The Price Of Admission

[OrthoRehab33]

Is anyone else becoming more and more concerned about the price of our education? Osteopathic tuition is roughly around 40,000$ then add in the cost of rent/water/utilities+textbooks+cell phone+medical equipment+health/dental/car insurance its not unfeasible to borrow 70k per year. You multiply that by 4 years and add interest for a 10 year pay back you can easily be looking at 350-400k of debt. I know faculty say don't worry about the debt, you'll eventually pay off it. Yet, what their describing are usually physicians that were in Medical school 15 or 25 years ago where the tuition was a lot cheaper and weren't experiencing reimbursement cuts as severely like today. Just curious what everyone else is thinking...

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[yanks26dmb]

If people can pay off 350-400k mortgates pulling in <100k a year, I don't see why you can't pay off that amount making <200k+ a year. Look at default rates for medical students..it appears the vast majority are able to pay off their loans, and I'm willing to bet you will too.

 

[TeddyBoomBoom]

Is anyone else becoming more and more concerned about the price of our education? Osteopathic tuition is roughly around 40,000$ then add in the cost of rent/water/utilities+textbooks+cell phone+medical equipment+health/dental/car insurance its not unfeasible to borrow 70k per year. You multiply that by 4 years and add interest for a 10 year pay back you can easily be looking at 350-400k of debt. I know faculty say don't worry about the debt, you'll eventually pay off it. Yet, what their describing are usually physicians that were in Medical school 15 or 25 years ago where the tuition was a lot cheaper and weren't experiencing reimbursement cuts as severely like today. Just curious what everyone else is thinking...

Yeah... I'm pissed about the incredibly rapid rising costs (not joking). However, if I were doing it for the money, I'd be doing something else.

 

[gmcguitar4]

It's not that much money in the grand scheme. It just seems like a lot because most of us have never dealt with such large quantities of money. Debt is a normal part of life of these days.

 

[NurWollen]

If people can pay off 350-400k mortgates pulling in <100k a year, I don't see why you can't pay off that amount making <200k+ a year. Look at default rates for medical students..it appears the vast majority are able to pay off their loans, and I'm willing to bet you will too.

I see what you're saying and partly agree with it but remember student loans have a of twice the interest rate homes do. And people take 30 years to pay of homes. Do you really want to be paying off your student loans right up until retirement age?

You're right though, we can pay off our loans if we're willing to live frugally and make paying off debt a priority.

 

[TopTomato]

A doctor once told me before I applied and said "only do it if you could see yourself doing nothing else".

 

[darklabel]

I see what you're saying and partly agree with it but remember student loans have a of twice the interest rate homes do. And people take 30 years to pay of homes. Do you really want to be paying off your student loans right up until retirement age?

You're right though, we can pay off our loans if we're willing to live frugally and make paying off debt a priority.

Yeah, funny how when congress took away ("allow to expire") subsidized loans, they didn't even bother to give a competitive interest rate

 

[Mehd School]

It's not that much money in the grand scheme.

Objectively, yes, it is a very large sum of money. Many of us will be looking down the barrel of close to half a million dollars worth of debt. I don't know your background, but half a million dollars is a lot of money to me.

 

[ShyRem]

As a newly graduated internal med physician, I currently have about $300k of student loan debt, I don't even want to think about how much credit card debt, my daughter in college I am paying for (although gratefully she got some great academic scholarships), and I'm about to buy a house. Not the most expensive house... It's a foreclosure but a REALLY nice one.

Bottom line: it's doable. Doable without going broke, and let me tell you it feels like a luxury to fill my gas tank after living through residency. I have a plan to have credit card debt gone in five years, student loan debt gone in ten, and my house paid off in fifteen. And that isn't living like a pauper. Not like a king (although after med school and residency it feels like it!) but not like a pauper either. I'm comfortable. I have a new car. I am building my retirement as fast as the government tax laws will allow. And I've budgeted for a nice trip to Europe in five years for my 25th wedding anniversary in there. And we go out to dinner to really nice places about once a month or so.

Yes, it's doable. Just don't expect to buy a BMW every year, a one million dollar house, and go to Europe every year. And don't marry a gold digger of either sex that spends money like water. Be smart and you'll be fine.

Thinking about my debt does make me vomit a little in my mouth though. It's a lot of money I owe. A lot.

