What’s a good specialty for a DO in NYC?

[OlafsPotato]

Me: DO, 250 step 1, no step 2 yet. Dunno if my comlex scores are relevant. I have a few research “experiences” but no pubs. My step score is probably my one saving grace.

Most important things for me:
1) be able to pay back my $600K loan debt
2) stay in the NYC metro area for both residency and employment. I have a wife and kids. My wife is a first-year PhD candidate and my daughter just began preschool. Relocating our family isn’t an option and I will not live away from them. A long commute is okay. It’s also important to note that I am not currently in NYC but I do have ties to the area.

I love all of medicine but I’m also very undecided about specialty. My favorite rotations were Radiology, Surgery, IM, EM, and Psych. However, I’ve heard any surgery or IM program in NYC will make suicide seem like an attractive option, and that lifestyle only gets worse after residency. Also, as a DO, I will probably be barred from any program that could get me a good fellowship. EM seems awesome but I worry about lack of options when I get too old for shiftwork. Psych is a great field but i will probably never pay off the loans on the craptastic NYC metro area salaries, and I’m not ready to “hang up the stethoscope.” Radiology seems great but I doubt I’ll be able to just waltz into an NYC program as a DO.

Any advice? Don’t bother with the “do what you love” stuff. I’m not passionate about a field, I’m passionate about the science of medicine and helping patients in general. What id “love” is being able to provide and be there for my family while I do it.

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[OlafsPotato]

crap, wrong forum, can a mod move it to Medical students/MD?

 

[gyngyn]

crap, wrong forum, can a mod move it to Medical students/MD?

They'll get to it shortly.

 

[efle]

$600K loan debt

how ???

 

[OlafsPotato]

how ???

SMP + ludicrous tuition/COA + interest

 

[efle]

SMP + ludicrous tuition/COA + interest

Damn. Well Radiology is probs the only option for that kind of debt, especially compared to IM/EM/Psych. Unless you'd be interested in a fellowship like cards or gastro, but landing that would mean another round of difficult matching

 

[Goro]

Me: DO, 250 step 1, no step 2 yet. Dunno if my comlex scores are relevant. I have a few research “experiences” but no pubs. My step score is probably my one saving grace.

Most important things for me:
1) be able to pay back my $600K loan debt
2) stay in the NYC metro area for both residency and employment. I have a wife and kids. My wife is a first-year PhD candidate and my daughter just began preschool. Relocating our family isn’t an option and I will not live away from them. A long commute is okay. It’s also important to note that I am not currently in NYC but I do have ties to the area.

I love all of medicine but I’m also very undecided about specialty. My favorite rotations were Radiology, Surgery, IM, EM, and Psych. However, I’ve heard any surgery or IM program in NYC will make suicide seem like an attractive option, and that lifestyle only gets worse after residency. Also, as a DO, I will probably be barred from any program that could get me a good fellowship. EM seems awesome but I worry about lack of options when I get too old for shiftwork. Psych is a great field but i will probably never pay off the loans on the craptastic NYC metro area salaries, and I’m not ready to “hang up the stethoscope.” Radiology seems great but I doubt I’ll be able to just waltz into an NYC program as a DO.

Any advice? Don’t bother with the “do what you love” stuff. I’m not passionate about a field, I’m passionate about the science of medicine and helping patients in general. What id “love” is being able to provide and be there for my family while I do it.

OMM/NMM. You can clear as much money as any decent plastic surgeon with less overhead!

 

[OlafsPotato]

OMM/NMM. You can clear as much money as any decent plastic surgeon with less overhead!

Ugh Goro I hate it when you’re right.

 

[BorntobeDO?]

How about the NJ suburb of NY, I hear its alot cheaper to live, and the standards are lower

 

[Tozanzibarbymotorcar]

Me: DO, 250 step 1, no step 2 yet. Dunno if my comlex scores are relevant. I have a few research “experiences” but no pubs. My step score is probably my one saving grace.

Most important things for me:
1) be able to pay back my $600K loan debt
2) stay in the NYC metro area for both residency and employment. I have a wife and kids. My wife is a first-year PhD candidate and my daughter just began preschool. Relocating our family isn’t an option and I will not live away from them. A long commute is okay. It’s also important to note that I am not currently in NYC but I do have ties to the area.

