PSLF-qualifying jobs in outpatient psychiatry?

[cottoncandypsych]

Hi everyone! I’m a PGY1 and trying to figure out how I want to tackle my debt burden. I have around $250k in med school loans.

I realize that public service loan forgiveness is the most financially prudent path, but it seems that public sector/nonprofit jobs in psych may be primarily limited to inpatient jobs. I definitely lean towards pursing a career in an outpatient clinic setting. What kind of PSLF-qualifying jobs are there for outpatient psychiatrists? I have heard that private practice job offers may include some loan forgiveness, but I don’t want to rely on that. I also am worried about committing to PSLF and then feeling trapped in terms of work setting.

If there aren’t many outpatient options, I’d rather just try to pay down my loans aggressively, but I’m not really sure what’s out there. I come from a non-medical family and could really use some guidance. Thank you so much!

---

Members don't see this ad.

 

[AcronymAllergy]

VA counts toward PSLF and is pretty much always looking for psychiatrists; they also have additional loan repayment incentives that you could "stack" with PSLF (e.g., EDRP for up to $200k) that could help you pay off the loans before PSLF hits. Indian Health Service should also qualify, and like VA may have their own additional loan repayment incentives. I suspect numerous academic medical facilities are theoretically/technically non-profit, but you'd have to check out each one.

 

[Stagg737]

The CMHC that is associated with my program qualifies for PSLF from what I was told. I'd imagine that plenty of other CMHC clinics would qualify for PSLF, but be aware you'd almost certainly be caring for those with severe mental illness or those with minimal socioeconomic means. You could always leave a PSLF job if you wanted, you'd just lose your loan forgiveness.

PSLF may not be the most prudent path. If you can find a high paying job straight out of residency, you may be able to pay down loans much more quickly and pay less in interest.

 

[jbomba]

I've asked this before but I'll post it again for a different set of eyes. why not grab one of those very high-paying locum jobs, something like 250 to $300 an hour, work in a prison or another not so great facility but just do it for one year. Bank 6-700k and get your loans paid off and then move on with your life. The often discussed alternative is stay in a mediocre paying job for 6 to 10 years in hopes of getting pslf.

 

[Taddy Mason]

For PSLF, you just have to be employed full time by a 501(c)(3) organization, which many hospital/healthcare systems are.

 

[cottoncandypsych]

The CMHC that is associated with my program qualifies for PSLF from what I was told. I'd imagine that plenty of other CMHC clinics would qualify for PSLF, but be aware you'd almost certainly be caring for those with severe mental illness or those with minimal socioeconomic means. You could always leave a PSLF job if you wanted, you'd just lose your loan forgiveness.

PSLF may not be the most prudent path. If you can find a high paying job straight out of residency, you may be able to pay down loans much more quickly and pay less in interest.

This is probably a dumb question, but does CMHC mean community health clinic? I’m guessing a setting like that would be higher volume/less flexible than private practice, right? Nothing inherently wrong with that, I’m just trying to get a feel for what the practice setting would be like.

 

[Stagg737]

This is probably a dumb question, but does CMHC mean community health clinic? I’m guessing a setting like that would be higher volume/less flexible than private practice, right? Nothing inherently wrong with that, I’m just trying to get a feel for what the practice setting would be like.

Yes. Our clinic has relatively high volume, but the physician positions are fairly flexible. I also have a fairly high no-show rate, which usually makes the day easier.

 

[dl2dp2]

Hi everyone! I’m a PGY1 and trying to figure out how I want to tackle my debt burden. I have around $250k in med school loans.

I realize that public service loan forgiveness is the most financially prudent path, but it seems that public sector/nonprofit jobs in psych may be primarily limited to inpatient jobs. I definitely lean towards pursing a career in an outpatient clinic setting. What kind of PSLF-qualifying jobs are there for outpatient psychiatrists? I have heard that private practice job offers may include some loan forgiveness, but I don’t want to rely on that. I also am worried about committing to PSLF and then feeling trapped in terms of work setting.

If there aren’t many outpatient options, I’d rather just try to pay down my loans aggressively, but I’m not really sure what’s out there. I come from a non-medical family and could really use some guidance. Thank you so much!

There are lots and lots and lots of jobs that are PSLF eligible that pay around 200-250k any place in the country that are outpatient. Essentially *all* generic academic-ish facilities-driven outpatient jobs are like this (i.e. large non-profit systems, Kaiser, Northwell, all the major academic and community medical centers, and their regional affiliates). Similarly, lots of non-profit private psych hospitals/systems would also make you PSLF eligible.

I wouldn't worry about the availability of jobs.

If you go for a non-PSLF eligible job (classically, a partnership track community private practice), you should aim for total comp target (i.e. including loan repayment, guaranteed bonus, etc) > $300k. Ideally > $350k.

 

[nexus73]

Lots of nonprofit health systems have psych clinics and pay reasonably well. Also almost all community mental health centers (CMHC) and federally qualified health centers (FQHC) will qualify.

Watch out for places like Kaiser, where the system is non profit but doctors are hired by the Kaiser physician group which is for profit and doesn’t qualify for PSLF.

 

[dl2dp2]

Watch out for places like Kaiser, where the system is non profit but doctors are hired by the Kaiser physician group which is for profit and doesn’t qualify for PSLF.

You are right! I was totally wrong re: Kaiser. However, if you are employed by their medical school as their faculty you may become eligible again.

 

[NickNaylor]

Lots of nonprofit health systems have psych clinics and pay reasonably well. Also almost all community mental health centers (CMHC) and federally qualified health centers (FQHC) will qualify.

Watch out for places like Kaiser, where the system is non profit but doctors are hired by the Kaiser physician group which is for profit and doesn’t qualify for PSLF.

This kind of arrangement is not that uncommon, particularly in private health systems. If you’re banking on PSLF you really have to be careful and understand the business arrangements that exist between the health systems and its physicians. For PSLF, you might be in for a rude awakening if you aren’t directly employed by the non-profit but, instead, go through some other kind of entity. Sometimes this arrangement is extremely opaque and not obvious.