Tutition Repayment Programs in Private Practice

[Dillatar]

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Hey everyone,

The topic of family practitioner salaries versus overall student loan debt seems to often come up as an issue for people deciding whether or not to pursue the specialty. I have heard recently that there are many practices which newly graduated residents can go to that will repay a good portion of your loan on top of your salary and benefits. Are these claims true?

Thx.

 

[cabinbuilder]

Hey everyone,

The topic of family practitioner salaries versus overall student loan debt seems to often come up as an issue for people deciding whether or not to pursue the specialty. I have heard recently that there are many practices which newly graduated residents can go to that will repay a good portion of your loan on top of your salary and benefits. Are these claims true?

Thx.

This is theoretically true the more rural you go. However, most student loan repayment options are dependent on federal funding and the money doesn't come from the employer per se. Usually the employer tells you they are in a high HPSA region so the probability of getting studen loans repayed is dependent on that score. However, you still have to apply yourself to the federal and state programs and cross your fingers. I have yet to see any help with student loans thus far and don't hold my breath.

If salary is an issue for you I can tell you that as an FP I may plenty of money and have no problem paying my student loan payment each month. My total debt is $220K

There is a huge shortage if family practice in this country. You can get a job anywhere you like and be ok with most salaries as long as you stay out of the big cities. I have found in the last 2 yrs working that the closer to the city you go, the lower the wages due to satuation of the market and influx of doctors wanting to be there.

 

[montessori2md]

Even if the practice does not qualify (google HPSA score map, but be aware that the map will change), non-profits hospitals/clinics can get a tax write-off for paying down your loans, so it benefits both you and the hospital relative to paying you more in salary. You may need to do a little legwork if the hospital administration doesn't know about this.
It really isn't that difficult at present to qualify for NHSC loan repayment based on HPSA, as they are currently well funded. Of course, there is the possibility that they won't stay that way.
Also, at present, if you work for the gov't or other qualified employer for 10 years, your loans will be forgiven. If you have a ton of debt or a low salary, that could be an option (remember, you will be paying 15% of your salary throughout that 10 yrs). I'm also skeptical that this will continue to be funded, and it would stink to get to year 9 and have Congress say, "meh, we don't need that."

 

[digitlnoize]

What about running your own non-profit on the side? Would that satisfy the "non-profit" requirement? Like, 30hrs/wk working for your non-profit, and 20-30 hrs/wk working a "real job" (say, part time ER, locums, etc). Would that work?

 

[cabinbuilder]

What about running your own non-profit on the side? Would that satisfy the "non-profit" requirement? Like, 30hrs/wk working for your non-profit, and 20-30 hrs/wk working a "real job" (say, part time ER, locums, etc). Would that work?

Yah, Good luck with that one. Get through med school and residency first and then see how you feel about that thought. Hmm. Not really seeing the means or the purpose.

 

[Dillatar]

Great! Thanks for the info, guys. If anyone else has anything to add, it would be appreciated. 👍

Yeah, I have have heard that the closer you get to the city, the lower you salary usually goes. One of my biggest concerns is that I plan to apply to all osteopathic schools. I've heard that the debt load is generally larger with osteopaths due to osteopathic schools primarily being private institutions. Any thoughts on this?

 

[digitlnoize]

Great! Thanks for the info, guys. If anyone else has anything to add, it would be appreciated. 👍

Yeah, I have have heard that the closer you get to the city, the lower you salary usually goes. One of my biggest concerns is that I plan to apply to all osteopathic schools. I've heard that the debt load is generally larger with osteopaths due to osteopathic schools primarily being private institutions. Any thoughts on this?

It depends. For example, in state tuition at my 3 state MD school was around 28k, 33k, and 35k. The private DO school here is around 38k. I wound up at LECOM Bradenton, FL, which is ~28k, as are the other two LECOM campuses in Penn. I also had an offer at NOVA in Ft. lauderdale, which is around 40k/yr.

