Please convince me not to do HPSP.

[majahops]

I spoke with the financial aid counselor at Boston University the other day, and she told me that it is projected that, if I live VERY modestly, I will be ~$300,000 in debt when I graduate from BU. Most of that debt will of course continue to accrue substantial interest while I am a poor resident, unable to make a sizable dent in it and when I am an attending, chipping slowly away at it for many years.

Enter the HPSP. They will pay 100% of my tuition ($46,000+/yr), my medical insurance (since it's required by BU) and give me $1950/month for living expenses. In return, I will have to do a military residency* and serve in the military for 4-5 years** as an attending. The pay for military residency is considerably higher than for residency "outside," but the pay for an attending "outside" is even more considerably higher than for that of a military attending.

I've considered the following downsides of HPSP, and have still decided it's worth it. If anybody here can think of any other compelling reasons (no jokes, please), would you please share them with me? Thanks so much.

Downsides Considered:

- Have to be in the military and abide by [sometimes ******ed] rules/authority.

- Have to be deployed for > 6 months of my time as an attending.

- Have to compete for far fewer slots in certain specialties (as low as 2 in specialties like neurology, for the entire US).

- Likely have to live in a hick town for a few years.

- Likely have to work at a hick hospital for a few years.

- Will likely see a different clinical population than my "outside" resident/attending counterparts, thereby theoretically giving me a different medical education/experience.

- Will get paid substantially less than my "outside" counterparts during my 4-5 years as an attending.

- Will more likely than not have less "choice" overall with regards to specialty and living conditions as compared to my "outside" counterparts.

---- PLEASE DON'T MOVE THIS TO THE MILITARY MEDICINE FORUM, I'D RATHER HAVE RESPONSES FROM THE GENERAL PREMED POP ---

* There are uncommon exceptions where students are allowed to do external residencies. This is very rare.

** Debt is equal to # of years HPSP paid for medical school or residency + fellowship, whichever is longer.

---

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[dragonfly99]

There are also situations where they will pull medical students out of school to deploy them, I have heard. I'm not 100% sure it's true, but I think it could happen if the US keeps up with a lot of deployments in places like Afghanistan and Iraq, etc.

If you are unsure, you might want to delay signing up for a while...at least until maybe 3rd year of school or some time when you know what specialty you want to do. The thing about being forced to do a residency you don't like is it may affect your psyche more than you realize...I'm not saying it's bad to do the military, just that there is no free lunch.

You might want to check the military medicine thread to get more input from folks in the know.

 

[majahops]

I can tell you that your first point, about being deployed during medical school is 100% illegal and cannot occur... (long story why I know this, but I do).

But all of your other points were much appreciated. Thanks so much!

There are also situations where they will pull medical students out of school to deploy them, I have heard. I'm not 100% sure it's true, but I think it could happen if the US keeps up with a lot of deployments in places like Afghanistan and Iraq, etc.

If you are unsure, you might want to delay signing up for a while...at least until maybe 3rd year of school or some time when you know what specialty you want to do. The thing about being forced to do a residency you don't like is it may affect your psyche more than you realize...I'm not saying it's bad to do the military, just that there is no free lunch.

You might want to check the military medicine thread to get more input from folks in the know.

 

[hussamdein]

You're right, they can't (and won't) pull you out of med school.

I know many people who have gone this route. Half are glad they did, and the other half aren't. Now for the half who weren't happy, I noticed most had one thing in common: they did HPSP for the money.

300K is a lot of money to anyone, but you're not the first one or the last one who ends up with that amount. You will be able to pay it off. Do not do HPSP for the money, because you will hate yourself eventually. Good luck.

 

[aggieallure]

Maybe I haven't done enough research on the HPSP, but I thought you could choose to complete a civilian residency. Also, where did you find the number of spots available for the different specialties?

