Since you're the people I *really* should be asking...

Discussion in 'General Residency Issues' started by SarahGM, Apr 13, 2004.

  1. SarahGM

    SarahGM Senior Member
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    If any current residents could give me an insight on this, especially because most of you are experiencing the reality of the burden of debt right now...

    I'm trying to decide between UNC (in-state) and Columbia P&S. I would much, much, MUCH prefer to be in NYC than Chapel Hill (where I'm at right now). Not to mention greater clinical opportunities in NYC, the fact that I am originally from New York (parents are in Syracuse, and I really, really don't like living down south) and Columbia's excellent match list. But generally, it all boils down to where I think I would ultimately be happier, and I believe that is at Columbia.

    Based on your experiences, would these reasons justify the higher cost of education at Columbia? Or should I just go for the cheaper school? Undergraduate debt is not a factor.
     
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  2. The White Coat Investor

    The White Coat Investor Practicing Doc and Blogger
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    So you're asking if you should go where you much, much, much prefer to go, would ultimately be happier, have greater clinical opportunities, be in your home state near you parents or go someplace a little cheaper where you really, really don't like living?

    Imagine someone else posted this and you are replying to them. What would your advice be? Look at it differently....do you take the job you really like that pays $80,000, or the one you hate that pays $90,000. There are some things more important in life than money.
     
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  3. SarahGM

    SarahGM Senior Member
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    Thanks for the insight. My heart also says the same, but I have so many people telling me that I would be "stupid" not to go to the cheaper school ("just ask any resident!"), that it was starting to wear on me.
     
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  4. margaritaboy

    margaritaboy Senior Member
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    I love it when people think they know more about your own needs than you do.

    Truthfully, comming out of medical school with some debt has made me a little nervous, but I would go where you think you would be happiest. Four years is a long time to spend in a place that you are not crazy about. On the flip side, four years of medical school can be made much more tolerable by surrounding yourself with people and activities that you love. Either way, you will be able to repay your debt and I'm sure you'll end up with a good education at either site.

    PS - I also really really don't like living in the South.
     
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  5. Winged Scapula

    Winged Scapula Cougariffic!
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    Please go where you'll be happiest, darn the cost (to some extent). In addition, if you plan on practicing in the NY area, your ease into practice will be aided by doing residency in the area (connections and the sort).
     
  6. drchris71

    drchris71 Member
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    Every decision in your life should be to choose happiness over money. Would you marry someone rich over someone you love??? I hope not. If you take your residents advice soon you'll be choosing a specialty based on pay also..where would it end...so please do what makes you happy!!!!!
     
  7. NYCDOC74

    NYCDOC74 Junior Member
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    I know where you're coming from. I'm also a NY'er. I did pre-med at UNC-Chapel Hill while my brother was in med school there, didn't like it, and ended up coming back to NY for my professional studies. Medical school can be very stressful at times, so being in an environment in which you would be happy and comfortable is crucial. Anyway, the food in NY is better......no Gumby's pizza here!

    BTW, is Buck still teaching analytical chemistry?
     
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  8. rustybruce

    rustybruce Member
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    I would seriously reconsider what everyone here is saying. As a northerner and 8 year "survivor" in Chapel Hill, my advice might be somewhat valuable. Columbia, though in the exciting city of New York, is going to set you back about 150 grand MORE, all things considered, than UNC would. I can't understand why people here would be bashing Chapel Hill, being that it is full of things to do, great people, wonderful jobs (for spouses) 2.5 hours from Beach and Mountains, best weather I could imagine (as you know, spring starts in February)

    You are not going to have a bad time down here and actually might grow to love it. Eat I luv NY pizza or Franklin St P n P. Learn to golf. Learn to water ski/wakeboard. Learn to get a tan. Learn how not to put up with all of the northern bu!!$hit. Med school doesn't last long but it can take you either 10 or 30 years to pay off. I recommend going the former route and doing RESIDENCY back in the Northeast. Coming out of UNC you can match wherever you want to. Also, because the cost of UNC is so low, a very large proportion of students are on full scholarship (that you find out about between 1st/2nd year)

    The program is excellent, the people are nicer (less than 5% competitive jerks, and over 50% really great people), the weather is better, and UNC has an unbelievable night life (though there's slightly less cocaine--if you prefer that sort of thing)

    I could not have imagined going anywhere else and don't regret deciding to stay down here for a second. Total debt: $4250
     
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  9. chef

    chef Senior Member
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    go to your state school.
     
  10. margaritaboy

    margaritaboy Senior Member
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    Who is bashing Chapel Hill?
     
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  11. WatchingWaiting

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    You might want to consider asking attendings rather than residents for advice on which school to choose. It feels very different making $200K a year and paying off a ~$180K debt than it does making $40K a year and paying off interest on ~$180K debt.
     
