Tuition Expense really that big of a deal?

[zoner]

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Between a school that charges 30k vs 50k a year, should you really decide on the school based on their tuition alone? That is about 80k difference in debt, but i heard somewhere that for every 100k in debt, you are expected to pay around 1k per month in school loan payment. So on average if you are a full time working doc, you make about 200k per year, so at least your take home is about 11k a year. Isn't that more than enough to pay back the loan and live comfortably? I won't be having any kid so I am not worried about child support or anything like that and I also don't have any expensive habits. So why is everyone making such big deal regarding the costs of medical school?

Thanks

 

[circulus vitios]

IBR repayment calculator: http://studentaid.ed.gov/node/128
Student loan repayment calculator: http://www.finaid.org/calculators/loanpayments.phtml

Take-home on $200k gross will be about $130k, depending on where you live. IBR eligibility goes by gross income. Note that GradPlus loans max out at, I believe, somewhere around $160k for medical students? The remainder of your loans will need to be funded with other loans which may not (probably will not) be eligible for IBR.

 

[Narmerguy]

Well, a lot of people just look at the final amount, then the final amount + interest, and say "That's 100K I could have spent on my kid's college" or whatever it is that they prioritize. Then you have to consider making $200K a year is not really $200K because a sizable portion of that has to go to taxes.

Personally I think the importance of student debt in selecting between schools is overblown on SDN. Sure don't spend money where you don't have to, but don't let the finances rule you. If anyone has even the slightest financial hardship through their career (which is uncommon), it's not going to be because of the additional medical school costs they accrued from choosing one school over the other.

 

[FSU2013]

Well, a lot of people just look at the final amount, then the final amount + interest, and say "That's 100K I could have spent on my kid's college" or whatever it is that they prioritize. Then you have to consider making $200K a year is not really $200K because a sizable portion of that has to go to taxes.

Personally I think the importance of student debt in selecting between schools is overblown on SDN. Sure don't spend money where you don't have to, but don't let the finances rule you. If anyone has even the slightest financial hardship through their career (which is uncommon), it's not going to be because of the additional medical school costs they accrued from choosing one school over the other.

This isn't sound advice. Physicians are notoriously bad investors, really of epic proportions. People think "well, I'll make a lot of money, so I can spend a little more now" - this is an awful mindset. If you have this mindset, you will be working into your 80s and never have true financial security.

Assuming you went to med school right out of undergrad, graduate on time and do a 4 year residency (i.e. graduate residency at 30), and put $1,000 a month into retirement savings instead of student loans, you would have $950,000 in your retirement fund from JUST THAT 1,000 a month assuming 6% return at the end of your 30 year repayment period. Let that amount mature for another 5 years until retirement, you're talking about 1.27 million dollars at age 65. That's the beauty of compounding interest.

That a $76K/year income from age 65 on just interest......

Go to the cheapest school that you can be happy at.....Also, listen to some Dave Ramsey or Clark Howard. Also, whitecoatinvestor.com (or something like that) is a pretty good blog to read by an EM SDN attending.

The importance of living without debt CANNOT be overstated. I have lived very frugally throughout med school, applied for every scholarship possible, had some help from my family and married a woman who is very frugal. I will be graduating with <80K in debt with some cash on hand and both of us own our cars outright. I may be able to pay off my loans during residency if we don't have kids for a little while and my wife continues to work. Every day I think about how good it will feel to graduate residency and be able to fully fund a retirement and pay off a house before I'm 40/45.....Life is good.

 

[blizzah]

I have lived very frugally throughout med school

I understand your line of thinking, and applaud you for it.

But I'm not about living poorly in my early 20s so that I can be financially secure at 45 instead of 55. It's not worth it in my view. Life is about enjoyment; get that enjoyment while you can, you can't take money to the grave.

 

[linebacker57]

This isn't sound advice. Physicians are notoriously bad investors, really of epic proportions. People think "well, I'll make a lot of money, so I can spend a little more now" - this is an awful mindset. If you have this mindset, you will be working into your 80s and never have true financial security.

