the debt......

[immolard]

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ITT: Doctors prescribing grammar... lmao.

 

[beachside]

Beachside: I understand why you feel more comfortable doing your calculations in terms of pretax income, because that's how people usually describe their salaries, but it's much more accurate and useful to consistently convert incomes into after-tax amounts, because those are the numbers that really matter. When your salary doubles, your actual after tax income may be considerably less. Similarly, when you retire and live on a pension or on withdrawals from a tax deferred 401k account, your withdrawals will be taxed as income, although without some of the additional medicare, disability, and other taxes that come out of your paycheck, and most likely at a lower effective tax rate, because the first dollars are tax free, and subsequent dollars taxed at lower rates, so you will need fewer dollars per year saved to get the same spending power.

So, you get partial credit for taking taxes into account, but I recommend that you actually think about all income in terms of after tax, rather than pre tax numbers, for maximal accuracy.

Unless you know the post-tax income of all other professional alternatives, knowing the post-tax income for your anticipated medical career is not very useful as tool for comparing potential career options. It's great for personal budget planning, yes, but not for comparing the salary of a physician to an engineer, for instance. All salary figures posted online are pretax income, and all salaries figures given to you by friends and family members in other professions are pretax income. It's a problem that I've seen over and over again here on SDN, people comparing post-tax physician income with pre-tax income in another profession.

Furthermore, the applicable tax rates for people in our profession do not increase significantly with income. Here are the current US tax brackets. Given that the FICA tax has an earnings ceiling of $118,500, you essentially see a 6.2% tax cut on income earned over that amount. With that considered, your tax rate does not change much at all between $90,000 and $411,000 of annual income. Of course your state tax rate may be somewhat different.

So yes, I agree that analyzing the details of your personal tax situation can be highly advantageous. For the purpose of someone asking essentially "Is medical school worth the cost", however, I think the pre-tax figures are far more useful. Telling a person that his salary is going to be the equivalent of someone who makes $85,000 per year in another profession is going to immediately enable them to compare and contrast that with their other options. Giving them a post-tax figure will mislead or confuse them. They're generally young 22-year-old kids here with no real work experience, so they're not exactly financially savvy yet.

 

[justadream]

Unless you know the post-tax income of all other professional alternatives, knowing the post-tax income for your anticipated medical career is not very useful as tool for comparing potential career options. It's great for personal budget planning, yes, but not for comparing the salary of a physician to an engineer, for instance. All salary figures posted online are pretax income, and all salaries figures given to you by friends and family members in other professions are pretax income. It's a problem that I've seen over and over again here on SDN, people comparing post-tax physician income with pre-tax income in another profession.

Furthermore, the applicable tax rates for people in our profession do not increase significantly with income. Here are the current US tax brackets. Given that the FICA tax has an earnings ceiling of $118,500, you essentially see a 6.2% tax cut on income earned over that amount. With that considered, your tax rate does not change much at all between $90,000 and $411,000 of annual income. Of course your state tax rate may be somewhat different.

So yes, I agree that analyzing the details of your personal tax situation can be highly advantageous. For the purpose of someone asking essentially "Is medical school worth the cost", however, I think the pre-tax figures are far more useful. Telling a person that his salary is going to be the equivalent of someone who makes $85,000 per year in another profession is going to immediately enable them to compare and contrast that with their other options. Giving them a post-tax figure will mislead or confuse them. They're generally young 22-year-old kids here with no real work experience, so they're not exactly financially savvy yet.

I think because the tax percentage changes depending on how much you make, it is better to compare post-tax to post-tax.

You are right that people should not be comparing post-tax physician salary to pre-tax [insert any occupation here] salary.

However, I don't think you should be comparing pre-tax to pre-tax either because the tax percentage changes.

Take the post-tax income of a physician and the post-tax income of [insert occupation here]. This would be the most ideal comparison.

 

[bc65]

Giving them a post-tax figure will mislead or confuse them. They're generally young 22-year-old kids here with no real work experience, so they're not exactly financially savvy yet.

Thanks for the reply. OK, that makes sense. I still prefer using after-tax numbers, but perhaps for teaching purposes doing it your way has some advantages.

 

[Lysinee]

ITT: Doctors prescribing grammar... lmao.

Include meme with prescription.

