NYT article/EM physician who can't afford his student loans

[miacomet]

He chose an expensive medical in an expensive city and has chosen academics in the same expensive city. It's unfortunate, but he's also made some wacky decisions. A cautionary tale to students and residents out there, I think.

Opinion | I’m a Doctor and Even I Can’t Afford My Student Loans

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[VA Hopeful Dr]

He chose an expensive medical in an expensive city and has chosen academics in the same expensive city. It's unfortunate, but he's also made some wacky decisions. A cautionary tale to students and residents out there, I think.

Opinion | I’m a Doctor and Even I Can’t Afford My Student Loans

The caution being don't live in NY and go into academics?

I think we can all agree on that one.

 

[Groove]

I don't buy it. Anyone making over 200K can pay back their educational loans. That's certainly no reason to platform Ocasio-Cortez of all people and stomp for free education. Don't get me wrong, I think medical school is too expensive... but an EM doc who can't pay back 188K? Please. I'd feel more sympathy if he were pediatrics or FM.

He needs to go work locums for a couple of years and get his ass out of NYC living in his high rise apt next to the cafe where he sips lattes before work every day. I see job offers all the time with 100K loan repayment. If I can pay off 400K in 3.5 years, he can pay off his 188K just fine, probably living anywhere he chooses as long as he exercised some financially responsible decisions.

 

[VA Hopeful Dr]

I don't buy it. Anyone making over 200K can pay back their educational loans. That's certainly no reason to platform Ocasio-Cortez of all people and stomp for free education. Don't get me wrong, I think medical school is too expensive... but an EM doc who can't pay back 188K? Please. I'd feel more sympathy if he were pediatrics or FM.

He needs to go work locums for a couple of years and get his ass out of NYC living in his high rise apt next to the cafe where he sips lattes before work every day. I see job offers all the time with 100K loan repayment. If I can pay off 400K in 3.5 years, he can pay off his 188K just fine, probably living anywhere he chooses as long as he exercised some financially responsible decisions.

Yep. When I was building my practice we lived on my IM wife's income alone (just over 200k). She had 180k in loans when we first got started. We were able to hire a full time nanny, eat out frequently, and go on vacation to the beach once/year.

Now granted we weren't in NYC either.

 

[miacomet]

The caution being don't live in NY and go into academics?

I think we can all agree on that one.

Lol, yes, but apparently some still haven't received the memo.

Funny he's blaming his loans, but not his decisions or his employer's lowball salary. I agree education is WAY too expensive, but he has a way out of this if he chooses, but he's just not making adult decisions. FT locums, working half-time in NYC and half time elsewhere, picking up extra shifts , doing some telehealth on the side, not to mention his choice of an expensive school in an expensive city.

 

[GonnaBeADoc2222]

I don't get his situation.

I graduated with similar debt from state med school, and now live in a moderate COL city.

Every month I stash $$$ away for retirement and saving for a house. I pay ~4k in loan payments / month - I don't even notice the payment going out.

My wife and I enjoy our lifestyle very much. We vacation and eat out whenever we desire.

Okkkk....you made the choice to do academics in NYC. Terrible choice. There are jobs that are easily attainable which pay way more.....

 

[southerndoc]

It's in how you spend your money. If you live lavishly, yes $180k in student debt can be a problem for you. If you're more devoted in eliminating debt and living within your means, then payments on a $180k loan are very easy with a $200k salary. These loans are almost always structured over a 30-year payback. Payments are usually less than $1500/month. The payment on that Benz is probably more.

 

[miacomet]

I'm also floored by "a mentor in residency, several years my senior, making over $200,000 per year." OK, the issue here is the NY salaries. Either find a place with loan repayment or just say no to a job paying a pediatrician salary. Crazy.

 

[WilcoWorld]

Yes, we can all criticize the author's decisions. That doesn't change the fact that this trend could lead to a situation where you can't staff the ED's of NYC.

Now, I avoid NYC like the plague, but that's still a problem.

 

[RoyBasch]

Lol, yes, but apparently some still haven't received the memo.

Funny he's blaming his loans, but not his decisions or his employer's lowball salary. I agree education is WAY too expensive, but he has a way out of this if he chooses, but he's just not making adult decisions. FT locums, working half-time in NYC and half time elsewhere, picking up extra shifts , doing some telehealth on the side, not to mention his choice of an expensive school in an expensive city.

This is it. Guy is on the lowest end of earning potential in our specialty based on choices/trade offs that he has made out of his own volition.

 

[RustedFox]

Yes, we can all criticize the author's decisions. That doesn't change the fact that this trend could lead to a situation where you can't staff the ED's of NYC.

I thought such was already the case.

 

[RustedFox]

On a related note; at no point should pursuing physicianhood come with such a high initial investment/low reimbursement tag that it makes living in [City X] just plain 'undoable'.

NYC, Chicago, the entire left coast... cost of living is just out of hand. Period.