Assuming you went to med school right out of undergrad, graduate on time and do a 4 year residency (i.e. graduate residency at 30), and put $1,000 a month into retirement savings instead of student loans, you would have $950,000 in your retirement fund from JUST THAT 1,000 a month assuming 6% return at the end of your 30 year repayment period. Let that amount mature for another 5 years until retirement, you're talking about 1.27 million dollars at age 65. That's the beauty of compounding interest.

That a $76K/year income from age 65 on just interest......

Go to the cheapest school that you can be happy at.....Also, listen to some Dave Ramsey or Clark Howard. Also, whitecoatinvestor.com (or something like that) is a pretty good blog to read by an EM SDN attending.

The importance of living without debt CANNOT be overstated. I have lived very frugally throughout med school, applied for every scholarship possible, had some help from my family and married a woman who is very frugal. I will be graduating with <80K in debt with some cash on hand and both of us own our cars outright. I may be able to pay off my loans during residency if we don't have kids for a little while and my wife continues to work. Every day I think about how good it will feel to graduate residency and be able to fully fund a retirement and pay off a house before I'm 40/45.....Life is good.

Where did you get that 30 year figure from? Most people do either 10 year fixed or graduated repayment plan, IBR, or income contingent repayment. Even with IBR, the loans are discharged after 25 years. IBR and public service loan forgiveness is a very viable option for those with a long residency and fellowship, because you will write off the lions share of your student loan amounts, assuming you take a position at any teaching hospital out of residency. And with the way universities and teaching hospitals are branding and marketing their physicians, (particularly their surgical staff), you can still make a very very good living at a teaching hospital

 

[blizzah]

Where did you get that 30 year figure from? Most people do either 10 year fixed or graduated repayment plan, IBR, or income contingent repayment. Even with IBR, the loans are discharged after 25 years. IBR and public service loan forgiveness is a very viable option for those with a long residency and fellowship, because you will write off the lions share of your student loan amounts, assuming you take a position at any teaching hospital out of residency. And with the way universities and teaching hospitals are branding and marketing their physicians, (particularly their surgical staff), you can still make a very very good living at a teaching hospital

You are not very good at reading. Read again.

 

[FSU2013]

Where did you get that 30 year figure from? Most people do either 10 year fixed or graduated repayment plan, IBR, or income contingent repayment. Even with IBR, the loans are discharged after 25 years. IBR and public service loan forgiveness is a very viable option for those with a long residency and fellowship, because you will write off the lions share of your student loan amounts, assuming you take a position at any teaching hospital out of residency. And with the way universities and teaching hospitals are branding and marketing their physicians, (particularly their surgical staff), you can still make a very very good living at a teaching hospital

30 years is the maximum time to pay off loans. A lot of physicians choose this (again, poor investors). That was obviously assuming you are not doing IRB but a standard flat repayment option, while putting your loans into forbearance(sp?) during residency. That would come up to the neighborhood of 1000/month - actually closer to 800, but not the point.

A lot of MDs that I've spoken to with high student loans and that go into private practice choose is option, because it is the only manageable monthly payment allowing them to have a lifestyle they want - particularly if you have two graduate degrees with one staying home to take care of kids.


Anyways - you're missing the forrest for the trees. A very small amount of money (20k/years) adds up very quickly and you are allowing your money to work for a bank (or worse) the federal government. Instead, by living frugally now, you can let your money work for you and be extremely wealth later in life. Or, as Clark Howard says, live like no one else now so that you can live like no one else later.

 

[Rumalum]

IBR is 120 payments max (10 years). if you do a 4 year residency and 3 year fellowship, you would be paying ~470 dollars a month for 7 years and then a full payment for 3 years. once you consider sign-on bonuses, loan forgiveness options, and your salary as a physician, these loans are very manageable. Yea it sucks a bit more if you enter medical school three times divorced, owning a car and two homes, but the general idea is to go into med school right after undergrad so don't listen to those poor saps

 

[ChiDO]

Yes, it is a big deal. Cheapest school >>>>>>>>>>>>>>>>>>>>>>>> anything else.

