As reimbursements continue to go down, tuition goes up, and US med student enrollment goes up (without requisite increase in residency slots, which is going to force more and more US students into the lower pay jobs that previously went to the offshore crowd), this is likely to become the norm, rather than the exception. You will likely not do as well as prior generations of doctors. But you should be able to pay your bills and live comfortably. Which is fine if you are doing something you enjoy. Not so fine if your goal is to maximize lifetime income. In which case you are on the wrong track.
This is the key point. And I have several others.
1. This dude racked up 18k in credit card debt. I would not look to him for financial advice. Without a loan from the Bank of Mom as he put it that could have completely torpedoed him financially.
2. The issue of opportunity cost is important but
complex. According to Wikipedia, in 2006 the median income for US households was $48k. That means that even as a first year resident (let's just call it 40k although that's probably low-balling it for along of the country) you're still in the middle fifth of household income for the US. By the time you are a senior resident you may be very near the median income in the US. You throw in a working spouse, even at a fairly low paying job (say 20k) and you are dealing with alot more money than many families will see in their lives.
3. So sure, your 4 years of medical school are not a great period financially, but then you can jump into a very average income for the next 3-5 years. Yes, I know you will be working harder than other people -- get over it.
4. And yes, I know that most of those households near you in income don't have 200k in student debt. But they aren't looking at seeing their 48k triple or quadruple or quintuple in the next few years.
5. Do some of your own calculations. Go type in 250k in debt to a loan calculator, put it at 10% interest (although most of us don't have that high of a rate) and see that over 30 years you pay 2k a month. Sure that's alot of money but then go type in 180k salary (again low-balled for many fields including mine: EM) and find out that you're doing about 10k a month after taxes. Go ask some of those people raising families on 48k/year if they could manage to scrape by on 8k/month (10k-2k loan payment). Even after taxes and your crushing student debt you are throwing around more than twice the jack of your average neighbor.
If you want to look at the decision to enter medical school as financial suicide then you can find plenty of friends on SDN. If you go to the most expensive school, max out private loans, rack up CC debt, and go into Family Med or Gen Peds you might be in some trouble.
I highly suspect that the vast majority of us will experience some variation of what L2D said, namely comfortable lives where we don't constantly have to fret about money but where we don't vacation on the Riveria every year.
Unlike previous generations of docs we will also likely carry some of our debt burden out over 20 years. No one thinks anything of a 30 year mortgage but SDN seems to go crazy at the thought that you might still be paying on student loans 20 years out. It's not that big of deal.
5, 10, 15 years down the road it is entirely possible that medical education will be financially devastating but I don't think we're there yet.
