When does the price difference become significant?

[FSU2013]

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No i understand. It was an extreme example to make a point. Having a butt load of disposable income at the age of 35 is not a high priority for me. Maybe I'm being too idealistic but most people make 50k per year. If im making 180k and spending 80k on loans, taxes, etc, I still have 100k.

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This is really poor foresight. Not only is half of your income going to tax, loans, etc - you may have to pay malpractice; you likely are in your early/mid 30's - you have 0 money in the bank for an emergency fund, 0 money for a down payment on a home, you have no money in a retirement fund and have lost the benefit of compounding interest, you likely need a new car, you may or may not have a family (for whom you'll have to buy health insurance), you'll need to get life, disability and car insurance insurance, you would like to occasionally go on vacation or out to eat or to a movie since you work so hard. Life is expensive. Start saving now.

 

[TipToad]

I'm thinking an 80k difference is too much (20k/yr). I think the most extra I'd be willing to pay is between 5-10k/yr.

Now I regret applying to all of these schools.

 

[sector9]

I'm thinking an 80k difference is too much (20k/yr). I think the most extra I'd be willing to pay is between 5-10k/yr.

Now I regret applying to all of these schools.

I wouldn't get that carried away. A significant cost difference between schools you've been accepted at might allow you to land some nice scholarships at a preferred school if you let the school know about it in the right way. Something like that ended up happening with me. But in the end when all the chips are down and you have to decide, cost should definitely come into play

 

[Birdnals]

I'm not worked up don't worry....

But I don't think my argument is foolish like you're making it seem. Why buy a huge house when I can live in a small one? Why buy a ferrari when a 5k used corolla will get me from point a to point b just as well? Why fly first class when I can fly business in the same plane? Why stay in the Ritz-Carlton when I can stay at the Best Western? Why waste all my time trying to court a hott girl when I can date an ugly girl who I can still make babies with?

The information might be standardized, but the delivery is different. There are certainly idiosyncrasies in each curriculum that make certain medical schools more favorable than others to different people, and I think this supersedes cost. Again, on a physician's salary, I'll be more than capable of repaying any debt I accumulate now.

Because your kids will be living on top of each other and unhappy. Because the 5k Corolla is going to break down when you get called to the hospital and you get fired for not owning reliable transportation. Because sometimes coach seats aren't available when you need to make your flight and all the rooms at the Best Western are booked. Wanna talk in terms of extremes? Your kid gets a rare cancer. Would you rather have have had 4 years at your number one choice or the ability to pay the best possible treatment of your kid? What if you die and your family is left with the burden of your debt? What if medicine becomes socialized and you only make 80k a year with 320k in debt?

Seriously though, I don't understand your rationale of only looking in things in terms of extremes. Fact is, we don't know what the future holds in store for us. Having money in the bank, no matter what you say, provides at least somewhat of a safety net for you from the unknown.

 

[Birdnals]

I'd love to have some background information on the people posting here. Even just the ages. Like those who say 320k in debt is worth attending choice #1 vs those who say that's foolish. I don't care what you make or your preferences, 320k in debt is something I'd never want over my head if I had a comparable substitute that would only put me 120k in debt. I feel like I'd be doing my family a disservice for my own selfish good.

 

[Silo004]

Oh... oh my.

"Screw my financial future, I need to decide if going to this school to learn a standardized body of material and paying twice the cost is better than going to THAT school to learn a standardized body of material at half the cost! At this one school there a such a cool lounge and call room that it's totally worth it!"

I'm obviously having some fun here, so don't get too worked up.

(sent from my phone)

Yeah you are lightweight trolling homeboy, even though I agree with you,

 

[Silo004]

I'm not worked up don't worry....
Again, on a physician's salary, I'll be more than capable of repaying any debt I accumulate now.

I think we have some heroic assumptions about the future of health care in this country.

 

[Geebeejay]

Because your kids will be living on top of each other and unhappy. Because the 5k Corolla is going to break down when you get called to the hospital and you get fired for not owning reliable transportation. Because sometimes coach seats aren't available when you need to make your flight and all the rooms at the Best Western are booked. Wanna talk in terms of extremes? Your kid gets a rare cancer. Would you rather have have had 4 years at a med school that you perceived as better or the ability to pay the best possible treatment of your kid?