 

[MedPR]

Yes, it is a big deal. Cheapest school >>>>>>>>>>>>>>>>>>>>>>>> anything else.

If this were true everyone at JHU would've chosen their state school instead.

 

[FSU2013]

IBR is 120 payments max (10 years). if you do a 4 year residency and 3 year fellowship, you would be paying ~470 dollars a month for 7 years and then a full payment for 3 years. once you consider sign-on bonuses, loan forgiveness options, and your salary as a physician, these loans are very manageable. Yea it sucks a bit more if you enter medical school three times divorced, owning a car and two homes, but the general idea is to go into med school right after undergrad so don't listen to those poor saps

Poor sap? You're going to be a douche because you disagree on how I manage my finances? Really? Other people's finances get you that way, or do you just always speak to/about people in a derogatory manner?

Anyway, that's really not good financial advice for a lot of reasons. You don't want to make financial plans based on other people. The federal government is bankrupt and the possibility of the dissolution or IRB is not out of the question. You're also closing the door on some shorter and lower paying specialties. What happens if you fall in love with peds or family and don't have the money to pay it back.....3-5 grand a month on a green attending's salary could be tough in a lot of fields. Youre basically taking a poverty oath for a decade. A lot of people don't exactly jump at the idea of spending 7 years in residency/fellowship. Whenever possible, you should not obligate future earnings unless necessary (I.e. it's always better to only buy what you can pay for now). Also, I'd much rather use a signing bonus as a down payment on a house as opposed to paying down debt.

Bottom line - do whatever you want. I err on the side of living very frugally (but well) now so that I will (hopefully) be out of debt before the end of residency. Some people "need" to live in areas in high cost of living areas or "need" to attend a med school with a big name. I think if you "need" those things to be happy, you should reevaluate your priorities. Sure, I didn't go to Harvard or Hopkins, but I'd put my grades, board scores and research up against anyone in the country. I'm sure I will be satisfied when interview offers start coming in next month (scary....eras opens SOON). I doubt I will ever regret not spending more money when I am 30 and debt free.

 

[Quicksilver005]

My advice: don't buy an expensive car unless you can really afford it.

Also, I see lots of physicians make dumb financial decisions because of their hubris. Many of these people don't come from money, which adds to the problem.

 

[AdrianVeidt]

bunch of rich kids (with the except of that one guy who gave you all some supreme knowledge) with no real understanding of the magnitude of owing 80 thousand more dollars in debt in this thread

 

[Quicksilver005]

bunch of rich kids (with the except of that one guy who gave you all some supreme knowledge) with no real understanding of the magnitude of owing 80 thousand more dollars in debt in this thread

[YOUTUBE]http://www.youtube.com/watch?v=ih0dRkZ8pFA[/YOUTUBE]

😀

 

[Frazier]

Debt is a very big deal for students, including those in medicine.

Perhaps more now than ever before in modern times, we face great uncertainty in our future profession.

Admittedly, it is easy to shrug off an extra 50k as a "drop in the bucket", per se. In fact, I have heard with my own ears practicing physicians try to offer comfort, "COA has gone up a lot since I have been in school. But, you will be able to pay it off - no problem."

Well, our predecessors are remiss to not acknowledge the differences in our respective situations:

Not only was the cost of their education greatly reduced in comparison to ours, but their loans were subsidized during their training... furthermore, our interest rate has increased by ~100%.

With that said, perhaps our greater risk rests on the back of the more obvious elephant in the room: compensation. Physicians of the 80's and 90's reaped the benefits of practicing medicine that many of us will be only able to dream of by the time we exit our respective residencies as fully-fledged physicians....Beyond a decrease in physician autonomy and simultaneous eruption of paperwork/restrictions.