 

[DrMattOglesby]

i was battling this same predicament for some time too...and still kinda am (even though I decided against it). I think my debt was less than yours but I didn't factor in interest accruing over the years (it was something like $265K)

here is a copy of a FB note I wrote outlining what I foresaw as some potential positives and negatives:

HPSP (Health Professions Scholarship Program - Armed Forces)

*pros*
-will pay a $2K/mo stipend 10.5 months out of the year, the remaining 1.5 months will secure a good chunk of change as well
-will pay for all tuition, books and misc. fees; so I walk out "debt free" (in a financial sense)
-is a good financial move to make if I go into pediatrics (or most primary care fields) as the pay difference would be minimal
-the army's main pediatric center is in Honolulu and matching into a peds residency shouldn't be a problem (training is rarely "interrupted" and one can go straight through and finish training before being deployed)
-my father served in Vietnam, grandfather in WWII, grandmother was a nurse in WWII, step-father was an army doc for a while; so there is some legacy to consider
-I like the physical fitness requirement of the military, disciplined lifestyle, and appearance standards (short hair-cut, no facial hair...just clean-cut)
-offers many "morale-boosting" programs such as MMA combat training, triathlon teams, volleyball, soccer, etc...good sense of camaraderie
-opportunity to travel and see more of the world
-possibility to participate in providing medical care to underdeveloped nations (ex; Honduras)
-may retire in 20 years at 50% income
-would treat a very brave group of young men and women

*cons*
-will not be worth the financial gains if I enter a high paying specialty
-may not obtain a preferred residency (spots become available by virtue of what the army deems is in shortage)
-may obtain a residency in a less than desirable location but forced to complete training there
-potential of having people with less academic merit serving as my boss due to being out-ranked
-potential of skill-atrophy if stationed in a location that doesn't allow continual practice of acquired training (especially important to consider for surgical skills)
-even if trained as a pediatrician, upon deployment I may operate as a General Medical Officer and thus not be practicing the type of medicine in which I completed training (may also lead to diminished competency in chosen field)
-have little say in where I get stationed, and deployments could land me in nasty war-zones (not front-line, but not the typical vacation destination)
-the higher ranked one is, the more administrative their work becomes (ie; more paper-pushing & less doctor-ing)
-patient population will be healthier than most and duties could become boring over time

 

[SketchsaurusRex]

if you need someone to convince you not to do HPSP all the info you need is here.

 

[DrMattOglesby]

and here is the epilogue:

This is just a quick update for all those kind and intelligent folks who took the time to offer me some of their advice about my school funding situation.

one of the heavy hitters that stood out for me was along the lines of;

**"if you had all the money--would you still sign up for the military?"

--> my answer, upon thoughtful consideration, was a simple 'no.' I felt like I was ready to tackle all that is military life simply because I think I am capable of doing so--not necessarily because it's what I wanted. Making a career in the military is not what I'm looking to accomplish...at least not right now. I feel like I am slightly older for a med student (because I kinda am), so when I finish my meducation, I want to have as much possible say in what I do and where I do it. Otherwise, a large chunk of my life might pass me by without my getting a chance to really chase some of my dreams and aspirations.

Money will certainly manifest itself as a potential limitation in my future...but over time, I have faith that things will work out in my favor so long as I am happy. And right now, it looks like having the freedom to choose is my functional definition of happiness...

 

[AFDOCtobe]

Absolutely DO NOT do HPSP for the money! I went to a service academy and then took an HPSP scholarship and am very happy! However, I always wanted to be in the military even before I thought about medicine! Only do HPSP if you want to be a military physician.

 

[Siverhideo1985]

It is incredibly tough...I am not very familiar with the HSPS because military was never an option for me.

Here is an AAMC website with other programs that might be able to help you with debt repayment. Of course, these will restrict you in other ways (i.e. primary care only, location) but maybe you'll find a program that fits your needs more so.

Hope it helps.

http://services.aamc.org/fed_loan_p...on=public.welcome&CFID=11762&CFTOKEN=56712889

 

[Bacchus]

majahops, you no where mention serving your country and the esteem and happiness you'd get with it. You're not the only 300,000'er and won't be the last. Don't do it, bro.

 

[JJMrK]

If you didn't need the money, would you still do it?

 

[DrMattOglesby]

If you didn't need the money, would you still do it?

i think i just heard a parrot...

 

[majahops]

"Don't do it for the money," I've heard 900 times. Yet, I would admittedly be doing it 100% for the money.

... Damn it, I think it's clear I shouldn't do it.

Thanks guys.

 

[JJMrK]

i think i just heard a parrot...

Didn't read the responses. Double

 

[DrMattOglesby]

Didn't read the responses. Double

it's gravy. good advice is worth repeating.

 

[phospho]

"Don't do it for the money," I've heard 900 times. Yet, I would admittedly be doing it 100% for the money.

... Damn it, I think it's clear I shouldn't do it.

Thanks guys.

