Sticker Shock

[jdwmont]

After doing some research into schools the cost of attendance per year seems to be 50k-70k, which to me seems obscene. How are people affording this? It doesn't matter what specialty you are in when graduated, $200,000+ in loans would be exceedingly difficult to pay off after 7-8% interest.

Someone please tell me there is a sane way to deal with this.

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[Thriller]

This is why nobody wants to do primary care. You can pay off debt a whole lot faster when you make $300,000 as a specialist as opposed to $150,000 as a pcp. The enormous debt incurred is one reason why it ticks me off so much when people complain about doctors being overpaid.

 

[chocolaterie]

really.. it's a lot like buying a house.

you'll probably spend a good chunk of your days paying it off... if you want to be a pcp - do research regarding scholarships, or years of service repayment plans.

if you're savvy with money and the real estate market wasn't crap - i would recommend buying a house on a 15 yr loan. By the time you finish med school + residency +any other training, the house will be paid off. Then you can sell the house to pay off any remaining debt (so long as the market doesn't get worse).

 

[Semicolon]

I'm going to actually go over the $300,000 debt mark...AND I'm interested in doing primary care (but not enough to limit myself to it).

Trust me; I'm trying not to think about it.

Still, even though you'll be paying off your loans for a long time to come, it's not like you won't live at least a decent life with what you do make.

 

[Handy388]

I don't quite understand DO and lower tiered MD schools. On one hand they charge you exonerant tuition, on the other hand they expect you to go into primary care.

 

[Bleurberry]

I don't quite understand DO and lower tiered MD schools. On one hand they charge you exonerant tuition, on the other hand they expect you to go into primary care.

I'm getting tired of you.

 

[digitlnoize]

There are cheaper options. My out-of-state DO school, for example, is <30k/yr. Cheaper than 2 out of 3 of my in-state MD schools.

If you're set on a school that costs THAT much, I'd think about considering the military or government programs. That's alot of money.

 

[engineeredout]

Some primary care programs offer lone repayment incentives.

 

[Bleurberry]

There are cheaper options. My out-of-state DO school, for example, is <30k/yr. Cheaper than 2 out of 3 of my in-state MD schools.

If you're set on a school that costs THAT much, I'd think about considering the military or government programs. That's alot of money.

OUCOM, LECOM, UMDNJCOM are notoriously cheap, too.
I know PCOM is competitive with the other 4 schools in the area, and Temple Medical is more expensive than PCOM.

 

[bioman2006]

.

 

[jdwmont]

Wow, so basically the only way for someone interested in primary care getting in the game now would be to do NHSC or the military it seems. I am begining to understand why the primary care physician is quickly becoming a dying breed.

 

[Anita817]

Wow, so basically the only way for someone interested in primary care getting in the game now would be to do NHSC or the military it seems. I am begining to understand why the primary care physician is quickly becoming a dying breed.

Or... you could accept the fact that becoming that type of doctor won't make you filthy rich, but will likely still allow you to live comfortably (AND have compartively more free time than many specialties might allow). Or you could assume that you will be living in a two-income household and making *only* 150k a year won't be a major source of strife. It's all a matter of perspective.

 

[countthestars]

Or... you could accept the fact that becoming that type of doctor won't make you filthy rich

Lets face it, no type of doctor these days will make you filthy rich. Medicine is not the way to go to make money. I wish more high schoolers and College premeds understand this.

 

[goosedander]

Yeah, except there's no equity in your medical degree.

And your house doesn't afford you a six-figure salary, every year, until you retire.

 

[Handy388]

OUCOM, LECOM, UMDNJCOM are notoriously cheap, too.
I know PCOM is competitive with the other 4 schools in the area, and Temple Medical is more expensive than PCOM.

except temple charge a 48k tuition.

you may dislike me for my comments, but it's true. look at the tuition of many top 20 MD schools. more often than not they are under 40k.

 

[WDeagle]

except temple charge a 48k tuition.

you may dislike me for my comments, but it's true. look at the tuition of many top 20 MD schools. more often than not they are under 40k.

Link?

 

[WDeagle]

I don't quite understand DO and lower tiered MD schools. On one hand they charge you exonerant tuition, on the other hand they expect you to go into primary care.

What dont you understand? It costs lots of money to train physicians. Private schools dont get government funding thus they must charge higher amounts for tuition. The majority of "lower tier" MD schools and DO schools are private. Did you really need someone to explain this do you or are you just trolling?