By the time we are ready, while it is possible that medical reimbursement will have managed to remain stagnant (which is unanimously considered as a rosy [and unlikely] prospect), it would still be a losing proposition when factoring in the ever-present burden of inflation.

But what if this prospect of compensation staticity fails to actualize? What if a "worst case scenario" becomes the actual scenario? For example, instead of the specialists enjoying plentiful fruit for their plentiful efforts -- what if they instead only get half the apple while having to climb just as high? What do they do then? Climb higher in hopes of attaining a bigger apple? With unfavorable tax rates and [already] pressing time constraints with practicing... it is an undesirable aspiration -- fore there are only so many hours in a day.

So what if in 2020, when many of us will be done with residency, zapped of our bright eyes and trimmed of our bushy tails, our compensation is only 150k?

Will that 50k extra in med school loans be worth just as much as when we thought we would be making 300k?

I don't know.

While we cannot predict the future of our monetary reimbursements 10 years from now anymore than we can predict gas prices of next week. We can make certain to remain cognizant that accumulated debt is a sure thing ...and, if anything, the old saying was cut short:

In this world nothing can be said to be certain, except death, taxes and the weight of debt that bears upon a man's shoulders.

Weigh your options carefully, I, personally, am not anti-debt... I would be willing to pay a reasonable premium to attend a school that I "loved" over one that I merely "liked". However, the choice is not a simple one and the risks are more real than they have been over the past half-century.

 

[Quicksilver005]

Debt is a very big deal for students, especially those in medicine.

Perhaps more now than ever before in modern times, we face great uncertainty in our future profession.

Admittedly, it is easy to shrug off an extra 50k as a "drop in the bucket", per se. In fact, I have heard with my own ears practicing physicians try to offer comfort, "COA has gone up a lot since I have been in school. But, you will be able to pay it off - no problem."

Well, our predecessors are remiss to not acknowledge the differences in our respective situations:

Not only was the cost of their education greatly reduced in comparison to ours, but their loans were subsidized during their training... furthermore, our interest rate has increased by ~100%.

With that said, perhaps our greater risk rests on the back of the more obvious elephant in the room: compensation. Physicians of the 80's and 90's reaped the benefits of practicing medicine that many of us will be only able to dream of by the time we exit our respective residencies as fully-fledged physicians....Beyond a decrease in physician autonomy and simultaneous eruption of paperwork/restrictions.

By that time, while it is possible that medical reimbursement will have managed to remain stagnant (which is unanimously considered as a rosy [and unlikely] prospect), it would still be a losing proposition when factoring in the ever-present burden of inflation.

But what if this prospect of compensation staticity fails to actualize? What if a "worst case scenario" becomes the actual scenario? For example, instead of the specialists enjoying plentiful fruit for their plentiful efforts -- what if they instead only get half the apple while having to climb just as high? What do they do then? Climb higher in hopes of attaining a bigger apple? With unfavorable tax rates and [already] pressing time constraints with practicing... it is an undesirable aspiration -- fore there are only so many hours in a day.

So what if in 2020, when many of us will be done with residency, zapped of our bright eyes and trimmed of our bushy tails, our compensation is only 150k?

Will that 50k extra in med school loans be worth just as much as when we thought we would be making 300k?

I don't know.

While we cannot predict the future of our monetary reimbursements 10 years from now anymore than we can predict gas prices of next week. We can make certain to remain cognizant that accumulated debt is a sure thing ...and, if anything, the old saying was cut short:

In this world nothing can be said to be certain, except death, taxes and the weight of debt that bears upon a man's shoulders.

Weigh your options carefully, I, personally, am not anti-debt... I would be willing to pay a reasonable premium to attend a school that I "loved" over one that I merely "liked". However, the choice is not a simple one and the risks are more real than they have been over the past half-century.

