Aug 11, 2018
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I have been accepted at school X. It is really expensive; I thought when applying there I'd be able to get more financial help, but this turns out not to be the case. I am older and very worried about taking on a lot of debt at my age. If I were to turn down this acceptance and re-apply to cheaper schools would I be looked at badly by adcoms due to my prior acceptance at school X? Would my commitment to medicine be questioned? I definitely want to be a doctor, but I'm talking $300k debt in my late 40s.
 

Moko

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I have been accepted at school X. It is really expensive; I thought when applying there I'd be able to get more financial help, but this turns out not to be the case. I am older and very worried about taking on a lot of debt at my age. If I were to turn down this acceptance and re-apply to cheaper schools would I be looked at badly by adcoms due to my prior acceptance at school X? Would my commitment to medicine be questioned? I definitely want to be a doctor, but I'm talking $300k debt in my late 40s.
If you were to reapply next year and not get into any medical schools, would you regret not taking this opportunity?
Also, reapplying next year would not guarantee acceptance to a cheaper medical school. And even if it was cheaper, you would also need to factor in that you have now lost one year's worth of attending salary.

Taking on this amount of debt should always warrant careful consideration, but given the opportunity cost and uncertainty of another application cycle, I personally would take acceptance and run with it. But only you can decide what's the right choice for yourself. Good luck
 

Deecee2DO

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I have been accepted at school X. It is really expensive; I thought when applying there I'd be able to get more financial help, but this turns out not to be the case. I am older and very worried about taking on a lot of debt at my age. If I were to turn down this acceptance and re-apply to cheaper schools would I be looked at badly by adcoms due to my prior acceptance at school X? Would my commitment to medicine be questioned? I definitely want to be a doctor, but I'm talking $300k debt in my late 40s.
Take your acceptance and run with it. If you decline this will seriously hurt your chances of ever being a doctor. Rarely would anyone on here recommend you decline an acceptance to med school in hopes of reapplying again the next cycle for a different acceptance (cheaper school, DO vs MD). You shouldnt have applied there if you couldnt see yourself attending. You are quite lucky to have the opportunity to be a physician-financial security is pretty darn good compared to other professions and youll be able to pay your loans back. Youre prety much guaranteed to be making 200+ minimum salary first year out and thats even on the low end if you decide on Peds or something. Dont worry about the money youll make it back. Congrats on the acceptance
 
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DrStephenStrange

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Unless you have rich parents or some sort of scholarship, Everybody take on a lot of debt (anywhere ranging from 250K to 400K) by going into medical school. That's basically the norm. Don't worry, as long you make it out, you'll be able to pay it off in 5 years.
 

Moocille

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That’s going to be almost my debt load and I’ll be 43 when I finish school. This is not counting my husband’s law school debt, or any future debt we will take on. I’m not sweating it...much.
 

spb1703

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Dont do it! You will pay it back with a doctor's salary. Do the math, imagine the school costs 60k and state school costs 30k. 60x4=240, 30x4=120. Family medicine (lowest paid speciality) average salary ~200k. If you delay this even by 1 year you will already loose 200-120=80k (even after taxes, you will still earn more). Don't do it!!!
 
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Also consider that declining an acceptance will cost you 1 year of a doctor’s salary over your career. Foregoing this opportunity now, even in your best-case scenario, might not be as financially favorable as you’re thinking.
 

ciestar

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This is my more cynical take.. assuming this is OP’s only acceptance. Why is there magical thinking that somehow if they reapply the results will change? Only 40% of applicants get an acceptance.

OP, do you want to be a doctor or not? Not going to a school because of debt is not a great reason. You knew that going in what the COA was.
 
OP
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Aug 11, 2018
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Thanks everyone for the input. Somewhat of a sidenote, where do you all think is the most reliable information on physician salaries? I see median salary numbers (median, not starting) anywhere from $150k to $230. Of course there will be wide variation by specialty and location, but srsly $200k starting salary is the norm now? Where are you getting these numbers?
 
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Thanks everyone for the input. Somewhat of a sidenote, where do you all think is the most reliable information on physician salaries? I see median salary numbers (median, not starting) anywhere from $150k to $230. Of course there will be wide variation by specialty and location, but srsly $200k starting salary is the norm now? Where are you getting these numbers?
150K is impossible unless you’re like an MD/PhD infectious disease professor that only goes into clinic 3 days a week.
 
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I have been accepted at school X. It is really expensive; I thought when applying there I'd be able to get more financial help, but this turns out not to be the case. I am older and very worried about taking on a lot of debt at my age. If I were to turn down this acceptance and re-apply to cheaper schools would I be looked at badly by adcoms due to my prior acceptance at school X? Would my commitment to medicine be questioned? I definitely want to be a doctor, but I'm talking $300k debt in my late 40s.
Long story short is yes it would hurt your chances reapplying.

People on here like to oversimplify when in reality we need more info to give good advice. How old are you exactly? Are you saying you'll be starting med school late 40's, finishing med school, finishing residency?

Also what's your current career and income? Why are you switching? What do your current assets look like? Any major expenses (mortgage, kids, student loans, etc.)