 

[chocolaterie]

hmm almost sounds like someone wants the students who matriculate at the more costly med schools to feel somehow less for going to those schools... i'm not saying that's what s/he wants - just an observation.

it is pretty obvious that private schools do not get federal funding.. they make this up by charging higher tuition... which implies you do understand why... so why ask? back to observation #1. don't be ______ . merci.

 

[Rollo]

What about your old man? My old man isn't filthy rich, but with his help, I won't be in as much debt.

I've also had several family members offer me money (with very low interest rate of course).

Also, look at ways to cut cost while in medical school. You don't have to live in that $1500 apartment or have subscription to $150 cable TV.

Got to be savvy with your money.

 

[jdwmont]

My parents seem to be just getting by and rapidly reaching retirement. I am sure they would do anything to help out but I would be a rather bad son for allowing them to. I am for all intents and purposes on my own aside from some minor contributions I'm sure will come along the way.

Is it common to obtain all necessary loans through the Federal government? Somehow I doubt it... Does anyone else think that we are getting gouged? Medical education in most parts of the world is dirt cheap compared to here. And I don't believe that we are any better at it than any other developed nation.

 

[beckhunter116]

What about your old man? My old man isn't filthy rich, but with his help, I won't be in as much debt.

I've also had several family members offer me money (with very low interest rate of course).

Also, look at ways to cut cost while in medical school. You don't have to live in that $1500 apartment or have subscription to $150 cable TV.

Got to be savvy with your money.

I wish my family would offer a low interest loan or help, but I imagine for many of us they can't/won't. Of course, I think everyone should plan a budget, and get used to thrifty spending patterns.

 

[Uranium678]

I don't quite understand DO and lower tiered MD schools. On one hand they charge you exonerant tuition, on the other hand they expect you to go into primary care.

I agree with the point you are trying to make here. Many DO schools do charge huge tuition and don't defray the cost with scholarships or grants. Many MD schools offer great financial aid packages so their students graduate with much less debt. The big difference is that many MD schools are linked to huge universities that want to attract top talent and don't mind paying to do so. Major MD schools (top 50 US News), are linked to research institutions and huge diverse graduate programs, not to mention undergraduates. They have massive alumni networks and budgets in hundreds of millions of dollars. It's impossible to compare schools like these to D.O. schools which get no NIH funding, have much smaller alumni networks, and derive most if not all of their revenue in tuition costs. It's two completely different leagues as far as money is concerned.

Mayo Clinic SOM and Cleveland Clinic Lerner COM offer full scholarships to all accepted students.

D.O. schools should figure out ways to increase their financial aid packages to encourage more students to go into pcp in underserved areas.

 

[slick27]

don't apply to those schools. Personally I wouldn't do medicine if it cost 50-70k a year.

 

[jdwmont]

Yeah, neither would I. I am not the type to enjoy crucifying myself. I can allready hear the cries of, "Don't go into medicine!"

I am allready a reasonably frugal person. The idea of spending 1500 a month for an apartment sounded ludicrous to me. I figure I can live on around 10k a year, probably several thousand more in an urban area.

I am just wondering where the money will come from. My adisors at school don't know anything worth knowing. I had always naievely assumed that I would "take out loans." But will the loans be there to cover such astronomical debt? With physician salaries declining, I am not so certain loans will be so easy to come by in the future.

 

[jdwmont]

As for making "only 150k" with two incomes, well I would like to be better compensated than a nurse for sacrificing a decade of my life. My question is; will my future children be able to attend medical school? Imagine how ridiculous tuition will be then.

 

[beckhunter116]

don't apply to those schools. Personally I wouldn't do medicine if it cost 50-70k a year.

What schools can you apply to then (for DO)? I mean even LECOM (one of the cheaper schools) is like 28K for tuition and then I imagine they give you close to 20K for housing/food/ect so that is close to the 50K for a year. And that is one of the cheapest DO schools except the TCOM, OU, and OSU for in-state residents.

 

[slick27]

Oh, i thought you were talking simply tuition. Living expenses you can't really count, since you'll be spending that if you're in school or not.

 

[beckhunter116]

As for making "only 150k" with two incomes, well I would like to be better compensated than a nurse for sacrificing a decade of my life. My question is; will my future children be able to attend medical school? Imagine how ridiculous tuition will be then.

I think that figure is low, unless your partner is making like 20-30K. Even most FP make over 120K a year unless they are working for the govn't for loan re-payment which has it's own advantage.

And nurses are not making that much, I figure less than 60K--from looking on two salary sites. www.allied-physicians.com/salary-surveys/nursing and http://www.payscale.com/research/US/Job=Registered_Nurse_(RN)/Salary

 

[beckhunter116]

Oh, i thought you were talking simply tuition. Living expenses you can't really count, since you'll be spending that if you're in school or not.