 

[calvnandhobbs68]

A good rule of thumb is to not really listen to financial advice from physicians unless they graduated in probably the last 10 years or so. Everyone else just doesn't have any idea about actually carrying the student loan load most students have now. The closest experience most of them have is some sticker shock because their kids have started to hit college age.

 

[FSU2013]

Blais - well said.

Although I am quite "anti-debt" I understand that there is (marginally) good debt and bad debt. Debt for education or a home (except for potentially in this economy) is good debt while most other debt is bad debt. The problem is when people think that since educational debt and home debt can be considered a food debt, they shouldn't worry about the amount. They go $350k into debt or buy a $1.5mil home because it's a "good investment." I looked at education as an investment - I think the marginal return (if any) in salary from going to a higher priced institution isn't worth the extra debt. You absolutely need to go somewhere that you will be happy - life is too short to be a miser, but hopefully you can be happy while being financially safe and have some deferred gratification. Also, I was in a position where there were 3 instate public schools so I didn't really have to consider going private or out of state. I realize this isn't a luxury that everyone has.

CalvinandHobbes - a better idea is to just not take financial advice from physicians......seriously, I don't see how so many people that are so smart and have so much education can be so bad with money.

 

[notbobtrustme]

The only place where I'd spend more money for education would be MD over DO. Other than that, go to the cheapest COA school you can and study your ******* off.

Secondly, pay attention to the state of primary care in the next 4-6 years. Do not go into primary care unless reimbursements go up (way up in some cases).

 

[qwerty2012]

quality of education over everything else. IF that unfortunately isn't the deciding factor, then tuition + location.

 

[Girly X]

Well said Blais. I recently heard from a policy analyst that the student loan debt situation will be the next crisis since it is a huge bubble similar to the housing market---people borrowing more than they will realistically be able to pay in the near future.

 

[FSU2013]

quality of education over everything else. IF that unfortunately isn't the deciding factor, then tuition + location.

I don't buy into that. We all use the same books. The only significant difference is your third year clerkships and research availability. You are in charge of your own education in med school and if you can't get it done at a state university, you have no business in medicine.

 

[kami333]

Whether your SO works or not is going to have a significantly larger impact on your long term finances than taking out that extra 50-100k in loans. It's just like anything else in life, balance and compromise is the key so don't ignore the finances but don't overdo it either.

When you start earning an income, are you never going to take a sabbatical or extended leave? When accepting a job offer, is the compensation the only thing you are going to look at or will you consider other factors such as location and culture? Are you (and more importantly your family) willing to move across the country for a better paying job? Unless you are going to live the rest of your life making decisions based solely on how much you'll make/be paid, I think it's stupid to choose a school based solely on tuition cost. It can make a great tie breaker, but if that's your only criteria I think you need to take a breath and reevaluate what's important to you.

 

[ChiDO]

If this were true everyone at JHU would've chosen their state school instead.

If they are paying $2-300k to go to JHU then they probably should have chosen their state school.

The ONLY reason you should go to an academic "top 10" school would be if you want to be an academic MD and do research or you have a free ride; otherwise, my statement holds true.

 

[FSU2013]

When you start earning an income, are you never going to take a sabbatical or extended leave? When accepting a job offer, is the compensation the only thing you are going to look at or will you consider other factors such as location and culture? Are you (and more importantly your family) willing to move across the country for a better paying job? Unless you are going to live the rest of your life making decisions based solely on how much you'll make/be paid, I think it's stupid to choose a school based solely on tuition cost. It can make a great tie breaker, but if that's your only criteria I think you need to take a breath and reevaluate what's important to you.

Youre being overly near-sighted. Of coarse I'm not going to want to uproot my family or work somewhere that's malignant to maximize compensation - that's why I'm living frugally now and doing everything in my power to keep my debt as low as possible. I'd like to be able to choose my first job as an attending based on job description and location. I hope to be in a position where if I hate my job I can walk away. I want to be able to take nice vacations as often as possible. I think my happiness at work will be largely related to the fact that I'll be doing it because I want to, not because I have to. If you have 350k in debt and your dream job doesn't compensate well, you're going to have to move to the middle of nowhere to get paid more.