 

[DrBowtie]

Personally, if I was staring 500k debt in the face and had a viable career based on undergrad, no chance I'd go to medical school.

 

[Gurby]

FWIW, OP's use of "loan" might not be as ridiculous as you all think... I've heard British people use the word "hire" to mean "rent": "We'll just hire a car", "I hired skis last weekend because mine were in the shop". Also, every now and then on SDN you see someone talk about "writing their MCAT". Obviously they aren't composing the test - they're taking it. In both cases the "opposite" word is being used. It's weird/wrong to use "loan" this way in American English, but I wouldn't be surprised if it was common in other countries?

 

[MajorBubblez]

lol you guys are hilarious.

 

[deuist]

if you were accepted into the HPSP scholarship (4-year payback) and decide to be a general surgeon, you'd be a doctor in the military for 9 years (5 years of training, 4 years of payback.)

You would be in the military for 17 years. 4 years of medical school + 5 years residency + 4 years of active duty payback + 4 years of individual reserve time = 17 years.

 

[Aloft085]

You would be in the military for 17 years. 4 years of medical school + 5 years residency + 4 years of active duty payback + 4 years of individual reserve time = 17 years.

Neither the medical school time nor the IRR time count as being "in the military". You're a civilian just like everyone else. Not subject to UCMJ, not accumulating retirement years. If you did a 5 year residency, you'd also owe 5 years active duty.

 

[Dullhead]

OP - if you're willing to disclose - how old are you now? Mid 20s? Late 20s? 30s? And what are your retirement goals? Retire at 55? 65? 75? With what income during retirement?

 

[sliceofbread136]

Just have your rich parents pay for everything

ez game ez life

 

[deuist]

Neither the medical school time nor the IRR time count as being "in the military". You're a civilian just like everyone else. Not subject to UCMJ, not accumulating retirement years. If you did a 5 year residency, you'd also owe 5 years active duty.

If you don't think that you are in the military during medical school, the US government will be happy to remind you of that you apply for the match. Also, internship does not tack on additional years of service. A five-year residency still only incurs a four-year service obligation.

 

[Aloft085]

If you don't think that you are in the military during medical school, the US government will be happy to remind you of that you apply for the match. Also, internship does not tack on additional years of service. A five-year residency still only incurs a four-year service obligation.

The fact that you're committed to joining the service does not make you "in the military". I get what you're trying to say, it's just seriously misleading in the way that you said it.

 

[NickNaylor]

The fact that you're committed to joining the service does not make you "in the military". I get what you're trying to say, it's just seriously misleading in the way that you said it.

I'm not in the HPSP, but I'm pretty sure you're expected to go to training in your off summers. There's a guy in my class who is in the HPSP and had to go to training during his M1 and M2 summers. Perhaps his situation in different in some way that I'm not aware of, though. And perhaps it's service-specific.

 

[xffan624]

I'm not in the HPSP, but I'm pretty sure you're expected to go to training in your off summers. There's a guy in my class who is in the HPSP and had to go to training during his M1 and M2 summers. Perhaps his situation in different in some way that I'm not aware of, though. And perhaps it's service-specific.

The only time you go to training is over the summer between M1 and M2 to get you acquainted with being an officer and your respective branch and then, yes, during that time, you are technically active duty. Other than that, you are inactive reserve, which for an active duty person like Aloft pretty much equals civilian life. It's not even the reserves where you have to train on the weekends. Your obligations are minuscule. The guys I know that are doing HPSP, actually grow beards at times, which if they were actually "in the military" would not be allowed. It does mean that if WWIII broke out tomorrow, they could call you up easier than having to draft you, but then you'd probably be last on the list, because trained doctors are much more valuable than a grunt.

 

[Aloft085]

I'm not in the HPSP, but I'm pretty sure you're expected to go to training in your off summers. There's a guy in my class who is in the HPSP and had to go to training during his M1 and M2 summers. Perhaps his situation in different in some way that I'm not aware of, though. And perhaps it's service-specific.

No, that's correct. You're active duty for that month or two. Then you're just a civilian again. Once you start extended active duty, you'll have accumulated 8 months or whatever of service time. That's depending on your school's schedule, I believe. Once you go back to school, however, you're just a civilian with a contract to join the military. You get none (or very few) of the priveledges and responsibilities associated with being active duty or regular reserve.