No the OP started this about the cost of attendance which includes living expenses and tuition/fees.

 

[jdwmont]

Living expenses would be covered by loans so they are part and parcel with cost of attendence. As for nurses, I dated a girl who was 22 and came straight out of a 3 year RN program and made 56k her very first year. She worked for it, but it is still an impressive sum to start out with. Also, my friend's dad (OB/Gyn) told me about an ICU RN in his hospital who made 180k last year. Let's not even get into CRNAs.

These are not average salaries but I assure you that girl I dated was average in her ambition. She had less than 1/3 of the education as a FM/IM physician but was making nearly half the pay right out of school. Granted, there are many aspects to consider other than reimbursment, but this seems to be a little ridiculous. And I don't think that nurses are overpaid.

An orthopedic surgeon I know was talking about a trip he made to the Soviet Union back in the 80s. He said that garbage men got paid more than doctors because doctors were expected to have higher job satisfaction. He also said there were wood chips in the toilet paper that would tear you a new one. I imagine getting sick was a pretty bad idea in the old USSR.

 

[Anita817]

As for making "only 150k" with two incomes, well I would like to be better compensated than a nurse for sacrificing a decade of my life. My question is; will my future children be able to attend medical school? Imagine how ridiculous tuition will be then.

Just to clarify, I was implying that a second income would obviously raise the total household income to above a paltry 150k. Meaning that if you went into primary care and chose to marry someone who also worked, your total household income would not be limited to you primary care salary-- ie, should two doctors, both in primary care, fall in love and decide to marry... bam! 300k/yr--this amount will comfortably provide for a family. On the other hand, if I was in a position where I would likely be the sole provider for a family, I would probably not consider primary care a viable option.

And just for the record, my father is a DO that chose to specialize in pulmonary critical care and I'd like to say my 5 brothers and sisters and I are all very well cared for. Additionally, I am incredibly blessed to have him helping me pay for medical school. The point being: it is totally possible to make money as a DO.

 

[phillyosteo]

I had another career that would have sent me to business school for free and guaranteed me a six figure salary (minimum) for the rest of my career. I'll be out of residency before I make as much as I did there as an analyst right out of college. I absolutely hated every hour I spent working there.

Medical school is a huge investment, but you can't let finances dictate your career path. Most of us will be graduating fairly young and have 30-40 year careers ahead of us. Plenty of time to pay off loans, but also an incredibly long time to be stuck in a specialty you dislike.

I personally think a medical degree is the best education investment you can make. The analytical skills you acquire allow you to enter almost any career path if you want to. You could leave practice to help engineer new medical devices, work for a large pharmaceutical company, teach, work in medical school administration, or even work as a consultant or an investment banker. The possibilities are almost endless and if any of those don't work out (see: i-banking 2008-2009), there's always a need for practicing physicians, assuming you've kept your skills up. No other degree gives you that flexibility and job security.

I also think primary care will be coming back in a big way soon. As with most things, I think the incredible demand for primary care physicians will lead to an increase in pay rates.

 

[Semicolon]

I had another career that would have sent me to business school for free and guaranteed me a six figure salary (minimum) for the rest of my career. I'll be out of residency before I make as much as I did there as an analyst right out of college. I absolutely hated every hour I spent working there.

Medical school is a huge investment, but you can't let finances dictate your career path. Most of us will be graduating fairly young and have 30-40 year careers ahead of us. Plenty of time to pay off loans, but also an incredibly long time to be stuck in a specialty you dislike.

I personally think a medical degree is the best education investment you can make. The analytical skills you acquire allow you to enter almost any career path if you want to. You could leave practice to help engineer new medical devices, work for a large pharmaceutical company, teach, work in medical school administration, or even work as a consultant or an investment banker. The possibilities are almost endless and if any of those don't work out (see: i-banking 2008-2009), there's always a need for practicing physicians, assuming you've kept your skills up. No other degree gives you that flexibility and job security.

I also think primary care will be coming back in a big way soon. As with most things, I think the incredible demand for primary care physicians will lead to an increase in pay rates.

A lot of people hope you're right.

A somewhat interesting blog article: http://mdsalaries.blogspot.com/2009/02/bonus-payments-long-before-residency.html

I've been somewhat leaning towards primary care, but since I'm going to have such an incredible debt, I'd be lying if I said that it's not affecting my judgment. Then again, I have yet to even begin medical school, so I'll leave my judging for when it actually matters!