 

[Postictal Raiden]

As a newly graduated internal med physician, I currently have about $300k of student loan debt, I don't even want to think about how much credit card debt, my daughter in college I am paying for (although gratefully she got some great academic scholarships), and I'm about to buy a house. Not the most expensive house... It's a foreclosure but a REALLY nice one.

Bottom line: it's doable. Doable without going broke, and let me tell you it feels like a luxury to fill my gas tank after living through residency. I have a plan to have credit card debt gone in five years, student loan debt gone in ten, and my house paid off in fifteen. And that isn't living like a pauper. Not like a king (although after med school and residency it feels like it!) but not like a pauper either. I'm comfortable. I have a new car. I am building my retirement as fast as the government tax laws will allow. And I've budgeted for a nice trip to Europe in five years for my 25th wedding anniversary in there. And we go out to dinner to really nice places about once a month or so.

Yes, it's doable. Just don't expect to buy a BMW every year, a one million dollar house, and go to Europe every year. And don't marry a gold digger of either sex that spends money like water. Be smart and you'll be fine.

Thinking about my debt does make me vomit a little in my mouth though. It's a lot of money I owe. A lot.

Thank you for posting this. If you don't mind I have two questions?

1) Are you utilizing any governmental repayment plan? If so, would you be able to afford the same lifestyle if you had to pay using the standard repayment plan?
2) Does your spouse earn high income? Because if he does then your situation may be a lot different than many of us (males) who will be the primary source of income in the household.

 

[coolingglasses]

A doctor once told me before I applied and said "only do it if you could see yourself doing nothing else".

Every doc I shadowed told me this, and that the system was changing in a way that didn't favor physician salaries.

And yet here I/we are.

 

[ShyRem]

Thank you for posting this. If you don't mind I have two questions?

1) Are you utilizing any governmental repayment plan? If so, would you be able to afford the same lifestyle if you had to pay using the standard repayment plan?
2) Does your spouse earn high income? Because if he does then your situation may be a lot different than many of us (males) who will be the primary source of income in the household.

I am on the income based repayment program. Throughout residency and for this first year out of residency, it made payments doable. The standard payment plan would have made my student loan payments more than I made as a resident per month. Next year they will go up and still be well within my budget. Yes, I am one of those people who have a budget forecast for ten years in the future both with and without pay raises, spreadsheets for amortization showing how much extra payments can lower debt faster, retirement forecasts, etc. I am rather OCD about money matters and balance my checkbook every three days.

My husband does not work. In fact, he plays golf almost every day and otherwise takes care of our son and the house. In all fairness, he deserves to not work. He left a career, cashed in his retirement, and has supported me along this journey. We are now starting over financially except the deep in debt part. As for the golf, he has become an expert at finding deals, coupons, etc for making his golf as cheap as possible.

And we have two children. As stated earlier, I have a daughter in a private college and a son in high school.

 

[NurWollen]

As a newly graduated internal med physician, I currently have about $300k of student loan debt, I don't even want to think about how much credit card debt, my daughter in college I am paying for (although gratefully she got some great academic scholarships), and I'm about to buy a house. Not the most expensive house... It's a foreclosure but a REALLY nice one.

Bottom line: it's doable. Doable without going broke, and let me tell you it feels like a luxury to fill my gas tank after living through residency. I have a plan to have credit card debt gone in five years, student loan debt gone in ten, and my house paid off in fifteen. And that isn't living like a pauper. Not like a king (although after med school and residency it feels like it!) but not like a pauper either. I'm comfortable. I have a new car. I am building my retirement as fast as the government tax laws will allow. And I've budgeted for a nice trip to Europe in five years for my 25th wedding anniversary in there. And we go out to dinner to really nice places about once a month or so.

Yes, it's doable. Just don't expect to buy a BMW every year, a one million dollar house, and go to Europe every year. And don't marry a gold digger of either sex that spends money like water. Be smart and you'll be fine.

Thinking about my debt does make me vomit a little in my mouth though. It's a lot of money I owe. A lot.

Thanks for your insight. One problem facing us is that tuition is rising fast that even new attendings have a different experience than we will have with ~50% more debt than you have.

But your point still remains. I think I'll be ok, I just have to be smart with my money. Anyone who expects to make so much money that they don't have to temper their spending and practice sound financial principles is kidding themself.

 

[katiemaude]

If people can pay off 350-400k mortgates pulling in <100k a year, I don't see why you can't pay off that amount making <200k+ a year. Look at default rates for medical students..it appears the vast majority are able to pay off their loans, and I'm willing to bet you will too.