We need about 3 billion LESS people on this planet, sharpish. If anyone wants to debate or educate (either is welcome) me on carrying capacity arguments, I'm game. I promise to remain civil, and I'll state upfront that my arguments are observation-based only and not from years of reading Malthus' laundry tags.

 

[GonnaBeADoc2222]

You can totally live in NYC and work locums elsewhere and do just fine. I have friends who do this and are quite comfortable.

 

[miacomet]

On a related note; at no point should pursuing physicianhood come with such a high initial investment/low reimbursement tag that it makes living in [City X] just plain 'undoable'.

NYC, Chicago, the entire left coast... cost of living is just out of hand. Period.

We need about 3 billion LESS people on this planet, sharpish. If anyone wants to debate or educate (either is welcome) me on carrying capacity arguments, I'm game. I promise to remain civil, and I'll state upfront that my arguments are observation-based only and not from years of reading Malthus' laundry tags.

RF, the good news is birth rates are in free fall around the planet. Current projections are that the total world population will peak at a too-high 10 billion, then rapidly decline. Sadly, we are here for the upswing, not the decline!

 

[VA Hopeful Dr]

Yes, we can all criticize the author's decisions. That doesn't change the fact that this trend could lead to a situation where you can't staff the ED's of NYC.

Now, I avoid NYC like the plague, but that's still a problem.

If that situation happens, pay will have to increase. Same reason rural pays more: because it has to to get people to practice there.

Given how much people love NYC, I think it more likely we'll see scenarios like SF already has - https://www.sfgate.com/technology/b...ing-crisis-market-rent-converted-12479861.php

 

[miacomet]

I thought such was already the case.

If that situation happens, pay will have to increase. Same reason rural pays more: because it has to to get people to practice there.

Given how much people love NYC, I think it more likely we'll see scenarios like SF already has - https://www.sfgate.com/technology/b...ing-crisis-market-rent-converted-12479861.php

Funny thing is that many places in NYC (Cornell, Columbia, Sinai system, Kings County) have a REALLY hard time hiring. Not a single Sinai grad was staying this year last I heard, Columbia and Cornell had a dozen open attending spots last year, and I believe KC is using a fair number of locums docs. Yet they prefer to operate understaffed as opposed to fixing the job. They keep saying "oh, it's hard to hire good people." Well, yes, if you make it impossible to work there.

 

[RustedFox]

Funny thing is that many places in NYC (Cornell, Columbia, Sinai system, Kings County) have a REALLY hard time hiring. Not a single Sinai grad was staying this year last I heard, Columbia and Cornell had a dozen open attending spots last year, and I believe KC is using a fair number of locums docs. Yet they prefer to operate understaffed as opposed to fixing the job. They keep saying "oh, it's hard to hire good people." Well, yes, if you make it impossible to work there.

This was precisely what I was trying to say; but didn't have the knowledge/etc to say.
Reason #395,387,802 why NYC is teh suck.

 

[RustedFox]

Given how much people love NYC, I think it more likely we'll see scenarios like SF already has - https://www.sfgate.com/technology/b...ing-crisis-market-rent-converted-12479861.php

This is precisely why I say we need 3 billion less people on the planet.
The old-timers at the shops that I work at here on the gulf coast of FL say things all the time like: "But that's back when (local town name) was wild and beautiful."
I'm sure they're not wrong. Now its New Jersey south.

 

[VA Hopeful Dr]

This is precisely why I say we need 3 billion less people on the planet.
The old-timers at the shops that I work at here on the gulf coast of FL say things all the time like: "But that's back when (local town name) was wild and beautiful."
I'm sure they're not wrong. Now its New Jersey south.

South Carolina would be glad to have you. I have not been impressed with the EM folks at my current Hospital, and honestly most of the posters here seem like good doctors who be pretty easy to work with.

 

[shookwell]

typical bull**** propaganda we've come to expect from the times

does anyone even read that nonsense any more

 

[EctopicFetus]

Add to the issue that people just think they deserve to have it all. No option type BS. He can be an ED doc anywhere in the US. us on here scoff at the notion of 200k/yr cause the average ED doc makes over 300k per the last few salary surveys I have seen. The good jobs are at 500k+.

Even using his math and high COL and high tax NYC.. he should be taking home over 8k per month. With a loan payment 3k he has 5k f0r living (say rent at 2k which in NYC would get you something not terrible) and another 3k to live on.

It’s not my hope or dream but this guy is choosing to live in a high COL place, with high taxes and with low pay. Thats his prerogative. I for one have no issue with free med school. My bigger thing is if it is mean to push people to FP/Peds a smarter approach is to forgive their loans after they match (or finish residency).

Otherwise the smart people will simply continue to go into the high paying fields. Would be stupid not to.

 

[VA Hopeful Dr]

Otherwise the smart people will simply continue to go into the high paying fields. Would be stupid not to.

