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I am looking at leaving medicine. I owe 225K. For reasons I won't go into, I don't see being able to get back into residency and then finishing. I love medicine, and had great dreams and goals but - there it is.

The main issue now is the debt. It seems there is no way to absolve this, even by say teaching in a low income area. Any suggestions, ideas on paying down the debt outside of medicine?

As I said, I love medicine and coming to this decision is very hard. But without finishing residency you cannot practice. That's just the way it is.
 
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I am looking at leaving medicine. I owe 225K. For reasons I won't go into, I don't see being able to get back into residency and then finishing. I love medicine, and had great dreams and goals but - there it is.

The main issue now is the debt. It seems there is no way to absolve this, even by say teaching in a low income area. Any suggestions, ideas on paying down the debt outside of medicine?

As I said, I love medicine and coming to this decision is very hard. But without finishing residency you cannot practice. That's just the way it is.
ever heard the term "debt slave"? it means debt forces people to do things that they do not want to do and thus restricts their freedom. These are things that have to be considered before piling on all that debt. It's like riding a sports bike, once you commit to leaning into the turn there is no going back
 

GoodmanBrown

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ever heard the term "debt slave"? it means debt forces people to do things that they do not want to do and thus restricts their freedom. These are things that have to be considered before piling on all that debt. It's like riding a sports bike, once you commit to leaning into the turn there is no going back
I'm not sure this is a really helpful reply to someone who clearly has taken some rough knocks in life.

To the OP: I really don't know what we can do to help. The health care reform bill has some student loan reforms that I believe help relieve debt if you work for a government agency for 10 years. Perhaps after the dust settles with the bill, you can learn more from a student loan officer? Best of luck and I hope things turn around for you!
 

Heathcliff

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From the title of your thread, I thought you were planning to walk away from medicine and your debt, just as some people have decided to walk away from their mortgages. I don't know if that is possible, and I don't recommend walking away from your loans, but maybe you can get some ideas from the website that people are using to help them leave their mortgages behind: http://youwalkaway.com/
 

doctorFred

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the short answer is, no. your student loan debt cannot be discharged, even through bankruptcy, and you are unlikely to find employment in any field other than medicine that will make it possible to pay off such a huge principal and substantial interest. sorry i can't be more helpful, but people who accumulate the type and amount of debt you're talking about have very few options. unless you become permanently disabled, staying out of medicine will almost ensure that you will be paying off that debt indefinitely.

someone please correct me if i'm mistaken or am being overly pessimistic.
 

heech

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I am looking at leaving medicine. I owe 225K. For reasons I won't go into, I don't see being able to get back into residency and then finishing. I love medicine, and had great dreams and goals but - there it is.

The main issue now is the debt. It seems there is no way to absolve this, even by say teaching in a low income area. Any suggestions, ideas on paying down the debt outside of medicine?

As I said, I love medicine and coming to this decision is very hard. But without finishing residency you cannot practice. That's just the way it is.
The odds are certainly against you. If you have the option of getting at least through the first year of residency (even if it means working in DarkSideOfTheMoon, Alaska)... you can at least practice in *some* form. Moonlight, locum tenens, prison system, county public health, social welfare...

If you can't do that, you can always look for business or consulting opportunities. Management consulting firms typically looks for new grads, but it doesn't hurt to start throwing resumes everywhere you can. As far as business goes... start networking every way you can. Look for conventions with medical startups, EMR vendors, big pharma. Show up, introduce yourself, and ask for a job.

The cold hard truth is that while this route is at least an option, it will be MUCH more unpredictable than a career in medicine would be. You may go months and years without employment, and may ultimately be stuck as an employee in a situation you truly detest. Stop talking to doctors, and start talking to other white collar workers to get an idea of what you're getting into, here.
 

gutonc

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If you're interested in doing research, I believe NIH has loan forgiveness programs if you're involved in clinical research.

http://www.lrp.nih.gov/faq/program_information.aspx

Edit: I don't have the time to read through all that. But seems like you can get 25% of your loan repaid up to $35k per year.
Yes, that's basically it. There are a lot of caveats and loopholes (as there are with any gov't program), the most important of which is that they fund ~40% of applications to the program. The moral of that story being: don't do research to get your loans partially repaid, get your loans partially repaid because you're doing research.
 

countingdays

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I don't know much about military medicine, but it might be something to consider in your position.

The Army Medical Corps will pay off $120000 of your loans over 3 years in addition to whatever you get paid for your work. You could bring your debt down to manageable levels in 3 years that way if you qualify.
 

aProgDirector

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Sounds like there are several pathways:

1. Find a way to get back into clinical medicine to finish a residency. The military option above (if you qualify), or finding some residency to do even if you're not wild about it. This leads to a physician job. Getting started this way is hard. Getting a long term salary this way is "easy" (meaning there are plenty of people who will hire you), it's stable, and it's probably the most stable plan.