I'm focused on delayed gratification, not living and breathing for money.

Again, I'm not proposing choosing an education based only on cost of attendance, but it should be a huge part of the decision. You shouldn't go somewhere you will be unhappy - life is way to short for that. But if the difference is between a place you like and a place you like a little more, but there is a $100k difference, go with the place you just like. If its a place you dislike and a place you love, but only a $20k difference, go where you'll love. It's also important to think about what you need to be happy. If you need a Mercedes to be happy, you should take a good look at your family life (not saying you shouldn't have nice things AT ALL). What will make me happy is being debt free and knowing that I can walk out on a job if I hate it.

 

[darkjedi]

If they are paying $2-300k to go to JHU then they probably should have chosen their state school.

The ONLY reason you should go to an academic "top 10" school would be if you want to be an academic MD and do research or you have a free ride; otherwise, my statement holds true.

State schools typically have much less funding than "top 10." There's a very good chance that the top 10 will be cheaper than many state schools given the amount of merit/need-based scholarships they are able to hand out, even if they aren't full rides.

There are also intangibles associated with top tier schools, such as access to connected faculty, well regarded dual degree programs, calibre of students.

While it's not the same industry, the reason people say that only the top 10 MBA's are worth their money is because of the people you can meet and network with in your class and within the faculty. It is not nearly as extreme for medical school, but still something to think about.

To say that cost of attendance trumps everything, including rankings is rather narrow minded.

 

[Starlightembers]

Well, a lot of people just look at the final amount, then the final amount + interest, and say "That's 100K I could have spent on my kid's college" or whatever it is that they prioritize. Then you have to consider making $200K a year is not really $200K because a sizable portion of that has to go to taxes.

Personally I think the importance of student debt in selecting between schools is overblown on SDN. Sure don't spend money where you don't have to, but don't let the finances rule you. If anyone has even the slightest financial hardship through their career (which is uncommon), it's not going to be because of the additional medical school costs they accrued from choosing one school over the other.

While accumulating a high amount of debt in medical school will not sentence one to a life of financial hardship, that does not mean that it cannot significantly and negatively impact the quality of life one has. That debt, for as long as one has it, will, in some way, influence the choices one makes when considering a specialty, employment opportunities, geographic location, home ownership, family planning, retirement and other important life pursuits. The student who dreams of working as a general pediatrician in a disadvantaged section of Brooklyn -- or, truthfully, anywhere -- will have to reconsider those goals if they are $300,000 in debt. Likewise, having a high debt load will force one to save less for retirement, save less for their children's education, spend less for a house, have to pick a less desirable area of the country to maintain their lifestyle of choice and, perhaps, even make them unable to expand their family as much as they wish to.

It is a personal decision as to if these sacrifices are worth making to attend a particular, favored medical school. For some, they very well may be; but students must be aware of and consider them, instead of pretending that debt will have minimal impact on their life later down the road.

I understand your line of thinking, and applaud you for it.

But I'm not about living poorly in my early 20s so that I can be financially secure at 45 instead of 55. It's not worth it in my view. Life is about enjoyment; get that enjoyment while you can, you can't take money to the grave.

It is faulty to assume that frugality and the enjoyment of life cannot co-exist. This is only true if you feel that you can solely reap joy by living a lifestyle marked by material items and unnecessarily expensive experiences. As someone who lives -- and has for quite some time -- below the poverty line, I can attest that, though living this way for the rest of my life and attempting to raise a family in these circumstances would be miserable, it does not prevent me from enjoying life now. While I cannot purchase the latest electronics or afford a large apartment, I have a social life rich with friends, am a short ride away from a city that offers numerous free or suggested donation activities (theater, music, museums, zoos, etc) and participate in numerous extra-curricular activities. I don't party or drink often due to a genetic risk of addiction; but, if I truly wanted to engage, there are numerous ways to do so for next to nothing thanks to the perks of a college campus. If anything, it is easier to find contentment in this lifestyle now, than when one is in their 30s, 40s and 50s and more focused on settling down, starting a family and, eventually, retiring; all things that are hampered, slowed or made more difficult when one is struggling with debt and financial insecurity.