Also, aside from tuition, consider cost of living. Rent and home prices in Bradenton, FL are about half of what they are for an equally nice place in Charlottesville, Va (UVa). NOVA would've also cost an arm and a leg in cost of living.

Finally, consider other benefits. LECOM had, by far, the best health insurance plan, with very low deductibles and copays, and 100% coverage of everything else. None of that "you pay 20%" crap. I took the opportunity to have my SVT heart arrhythmia ablated, which would've cost me about $25k, or $5k with pretty much any other insurance (20% copay). I paid $10. My wife and I are also considering having a baby while we have this great insurance.

Finally, do consider your goals. If you want to do research, I'd go MD (or one of the more research oriented DO school, although they all have research, it just may not be in your field. If you want a super competitive field, consider MD. DOs can match into any field MDs can, and its mostly up to you, but statistically speaking, you have a better shot at, say, rad onc, coming from an MD school (see the NRMP match statistics PDF for more info). Please don't think I'm trying t dissuade you from DO school, because I'm not. I've loved my time at LECOM, gotten a great education, and I think I will meet my goals just fine. But, I can see how some things could be harder, if you had an interest in them (research, snotty academia, etc).

 

[Prncssbuttercup]

Even if the practice does not qualify (google HPSA score map, but be aware that the map will change), non-profits hospitals/clinics can get a tax write-off for paying down your loans, so it benefits both you and the hospital relative to paying you more in salary. You may need to do a little legwork if the hospital administration doesn't know about this.
It really isn't that difficult at present to qualify for NHSC loan repayment based on HPSA, as they are currently well funded. Of course, there is the possibility that they won't stay that way.
Also, at present, if you work for the gov't or other qualified employer for 10 years, your loans will be forgiven. If you have a ton of debt or a low salary, that could be an option (remember, you will be paying 15% of your salary throughout that 10 yrs). I'm also skeptical that this will continue to be funded, and it would stink to get to year 9 and have Congress say, "meh, we don't need that."

I have heard the opposite. Cabinbulder, as well as people I know currently in their last year of residency have said they have met no one and heard of no one getting these funds. I am wondering currently, if there is a difference of rural vs urban practices getting more money, but again, I'd like to know if you actually KNOW someone who's received the money... Seriously, let me know 😉 I still want to do FP, but where I would do it could change depending on whether you can actually get loan repayment somewhere... I have heard from too many sources that rural gets a higher salary, but the loan payoff money is not really there...

 

[Slaol]

The US National Health Science Corps has a loan-repayment program that will forgive $60,000 for 2 years of full-time service at an approved site, $170,000 for 5 years, and $200,000 for 6 years.

There is a job search on the site for available openings.

http://nhsc.hrsa.gov/loanrepayment/

 

[cabinbuilder]

The US National Health Science Corps has a loan-repayment program that will forgive $60,000 for 2 years of full-time service at an approved site, $170,000 for 5 years, and $200,000 for 6 years.

There is a job search on the site for available openings.

http://nhsc.hrsa.gov/loanrepayment/

DO you actually know someone who received this?? I have have worked rural medicine for 2 yrs applied for this scholarship and waited for 18 months before being denied!!! Don't count on it.

 

[montessori2md]

DO you actually know someone who received this?? I have have worked rural medicine for 2 yrs applied for this scholarship and waited for 18 months before being denied!!! Don't count on it.

I'm a scholar, it took about 8 months to hear back from them, when I was denied in 2008, then another 8 months to hear from them for the accept in 2009. NHSC scholars are different from repayors. HRSA grants about 100 scholarships/year, and about 9000 loan repayments/year, so it is MUCH easier to get LRP. Scholars only apply once a year over about a 3 week period. LRP is a rolling, automated application process. Nearly anyone who has completed residency and can work in primary care can be a loan repayor. The available jobs are listed on their website by state, and they have regular conferences for LRP to explain the process and to give you an opportunity to network with potential employers.