Seriously though, I don't understand your rationale of only looking in things in terms of extremes. Fact is, we don't know what the future holds in store for us. Having money in the bank, no matter what you say, provides at least somewhat of a safety net for you from the unknown.

I think you misunderstood my post....I am making this as a comparison to medical school. Saying "why pay extra for a medical school you fit better into" is the same as asking why anyone prefers anything more expensive that provides the same basic purpose as something comparable and cheaper, yet lower quality.

If my kid gets a rare cancer, I'm not gonna be able to afford it no matter what profession I have. That's why my kids (hopefully not plural until after I've repaid my debt) will be covered on my insurance. And my 5k 2003 Corolla still runs excellent, and I dunno about you, but I've seen much older models on the roads 🙂

I'm only saying that while cost should be a factor, you shouldn't blindly choose the cheapest school you get into, and I don't plan on it. Plenty of people out there have almost as much debt to repay as we do with far less lucrative careers.

I think we have some heroic assumptions about the future of health care in this country.

Oh boy, not another "Doctors are poor" argument...

 

[911 Turbo]

I'm not worked up don't worry....

But I don't think my argument is foolish like you're making it seem. Why buy a huge house when I can live in a small one? Why buy a ferrari when a 5k used corolla will get me from point a to point b just as well? Why fly first class when I can fly business in the same plane? Why stay in the Ritz-Carlton when I can stay at the Best Western? Why waste all my time trying to court a hott girl when I can date an ugly girl who I can still make babies with?

Yeah!! Wait... What??
Son stop being so beta

 

[Birdnals]

I think you misunderstood my post....I am making this as a comparison to medical school. Saying "why pay extra for a medical school you fit better into" is the same as asking why anyone prefers anything more expensive that provides the same basic purpose as something comparable and cheaper, yet lower quality.

If my kid gets a rare cancer, I'm not gonna be able to afford it no matter what profession I have. That's why my kids (hopefully not plural until after I've repaid my debt) will be covered on my insurance. And my 5k 2003 Corolla still runs excellent, and I dunno about you, but I've seen much older models on the roads 🙂

I'm only saying that while cost should be a factor, you shouldn't blindly choose the cheapest school you get into, and I don't plan on it. Plenty of people out there have almost as much debt to repay as we do with far less lucrative careers.

You're aware that not all treatments are covered by insurance right?

 

[Birdnals]

And that just because your car runs now doesn't mean that it will for another 10 years.

 

[NickNaylor]

Yeah you are lightweight trolling homeboy, even though I agree with you,

Not sure you know what trolling means...

 

[Geebeejay]

Yeah!! Wait... What??
Son stop being so beta

Lol

Birdnails, send me your address so I can drive up to your house in my 5k corolla in 2022 buddy! In Toyota We Trust!

 

[911 Turbo]

Lol

Birdnails, send me your address so I can drive up to your house in my 5k corolla in 2022 buddy! In Toyota We Trust!

Bird nails??? Bird nails?????? Thats not how you talk to a cash money executive

 

[Geebeejay]

Bird nails??? Bird nails?????? Thats not how you talk to a cash money executive

Lol Birdnals*...I was directing that to birdnals and his dumb, probably american car that won't last till 2022

 

[Textbookversion]

The difference in disposable income (salary - minus expenses) between different geographic areas is dramatic for physicians.

Choosing to work in Iowa for 1 year vs. NYC should be about the difference of all four years of medical school tuition and CoA for pretty much every specialty, even FM. 1 yr vs 4 yrs it's up to you. Plus if you end up doing IBR and PSLF it won't really matter how pricy your school is anyway.

Personally the only deal breaker for me was high cost of living cities. I don't want to strapped for cash living off my loan money. Tuition didn't really factor into the equation. I'd recommend the same philosophy to most people, especially those with families.

Obviously if a school offers you something extreme like a full tuition scholarship take it,

 

[Silo004]

I think you misunderstood my post....I am making this as a comparison to medical school. Saying "why pay extra for a medical school you fit better into" is the same as asking why anyone prefers anything more expensive that provides the same basic purpose as something comparable and cheaper, yet lower quality.