It's like doing medicine for the money. You might get away with your bio prereqs, maybe also your chem prereqs. By the time you hit your 2nd course of ochem, you will hate your life and everything in it. Not all the money in the world could convince you to stay at that point. You need to be atleast partially interested in something about biology/science to go through with medicine.

Same with HPSP - the happiest ones are the people who would still have done it even if they weren't getting any money.

 

[DrMattOglesby]

"Don't do it for the money," I've heard 900 times. Yet, I would admittedly be doing it 100% for the money.

... Damn it, I think it's clear I shouldn't do it.

Thanks guys.

yeah but who knows for sure?
You could go through with it, serve your time, and walk out debt free in 4-5 years and be working as a civilian. I'm sure other people have done it solely for money and are happy with how things worked out...

 

[majahops]

I want to serve my country, don't get me wrong, but I went for a physical to one of the hospitals. They herd people around like cattle there. They use this damn "heal our 'warriors'" campaign crap, it's insulting to our soldiers and our country. What is this, Team America the freaking movie here?! I was very turned off by the approach. Very turned off. And with the buzz cuts the doctors wore. Damn, if I'm a military person seeing a doctor, let me see a freaking nerdy doctor, not another freaking soldier. There are just so many backwards things about it.

I want to serve my country. And it's all about the medicine and the people... But I promise you milmed ain't all about the medicine and the people. It's first about the military, then about MILITARY medicine, then about "warriors." Blek.

majahops, you no where mention serving your country and the esteem and happiness you'd get with it. You're not the only 300,000'er and won't be the last. Don't do it, bro.

 

[pianola]

I know that you're in an important relationship majahops...talk to your girl about it and see what she says.

It seems like one of the things that will break up a couple faster than medical school/residency/training is the military. For that reason alone, I would never do it.

 

[Bacchus]

I want to serve my country, don't get me wrong, but I went for a physical to one of the hospitals. They herd people around like cattle there. They use this damn "heal our 'warriors'" campaign crap, it's insulting to our soldiers and our country. What is this, Team America the freaking movie here?! I was very turned off by the approach. Very turned off. And with the buzz cuts the doctors wore. Damn, if I'm a military person seeing a doctor, let me see a freaking nerdy doctor, not another freaking soldier. There are just so many backwards things about it.

I want to serve my country. And it's all about the medicine and the people... But I promise you milmed ain't all about the medicine and the people. It's first about the military, then about MILITARY medicine, then about "warriors." Blek.

I want to serve my country too, but make a decent living, and try to have some of it on my terms... civilian medicine isn't as restrictive as military medicine.

 

[majahops]

Haha, you are so wise pianola. She = not too happy about the milmed.

I know that you're in an important relationship majahops...talk to your girl about it and see what she says.

It seems like one of the things that will break up a couple faster than medical school/residency/training is the military. For that reason alone, I would never do it.

 

[MilkmanAl]

"Don't do it for the money," I've heard 900 times. Yet, I would admittedly be doing it 100% for the money.

... Damn it, I think it's clear I shouldn't do it.

Thanks guys.

Just as a final nail in HPSP's coffin, consider this: While you're serving your 4 years, you won't make more than $120k or so. In other words, unless you're planning on doing primary care, you're going to be sacrificing far more money over those 4 years than you gained by going for the scholarship. If money is your motivation, don't do it.

 

[pianola]

Haha, you are so wise pianola. She = not too happy about the milmed.

Heh, I'm blushing.

But seriously, though -- even me going to a pretty inexpensive school means I will probably take out around $200K when all is said and done.

But I know I'm gonna have some help from my s.o. with the loans (he'll be working). I know that I can make certain choices that will help me pay off the loans by living frugally. Maybe you will have some support, too?

It's DEFINITELY a lot of money. No question. My parents don't even know what loans of this magnitude are supposed to mean.

But giving up your freedom for 4 years is asking a lot. I mean you CANNOT leave the military once you've signed up. And that to me is a HUGE thing. Your freedom is worth a lot.

 

[majahops]

Another question. If I am $300k in debt when I graduate, and almost all of that is immediately interest-accruing loans, and I become an Oncologist... how long before I can expect to be able to live like a professional person earning a professional income? I am 28 years old right now.

 

[TheGoodGoodTime]

I strongly considered doing this, met with the recruiter with my parents, was about to sign the contract and then got this horrible feeling. I realized I was doing this solely because I was freaked about the money. So I didn't sign it, and bailed.