As an added note, while you cannot take money to the grave, if you die having not paid all of your debt off (not counting, of course, federal student loans, which does not cover everything for many students), having accumulated it in the name of enjoyment that you somehow could not have attained without it, money does come out of your estate to cover it. Thus, for those of you that one day hope to have families, realize that taking on excess debt can take away from what you hoped to leave them.

Bottom line: While life is about enjoyment, that enjoyment is not dependent on ultimately insignificant differences in circumstances, such as having a larger apartment, going to a more expensive school or other such factor. You can live frugally and happily -- fully -- if you choose; being smart about finances does not sentence one to a miserable existence. If, however, you want to make decisions that cost you more, that is in your right; but do not delude yourself into believing that you are making them because there is no other way you could experience enjoyment.

bunch of rich kids (with the except of that one guy who gave you all some supreme knowledge) with no real understanding of the magnitude of owing 80 thousand more dollars in debt in this thread

Unfortunately, it seems so. $80,000 is a significant amount of money, folks. That is enough to live more than comfortably on for at least a year; it is enough to cover the entire COA for all four years for an undergraduate studying at a state school and enough to cover the COA for 1.5 - 2 years at most private colleges; it is enough for a down payment (20%) on a house costing 400k which, in many/most areas of the country (ie, not NYC, Boston, SF, LA, etc) is more than respectable; and it is about twice that of the average yearly income in America.

If you believe that a particular school is worth that, then all of the power and luck to you; but do not dismiss it as a bunch of pocket change.

EDIT: As an added comment, I wanted to note that I do not believe that everyone, no matter the circumstance, should simply attend the cheapest school. These decisions are complex and involve numerous competing factors; as someone who wants to pursue an academic/research career, I would certainly be willing to attend a more expensive school if they offered better opportunities, especially since the amount of need based aid offered by such schools would help alleviate a significant amount of the cost. That said, I do believe that students should seriously consider -- and understand -- the financial aspects of attaining an education and how that may intersect with their future and their priorities.

 

[qwerty2012]

I don't buy into that. We all use the same books. The only significant difference is your third year clerkships and research availability. You are in charge of your own education in med school and if you can't get it done at a state university, you have no business in medicine.

The circle that you are in is totally different if you are in the top schools. And there are much more opportunities just by going there. Just take a took at Harvard's class, many more students are doing something other than traditional MD because they are ambitious. Some are doing MD/MBA and so on.

 

[ShenanigansMD]

A relevant question: Do interviewers ever ask how you plan on paying for medical school? What would be a good answer to that? I guess I could say "uh... loans," but I"m not sure if that's what they are looking for.

 

[FSU2013]

The circle that you are in is totally different if you are in the top schools. And there are much more opportunities just by going there. Just take a took at Harvard's class, many more students are doing something other than traditional MD because they are ambitious. Some are doing MD/MBA and so on.

So you equate doing something outside of medicine as more ambitious than wanting to be a practicing physician?

I went to med school because I want to be a doctor, not a CEO. If I wanted to be an administrator, I would have gotten an MBA. If I wanted a reaearcher, I would have gotten a phd. But I didn't, I'm getting an MD because I want to be, wait for it, a doctor. I don't have any more respect for someone who went to Harvard or Hopkins then went into consulting or administration than I do for someone who went to a state COM and actually practices medicine.

 

[qwerty2012]

So you equate doing something outside of medicine as more ambitious than wanting to be a practicing physician?