If my kid gets a rare cancer, I'm not gonna be able to afford it no matter what profession I have. That's why my kids (hopefully not plural until after I've repaid my debt) will be covered on my insurance. And my 5k 2003 Corolla still runs excellent, and I dunno about you, but I've seen much older models on the roads 🙂

I'm only saying that while cost should be a factor, you shouldn't blindly choose the cheapest school you get into, and I don't plan on it. Plenty of people out there have almost as much debt to repay as we do with far less lucrative careers.
.

You sound like the kid in this scene.

 

[MedPR]

Ok look. Lets say an extra 80k over four years ultimately ends up being 320k counting interest. That's less than three years salary even for the lowest paid docs. So I retire three years later than you guys, but I had a happier four years in med school. Im still a year ahead.

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[Amazingmuzmo]

Ok look. Lets say an extra 80k over four years ultimately ends up being 320k counting interest. That's less than three years salary even for the lowest paid docs. So I retire three years later than you guys, but I had a happier four years in med school. Im still a year ahead.

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Nobody spends their entire salary paying for loans, I don't think you realize how much 320k is. It's going to be a lot more than three years...

 

[lobo.solo]

I would go to the cheapest school no matter what.

 

[MedPR]

Nobody spends their entire salary paying for loans, I don't think you realize how much 320k is. It's going to be a lot more than three years...

I didn't say I'd spend my whole salary... you might need to relearn basic algebra.

over simplified below
You borrow 300k amd I borrow 380k. At 30k per year it takes you 10 years and me 12.7 years.

Obviously as interest accrues it will slowly increase the payment gap, but it will never be more than a few years difference.

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[QuesoAndFromage]

my main argument for happiness is that when I am happy I will perform MUCH better, leading to better grades and residency options. I turned down a decent scholarship on the east coast at a top 20 to stay locally (though its also a top 20, and I think its ranked slightly higher but that doesnt really matter at that point). I have family and a fiancee here and having a long distance relationship would make me (and her) miserable. On top of that I liked the other school but I hated both the immediate area and the city, including (but also much more than) the weather-- and the city has a higher COL.

In addition, my current school is in the city I want to do residency in (and more specifically, I want to do residency at the hospital here, and having the "connections" here would definitely help)

Am I saying my line of thinking should apply for everyone? Of course not, that would be ridiculous. However, I do not regret my choice since I am very happy overall and its reflecting in my performance

 

[circulus vitios]

I didn't say I'd spend my whole salary... you might need to relearn basic algebra.

over simplified below
You borrow 300k amd I borrow 380k. At 30k per year it takes you 10 years and me 12.7 years.

Obviously as interest accrues it will slowly increase the payment gap, but it will never be more than a few years difference.

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$300k, 6.8% interest, $30k/year ($2.5k/month) is 202 payments. $504k cumulative.
$380k, 6.8% interest, $30k/year ($2.5k/month) is 350 payments. $875k cumulative.

If you wanted to pay $300k off in 10 years, that's 120 payments of $3500. $414k cumulative.
If you wanted to pay $380k off in 10 years, that's 120 payments of $4400. $525k cumulative.

I'm not sure if loans can be deferred during residency so those figures could be much higher if they compound for 3+ years of residency.

On the lower end of salaries you might have a gross income of $180k/year or about $115k/year net. That's about $9600 a month. It's a lot of money but there's no point in spending a decade in school, 3-7 years of slaving away in residency, and 10 years of your life working 60, 70, or 80 hours a week when you're taking home $9600 a month and dropping nearly half of that on loans for 10 years. 😳

 

[MedPR]

$300k, 6.8% interest, $30k/year ($2.5k/month) is 202 payments. $504k cumulative.
$380k, 6.8% interest, $30k/year ($2.5k/month) is 350 payments. $875k cumulative.

If you wanted to pay $300k off in 10 years, that's 120 payments of $3500. $414k cumulative.
If you wanted to pay $380k off in 10 years, that's 120 payments of $4400. $525k cumulative.

😳

Ok so $1100 more per month assuming a 10 yr repayment. I don't see the big deal with that.