Also, as a primary care doc you can find other ways to make money on the side, such as laser hair removal! http://mdsalaries.blogspot.com/2008/01/round-up-of-extra-income-ideas-for.html

 

[Handy388]

hmm almost sounds like someone wants the students who matriculate at the more costly med schools to feel somehow less for going to those schools... i'm not saying that's what s/he wants - just an observation.

it is pretty obvious that private schools do not get federal funding.. they make this up by charging higher tuition... which implies you do understand why... so why ask? back to observation #1. don't be ______ . merci.

my apologies. It seems that the top 20 private schools tuition still are mostly in excess of 40k.

However, I don't mean to belittle anyone, I bring up a valid point, the cost of training continue to increase while the return diminishes.

Look at the field of law right now as an extreme example. lower ranked law schools charge tuition over 40k to put out classes who are largely unempolyed.

https://services.aamc.org/tsfreports/report.cfm?select_control=PRI&year_of_study=2009

 

[Bleurberry]

No doubt about it, we're getting the screws turned on us in terms of tuition. I know someone in a previous thread made an excellent point that it can be linked to the free-flowing money from the staffords - when the federal loan program kicked in, the tuition rate's started their exponential climb toward the skies.

my apologies. It seems that the top 20 private schools tuition still are mostly in excess of 40k.

However, I don't mean to belittle anyone, I bring up a valid point, the cost of training continue to increase while the return diminishes.

Look at the field of law right now as an extreme example. lower ranked law schools charge tuition over 40k to put out classes who are largely unempolyed.

https://services.aamc.org/tsfreports/report.cfm?select_control=PRI&year_of_study=2009

 

[chocolaterie]

it's really quite a pickle. how can we decrease the cost of tuition? have the gov't subsidize the costs? I look at the CDN med edu set up, where they have an average of 4 applicants per spot but tuition is less than 20 k per year. Is there a system that works better? I don't know... what I do know is that I'm looking to go to a school with tuition costing 38K per year unless by some miracle I get into a Cdn school/state school. Realistically, I plan on using my state's loan program to pay off the debt with the promise of practicing so many years in an under served area.

 

[Rollo]

My parents seem to be just getting by and rapidly reaching retirement. I am sure they would do anything to help out but I would be a rather bad son for allowing them to. I am for all intents and purposes on my own aside from some minor contributions I'm sure will come along the way.

Is it common to obtain all necessary loans through the Federal government? Somehow I doubt it... Does anyone else think that we are getting gouged? Medical education in most parts of the world is dirt cheap compared to here. And I don't believe that we are any better at it than any other developed nation.

How would you be a "bad son" for allowing your parents to help you out financially in medical school?

 

[EricH]

I had this conversation with a wealthy old physician friend of mine, who was SHOCKED by our tuition cost. Anyhoo, he suggested that medicine won't make you wealthy, comfortable yes, but wealthy no. He made some of his dough in real estate. He saved some money and bought rental properties one after another until he had about a dozen of them. He has held these properties for over 20 years and told me that he is clearing at least $1800/mo on each of them. He reinvests the money in more real estate or other markets. Plus in a normal market he figures that all told they are worth about six million bucks. He said that he took a few losses over the years in maintenance and vacancy, however he invested less than 100k to buy all of them (not adjusted for inflation). With his other investments the guy is probably worth 10 million.

The moral of the story, there are far more paths to wealth than your salary.

As an aside, I did ask him for a scholarship.....he laughed and said no. He said that he didn't get where he is by giving his money away.

 

[Revilla]

ETA: Already stated!

 

[Uranium678]

Its the LACK of scholarships and grants at D.O. schools that makes the difference

Look at the average financial aid award for top 50 M.D. schools and then look at D.O. schools.

Top M.D. schools, Mid/low range M.D. schools and D.O. schools all charge similar tuition.

but
US M.D. students, on average, graduate with much less debt.

 

[binko]

OUCOM, LECOM, UMDNJCOM are notoriously cheap, too.
I know PCOM is competitive with the other 4 schools in the area, and Temple Medical is more expensive than PCOM.

OUCOM is inexpensive but their facilities are

Big plasma screens and ceiling/mount articulated cameras in OMM and cadaver labs, &#8804;4 people per cadaver, and their own plasticination machine thingie.

 

[JanikeyDoc]

Many primary care doctors I have spoken with can earn a lot more than $150k a year, the ones I know make a lot more in private practice but it really all depends. Specialist salaries can be a lot higher than 300k a year but that can vary too. Attendings just out of Anesthesiology earn at least 300k a year after residency and salaries can climb to as high as 500k, some in private practice can earn nearly a $1 million. I recall my bill when I visited a pain specialist, he is definitely a millionaire.