Talked to plenty of physicians who all said don't worry about it too much as it will not be much of an issue once you're practicing. Then I talked to another that did the program back in the 70s. He told me that I better prepare myself for the military life if I choose to do it. I don't know. I just got cold feet thinking about how they would dictate where and what I did for 4-5 years. Family and friends mean a lot to me, and I just couldn't see myself moving away from OH for a long-time to pursue something I could do much more happily in my local area.

You kind of have to prioritize really. If you're looking for a change of scene and lifestyle, maybe this is your opportunity. If not, I would not do it.

 

[phospho]

Another question. If I am $300k in debt when I graduate, and almost all of that is immediately interest-accruing loans, and I become an Oncologist... how long before I can expect to be able to live like a professional person earning a professional income? I am 28 years old right now.

My BF's dad is an oncologist and absolutely loves it. I've never seen anyone who loves his job as much as he does (or makes half as much money )

It's 4 years of med school, 4 years of IM, and I think 2 or 3 years of Hemeonc. I'm not sure if they have combined programs like plastics.

 

[majahops]

No, no hehe. I mean how long before I start being out of major debt, and can enjoy my life.

My BF's dad is an oncologist and absolutely loves it. I've never seen anyone who loves his job as much as he does (or makes half as much money )

It's 4 years of med school, 4 years of IM, and I think 2 or 3 years of Hemeonc. I'm not sure if they have combined programs like plastics.

 

[phospho]

No, no hehe. I mean how long before I start being out of major debt, and can enjoy my life.

ahh, i see what you mean.... I've actually asked him that before...He had undergrad, grad, and medical school loans. He says that he paid his loans off within 5 years of finishing residency. He lived in his old/cheap apartment and kept his old car (and his cheap lifestyle) until he had everything paid off.

 

[DrMattOglesby]

No, no hehe. I mean how long before I start being out of major debt, and can enjoy my life.

i think it could take anywhere from 10-30 years just to pay off loans...and that clock starts after you've completed all training!
I think living with debt will just be something we have to get used to. I am 27, myself, and will anticipate being debt free around age 50 ...won't be so bad if I'm happy the whole time though

 

[Bacchus]

Hops, at the most it will be 20 years because I believe that's the longest period you have to repay. Otherwise, I'd suspect 10-15 years is "average."

 

[sarahg]

I want to serve my country, don't get me wrong, but I went for a physical to one of the hospitals. They herd people around like cattle there. They use this damn "heal our 'warriors'" campaign crap, it's insulting to our soldiers and our country. What is this, Team America the freaking movie here?! I was very turned off by the approach. Very turned off. And with the buzz cuts the doctors wore. Damn, if I'm a military person seeing a doctor, let me see a freaking nerdy doctor, not another freaking soldier. There are just so many backwards things about it.

I want to serve my country. And it's all about the medicine and the people... But I promise you milmed ain't all about the medicine and the people. It's first about the military, then about MILITARY medicine, then about "warriors." Blek.

You could always go through med school as a civilian then get a federal job after residency. The pay isn't amazing but the benefits are good and sometimes include loan repayment. The Veteran's hospitals, State Department, Indian Health Service, and even the CIA need physicians. You can serve the country without conforming to military principles that way.

 

[mcaliboyw]

It seems like one of the things that will break up a couple faster than medical school/residency/training is the military. For that reason alone, I would never do it.

Yeah with all my time spent getting buzz-cuts, my wife and I immediately divorced.

Seriously though, it seems like you've realized that doing it strictly for the money is a bad idea. But being in the military isn't like being in the Hitler youth (as this thread makes it out to be).

 

[deleted191570]

I was offered an HPSP scholarship but I turned it down after some heavy contemplation.

I agree with these reasons why:

*cons*
-may not obtain a preferred residency (spots become available by virtue of what the army deems is in shortage)
-may obtain a residency in a less than desirable location but forced to complete training there
-even if trained as a pediatrician, upon deployment I may operate as a General Medical Officer and thus not be practicing the type of medicine in which I completed training (may also lead to diminished competency in chosen field)
-have little say in where I get stationed, and deployments could land me in nasty war-zones (not front-line, but not the typical vacation destination)

Basically, my biggest concerns could be summed up with one word: bureaucracy. It would be hard to get good duty assignments if you aren't the cream of the crop or don't KNOW someone important. Plus, the GMO thing seems scary-- I read somewhere that you could get stuck in limbo for a while. All the writing in the contracts and what the recruiters tell you can be pretty unclear, so it's hard to know for sure.