It's hard to recommend taking on 300k debt so late in life unless your current financial situation is either a.) Very low income (ie. Not missing out on much) or b.) Very strong assets/passive income that you can afford some "intelectual exploration"
 
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gonnif

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By far, the worst mistake a premed can make is turning down an acceptance
 
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I have been accepted at school X. It is really expensive; I thought when applying there I'd be able to get more financial help, but this turns out not to be the case. I am older and very worried about taking on a lot of debt at my age. If I were to turn down this acceptance and re-apply to cheaper schools would I be looked at badly by adcoms due to my prior acceptance at school X? Would my commitment to medicine be questioned? I definitely want to be a doctor, but I'm talking $300k debt in my late 40s.
Think of the money you will be losing turning down a years worth of physician salary. Starting a year later with less debt might not even save money.
 

FoodLovinMD

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Absolutely do not accept the acceptance. The debt that burdens people that are not externally funded (i.e. parents) when they go through medical school is crippling. No matter which medical school you attend and no matter which medical specialty you choose, there is a high probability that you will not practice clinical medicine for long enough to fund your student loan repayment. Please read this very recent and exemplary essay on why so many doctors are leaving clinical medicine: Opinion | The Business of Health Care Depends on Exploiting Doctors and Nurses

I am only in my low 30s. Every single interaction I have with an MD from my age cohort is about our escape plans from clinical medicine. Literally every single conversation. Out of hundreds of doctors I know that are my age, I can count on two hands how many do not regret going into medicine.
 
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DrStephenStrange

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Absolutely do not accept the acceptance. The debt that burdens people that are not externally funded (i.e. parents) when they go through medical school is crippling. No matter which medical school you attend and no matter which medical specialty you choose, there is a high probability that you will not practice clinical medicine for long enough to fund your student loan repayment. Please read this very recent and exemplary essay on why so many doctors are leaving clinical medicine: Opinion | The Business of Health Care Depends on Exploiting Doctors and Nurses

I am only in my low 30s. Every single interaction I have with an MD from my age cohort is about our escape plans from clinical medicine. Literally every single conversation. Out of hundreds of doctors I know that are my age, I can count on two hands how many do not regret going into medicine.
This is absolutely not true. Not a single one of the Doctors that I have worked with has said anything close to what you're saying.
 

chemdoctor

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Don't do it man. I know the debt sucks but cant you ask for a financial aid package or something?

You really can't bank on getting into cheaper schools next year.

I guess what you could do maybe, is ask to defer if you think you'd be in a better position next year financially?

Do NOT turn down this acceptance
 
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Planes2Doc

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I think some of the posts above have oversimplified parts. You say you're taking in the 300k's of debt in your late 40s. I do think that is worth re-considering. I'm not saying don't do it; I'm just saying thoughtfully consider it like you are. Assuming you would want to retire in the 65-70 yo range like most people it may not be a financially smart move to take out 300k in debt over 4 years, then have a residency where you will be making very little for 3-5 yrs, and then have to repay. You would be able to repay the debt (in most cases), but the whole process of school, residency, repayment might severely hinder your retirement savings plans and quality of life (do you have kids you are trying to send to college, do you own a house, etc). I am assuming you mean you are in your late 40s now, but maybe that's not what you mean. I think you should try to plan things out on an excel doc and see what your financial future would look like whether you go to medical school vs whether you don't. If you can't stomach your financial future with taking out 300k in debt, then I think it is reasonable to turn down the acceptance. As far as applying next year and hoping things will be better, that seems unlikely. Yes some schools give better financial aid than others, but the chances that you actually reapply and get in to a school that gives you more money does not seem high enough to warrant the gamble. I think you are choosing between going to medical school (knowing it will require all that debt) vs not going to medical school
 

FoodLovinMD

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This is absolutely not true. Not a single one of the Doctors that I have worked with has said anything close to what you're saying.
Why more physicians are leaving medicine: 4 takeaways. Despite spending hundreds of thousands of dollars on medical school, physicians are increasingly forgoing medical practice in favor of other health-related ventures, claiming they can do more to improve care delivery worldwide as entrepreneurs, The Boston Globe reports.

I would not stake my future on the sample that you reference. As a medical student, you are likely exposed to a specific group of attendings that has a positive culture. That is excellent.

I am an attending that has gone through medical school, internship, residency, clinical fellowship, and attending/teaching roles spanning 6 different states and I have interacted with hundreds of physicians from diverse backgrounds, practice settings, and specialties.

More objectively, look at the growing number of physicians stating they seek to leave clinical jobs in the attached press release. I guarantee that 16.6% in 2016 is well over 25% now.

There certainly are happy physicians, as there are happy architects and janitors. However, being in your late 40s with 500k of medical school debt, complete dejection due to the deterioration of clinical medicine, and a lack of desire to continue to do the work that saddled you with that debt just to pay it off is not a formula for happiness.

I heard similar whispers from a minority of physicians when I was a pre-med. The drum beats louder each year. Take it or leave it, but I wished I'd listened at the time.
 