Edit: $900 more I mean.. good maths.
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[kpcrew]

Ok so $1100 more per month assuming a 10 yr repayment. I don't see the big deal with that

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Well if 130k isn't a big deal to you, let me borrow some money.

 

[MedPR]

Well if 130k isn't a big deal to you, let me borrow some money.

Where is 130k coming from?

Its 108k more assuming 80k initially.

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[notbobtrustme]

$300k, 6.8% interest, $30k/year ($2.5k/month) is 202 payments. $504k cumulative.
$380k, 6.8% interest, $30k/year ($2.5k/month) is 350 payments. $875k cumulative.

If you wanted to pay $300k off in 10 years, that's 120 payments of $3500. $414k cumulative.
If you wanted to pay $380k off in 10 years, that's 120 payments of $4400. $525k cumulative.

I'm not sure if loans can be deferred during residency so those figures could be much higher if they compound for 3+ years of residency.

On the lower end of salaries you might have a gross income of $180k/year or about $115k/year net. That's about $9600 a month. It's a lot of money but there's no point in spending a decade in school, 3-7 years of slaving away in residency, and 10 years of your life working 60, 70, or 80 hours a week when you're taking home $9600 a month and dropping nearly half of that on loans for 10 years. 😳

This is an underestimate because Staffords, which are the 6.8% loans, are capped at 40.5k/year and 180k lifetime and includes undergraduate loans I believe, so the remainder has to GradPLUS at 7.9% or private loans, which are almost always higher. You can do a hardship forbearance during residency, but interest will accumulate and capitalize.

And remember, 9600/month sounds like a lot, but when you start subtracting expenses, it doesn't go nearly as far as you think it does.

 

[MedPR]

It seems more and more unreasonable to spend the extra money on a specific school...

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[TipToad]

It seems more and more unreasonable to spend the extra money on a specific school...

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80k can pay for my surrogacy costs!

 

[Moosepig]

I would go to medical school in Guantanamo bay if it saved me 80k. I sacrifice some happiness, but imagine how much happiness for how many people 80k in charity could do. I am willing to be a little less happy with how the building smells or what color the walls are painted or how much traffic there is around campus or the options in the cafeteria if it means 80k in cancer research or 80k in African wells or 80k for a scholarship fund for underprivileged youth.

 

[Narmerguy]

I think people on SDN make the mistake of thinking that all of us have the ultimate goal of having as much money down the line as possible, thus if you make a medical school choice now that will cost you money, you've somehow missed the point. That's simply not the ultimate goal for a lot of students, myself included. I'm obviously not in favor of throwing money out the window, but if there are things at one school that I significantly care about, I'm willing to pay for it.

We will all have enough money to live happy comfortable lives with plenty of toys if that's what you want. I'm not saying disregard money, but perhaps we should cut some of the religious zeal with which people are being advised to make money the centerpiece of every decision.

 

[NickNaylor]

I think people on SDN make the mistake of thinking that all of us have the ultimate goal of having as much money down the line as possible, thus if you make a medical school choice now that will cost you money, you've somehow missed the point. That's simply not the ultimate goal for a lot of students, myself included. I'm obviously not in favor of throwing money out the window, but if there are things at one school that I significantly care about, I'm willing to pay for it.

We will all have enough money to live happy comfortable lives with plenty of toys if that's what you want. I'm not saying disregard money, but perhaps we should cut some of the religious zeal with which people are being advised to make money the centerpiece of every decision.

A few things:

-I don't think anyone is advising people with "religious zeal" or to "make money the centerpiece of every decision." That's a bit hyperbolic. What people ARE doing (myself included) is trying to put those costs in context.

-It should be obvious from this thread there is a pretty huge lack of understanding about how compound interest works. You don't simply pay off $80k in loans by paying $30k/yr for three more years. This is also a significant problem. Many premeds THINK they're making a good decision ("oh, it's only $80k more, that's no prob when I'll be making $400k/yr as a cardiologist") when in reality they aren't because they don't understand some basic personal finance and/or are basing their decision on blatantly incorrect information.

