the business of making money, just like all other businesses. The difference between them and wal mart is that the federal government will loan you a huge chunk of change, no matter what you study, just to show up and have a good time. All the while society keeps telling you that the only way you will ever succeed in life is if you finish that poly sci degree.

 

[dragonfly99]

great post
danzman
Now I am agreeing with you. This should be read 2x by all premeds.
I actually am 100% sure that my college actually cared about providing a great education, but the older I get the more I begin to realize that my school was probably in a tiny minority and I feel lucky that I happened upon it, because I think it was partly be sheer luck. My med school definitely fell into your above description of "a money making entity/business" IMHO most other med schools do as well.

 

[wobit]

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?

Yes.

I worked my way through a state undergrad, worked a few years and then with no debt of any kind, got into a state med school with low tuition. Since I'm now older, here my path is different - my husband works, we have a child but we live frugally. We do take the subsidized loans because the rates are better than we could do investing his salary, but when they start to charge real interest we will close them.

I am thrilled to be in medicine, delighted to have the options and opportunities that I do now, debt free, even as a non-trad student. I have always felt a little horrified at the debt that some of my classmates carry from their ivy league undergrad degrees. My parents both went to state schools in their day and paying more than 15k a year was an idea I was never comfortable with.

I agree that other schools are probably not worth the 40-50k per year or more, and I find it hard to fathom how so many successive classes of students bought into the system to let it get that way.

 

[BlondeDocteur]

Likewise. I too was blessed to have full scholarships for my undergraduate and graduate school, and have paid for medical school with cash. I will graduate with no debt and can't think of a way I would rather have spent that money.

 

[sjdsn135]

I've heard that after you graduate from med school you can go to a small town that is in real need of doctors and they will pay your loans for you in full in addition to a reasonable salary.

Has anyone else heard this? How long do you have to stay usually if you do this?

If this really is the case why wouldn't more people do it?

 

[Substance]

I've heard that after you graduate from med school you can go to a small town that is in real need of doctors and they will pay your loans for you in full in addition to a reasonable salary.

Has anyone else heard this? How long do you have to stay usually if you do this?

If this really is the case why wouldn't more people do it?

Usually, going back to small towns means that you have to do primary care. In the long run, doing something like ophtho or anesthesia without this arrangement is FAR FAR FAR more lucrative than doing primary care with this arrangement. So, there really exists no long-term financial benefit in taking part in a scheme like this. Therefore, it only provides an advantage to the small number of graduates who already had their sights set on practicing primary care in the middle of nowhere.


When signing return-of-service agreements, they usually want you to stay one year for every year of residency funded by them. Usually this is 4 or 5 years. It's a binding contract, so unless you have the money to pay back the town, you're stuck there for a good half-decade.


These return-of-service arrangements are highly coercive in my opinion, and should not be tolerated by the medical community.

 

[dragonfly99]

There are numerous programs for student loan payback, but as stated above these are usually only for primary care. However, there are binding contracts you have to sign, at least from what I know. And they don't just "pay all your loans for you". I think it's usually 20-30k/year student loan payback or something. That's nice if you were already planning to live there, but might not be enough to induce someone to move to the middle of nowhere if that wasn't in his/her original plans. Some of these places might be nice, but some are not...part of the reason they might have to pay people extra to go there is that the work is harder, and there may not be good access to specialist consults.

 

[sjdsn135]

Thanks for the responses, Substance and dragonfly99. I had a feeling this deal was too good to be true.

 

[Doowai]

Likewise. I too was blessed to have full scholarships for my undergraduate and graduate school, and have paid for medical school with cash. I will graduate with no debt and can't think of a way I would rather have spent that money.

Pardon my bluntness, but where did the cash come from? Was it more scholarships?

 

[BlondeDocteur]

No, from the same places other people get cash-- jobs, investments, and so forth. And since I went to State U on the academic full ride and had my time in Britain covered by a private trust, my college fund was untouched.

I know I am lucky and other people are not in the same situation, and that it is a complete luxury to choose a specialty based on what I enjoy rather than financial constraints.

 

[72531]

Usually, going back to small towns means that you have to do primary care. In the long run, doing something like ophtho or anesthesia without this arrangement is FAR FAR FAR more lucrative than doing primary care with this arrangement. So, there really exists no long-term financial benefit in taking part in a scheme like this. Therefore, it only provides an advantage to the small number of graduates who already had their sights set on practicing primary care in the middle of nowhere.


When signing return-of-service agreements, they usually want you to stay one year for every year of residency funded by them. Usually this is 4 or 5 years. It's a binding contract, so unless you have the money to pay back the town, you're stuck there for a good half-decade.


These return-of-service arrangements are highly coercive in my opinion, and should not be tolerated by the medical community.

I'm wondering...if you do an IM residency and then go work in an underserved area for a few years..are you able to apply to IM subspecialty fellowships such an ID after you finish your obligation?

 

[smq123]

I'm wondering...if you do an IM residency and then go work in an underserved area for a few years..are you able to apply to IM subspecialty fellowships such an ID after you finish your obligation?

Yes, you can. Once you've paid them back, you have no further obligation to them.

 

[notinkansas]

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?

Wow. You sound just like I did. The difference now is that I've got my MD degree, partially completed a residency and bailed out because I HATED IT!

Part of me cannot believe that I wound up hating being a doctor so much. It is so rare that I have a good experience as a doctor. Patients, nurses, government agencies interfering...it's a horrible experience. It absolutely sucks the life out of me. I'm working a transitional clinical job as I try to figure out how to get into some form of nonclincial medicine that will still allow me to service my $269K student loan debt and maybe save some for retirement. Any shift I do i come home angry and irritated and I just want people to leave me the f(*k alone.

I read an interesting article while in residency about by a cardiac surgeon who had to take time off because he had a MI. Once he had the opportunity to slow down and think, he described the practice of medicine very adeptly: "Altruistic Self Destruction"

That really resonated with me. Not only are patients demanding and unreasonable, and nurses have been empowered to report and cause trouble for doctors they don't like (these days all that needs to happen is one of them doesn't like the expression on your face). But culturally, in medicine, you are generally considered weak if you take care of yourself.

Like you, nobody or nothing could have talked me out of it. I was willing to incur any amount of debt to achieve the goal of becoming MD. Now I feel nothing but enslaved by my debt. I'd rather be a barrista and have control of my life. But since student loan debt is non-dischargable- the government will hound you with KGB like ferocity until they are paid, all the while happily increasing the interest! I am not that different from an endentured servant.

 

[medicinesux]

I read an interesting article while in residency about by a cardiac surgeon who had to take time off because he had a MI. Once he had the opportunity to slow down and think, he described the practice of medicine very adeptly: "Altruistic Self Destruction"

I believe this is the article you were referring to-
http://journals.lww.com/oncology-ti...ng_Life_s__Chapter_Two__After_Surgery.15.aspx