I went to med school because I want to be a doctor, not a CEO. If I wanted to be an administrator, I would have gotten an MBA. If I wanted a reaearcher, I would have gotten a phd. But I didn't, I'm getting an MD because I want to be, wait for it, a doctor. I don't have any more respect for someone who went to Harvard or Hopkins then went into consulting or administration than I do for someone who went to a state COM and actually practices medicine.

They are still in the healthcare system. But normally, it takes a little bit more effort for physicians to consider management,consulting since it won't be a straight path and requires more planning. Yes, I do consider that pretty ambitious but not more ambitious than physicians who want to practice.

In the end, I know they are more successful than I am and I don't think I have enough credits to judge. But getting into a good school is already quite an accomplishment considering med schools are extremely selective.

 

[calvnandhobbs68]

They are still in the healthcare system. But normally, it takes a little bit more effort for physicians to consider management,consulting since it won't be a straight path and requires more planning. Yes, I do consider that pretty ambitious but not more ambitious than physicians who want to practice.

In the end, I know they are more successful than I am and I don't think I have enough credits to judge. But getting into a good school is already quite an accomplishment considering med schools are extremely selective.

haha thanks for making me laugh bud. Ambitious physicians go to consulting firms? Try the ones who went to medical school and realized they didn't actually want to practice medicine so went for the easiest money making path instead. You don't even need an MD to do medical consulting because most of medical school has almost nothing to do with the work you'll be doing in consulting. If you'd like to get laughed at by real doctors for the rest of your life head down the MD medical consulting pathway.

 

[mcworbust]

A good rule of thumb is to not really listen to financial advice from physicians unless they graduated in probably the last 10 years or so. Everyone else just doesn't have any idea about actually carrying the student loan load most students have now. The closest experience most of them have is some sticker shock because their kids have started to hit college age.

So true! Physicians who have been practicing 10+ years payed way lower tuitions and their interest rates were lower - older docs used to stretch their loan payments out because it was financially advantageous to use that money to invest (because rates of return on investments used to be much higher than interest rates on loans, now this is the opposite in general)

If they are paying $2-300k to go to JHU then they probably should have chosen their state school.

The ONLY reason you should go to an academic "top 10" school would be if you want to be an academic MD and do research or you have a free ride; otherwise, my statement holds true.

Agreed. Also, take into consideration the limitations debt can put on your career choice. I've explored this issue and learned that financial advisors for physicians recommend that you aim to have your total loan amount after 4 years of medical school (including UG loans, not including accumulated interest) come to 2/3 of your total annual income. Since physicians typically are not able to start savings and retirement funds until later in life, a disproportionate percentage of your income needs to go to savings as compared to the typical employeed person. Therefore, if you have 200k in loans, it is recommended that you aim to earn 300k annually. This debt can severely limit your specialty choice and make your life and practice much less enjoyable, so limit debt whenever possible!

 

[darkjedi]

MD's go to consulting if they fail their boards or fail to match.

By 'ambitious' physicians, I think people are referring more towards people like Paul Farmer and Ezekiel Emanuel. Any industry will need leaders, but who better to lead than the MD's who understand the industry the best? In many ways you can touch many more lives than being a PCP by changing policy on a national scale.

 

[LaughingMan]

Debt is a very dangerous thing.

Work as much as you can to avoid it.

Set up a Mint.com account---link your debts and assets. Work from there.

For my masters--I chose a lower ranked school over a higher ranked.

My total masters will cost me 15k. 1 semester comparatively at Yale was 23k.

 

[ShenanigansMD]

MD's go to consulting if they fail their boards or fail to match.

By 'ambitious' physicians, I think people are referring more towards people like Paul Farmer and Ezekiel Emanuel. Any industry will need leaders, but who better to lead than the MD's who understand the industry the best? In many ways you can touch many more lives than being a PCP by changing policy on a national scale.

What about surgeons who retire when they're older, like the one's who have lost their dexterity maybe? Do they go into consulting?