2. Find a way to get the minimum amount of GME experience needed for a full license, but don't finish a residency. This would let you work as a physician, but your employment might be unstable. It's possible that whatever job you found might require board certification in the future, or you might be replaced by an NP/PA because they are cheaper. Or you simply would get paid at the same rate as an NP/PA. This would be easier to do than #1, but the long term prospects are less safe / stable.

3. Forget about clinical medicine and do something else. This doesn't involve any further residency training. You'll need to forge your own path if this is what you want to do. You'll never find a job in a classified saying "Looking for someone with MD but no residency". But, presumably if you went to medical school you're quite smart. You could start your own business. You could find a way to market yourself. You could teach MCAT / USMLE review courses. You could manage a medical office. None of these jobs are going to be looking for you -- you're going to have to make them happen. This is the most chaotic pathway without a clear definition or plan. But if you're creative you can probably find something. It would be completely up to you.
 
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Sounds like there are several pathways:

1. Find a way to get back into clinical medicine to finish a residency. The military option above (if you qualify), or finding some residency to do even if you're not wild about it. This leads to a physician job. Getting started this way is hard. Getting a long term salary this way is "easy" (meaning there are plenty of people who will hire you), it's stable, and it's probably the most stable plan.

Yes, this is the one I want to do. I am trying to get back into a residency but it is incredibly hard. I am not an FMG/IMG but it is still very difficult. I am shocked at how hard it is to get back into a residency one you are out. Your value drops like a new car driven off the lot. Also, the stigma of being out is intense and has its own dynamic which is also hard to overcome. I have been working very hard at this and it takes alot of inner confidence and determination to continue in the face of repeated slights and rejection. When you are in medicine, you are golden; but once you step out, then it's like you are a leper or worse.

Yes, I would like more than anything to just go back and finish. That would be great! It just seems that at some point I have to figure out what my options are and the tidal wave of loan repayments is looming large.
 
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Thanks to everyone who posted, these are great ideas and suggestions. There is no easy answer, as I knew. But, still it's good to hear these suggestions again and consider them. Thanks also for the kind words, and the support.
 

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How long have you been out of residency?

Are you willing to do research? People are always looking for research assistants in the lab...the problem is that it doesn't pay very well. There is sometimes the possibility of NIH loan repayment, but generally I believe you have to apply in September for the following April, and you have to be doing research continuously for 2 years from the time they start supporting you. also, as mentioned by gutonc, they only fund about 40% of the people who apply for loan repayment...if you do something related to underserved populations sometimes your chance would be greater.
 

brotherman

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Thanks to everyone who posted, these are great ideas and suggestions. There is no easy answer, as I knew. But, still it's good to hear these suggestions again and consider them. Thanks also for the kind words, and the support.
OP, I guess it would be useful to know, if you, of course, want to divulge a little more details about what happened so we can help you. You are correct, once you leave a residency, your value does drop off quite a bit. It does depend on the reason for leaving, specialty, USMLE, ect.
Point being, finding another residency can be accomplished. It will be difficult to do so, but it can be done.
 

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The new Income based repayment option is your ticket to salvation. It essentially can not be denied to you, and makes it so you only pay 15% of your income above federal poverty line to your loans, regardless of your level of debt and your level of income (until your 15% payment becomes higher than your standard payment, but then you don't have this issue). Then, if you work in public service for 10 years (you would have to look into what qualifies... I know almost all residencies do qualify, most non-profits...), and IF your loan is serviced by direct loans (which is where you can consolidate your loans if you haven't already), you can have all your loans forgiven. IF you don't do public service, after 25 years (might have been reduced to 20 years in the bill) your balance will be forgiven (regardless of loan owner, however, the forgiven amount is considered taxable income). So yeah, you will be saddled with debt for likely the next 25 years of your life (at a reasonable payment), but you won't be saddled to Medicine if you don't want to.
 

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do a year of internship, get into mil med, do gmo, get out, don't finish residency.
 

w a n g

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i guess you cant just start a new character from level 1
 

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I am shocked at how hard it is to get back into a residency one you are out...When you are in medicine, you are golden; but once you step out, then it's like you are a leper or worse.
Much depends on why, how, and when you left. If you were doing fine, left for a year to write a novel / have a baby / etc and want to come back, you would not have much problem (depends on the field). If you failed out of a residency, or had some major medical issues that have been addressed, and are now trying to get back in 3+ years later, you'll find it much more difficult. If you're 10+ years out for almost any reason, it will be tough.
 