If anything, too, I think the FAP route (loan repayment) seems much better than HPSP. (FAP, I believe, is after you secure a residency in a field of your choosing.)

I applied with the Army; the Army will tell you ANYTHING to get you to sign. The biggest problem I had was that none of the recruiters have really ever worked in Army healthcare, therefore after a while, I got the impression that they didn't really know what they were talking about. They were just really good at seeming like they did.

BTW, for background, I was also an ROTC cadet in college, so my interest in military service preceded my interest in medicine... But medicine was the reason I dropped out of the program (long story short: ROTC + HPSP = career in Army; not a good route if you're not 100% career committed) Really though, the process is just pretty hairy, and that kind of scared me off... at least for now.

 

[pianola]

Yeah with all my time spent getting buzz-cuts, my wife and I immediately divorced.

I never made the comment about buzzcuts. But I would imagine most normal spouses wouldn't be so thrilled with the idea of moving whenever and wherever at a moment's notice. And/or having their spouse deployed overseas.

I mean, it's only anecdotal evidence.

But are you honestly disputing that military marriages are often difficult? That it wouldn't be an extra strain on his relationship beyond what medical school already entails?

 

[HPSPpayissues]

First of all, the health care system is becoming more and more nationalized. With Obama pushing for a standardized health care system, ( for 8 years - followed by Hilary Clinton as a president for another 8 years) coupled with the fact that the economy is sprialing out of control, it is likely to happen in the near future.

How fast you re-pay the loans back would highly depend on what specialty you get into. If you get into Peds, psychiatry, or family practice, it will take almost 15 to 20 years to re-pay the loans back, and you are better off going to HPSP.

 

[Lukkie]

My BF's dad is an oncologist and absolutely loves it. I've never seen anyone who loves his job as much as he does (or makes half as much money )

It's 4 years of med school, 4 years of IM, and I think 2 or 3 years of Hemeonc. I'm not sure if they have combined programs like plastics.

3 years IM, 3 years fellowship most do hem/onc. but you can do just hem or onc but those limit your oppurtunities. for example if you want to go private you definitely want onc as you probably won't get enough business pure hem. however if you want to stay in academia there are good oppurtinities as pure hem. at least this is the impression i got from spying on the IM subspecialties subforum here on SDN (texasOnc i think the guys name is - lots of great advice.)

 

[majahops]

No, I sort of made it. Actually, I thought the guy's comment was kind of funny. haha, he was kidding!

I never made the comment about buzzcuts. But I would imagine most normal spouses wouldn't be so thrilled with the idea of moving whenever and wherever at a moment's notice. And/or having their spouse deployed overseas.

I mean, it's only anecdotal evidence.

But are you honestly disputing that military marriages are often difficult? That it wouldn't be an extra strain on his relationship beyond what medical school already entails?

 

[majahops]

p.s. my grandpa was commandant of midshipmen and my big bro went to Annapolis as well, so the "legacy" is there... but meh... and then the girlfriend comment made it for me... she wants to be in fashion and own her own store in a thriving fashion area... there's a good chance that her ability to do that will be compromised (even moreso than with a career in medicine in general) as a military doc

Yeah with all my time spent getting buzz-cuts, my wife and I immediately divorced.

Seriously though, it seems like you've realized that doing it strictly for the money is a bad idea. But being in the military isn't like being in the Hitler youth (as this thread makes it out to be).

 

[mcaliboyw]

I never made the comment about buzzcuts. But I would imagine most normal spouses wouldn't be so thrilled with the idea of moving whenever and wherever at a moment's notice. And/or having their spouse deployed overseas.

I mean, it's only anecdotal evidence.

But are you honestly disputing that military marriages are often difficult? That it wouldn't be an extra strain on his relationship beyond what medical school already entails?

I totally agree that, on the surface, the mechanics of a 'military marriage' don't sound very appealing. But, to quote Jack Nicholson, whose gonna do it? You? You, Lt. Weinburg? I mean, marriage (and life in general) can be a difficult endeavor, military non-withstanding. I guess I am just reacting to what seems to be a rumor, propagated as fact, used to persuade someone not to join the military. It already seems like Maja has come to the right conclusion anyway.