 

[Semicolon]

Many primary care doctors I have spoken with can earn a lot more than $150k a year, the ones I know make a lot more in private practice but it really all depends. Specialist salaries can be a lot higher than 300k a year but that can vary too. Attendings just out of Anesthesiology earn at least 300k a year after residency and salaries can climb to as high as 500k, some in private practice can earn nearly a $1 million. I recall my bill when I visited a pain specialist, he is definitely a millionaire.

A lot of that is based on region. Primary care docs in the city can make considerably less than those in less saturated areas.

 

[Chocolate Bear]

Many primary care doctors I have spoken with can earn a lot more than $150k a year, the ones I know make a lot more in private practice but it really all depends. Specialist salaries can be a lot higher than 300k a year but that can vary too. Attendings just out of Anesthesiology earn at least 300k a year after residency and salaries can climb to as high as 500k, some in private practice can earn nearly a $1 million. I recall my bill when I visited a pain specialist, he is definitely a millionaire.

Averages are just that. Those that are crushing the average are doing so for a reason. Business savvy, location, sacrificing personal life, procedures....the list goes on. But the average GP isn't driving a Ferrari.

Pain medicine can be quite lucrative, as many of the procedures are only performed by pain specialists (anesthesiology or PM&R docs --> pain fellowship), are very quick, and can be billed heavily to insurance.

 

[EricH]

Pain medicine can be quite lucrative, as many of the procedures are only performed by pain specialists (anesthesiology or PM&R docs --> pain fellowship), are very quick, and can be billed heavily to insurance.

Plus you can have "Dr. Feelgood" embroidered on your coat

 

[EricH]

Many primary care doctors I have spoken with can earn a lot more than $150k a year, the ones I know make a lot more in private practice but it really all depends. Specialist salaries can be a lot higher than 300k a year but that can vary too. Attendings just out of Anesthesiology earn at least 300k a year after residency and salaries can climb to as high as 500k, some in private practice can earn nearly a $1 million. I recall my bill when I visited a pain specialist, he is definitely a millionaire.

I have a DO FP doc in the family who makes about $250/yr in Las Vegas. Her best year was $350....about 4 years ago. She has been practicing for 20 years and works in a PPO only group.

 

[DrMattOglesby]

AOA head honcho on medical student debt

 

[EricH]

AOA head honcho on medical student debt

$168,000...that's adorable. How old are their stats?

 

[235750]

my apologies. It seems that the top 20 private schools tuition still are mostly in excess of 40k.

However, I don't mean to belittle anyone, I bring up a valid point, the cost of training continue to increase while the return diminishes.

But your original point was that this is a phenomena found in DO schools and "low tier" MD schools, to use your words. Now that you've done some research (ie. googled "MD" and "tuition"), hopefully you realize this is not the case: this is a problem seen in all of medicine.

DO schools have an underlying philosophy that you're a generalist first and a specialist second, if you choose to subspecialize. They don't force primary care as a specialty, they just want you to be a well-rounded physician.

Look at the field of law right now as an extreme example. lower ranked law schools charge tuition over 40k to put out classes who are largely unempolyed.

Really? You're going to try to compare medicine and law?

First of all, I thought Columbia was a good law school, right? So why are their grads having a hard time? Your argument only makes sense if it were only low tier law schools having trouble getting hired, but in actuality it looks like, again, this has effected everyone.

Also, there are FAR more laws schoosl than medical schools in the US. There are still plenty of jobs around for doctors, even for the lowly DO You know that goole research you did earlier? Try it again with 'physician job openings'. For a start, look at www.usajobs.gov/ and get back to me

To the OP: relax. If you are flexible, you'll pay your debt off eventually (the avg is 10 years right now). I'm going to work for the VA, they offer a great loan forgiveness program. Plenty of jobs offer that sort of thing too. If you really panic later on you can do FAP or rural medicine with the NHSC to pay back loans.

You'll do an entrance/exit interview with your medical school and they'll explain what you need to know. Talk to the financial advisor directly if you have Qs.

Good luck

 

[MaximusD]

After doing some research into schools the cost of attendance per year seems to be 50k-70k, which to me seems obscene. How are people affording this? It doesn't matter what specialty you are in when graduated, $200,000+ in loans would be exceedingly difficult to pay off after 7-8% interest.

Someone please tell me there is a sane way to deal with this.

sign on the dotted line and don't look back It's just debt and money isn't real especially since you'll never starve as a doctor.

Or do what I did and mortgage a few years of your life in the military