Just want to point out that mortgage interest rates right now for most people are in the 3.5-5% range. School loans are higher (8%?). Also you don't defer your mortgage payments for four years while they rack up interest, and then make small payments for another 3-4 years (residency).

 

[cliquesh]

I don't think it's worth being a physician unless there really isn't anything else you want to do with your life. You're going to waste some of the best years of your life in med school and in residency, you'll likely be in huge debt when you graduate, and future salaries are likely to go down; not up.

I think for the average joe, being a PA, cRNA, or some other mid level is probably a better life choice, especially if you're going to graduate with some absurd amount of debt. It may be a financially better choice in the long run to be a physician, but the training is so much shorter, the hours are so much better, and you can spend more time with your family as a mid level that I think it would be a better choice for many.

 

[Kerosene Hat]

 

[NurWollen]

Haha! Perfect!

 

[Escape_Goat]

I do not worry about the cost of education because I see it as an investment in myself and my family's future, and the realization of a goal I've spent the past decade working towards.

 

[darklabel]

I don't think it's worth being a physician unless there really isn't anything else you want to do with your life. You're going to waste some of the best years of your life in med school and in residency, you'll likely be in huge debt when you graduate, and future salaries are likely to go down; not up.

I think for the average joe, being a PA, cRNA, or some other mid level is probably a better life choice, especially if you're going to graduate with some absurd amount of debt. It may be a financially better choice in the long run to be a physician, but the training is so much shorter, the hours are so much better, and you can spend more time with your family as a mid level that I think it would be a better choice for many.

Midlevels would definitely argue with you about that.

Also the job market for them isn't anything like it is for physicians when entering the work force. While for seasoned nurses getting a job may be easy, new nurses tend to have a difficult time finding work.

 

[TeddyBoomBoom]

Midlevels would definitely argue with you about that.

Also the job market for them isn't anything like it is for physicians when entering the work force. While for seasoned nurses getting a job may be easy, new nurses tend to have a difficult time finding work.

I don't know where you got this, but this is completely incorrect.

 

[darklabel]

I don't know where you got this, but this is completely incorrect.

Fiancee was a new grad and had a difficult time finding work in the beginning as did most of her class in a metro area. I can't comment on PA's.

n=1 info, but it isn't some new phenomena and CNNMoney and WSJ have covered the news in the past.

 

[TeddyBoomBoom]

Fiancee was a new grad and had a difficult time finding work in the beginning as did most of her class in a metro area. I can't comment on PA's.

n=1 info, but it isn't some new phenomena and CNNMoney and WSJ have covered the news in the past.

My bad, man, I didn't mean to sound like a dick. I have always thought nursing was a very in-demand field. I've been wrong before lol

 

[Postictal Raiden]

My bad, man, I didn't mean to sound like a dick. I have always thought nursing was a very in-demand field. I've been wrong before lol

The demand is there, but large cities are supersaturated. Any job in healthcare, be it a physician, a nurse, a PA or even a pharmacist, is generally in demand. However, new grads must be welling to sacrifice the location for the initial few years after graduation till they acquire some experience. Then they will be competitive enough to secure jobs in desired locations. With that said, some fields are more prone to competition than others. A congenital cardiothoracic surgeon won't have as much difficulty securing a job in NYC as pharmacist.

 

[darklabel]

The demand is there, but large cities are supersaturated. Any job in healthcare, be it a physician, a nurse, a PA or even a pharmacist, is generally in demand. However, new grads must be welling to sacrifice the location for the initial few years after graduation till they acquire some experience. Then they will be competitive enough to secure jobs in desired locations. With that said, some fields are more prone to competition than others. A congenital cardiothoracic surgeon won't have as much difficulty securing a job in NYC as pharmacist.

And an FM won't either, but good luck to a new nursing grad finding a job there. Not impossible, but just not what people expected once they graduate and being told constantly how much they're needed in the workforce only to be shocked that they can't just walk into a hospital and get hired on the spot.

 

[Seth Joo]

Is anyone else becoming more and more concerned about the price of our education? Osteopathic tuition is roughly around 40,000$ then add in the cost of rent/water/utilities+textbooks+cell phone+medical equipment+health/dental/car insurance its not unfeasible to borrow 70k per year. You multiply that by 4 years and add interest for a 10 year pay back you can easily be looking at 350-400k of debt. I know faculty say don't worry about the debt, you'll eventually pay off it. Yet, what their describing are usually physicians that were in Medical school 15 or 25 years ago where the tuition was a lot cheaper and weren't experiencing reimbursement cuts as severely like today. Just curious what everyone else is thinking...