I love all of medicine but I’m also very undecided about specialty. My favorite rotations were Radiology, Surgery, IM, EM, and Psych. However, I’ve heard any surgery or IM program in NYC will make suicide seem like an attractive option, and that lifestyle only gets worse after residency. Also, as a DO, I will probably be barred from any program that could get me a good fellowship. EM seems awesome but I worry about lack of options when I get too old for shiftwork. Psych is a great field but i will probably never pay off the loans on the craptastic NYC metro area salaries, and I’m not ready to “hang up the stethoscope.” Radiology seems great but I doubt I’ll be able to just waltz into an NYC program as a DO.

Any advice? Don’t bother with the “do what you love” stuff. I’m not passionate about a field, I’m passionate about the science of medicine and helping patients in general. What id “love” is being able to provide and be there for my family while I do it.

600K is crazy. Everyone I knew who matched in NYC had contacts with the program or did an away. It doesn't hurt to go to Touro or NYIT.

 

[Splenda88]

Radiology... You should be able to match at some university/community programs in NY city/suburbs with your stats.

With your loan, you need a specialy in which you can make 350k+/yr. Rad average salary is 450k+, but not sure if there is a big pay cut in these metro areas

 

[Sardonix]

Isn't EM pay average like $300-375K? Not very familiar with NY pay, but that leaves a decent chunk post taxes, post loans.

 

[Rekt]

Isn't EM pay average like $300-375K? Not very familiar with NY pay, but that leaves a decent chunk post taxes, post loans.

Average is around 325, for now. It's getting quite saturated and most of the good jobs are long gone (private groups). You'll likely end up working for a contract management group, managing multiple mid-levels. The future isn't great for most specialities, but EM will be getting hit hard.

Also, at OP, with 600k in debt, you better pick somewhere else to live.

 

[CyrusHabs7695]

I would do EM and then you and your wife should be finishing up at the same time, then move the family somewhere else more affordable

 

[anon6134]

600k. Man.

Anyways, your best bet is likely going to be in northern/central NJ for anything more competitive than slave labor IM programs. There are some strong EM programs that may or may not take DO's but you are going to have to get on that ship like yesterday and get your stuff together.
Rads is great, but you will go through 6 PGYs prior to making any money while your 600k compounds into 1 million.
Anesthesia might be where you're headed

 

[BorntobeDO?]

600k. Man.

Anyways, your best bet is likely going to be in northern/central NJ for anything more competitive than slave labor IM programs. There are some strong EM programs that may or may not take DO's but you are going to have to get on that ship like yesterday and get your stuff together.
Rads is great, but you will go through 6 PGYs prior to making any money while your 600k compounds into 1 million.
Anesthesia might be where you're headed

Agree on the Gas, the long term outlook isn't good, but I think its just what the doctor ordered short term.

 

[AMEHigh]

If you just want to make money and have a decent lifestyle then I’d try for radiology. After that it’s a toss up between psych and EM. Although I think psych would be better than EM. I have a friend who did psych in nyc and was able to moonlight during residency and he’s still doing it now as an attending because the money is good. Also don’t forget to look at programs in NJ. Since there are DO schools in NYC, NJ and PA, the region is pretty DO friendly.

 

[Splenda88]

My loan disbursement was 277k and now my balance is 323K... So there is 46k interest already added to the loan? How is that even possible?

By the time I am done with residency (IM PGY1 now), that balance will be 450k+ then.

 

[Splenda88]

Are you in REPAYE? Do you have private loans? If you aren’t in the former and you say yes to the latter that could explain a lot.

I am in REPAYE

I don't have private loan... I have GradPlus and Stafford

 

[BorntobeDO?]

My loan disbursement was 277k and now my balance is 323K... So there is 46k interest already added to the loan? How is that even possible?

By the time I am done with residency (IM PGY1 now), that balance will be 450k+ then.

You interest doesn't compound while you are in school, 6 months after residency starts it compounds, and you get 4 years of med school interest dumped on your loans all at once. You will not gain 46k every year. More like 20k, but since your doing REPAYE it will be more like 10k a year. Its bad, but not that bad.

 

[Splenda88]

You interest doesn't compound while you are in school, 6 months after residency starts it compounds, and you get 4 years of med school interest dumped on your loans all at once. You will not gain 46k every year. More like 20k, but since your doing REPAYE it will be more like 10k a year. Its bad, but not that bad.