-Finally, people are going to make the decisions they're going to make. However, they would also do well by listening to the advice from others that have gone through the process. By no means should you follow that advice unconditionally, BUT medical students, residents, and physicians that have already done this research and made these decisions have more wisdom about both 1) the consequences of such a choice and 2) prioritizing what is actually important and what isn't. Of course everyone is looking for different things in schools, however I find it highly unlikely that anything at a school is worth spending $100k more to get. Thinking that way is being either short-sighted or thinking that things are more important than they actually are. I'm a huge advocate for P/F and unranked grading schemes, but even I wouldn't go pay $100k+ to go to a school with those very desirable features if I had a much cheaper option. I guess I'm just at a loss for what you could possibly discover in the course of an interview day, MAYBE a second look weekend, and somewhat superficial discussions with students and faculty that would convince you, "yes, I would love to pay thousands more dollars per month for years because of this/these lovely feature(s)!" Perhaps the only exceptions to this I can think of are if living near family is a must OR if you're moving with a significant other and must consider his/her preferences as well.

I guess my point is that no one is begrudging you for the decisions you make - I (and I'm sure everyone else) certainly don't care if you take yourself into a financial ****hole. In my experience, however, an overwhelming majority of pre-meds 1) don't understand the consequences of acquiring so much education debt, ESPECIALLY if you already have a ton of undergrad debt, and 2) are myopically focused on utterly unimportant things in the long run such that they're willing to acquire that debt for nonsensical reasons.

 

[Narmerguy]

A few things:

-I don't think anyone is advising people with "religious zeal" or to "make money the centerpiece of every decision." That's a bit hyperbolic. What people ARE doing (myself included) is trying to put those costs in context.

-It should be obvious from this thread there is a pretty huge lack of understanding about how compound interest works. You don't simply pay off $80k in loans by paying $30k/yr for three more years. This is also a significant problem. Many premeds THINK they're making a good decision ("oh, it's only $80k more, that's no prob when I'll be making $400k/yr as a cardiologist") when in reality they aren't because they don't understand some basic personal finance and/or are basing their decision on blatantly incorrect information.

-Finally, people are going to make the decisions they're going to make. However, they would also do well by listening to the advice from others that have gone through the process. By no means should you follow that advice unconditionally, BUT medical students, residents, and physicians that have already done this research and made these decisions have more wisdom about both 1) the consequences of such a choice and 2) prioritizing what is actually important and what isn't. Of course everyone is looking for different things in schools, however I find it highly unlikely that anything at a school is worth spending $100k more to get. Thinking that way is being either short-sighted or thinking that things are more important than they actually are. I'm a huge advocate for P/F and unranked grading schemes, but even I wouldn't go pay $100k+ to go to a school with those very desirable features if I had a much cheaper option. I guess I'm just at a loss for what you could possibly discover in the course of an interview day, MAYBE a second look weekend, and somewhat superficial discussions with students and faculty that would convince you, "yes, I would love to pay thousands more dollars per month for years because of this/these lovely feature(s)!" Perhaps the only exceptions to this I can think of are if living near family is a must OR if you're moving with a significant other and must consider his/her preferences as well.

I guess my point is that no one is begrudging you for the decisions you make - I (and I'm sure everyone else) certainly don't care if you take yourself into a financial ****hole. In my experience, however, an overwhelming majority of pre-meds 1) don't understand the consequences of acquiring so much education debt, ESPECIALLY if you already have a ton of undergrad debt, and 2) are myopically focused on utterly unimportant things in the long run such that they're willing to acquire that debt for nonsensical reasons.

I strongly disagree with you on multiple counts.

-Yes, multiple, many people on SDN do advise others with a fervor to make the cost difference their primary consideration. If the cost difference isn't below some arbitrary threshold ($30,000 let's say?) then others are told quite strongly a) all medical schools will train you well b) prestige doesn't matter c) you think stuff matters now but you don't realize it doesn't matter d) that interest and total costs will be crippling afterward e) you don't earn more money for going to a better school f) there's no significant differences between medical schools g) residencies are all that really matter h) residencies don't care what school you've been to etc etc etc. The arguments are very one-sided, and presented as if there is little or no rational reason to choose otherwise. I am not at all being hyperbolic and I'm speaking from experience of reading this forum for over 5 years where this topic comes up once a month or more.