 

[wholeheartedly]

I didn't read this as him wanting people to feel sorry for him. He repeatedly says if it's challenging for high earners to deal with student loans, then what about people in lower earning fields? The point was education costs are getting beyond ridiculous for everyone and we need to try to put the brakes on that.

We can all criticize the apparent choices people have made, but that doesn't change the fact that education costs are insane right now. It doesn't take into account the reasons people make some of those choices. Some people choose locations because they want to be close to help care for aging parents, or near family with their kids, or spouse is still in training there, or not moonlight across the country because of kids, or be paying for elder care, etc. It's not always the ego and the Benz holding people back.

I just took a huge financial hit to move back and care for my grandma. This meant I made $15,000 less in a higher cost of living area. I just get by now, break even. My choice? Yes. Poor choice? Yes. Would I make it again? Yup. Does the fact that this was my choice mean I can't be frustrated with the state of higher education costs and vent that frustration? Nope. Tuition costs are ridiculous regardless.

We could all probably make better financial choices, but I'm fine with this piece and someone pointing out "I'm a high earner and I'm having a hard time with this, so imagine what regular folks are going through."

 

[VA Hopeful Dr]

I didn't read this as him wanting people to feel sorry for him. He repeatedly says if it's challenging for high earners to deal with student loans, then what about people in lower earning fields? The point was education costs are getting beyond ridiculous for everyone and we need to try to put the brakes on that.

We can all criticize the apparent choices people have made, but that doesn't change the fact that education costs are insane right now. It doesn't take into account the reasons people make some of those choices. Some people choose locations because they want to be close to help care for aging parents, or near family with their kids, or spouse is still in training there, or not moonlight across the country because of kids, or be paying for elder care, etc. It's not always the ego and the Benz holding people back.

I just took a huge financial hit to move back and care for my grandma. This meant I made $15,000 less in a higher cost of living area. I just get by now, break even. My choice? Yes. Poor choice? Yes. Would I make it again? Yup. Does the fact that this was my choice mean I can't be frustrated with the state of higher education costs and vent that frustration? Nope. Tuition costs are ridiculous regardless.

We could all probably make better financial choices, but I'm fine with this piece and someone pointing out "I'm a high earner and I'm having a hard time with this, so imagine what regular folks are going through."

Meh. We're all aware of the costs of school when we start. You're also aware of the pay when you take a job.

I see this as being no different than if I buy a house and 6 months later complain that the mortgage is too high.

 

[deleted109597]

We need about 3 billion LESS people on this planet, sharpish. If anyone wants to debate or educate (either is welcome) me on carrying capacity arguments, I'm game. I promise to remain civil, and I'll state upfront that my arguments are observation-based only and not from years of reading Malthus' laundry tags.

Well just snap your fingers Thanos

 

[gutonc]

Meh. We're all aware of the costs of school when we start. You're also aware of the pay when you take a job.

I see this as being no different than if I buy a house and 6 months later complain that the mortgage is too high.

I don't disagree with you, at all.

But the disconnect here is that, while we are all theoretically aware of the costs of school when we start (and are we talking about UG, med school or both?), and the pay when you take a job, it can be hard for the 18-25yo out there to project the costs of that education and their income 10-15 years down the road. Not defending it, just understanding it.

 

[VA Hopeful Dr]

I don't disagree with you, at all.

But the disconnect here is that, while we are all theoretically aware of the costs of school when we start (and are we talking about UG, med school or both?), and the pay when you take a job, it can be hard for the 18-25yo out there to project the costs of that education and their income 10-15 years down the road. Not defending it, just understanding it.

Yeah, I get that and I completely agree with everyone who has said tuition in general and med school specifically is too high (my med school's tuition has doubled in the 8 years I've been out).

But when you're in one of the highest paid specialties on an hourly basis but chose both academics AND the highest (or second highest) location to live, I have absolutely no sympathy.

 

[wholeheartedly]

I don't disagree with you, at all.

But the disconnect here is that, while we are all theoretically aware of the costs of school when we start (and are we talking about UG, med school or both?), and the pay when you take a job, it can be hard for the 18-25yo out there to project the costs of that education and their income 10-15 years down the road. Not defending it, just understanding it.

This is very true.

When I was thinking about grad school in the nearby town, I spent a lot of time crunching numbers. Tuition was 640 a credit, I planned for tuition increases annually, overestimated the price of gas for my commute, vehicle wear and tear, my employers contribution, books, all of it. I was comfortable with that. Second year tuition was 890 a credit and gas went through the roof and my employer decreased their contribution rate. I was a part-time student student so I wasn't finishing in the usual 2.5 years either. That changed things pretty dramatically.

With med school it seems by the time you figure it out you're too far down the rabbit hole to shift gears anyway.

 

[enalli]

typical bull**** propaganda we've come to expect from the times

does anyone even read that nonsense any more

This was an opinion piece clearly labeled as such--it was the first word of the page.

Which American news organizations do you consider to be more trustworthy?