  12. gaslady

    gaslady Senior Member
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    If being closer to your family is one of your prime motivators, think about how many airline tickets you could purchase going to the cheaper school. Also, if you think you may want to go into primary care and plan on settling in the tristate area, you will likely have difficulty paying back your loans from columbia. That amount of debt will be a big burden because salaries are lower in major metro areas. However, if you think you want to go into a more competitive subspecialty then going to an IVY might be an advantage. It would probably be difficult to find an attending who would have the kind of debt that you will after going to columbia because most doctor's student loan indebtedness aren't nearly what they are for med students and recent grads.
     
  13. NYCDOC74

    NYCDOC74 Junior Member
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    Don't be discouraged by debt. The money will be there once you get out.....If you think you will be happy in NY, then go to Columbia.......primary care and 200k+ debt is still very, very managable once you finish in the tri-state area, just be smart. Especially with staffords given at an all time low of 3% and private loans at 5%. You can easily make 200k+ as an internist 60 miles north of the city or in NYC as well......I have to admit, I never liked NC and never will, it was years of misery, and am glad I left and came back to NY.......
     
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  14. medres

    medres Junior Member
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    NYCDOC74- I'm dying to know where you can make 200,000 within 60 miles of NYC. I recently completed my job search, and I'd say the average NYC area IM salary is 110-130,000.
     
  15. Goofy

    Goofy Senior Member
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    This topic seems to come up here quite frequently. I recommend a search on past topics for a more comprehensive look at what both sides have to say.

    My bias is against an expensive ivy league school. I made this 'mistake'. If your argument was simply because columbia has a better name, than I would highly recommend you reconsider. ALL US med schools are excellent, and US grads in general do exceptionally well in the match process. You will get the residency of your choice if you excell in either school.

    The debt burden is very real, and I doubt many on this board advocating the more expensive route really understand what it means to owe 200k in debt. This is a phenomenal amount of money, a number likely to impact your lifestyle. A cheaper state school is a rock solid investment, one that will deliver just as good an education.

    You do offer some legitimate reasons to stay in NY however. Family, personal happiness with locations are solid reasons to stay. Just don't let anyone here delude you into thinking the cost is easily recouped. Saddled with 200k in debt is tremendous, and will have lifestyle implications unless you are independantly wealthy, or have someone willing to foot the bill. In my class (expensive ivy league program) I had several friends who 'could not afford' to enter pediatrics because there was 'no way' an 80k job could pay back such a heavy debt burden.

    It is very difficult to appreciate the nuances alluded to in my post when you are so early in your training. It is easy to get lost in the name game and forget how burdensom sizable debt can be.
     
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  16. Kalel

    Kalel Membership Revoked
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    I strongly agree with many of the opinions being expressed in here. Here is a cut and paste quote of mine from the IM forum regarding whether or not med school reputation is important in IM:
    "I strongly agree with the assertion that a school?s reputation plays a huge role in where one will be able to get interviews at. I know of a student at a top 5 medical school who had below average step I and clinical grades but who was able to secure a good number of interviews at top-ranked schools which were not interviewing many of my classmates who had better step I scores and grades but who came from my state school. I still don?t think that it?s worth a lot of extra money to go to a top 20 school just so that you can get into a top 20 IM residency because many students from unranked schools are still able to secure top IM residencies (they just have to be a little bit more competitive), and there are many ?unranked? IM residencies that are still excellent training programs and have very high placements ratios in all competitive fellowships. Ultimately, if you are good, I think that you will be able to get whatever specialty you want to in IM coming from whatever school you are coming from in the US."

    I also wanted to add that UNC is an excellent school and has a very strong national reputation. It's tuition is also particularly low even as a state school. However, if you truly believe that you'd be happier at Columbia, then I don't see anything wrong with going where you think that you'd be happier too. The difference in cost is substantial (remember that you are essentially "giving up" 3-4 extra cars/a nicer house/ earlier retirement in your life by choosing to Columbia over UNC), but Columbia students are all mostly able to manage their debt. Be careful about overestimating your income potential as a physician, it's very difficult to predict these days. Anyways, I would not choose Columbia over UNC for reputation purposes or if you think that you will just be able to get into a better residency from there, but if you are really unhappy in Chappel Hill and believe that you'd be happier in NYC, then I'd go to Columbia. As a side note, are you able to speak Spanish? I've heard that ~25% of Columbia's patient population is spanish speaking only. That may be one factor in your decision too, but I know that residents/med students are still able to function at Columbia without knowing how to speak any Spanish.
     
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  17. care bear

    care bear pink fuzzy user
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    by the way kalel. . . unc is actually a 'top twenty' school. it ties for # 20 with northwestern. anyway. . .

    that being said, i really shouldn't give an opinion, cause i'm the same age as you and with no real helpful info to give. but, if i were in your spot i would be in NYC in a heartbeat. location and all that stuff is undervalued IMO.

    and i know that at my age i probably don't appreciate a 'burdensome debt' enough. but if you pay off $200,000 over 15 years, isn't that like $13000 per year? and if you're making $80,000 (low end) that's $65,000 disposable income. yes, it's a big difference from $80,000. . .. but definitely enough to raise a normal family on.
     