The lifestyle for doctors is definitely changing. Many are living a lot more modestly than before. And yes the increase in the cost of becoming a doctor is increasing much faster than the amount of money that most doctors earn. I heard that Family Doctors are earning slightly more than they have a few years ago, but when you consider that the costs of education are rising so fast, its a very small gain.

I remember when I was a kid, a friend of mine's dad was a heart surgeon and he lived in big house and his dad owned several high end automobiles. There are still doctors who are making money but not as much.

Obamacare is also going to hit a lot doctors in the wallet, particularly specialists. It doesn't surprise me that many doctors are finding more creative ways to make money. There are quite a few DOs who focus on cash based OMM practice for example.

 

[GypsyHummus]

As a newly graduated internal med physician, I currently have about $300k of student loan debt, I don't even want to think about how much credit card debt, my daughter in college I am paying for (although gratefully she got some great academic scholarships), and I'm about to buy a house. Not the most expensive house... It's a foreclosure but a REALLY nice one.

Bottom line: it's doable. Doable without going broke, and let me tell you it feels like a luxury to fill my gas tank after living through residency. I have a plan to have credit card debt gone in five years, student loan debt gone in ten, and my house paid off in fifteen. And that isn't living like a pauper. Not like a king (although after med school and residency it feels like it!) but not like a pauper either. I'm comfortable. I have a new car. I am building my retirement as fast as the government tax laws will allow. And I've budgeted for a nice trip to Europe in five years for my 25th wedding anniversary in there. And we go out to dinner to really nice places about once a month or so.

Yes, it's doable. Just don't expect to buy a BMW every year, a one million dollar house, and go to Europe every year. And don't marry a gold digger of either sex that spends money like water. Be smart and you'll be fine.

Thinking about my debt does make me vomit a little in my mouth though. It's a lot of money I owe. A lot.

That is a very interesting perspective. I do have a couple questions

How much does a physician in your specialty generally get to take home after taxes?

How much was your tuition, room, and board when you were going to school?

Now that you are an attending, would you have still gone into medicine if you had to do it over again?

Was there an option for you to go into a repayment if you worked in an underserved or rural area where they take care of all your debt?

Why did you choose internal med when other specialties pay so much more and the income based repayment could have worked better for a couple more years in your favor?

What do you think of the outlook for doctors in your area? Is the market saturated, will docs just graduating have a tougher time finding work?

Thank you for your insight.

 

[iceman55]

I remember when I was a kid, a friend of mine's dad was a heart surgeon and he lived in big house and his dad owned several high end automobiles. There are still doctors who are making money but not as much.

I realize that physicians pay has dropped over time, but trust me heart surgeons today are still making really good money...although they are still working crazy amount of hours.

 

[Seth Joo]

I realize that physicians pay has dropped over time, but trust me heart surgeons today are still making really good money...although they are still working crazy amount of hours.

It depends upon how you look at it, if you factor in inflation, yes doctor salaries have fallen, if you just go with the nominal numbers doctor salaries have went up slightly.

Some specialists make big bucks of course, but there are outliers in every field. With health care reform, downward pressure on doctor incomes is only going to increase.

 

[ShyRem]

That is a very interesting perspective. I do have a couple questions

How much does a physician in your specialty generally get to take home after taxes?

How much was your tuition, room, and board when you were going to school?

Now that you are an attending, would you have still gone into medicine if you had to do it over again?

Was there an option for you to go into a repayment if you worked in an underserved or rural area where they take care of all your debt?

Why did you choose internal med when other specialties pay so much more and the income based repayment could have worked better for a couple more years in your favor?

What do you think of the outlook for doctors in your area? Is the market saturated, will docs just graduating have a tougher time finding work?

Thank you for your insight.

Goodness. A few questions.

1. Depends on how much you have taken out, whether you have a family to have insurance for, extra life insurance, retirement, etc. not a question with an easy answer.

2. Like I said, I have about $300k in medical student loan debt. COA at my school was around $75k a year.

3. Yes. I love my job

4. I did not look into this. There are lots of programs out there and I do not pretend to be the expert in this category. This information also changes frequently.

5. I liked it.

6. Jobs are dependent on where you live. Where I am there are jobs to be had both inpatient and outpatient. The outlook is bright where I live.