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There are alot of threads by other people on this forum about why they left or were forced out or whatever. I don't want to add my story to the pile, this is a public forum. I have not been out very long. I am willing to take responsibility and learn from the experience, but realistically I see that my value has dropped and people are not interested. So, I can keep trying or I can be realistic and start to look at other options. It has been a very painful process.
 
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We had a categorical medicine intern who was recently fired a few weeks ago (rumor is that it was over patient safety). He is an FMG but US citizen. He says that program will support him finding another position elsewhere. What's his chances of getting another spot?
 
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Brotherman, I think your position was a good one because your pd was supportive of you and helped you in your process of leaving and switching. That is very valuable. Having someone like that, or a strong mentor, is really vital. Not the least significant is that your confidence level would be very different than if you were doing it by yourself. Congratulations on your new position.

PS - I had no patient safety issues, or moral/ethical issues.
 
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Dr.Millisevert

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I love medicine, and had great dreams and goals but - there it is.

The main issue now is the debt. It seems there is no way out.
you could always run away to a foreign country.

http://money.cnn.com/2008/10/23/pf/college/student_loan_fugitives/index.htm?section=money_pf_college

...at least in your situation... You're a doctor so you could maybe set up a cash only cosmetic medicine day spa in a 3rd world island country. Make money off tourists and put it into a Swiss account. The locals will love you too if you do a little pro-bono family practice for them. ... Or you could work as a doctor on a barter system.. Trade physical exams and prescriptions for fresh produce and livestock. Sounds better than some of those other options.
 

notinkansas

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I know of the following residency changes:

Gen surg to anesthesia, took a couple years between to work moonlighting type jobs: 3 people

Gen surg to radiology after PGY1 One person

Ortho to radiology after PGY 1 one person

Gen surg to EM after PGY2 clinical years and 2 research years

IM to Gen surg after PGY 2

Anesthesia to gen surg after PGY 1

Ortho to gen surg after PGY 1

Granted, most of these switches were arranged before leaving the first program and all occured between programs at the same institution.

I myself left Gen Surg after PGY3, working a moonlighting type job and planning to go back in 2011. Looking at a couple options for what field.

My debt burden is a little larger than yours. You are right, it is very difficult to find a job outside medicine that pays well enough to allow that debt burden to be serviced. I had hoped to pay a big chunk down with my moonlighting type job. It went well for a while, was working full time hours, but now the hours have been cut back because the lab residents want to make more money (and some of the PAs do too!) so I didn't reduce debt as much as I wanted.

I think if you don't have the support of your former PD and good LOR it will be difficult. If you do, programs at your institution or in the same city will be your best bet. You must be able to clearly and logically state your reasons for leaving your first residency and what your interest is in the field you are applying to. Plus I'd try to meet with the PD of the program you want to get into, well before the match. Have some intelligent questions about the field- questions that relate to you examining this field as a career choice.

Good luck.
 

gutonc

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Granted, most of these switches were arranged before leaving the first program and all occured between programs at the same institution.
Best point in this thread. If you just walk away from a program mid-year and somehow expect to just waltz into another program the following year, you have a lot to learn about the way the world works.

Switching specialties, like switching any non-medical job is totally possible, assuming you're qualified to do it. But you need to be realistic about what potential employers (i.e. PDs) are going to want and if you have already proven that you're willing to just bail on one job, they're less likely to be willing to give you another one.
 

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Are you an AMG? If so, I would bet that you would find a position easily as you stated you've only been out for a few months. Did you apply for the match or scramble? Just keep trying and I'm sure you will make it.

As you stated earlier, you are interested in going back to clinical medicine or the military. If you don't mind working on ships, the navy may be a good deal as they pay you tons of money extra in addition to your resident salary, plus you work in vast arrays of settings like earthquake disasters that are way cooler than civilian medicine.

Maybe if you're interested, go into FP or IM or psych or preventative medicine or even nuclear medicine, which don't require as much training as other programs and some are easy to get into. That way you can pay off your debt faster. Work a few years and then do something else if you don't like it.

Another alternative is to put yourself in just a little more debt and just go to law school (4 years) or PA school (2 years) or get your PHD (3 years minimum with some schools paying you to go to school) or even nursing school (1 year minimum) to make decent pay if you want to do something else completely. That way you'll be making anywhere from $60k + up to $100k +. Some say that MBA's can get you places too (minimum 10 months education). i hear you can make a pretty high salary comparable to doctors with MBA's; however, i have an mba but it didn't get me anywhere but i really didn't know what to apply to. Lastly, there are options such as pharm rep..they make around $70k. Medical writing may or may not get you the high salary you need to pay your debt. You always have other options if you're not interested in medicine anymore.