 

[deuist]

Why are you premeds and junior medical student so argumentative? I went through HPSP and now I am an attending with the military. I know exactly what I'm talking about. None of the rest of you who've chimed in have any experience with this program – so I don't know why you feel the need to try to tell me how it works.

The guys I know that are doing HPSP, actually grow beards at times, which if they were actually "in the military" would not be allowed.

A beard? Well I guess that negates everything I said about being in the military.

Once you start extended active duty, you'll have accumulated 8 months or whatever of service time. That's depending on your school's schedule, I believe.

Your beliefs would be incorrect. Upon graduating medical school, you are recommissioned as an 0-3 with zero years of experience.

You get none (or very few) of the priveledges and responsibilities associated with being active duty or regular reserve.

Also incorrect. You have a military ID and are certainly welcome to use on-base facilities, whether it be the BX, the JAG office, the officers club, and so on.

 

[Aloft085]

Why are you premeds and junior medical student so argumentative? I went through HPSP and now I am an attending with the military. I know exactly what I'm talking about. None of the rest of you who've chimed in have any experience with this program – so I don't know why you feel the need to try to tell me how it works.



A beard? Well I guess that negates everything I said about being in the military.



Your beliefs would be incorrect. Upon graduating medical school, you are recommissioned as an 0-3 with zero years of experience.



Also incorrect. You have a military ID and are certainly welcome to use on-base facilities, whether it be the BX, the JAG office, the officers club, and so on.

I spent over a year in Afghanistan and nearly a decade of my life in the military, and am now in the IRR. I think I know the difference between being in the actual military and being a civilian on contract. Congrats on finishing your residency though, that must make you an expert on all things military. When you grow up enough to actually finish your first tour of service, you'll realize that the IRR is 100% civilian life, with a caveat that they can call you back to service later on if they want. In reality, that almost never happens anyway.

Try to reign back your know-it-all attitude a little, attending. Being further ahead in medical education does not put you further ahead in life, in military rank, or in knowledge of how the military works. Thanks.

To bring this conversation back to where it began, no, you do not owe 17-years of military service if you join HPSP. You have to do summers while in med school, possibly residency (unless you defer), and then 3+ years of active duty service. You're then subject to recall in the event of a major war breaking out. That's not 17-years, or anything even close to it. When you've actually served more than a few years post-schooling, perhaps you'll appreciate the distinction between active duty and inactive reserve status.

 

[FutureOncologist]

I spent over a year in Afghanistan and nearly a decade of my life in the military, and am now in the IRR. I think I know the difference between being in the actual military and being a civilian on contract. Congrats on finishing your residency though, that must make you an expert on all things military. When you grow up enough to actually finish your first tour of service, you'll realize that the IRR is 100% civilian life, with a caveat that they can call you back to service later on if they want. In reality, that almost never happens anyway.

Try to reign back your know-it-all attitude a little, attending. Being further ahead in medical education does not put you further ahead in life, in military rank, or in knowledge of how the military works. Thanks.

To bring this conversation back to where it began, no, you do not owe 17-years of military service if you join HPSP. You have to do summers while in med school, possibly residency (unless you defer), and then 3+ years of active duty service. You're then subject to recall in the event of a major war breaking out. That's not 17-years, or anything even close to it. When you've actually served more than a few years post-schooling, perhaps you'll appreciate the distinction between active duty and inactive reserve status.

Can we not argue about this? Especially with the petty ad hominem attacks?

 

[bluejay456]

There are a few programs out there that cover tuition such as the Cleveland clinic college learners program through Case Western. The program is 5 years and you have to do a masters thesis but it's totally free, you only pay for living. There are other programs like this (I think mount sinai portal program is similar but I am unsure). Other schools such as Vanderbilt are notorious for providing 75% scholarships.

 

[QuantumFlame]

Hi OP. bluejay456 makes a good point. Some schools are known for being more generous. CCLCM, Vanderbilt, Baylor (in general low tuition plus they give out some scholarships) as well as Penn (a number of full tuition/fees merit based scholarships a year), Pritzker, Duke, Mayo etc. all have some form of sizable aid. I realize that these are top programs, and within them, these scholarships are very competitive. That being said you may want to do your research and try and pick schools were you at least have a shot at some merit aid love. I don't know your stats, so you'll have to make the final judgement. Best of luck, we are all on this path together.