 

[Bacchus]

First of all, the health care system is becoming more and more nationalized. With Obama pushing for a standardized health care system, ( for 8 years - followed by Hilary Clinton as a president for another 8 years) coupled with the fact that the economy is sprialing out of control, it is likely to happen in the near future.

How fast you re-pay the loans back would highly depend on what specialty you get into. If you get into Peds, psychiatry, or family practice, it will take almost 15 to 20 years to re-pay the loans back, and you are better off going to HPSP.

I'm sold! Where are my recruitment papers?

 

[RoadRunner17]

Without reading any of the responses (I'll take a closer look when I get back from dinner tonight), my only advice to you is: MARRY RICH.

 

[phospho]

3 years IM, 3 years fellowship most do hem/onc. but you can do just hem or onc but those limit your oppurtunities. for example if you want to go private you definitely want onc as you probably won't get enough business pure hem. however if you want to stay in academia there are good oppurtinities as pure hem. at least this is the impression i got from spying on the IM subspecialties subforum here on SDN (texasOnc i think the guys name is - lots of great advice.)

thanks for the heads up... do you know if it's competitive or not? I wonder how often someone goes into IM with the hopes to get into hemeonc but can't land a fellowship.

 

[majahops]

Gulp. If I could do it all over again.... naw, I won't go there... I love my girl.

Without reading any of the responses (I'll take a closer look when I get back from dinner tonight), my only advice to you is: MARRY RICH.

 

[majahops]

I always figured hematology was an integral part of oncology, given the number of malignancies of the blood and lymphatic system.

thanks for the heads up... do you know if it's competitive or not? I wonder how often someone goes into IM with the hopes to get into hemeonc but can't land a fellowship.

 

[circulus vitios]

Maybe I missed this, but why don't you go to a school that isn't so expensive?

 

[majahops]

Didn't get into any. All of the schools I got into are extremely expensive. The only major differences will be in rent... but if I chose a school based on differences in rent, I mean, come on that'd be a bit much.

Maybe I missed this, but why don't you go to a school that isn't so expensive?

 

[Lukkie]

thanks for the heads up... do you know if it's competitive or not? I wonder how often someone goes into IM with the hopes to get into hemeonc but can't land a fellowship.

from the IM board on SDN, its in the middle of the pack
http://forums.studentdoctor.net/showthread.php?t=564933

most people there agree cards #1, then usually a toss up GI/allergy/sometimes hem-onc. but of course i'd just click the forum link i posted for more interesting/useful discussion than you would get from the usual pre-med banter here

I always figured hematology was an integral part of oncology, given the number of malignancies of the blood and lymphatic system.

i cant find the thread atm but one of the private practice onc docs here on SDN posted about it... said he sees about 50% breast cancer and 50% other. id assume that 50% other would be mostly lung/colon, few hem.

heres a good thread - gutonc has tons of great information.
http://forums.studentdoctor.net/showthread.php?t=573862

 

[Perrotfish]

You could always go through med school as a civilian then get a federal job after residency. The pay isn't amazing but the benefits are good and sometimes include loan repayment. The Veteran's hospitals, State Department, Indian Health Service, and even the CIA need physicians. You can serve the country without conforming to military principles that way.

The amount of debt you accumulate in medical school compared to the amount that the government pays basically means that, if you want to do a government/military job coming from an uber expensive school you pretty much have to take one of the government scholarships or you need to wait until after you've paid own your debt in the civilian world.

Simple math: HPSP pays

All tuition

All books and fees

20K bonus

25K/year Stipend

equivalent of 80k/year + benifits in a military residency (twice what civies make)

So by the end of residency you'll have made about 500K more than your civilian colleagues, which if you want to work in the military will make their around 100K/year salary quite bearable.

On the other hand, if you need 300K to get get through college and go out for a government job that pays the same slightly less than 100K, even with the (best offer) 160K of loan repayment from the military's financial assistance program you're going to be pretty much drowning in debt. It's hard to see how you're going to live a middle class lifestyle while paying down those loans on that kind of paycheck unless you're still single and childless.

 

[HPSPpayissues]

Like I said, I recommend doing it if you know or if you are likely to get into Ped, IM, Family Practice, or other primary care type fields. It should save you much heartache and money in the long run. Otherwise, it is a tough choice. You might actually end up losing quiet a bit of money with high-paying specialties, such as neurosurgery and dermatology!