Goro

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I have been accepted at school X. It is really expensive; I thought when applying there I'd be able to get more financial help, but this turns out not to be the case. I am older and very worried about taking on a lot of debt at my age. If I were to turn down this acceptance and re-apply to cheaper schools would I be looked at badly by adcoms due to my prior acceptance at school X? Would my commitment to medicine be questioned? I definitely want to be a doctor, but I'm talking $300k debt in my late 40s.
You and every other med school graduate will be in debt to the tune of three Teslas.

Turning down the accept says that finances are more important to you than being a doctor.

Many med school apps will ask if you have been accepted elsewhere. How will you answer?
 

Moko

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You and every other med school graduate will be in debt to the tune of three Teslas.
Or 8 Teslas if you're okay with the model 3's. ;)

I see median salary numbers (median, not starting) anywhere from $150k to $230. Of course there will be wide variation by specialty and location, but srsly $200k starting salary is the norm now?
As you mentioned, these numbers can be deceiving as it very much varies by specialty and location.

- In general, if you want to practice in an urban environment, you are taking a 25-50% pay cut compared to your peers practicing in rural areas.
- Academic medicine is another 15-25% pay cut.
- If you are practicing at a hospital that is "best in the region" ('Quaternary+' care), that's usually another 10-20% pay cut.

As a hospitalist, the range of offers that I first saw coming out of residency went from low $100s up to $400k+ depending on location, practice setting, etc. This is excluding moonlighting hours. The idea here is that if paying off debt is important to you, then you will be able to do so as long as you're willing to make sacrifices by going to the middle of nowhere, not being at an academic medical center (if that's important to you), working additional moonlighting shifts (i.e time not spent with family), etc.

Now whether these are sacrifices that make sense for you to make, only you can answer this question. Hope this helps.
 

MemeLord

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In general, if you want to practice in an urban environment, you are taking a 25-50% pay cut compared to your peers practicing in rural areas.
- Academic medicine is another 15-25% pay cut.
- If you are practicing at a hospital that is "best in the region" ('Quaternary+' care), that's usually another 10-20% pay cut.
These all seem contradictory to what my expectations would be.

My expectations:

More city means more people means more work to do means more money

Academic means conducting research and educations means they want the best to teach the best means more money

Best hospital means best talent means more money

Why are those not what happens?
 

Moko

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These all seem contradictory to what my expectations would be.

My expectations:

More city means more people means more work to do means more money

Academic means conducting research and educations means they want the best to teach the best means more money

Best hospital means best talent means more money

Why are those not what happens?
- Everyone wants to work in or around major cities, so while demand for healthcare is high in cities, there nevertheless is still a greater supply of physicians willing to take a pay cut to work there.
- Research usually produces less income for hospitals (as far as I know). Many folks in academia enjoy teaching and/or research so much so that they are willing to take a pay cut to have this as part of their career.
- Best hospital means everyone wants to work there, which means the hospital can pay less. In essence you are partially being paid in "prestige" when you work at the "best hospitals".
 

MemeLord

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- Everyone wants to work in or around major cities, so while demand for healthcare is high in cities, there nevertheless is still a greater supply of physicians willing to take a pay cut to work there.
- Research usually produces less income for hospitals (as far as I know). Many folks in academia enjoy teaching and/or research so much so that they are willing to take a pay cut to have this as part of their career
- Best hospital means everyone wants to work there, which means the hospital can pay less. In essence you are partially being paid in "prestige" when you work at the "best hospitals".
Silly people and their silly interests lol

Right on, that makes sense thank you!
 
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Sunbodi

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I have been accepted at school X. It is really expensive; I thought when applying there I'd be able to get more financial help, but this turns out not to be the case. I am older and very worried about taking on a lot of debt at my age. If I were to turn down this acceptance and re-apply to cheaper schools would I be looked at badly by adcoms due to my prior acceptance at school X? Would my commitment to medicine be questioned? I definitely want to be a doctor, but I'm talking $300k debt in my late 40s.
If finances/debt were more important to you in your 40s then why would you even apply to a profession that has an average debt of 200-300k?
 
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Would you buy a 300k house right now, in your forties? This is on the lower end for my average student for college and med school. And not to be lecturing you, but why did you, as a grown up, apply to an expensive medical school without a firm plan on how to pay for it? I am constantly telling pre meds to do the math and see if it works for you. Look for alternative sources of funding, military or National health service scholarships. Some small towns will offer loan forgiveness if you practice. Dont turn down the acceptance, unless you aren't that gung ho about being a doctor. If that's the case, turn it down and give the seat to someone who really wants it.
 

Walter Raleigh

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By far, the worst mistake a premed can make is turning down an acceptance
Second-worst, the worst being a felony conviction. I've heard (rare!) stories of people being admitted after turning acceptances down, but none of felons getting accepted.
 
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Walter Raleigh

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It is regrettable that neither @Goro nor I have figured out how to get our boots through the Internet and apply them to a certain region of your anatomy. Indeed, certain adcoms here would want to kick you so hard there that it would require the combined efforts of a podiatrist, a gastrointestinal surgeon, and a proctologist to dislodge adcom and fool.

By doing this, you have severely, perhaps mortally, wounded your medical career. If medicine isn't for you, that is fine. But you're most likely closing doors by doing this.