I see. I thought the interest was being compounded while I was in school. So that 46k added to my loan is about accurate.

 

[InternistDO]

Your interest definitely compounds during school. 6 months after graduation is when you must begin to make the minimum payment, but you're collecting interest the whole time.

 

[Splenda88]

Will call my servicer to find out where that 46k comes from...

That seems to be a lot.

 

[Sardonix]

Your interest definitely compounds during school. 6 months after graduation is when you must begin to make the minimum payment, but you're collecting interest the whole time.

I think what BorntobeDO meant was that they don't actually tack on the interest while in school, but it's accruing. Then once you've graduated all that interest gets added on "as if" it came out of nowhere.

Would have no idea though since I am not yet graduated and the only debt I see is from principal so far.

 

[InternistDO]

I think what BorntobeDO meant was that they don't actually tack on the interest while in school, but it's accruing. Then once you've graduated all that interest gets added on "as if" it came out of nowhere.

Would have no idea though since I am not yet graduated and the only debt I see is from principal so far.

My interest gets added on throughout the year. Maybe it depends on your servicer though?

 

[Neopolymath]

Guys, the term you are looking for is interest capitalization. Look it up and give the team a 5 minute presentation on rounds tomorrow.

 

[Neopolymath]

He’s in REPAYE, though. Capitalization doesn’t occur if he’s in the program

Sounds like something is messed up then

 

[BorntobeDO?]

??? Wait a second, are you saying not only am I accruing massive interest during school but then I’ll also be dropped a compounded bomb on my principle + interest accrued during school?

I will try and explain this is to the best of my understanding. Note that I am not a finance professional, but this is what I understand currently:

So the interest is kept separate from the principle during school and is not capitilized. What this means is that our loans are effectively not ture compound interest during medical school. So 6 months after we graduate we get all that interest dropped on us and then it starts to compound (i.e. the interest is added back to the principle every day, and then more interest is draw on the new combined amount.) This is what people mean by the term capitalization.

I will try to explain with numbers. I believe that interest on student loans is compounded daily so we will work with that.

So lets say for the first year of medical school you took 75,000 @ 10% interest. Every year you are in school there will be a separate 7500 that doesn't add back into the principle and to my understanding does not compound on itself (I believe it is simple). So after 4 years, you would have 30k of interest just waiting to be added back onto the principle. 6 months after you graduate that 30k is dumped onto your principle (the original 75k), and now you have 105k that adds interest daily.

At 10% interest divided by 365 days would make for a 0.0274% daily interest rate or 0.00274 in decimals. So the first day of 105k you multiply it by 0.000274, add that amount to 105k and thats the new balance for the next day. So $28.77 dollars in interest for the first day, then your new balance is 105,028.77. Multiple that by 0.000274 again and add it back to the principle, and that's day two. You can see how daily compounding can make your loan go up a lot faster than simple interest or even uncapitalized interest.

However, because REPAYE will pay upto half the interest that you are deemed unable to afford, it will effectively cut your interest rate in half. This makes it kind of similar to simple interest. But when your dealing with numbers as big as we are, you still need a plan.

I think what BorntobeDO meant was that they don't actually tack on the interest while in school, but it's accruing. Then once you've graduated all that interest gets added on "as if" it came out of nowhere.

Would have no idea though since I am not yet graduated and the only debt I see is from principal so far.

You are right.

 

[BorntobeDO?]

He’s in REPAYE, though. Capitalization doesn’t occur if he’s in the program

Capitilization does occur when he switches from med school to graduated status. Even picking a repayment plan makes capitalization occur. There is basically no way to avoid it once you graduate. I am not sure if REPAYE avoids any new capitilization, but if it does that would make it an even better deal than it already is.

 

[Sardonix]

You are right.

Dang. Get my attending to say that every once in a while and we'll have a real party going!

 

[pgy0246]

Anesthesia, EM, IM, or psych.
Always pick a hospital that allows moonlighting

You should factor in that your student loan will grow another 10-20% by the time you graduate from residency.

 

[sylvanthus]

As someone who is technically in NYC now, I would absolutely not live here with 600k student loan debt. Live someplace with a lower cost of living, less taxes, etc, pay that **** off and then move to NYC. You are going to be living a lower middle class life with that kind of debt if you are in NYC.

 

[nimbus]

When I was an intern at a now closed hospital in Greenwich village, the busiest orthopedist there was a DO.