If you're tired of the US, you can always go overseas and practice as a doctor. NZ will take you if you took your step 1/2 within 5 years.

good luck :luck:
 

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If you're not going to complete a residency, you can still find some great non-clinical career options where you'll be able to pay your loans. I think this is the most practical option instead of trying to practice medicine without residency completion. The latter will only get more difficult in the United States as time goes on.
 

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I second the suggestion for law school.

It is only 3 years, and as an MD/JD, no matter which schools you went to, you'll be well positioned to make ridiculous money when you are done.

In the meantime, you should income-sensitive repayment on your loans.

Good luck.
 

Taurus

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Unless you go to the top 14, law school is a complete waste. I've even heard of Harvard Law students having difficulty finding jobs in this market. The law field is also changing and not for the better. Outsourcing, the death of the billable hour, too many law schools, etc. Do you due diligence before you embark on such a risky move. Here's a good place to start. JD Underground.
 

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Although, in general, law as a field is experiencing a general downturn, how many JDs also have an MD? A percent of a percent, if that?

In my opinion, it would likely be incorrect to draw too a strong conclusion as regards the marketability of someone with a JD/MD based upon the situation of those solely with JDs.
 

Taurus

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Although, in general, law as a field is experiencing a general downturn, how many JDs also have an MD? A percent of a percent, if that?

In my opinion, it would likely be incorrect to draw too a strong conclusion as regards the marketability of someone with a JD/MD based upon the situation of those solely with JDs.
You either practice as a physician or lawyer, not both. If an MD/JD is a great malpractice lawyer, he's probably a great lawyer period. He would have been a great lawyer with just a JD. The converse is also true. Someone who is a lousy lawyer will still be a lousy malpractice lawyer even with an MD/JD. I've met 3 MD/JD's. They all practice medicine and not law. One went to Columbia Law and worked in Big Law for a few years and then went back to medical school. He hated Big Law. I think he's doing derm now. Another did the dual MD/JD track and is now doing ob/gyn residency. Last one was an ED attending who went to law school part-time. He still works as an ED attending and has written like 5 books.

This topic touches on the idea of MD/MBA as well. How many MD's do you know who went on to get an MBA while in medical school or after? I know quite a few. What these people have in common is that most of them feel that the MBA is useless. Why? Just because you're a great physician does not mean you'll be great in business. An MBA does not guarantee that you'll succeed in business. Business success depends more on innate skills that can't be taught in a classroom. That's why there are so many disillusioned MBA's out there. It's also true about the JD. Both the MBA and JD degrees (and the pharmD is on the same trajectory) are diluted and worthless because it's too easy to obtain and almost everyone has one. If you want one, you should get it because you're truly interested in the field and not because you think it will propel your career. It won't.
 

Freudster

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I've met 3 MD/JD's. They all practice medicine and not law.
Well... I never claimed that one should practice both medicine and law.

I was making a simple claim: having a JD/MD would make one much more **marketable** as a lawyer (particularly in any field vaguely related to healthcare or science).

While I respect the points you do make, I don't believe you actually addressed the point I was making.

My apologies for unintentionally hijacking this thread.
 

MedicalDoctorV

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Well... I never claimed that one should practice both medicine and law.

I was making a simple claim: having a JD/MD would make one much more **marketable** as a lawyer (particularly in any field vaguely related to healthcare or science).

While I respect the points you do make, I don't believe you actually addressed the point I was making.

My apologies for unintentionally hijacking this thread.
Get an MBA in health care management - that's only 2 years. You can work for big pharma, an HMO, the sky is the limit - and no one will care whether or not you have a medical license. The MD itself will make you marketable above other people who don't have one.

Granted - this option involves taking on MORE debt for the next few years, but if you can no longer go through the find-another-residency route - it's a good one.
 

notinkansas

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Best point in this thread. If you just walk away from a program mid-year and somehow expect to just waltz into another program the following year, you have a lot to learn about the way the world works.

Switching specialties, like switching any non-medical job is totally possible, assuming you're qualified to do it. But you need to be realistic about what potential employers (i.e. PDs) are going to want and if you have already proven that you're willing to just bail on one job, they're less likely to be willing to give you another one.
Seems I should clarify: in all the switches I posted, the person making the change also finished out the full academic year in their original program, and started the new program the next academic year. Some of the switches occurred in lab years. As an example, the GS to Rad switch was by an intern, who finished PGY 1 of GS and then started Rads.
 

gutonc

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Seems I should clarify: in all the switches I posted, the person making the change also finished out the full academic year in their original program, and started the new program the next academic year. Some of the switches occurred in lab years. As an example, the GS to Rad switch was by an intern, who finished PGY 1 of GS and then started Rads.
No need to clarify...I was reiterating your point which I agree with.