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  18. Apollyon

    Apollyon Screw the GST
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    60 miles? Long Island, baby, or up into Westchester/Putnam.
     
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  19. San_Juan_Sun

    San_Juan_Sun Professor of Life
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    A couple of quick comments:

    1. You should be making more than 80K just out of residency.

    2. Even if you were making 80K, you won't be taking home 65K after loans. You're forgetting a not so little thing called taxes.

    3. I don't know where you come from, but here in America, 80K will raise a "normal" family quite nicely.
     
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  20. SarahGM

    SarahGM Senior Member
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    OK everyone- sorry for the hiatus, but I just got back from P&S Revisit. I met with the fin. aid office, and was able to see my official "package." I received $26,000 a year in scholarships, and the rest (aside from a small family contribution) is covered entirely by subsidized loans. As it stands, Columbia is now effectively CHEAPER than UNC. And as UNC has told me over the phone that they won't give out *their* fin. aid packages until at least June 1 (well past the deadline for choosing a school)... well, y'all can see where this is heading.

    Thanks very much for all of the input!
     
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  21. banannie

    banannie Senior Member
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    congratulations, SarahGM!
    i am so glad columbia came through for you.
    now, get the heck out of here, you north carolina hater! we don't want you here!
    ;)
     
  22. care bear

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    yep, that's what i was saying. and of course i know that a huge chunk goes to taxes :) i meant that even with taxes, you can be more than quite comfortable in america with a $80000 salary, even if you are paying off huge loans.

    i guess it all depends how you grew up and what you're used to, and what you want materially in life.

    (not directed at you, sarahgm. . .just talking in generalities at this point. especially since it's a moot point for you since you got such great fin aid! congrats!!)
     
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  23. Goofy

    Goofy Senior Member
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    Saying it doesn't make it true. It is fairly obvious that you haven't attempted to live on that kind of salary while paying back 200k loans, a mortgage, car payments, school payments, oh and I forgot food. A salary of 80k brings home about 4k a month. Half of that can easily go towards a mortgage on a modest house. Another 1500 a month will go to your med school loans. Anyone have college loans too? Gas/electric easily cost about 400 a month. That leaves you with 100 dollars a month to purchase everything else. You don't even have a car yet or food! Gas payments, travel expenses. Oh and are you planning on never having kids?

    I guess if you plan on living in a shoe box, defaulting on your loans, walking to work, and surviving on the free ketchup packets at your hospitals cafeteria, than you live quite well. Good luck with your lifestyle.
     
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  24. Fermata

    Fermata Hold me.
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    Congratulations. It's always nice when a plan comes together. :)
     
  25. care bear

    care bear pink fuzzy user
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    actually, i am basing this on personal experience.
    (not my own, obviously- my family.)
    i never wanted for anything as a child, on much less money. like i said it's about what you want/feel you need from life.
    for example, your mortgage payment example :) 2k per month for a house? i just don't need that kind of house!!

    p.s. i was not raised in a shoebox, either. a happy medium *does* exist :)
     
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  26. ortho2003

    ortho2003 Senior Member
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    A salary of 80 K will likely bring home closer to 5K a month, before you consider all the tax breaks for the mortgage payment and student loan payments, which you are eligible for on an 80K salary. If you are paying 2K on a mortgage, you are looking at a 400K house...that is far from modest if you ask me. If you are willing to live modest(200K house with a 1K payment, rather than the 400K house) for 10 years while you pay off loans you can live quite well on 80 K a year. You would bring home about 5k a month and put 3k into student loand and mortgage, leaving you 2k to pay utilities and car payments. That shouldn't be too difficult...i currently bring home 2200 a month and make 2 car payments, a mortgage payment, insurance, groceries, utilitilities (including dropping $50 a month on cable modem which isn't modest living), and entertainment such as dining out and movies with my wife...not to mention diapers from my 7-month old son and manage to save $100 or so a month. So it is purely a lifestyle issue. If you are willing to live modest for a while, you can survive and be doing quite well once the student loans are paid off and you get the extra 2K a month. By the way, very few docs start at 80K, and those that do, don't stay there long.
     
  27. ZephyrX

    ZephyrX Member
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    Unfortunately all of this started in pre-allo when i suggested to an applicant that he better talk to a few residents/fellows before he makes his decision. The decision was UCSF with out of state tuition vs UVA full ride. Every single pre-med (including SarahGM) was going "yeah you rock", "great choice UCSF", "go with UCSF" etc. Noone was throwing in the idea of almost 150,000 difference between the two institutions and if the reputational difference was big enough to justify such a huge amount of money.

    Sadly, just like every other egocentric pre-med, SarahGM thought i was talking to her when i suggested that the OP should talk to some residents first. Since the entire world revolves around her and everything that is said is directed at her, she had to come here and ask about her choices.
     
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  28. The White Coat Investor

    The White Coat Investor Practicing Doc and Blogger
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    ? WTF? ..........
     
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  29. ortho2003

    ortho2003 Senior Member
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    ditto...who is the egocentric one here?
     

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