Requesting Advice

[C. Diff]

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3.5X GPA/511 MCAT/66 LizzyM
Post-bac GPA (80 credits) = 3.9X
ORM {22% lower/78% higher} per LizzyM

Been working as an ICU nurse at an academic hospital for the past 3-5 years, have had a collective ten years of clinical experience (technician, nursing assistant). Worked in various settings: OR, cards/tele, and have spent the half a decade working in neuro. Considering all the student loans have been paid off and my financial goals are FIRE to retire, having financial issues with applying to medical school knowing:

1. In all likelihood will be looking at DO. Racially within the top 3 of ORMs, take your pick.
2. Likely not getting placement into initial specialties of interest:
- NSG/Ortho with limited interest in neuro/psych (shadowed and gotten feedback from many physicians)
- Aware of potential lifestyle factors, direct family members in surgical specialties
3. Hate the concept of going into student debt knowing that I'm the one actually doing all the work
- Anki, B&B, Lightyear, Physio, e.g. "active learning" v. professor on a pulpit
- PBL models

Struggling between deciding whether or not to pursue an NP knowing that total projected tuition for the 4-5 year DNP program will be under $60,000 {less than one year of medical school tuition} and I will still be able to work 3 shifts - 4 shifts on with the class schedule for at least the first 3 years of the program. Accruing additional student debt and finances are a concern considering I've been heavily investing in 401K and R.IRA options. I am heavily into a FIRE oriented mindset having seen how the rat race can destroy people and would love to be free of being financially dependent on a job so I can actually enjoy working on a per diem/locums basis. For other nurses who were stuck in a similar position, what drove you to decide on going to medical school over choosing options like NP/CRNA?

Sincerely,
Throwaway Account.

 

[Kardio]

If early retirement is your biggest priority, why not draft an excel spreadsheet for year-by-year projections of your financial status for both the RN/NP path and MD/DO option. There’s your answer.

 

[C. Diff]

If early retirement is your biggest priority, why not draft an excel spreadsheet for year-by-year projections of your financial status for both the RN/NP path and MD/DO option. There’s your answer.

What is the limitation on Grad Plus loans for medical school? Also, what is the going rate for private loan providers?

 

[Kardio]

What is the limitation on Grad Plus loans for medical school? Also, what is the going rate for private loan providers?

No limits on GradPlus. Rate at ~7%. I don’t know if it capitalizes or not. More flexible repayment options than private lenders.

I don’t know private rates. Probably around 4%.

If you’re going MD/DO because it’s the quickest route to FIRE, I don’t think the juice is worth the squeeze (from your current position). There are almost weekly posts from people who went into medicine for the money; they are the demographic that’s most likely to regret the decision.

 

[C. Diff]

@gonnif That's good to hear. Perhaps I should be more optimistic.
@Kardio FIRE would be secondary to being able to scrub in/be first-assist for a PLF, ACDF, crani procedure. The problem is that specializing in either neuro or spine requires entry into possibly two of the most competitive surgical specialties. The attending for our hospital had numerous research publications with a PhD in pharmacology. The papers were on drug metabolism regarding X medication for patients with a degenerative neurological condition (being intentionally vague, sorry). To be frank, the last research I'm on was being last author on a genetics paper in a secondary publication.

 

[Kardio]

@gonnif That's good to hear. Perhaps I should be more optimistic.
@Kardio FIRE would be secondary to being able to scrub in/be first-assist for a PLF, ACDF, crani procedure. The problem is that specializing in either neuro or spine requires entry into possibly two of the most competitive surgical specialties. The attending for our hospital had numerous research publications with a PhD in pharmacology. The papers were on drug metabolism regarding X medication for patients with a degenerative neurological condition (being intentionally vague, sorry). To be frank, the last research I'm on was being last author on a genetics paper in a secondary publication.

You’re at least a decade away practicing independently as a neurosurgeon or orthopedic surgeon. You can make plenty of money, but gunning for early retirement is sort of incompatible with the drive needed to get into and through those fields.

 

[C. Diff]

@Kardio Respectfully disagree, but I can see where the sentiment comes from knowing most people don't save any money in the first place. Employer matching on 401k plans are incredibly generous from a general investment standpoint, avoiding being taxed at higher brackets for putting in more hours is also a convenient advantage. Even if someone wants to pay tax up front, most health networks offer Roth IRA options. Being interested in finance and savings shouldn't isolate someone from becoming a surgeon. There is no excuse for financial ignorance. In addition, this thread comes up at a time where vesting service is completed and funds can be withdrawn with employer matching benefit.

What drive comes to someone who is financially illiterate, make a ton of money, but pisses it all away the moment they get it?

 

[Med Ed]

avoiding being taxed at higher brackets for putting in more hours

So you have a "FIRE oriented mindset" but don't understand marginal tax rates. Interesting, to say the least.

 

[electropartyogram]

Evaluate your options. Honestly, and this might be frowned upon, but going CRNA at this point would not be a bad choice if you are set on FIRE.

MD/DO: 8 years until income.
CRNA: 1-2 years? Very competitive income, lifestyle accommodating, can pull serious income in certain states in private practice.

Two “relatives” are CRNAs, one chose that route because of the income, the other (his father) is doing quite well for working 40 hrs per week.

 

[Kardio]

@Kardio Respectfully disagree, but I can see where the sentiment comes from knowing most people don't save any money in the first place. Employer matching on 401k plans are incredibly generous from a general investment standpoint, avoiding being taxed at higher brackets for putting in more hours is also a convenient advantage. Even if someone wants to pay tax up front, most health networks offer Roth IRA options. Being interested in finance and savings shouldn't isolate someone from becoming a surgeon. There is no excuse for financial ignorance. In addition, this thread comes up at a time where vesting service is completed and funds can be withdrawn with employer matching benefit.

What drive comes to someone who is financially illiterate, make a ton of money, but pisses it all away the moment they get it?

I said that I see neurosurgery and early retirement as mutually exclusive. I didn’t say that there’s anything wrong with making financially responsible decisions.

 

[LizzyM]

Unless you have wealthy parents or a lucrative career prior to medical school (professional sports is most typical), you are likely to have to go into debt to attend medical school. That is the reality.

Loans become golden handcuffs that keep you in the workforce for as long as it takes to pay off the loans. They also limit how much you can save toward retirement (every dollar going to loans is a dollar you can't save toward retirement).

If the thought of going into debt makes you break out in hives, and if you can imagine yourself feeling happy and fulfilled as a nurse practitioner, go for it. Don't look to what other people have done to make themselves happy -- use your brain and work things out (you seem to have already figured out that the collaborative, team based, PBL approach to med education would drive you nuts) to make a decision is the best one for you!