HRSA funding for NHSC has nearly doubled, and the new head of NHSC is much more organized and engaged than the administrator under the Bush administration. They are still basically a Russian bureaucracy, but I've found dealing with them this year to be much improved over last year, as far as figuring out what is going on, dealing with paperwork, etc, and as I understand it, scholars have a much harder time than loan repayors with bureaucracy (just due to us being fewer and therefore less support avail). They have a facebook page, and actually answer specific questions there, which I have found helpful, believe it or not.

As far as getting denied, my first step would be to make contact with someone at NHSC who could verify that my paperwork was received and complete (most common reason for denial is they were missing something, either because they lost it or whatever). This may require several phone calls to make contact with someone who actually knows -call center staff are variable in their ability/training/interest. If you get confirmation that your application was complete, yet denied, then I would ask for a reason for the denial, so that you can fix whatever the cause for denial was. If you are trying to get LRP for a private practice, the paperwork is more intense than if you intend to work for a gov't agency or CHC.

 

[Prncssbuttercup]

I'm a scholar, it took about 8 months to hear back from them, when I was denied in 2008, then another 8 months to hear from them for the accept in 2009. NHSC scholars are different from repayors. HRSA grants about 100 scholarships/year, and about 9000 loan repayments/year, so it is MUCH easier to get LRP. Scholars only apply once a year over about a 3 week period. LRP is a rolling, automated application process. Nearly anyone who has completed residency and can work in primary care can be a loan repayor. The available jobs are listed on their website by state, and they have regular conferences for LRP to explain the process and to give you an opportunity to network with potential employers.

HRSA funding for NHSC has nearly doubled, and the new head of NHSC is much more organized and engaged than the administrator under the Bush administration. They are still basically a Russian bureaucracy, but I've found dealing with them this year to be much improved over last year, as far as figuring out what is going on, dealing with paperwork, etc, and as I understand it, scholars have a much harder time than loan repayors with bureaucracy (just due to us being fewer and therefore less support avail). They have a facebook page, and actually answer specific questions there, which I have found helpful, believe it or not.

As far as getting denied, my first step would be to make contact with someone at NHSC who could verify that my paperwork was received and complete (most common reason for denial is they were missing something, either because they lost it or whatever). This may require several phone calls to make contact with someone who actually knows -call center staff are variable in their ability/training/interest. If you get confirmation that your application was complete, yet denied, then I would ask for a reason for the denial, so that you can fix whatever the cause for denial was. If you are trying to get LRP for a private practice, the paperwork is more intense than if you intend to work for a gov't agency or CHC.

OK, so you are a scholar. From what I've heard, you're going to have a rough time after your residency. They send you where they want you, and you have to go... I won't even consider that as an option. Also, I've seen the list of "job openings" that 'qualify' for the LRP money, but I've heard that no one actually gets it. Since you are a med student, you can't possibly know for a fact that people DO in fact get the money. I was very interested in this, until I heard from numerous sources that it is about impossible to actually GET the money!

 

[cabinbuilder]

As far as getting denied, my first step would be to make contact with someone at NHSC who could verify that my paperwork was received and complete (most common reason for denial is they were missing something, either because they lost it or whatever). This may require several phone calls to make contact with someone who actually knows -call center staff are variable in their ability/training/interest. If you get confirmation that your application was complete, yet denied, then I would ask for a reason for the denial, so that you can fix whatever the cause for denial was. If you are trying to get LRP for a private practice, the paperwork is more intense than if you intend to work for a gov't agency or CHC.

Just for the record, I did talk to NHSC multiple times over that year. My application was complete within one month of my initially applying. I did get a reason for my denial (they said they ran out of funding and there was no more money!!!!) I can't fix the governments mismanagement of funds. BTW, it was not for private practice. No one can afford to do that anymore. We are all employees and pawns of the system these days.

 

[Dillatar]

(they said they ran out of funding and there was no more money!!!!)

Surprising no one, of course...