-You have as much a basis for determining what is worth spending $100K on a school as you have a basis for determining what is worth spending $100K more on a house, or my children's education, or making manny $100k less because of my choice of specialty. Your claim that people who disagree must be either short-sighted or mistaken paints quite broadly over hundreds of students at these institutions every year, and the thousands and thousands that have attended. As I recall, there are multiple medical students, residents, and physicians who welcome and encourage students to attend these schools--yours is not the exclusive position of seniority.

-I am not at all suggesting that you are wrong in pointing out the financial consequences of these decisions and I am under no illusions that anyone is concerned with my personal or financial well-being. However, there's a difference between pointing out a fact--that being the incredible amount of money one will have to pay, especially when interest is accounted for--and declaring a single, rational conclusion from that fact--we must all strive to limit the amount we pay as much as possible to a certain small amount before considering other factors.

I greatly appreciate how focused SDN is on making sure students do not take on these debts lightly, and I appreciate that maybe some of this is even motivated by genuine concern for others' wellbeing. But to continue to portray the medical school selection decision so narrowly does a serious disservice to applying students, is incredibly belittling to the hundreds of students that attend these schools every year, and quite honestly smacks of arrogance.

I hope you understand I do not direct this at you, as I'm not aware of the nuances of your position.

 

[NickNaylor]

I strongly disagree with you on multiple counts.

-Yes, multiple, many people on SDN do advise others with a fervor to make the cost difference their primary consideration. If the cost difference isn't below some arbitrary threshold ($30,000 let's say?) then others are told quite strongly a) all medical schools will train you well b) prestige doesn't matter c) you think stuff matters now but you don't realize it doesn't matter d) that interest and total costs will be crippling afterward e) you don't earn more money for going to a better school f) there's no significant differences between medical schools g) residencies are all that really matter h) residencies don't care what school you've been to etc etc etc. The arguments are very one-sided, and presented as if there is little or no rational reason to choose otherwise. I am not at all being hyperbolic and I'm speaking from experience of reading this forum for over 5 years where this topic comes up once a month or more.

-You have as much a basis for determining what is worth spending $100K on a school as you have a basis for determining what is worth spending $100K more on a house, or my children's education, or making manny $100k less because of my choice of specialty. Your claim that people who disagree must be either short-sighted or mistaken paints quite broadly over hundreds of students at these institutions every year, and the thousands and thousands that have attended. As I recall, there are multiple medical students, residents, and physicians who welcome and encourage students to attend these schools--yours is not the exclusive position of seniority.

-I am not at all suggesting that you are wrong in pointing out the financial consequences of these decisions and I am under no illusions that anyone is concerned with my personal or financial well-being. However, there's a difference between pointing out a fact--that being the incredible amount of money one will have to pay, especially when interest is accounted for--and declaring a single, rational conclusion from that fact--we must all strive to limit the amount we pay as much as possible to a certain small amount before considering other factors.

I greatly appreciate how focused SDN is on making sure students do not take on these debts lightly, and I appreciate that maybe some of this is even motivated by genuine concern for others' wellbeing. But to continue to portray the medical school selection decision so narrowly does a serious disservice to applying students, is incredibly belittling to the hundreds of students that attend these schools every year, and quite honestly smacks of arrogance.

I hope you understand I do not direct this at you, as I'm not aware of the nuances of your position.

Frankly reasons a-h and beyond all seem like pretty good reasons to not spend a ton of money on your medical education if you can avoid it. By the way, there's a TON of emphasis on picking the place that you will be "happiest" at. Does that mean if you don't attend that place that you WON'T be happy and are doomed to despair for your medical education? It seems like there's a false dichotomy of "I must attend school A or I will be unhappy." That's a pretty immature position to take.

With respect to my position, hopefully I don't come across as preaching from the mount and decreeing divine orders from above. I certainly don't want to be perceived that way. But this is something that I've spoken to a lot of people about and feel pretty strongly about. You have a good head on your shoulders and seem to understand the choice(s) you will face. However, you should also understand that you're in the minority by far. An overwhelming majority of premeds and even medical students and residents have almost zero understanding of personal finance.

I think the tl;dr of my position and perhaps others' is that people shouldn't be so quick to make a choice to attend a school in the midst of the excitement and make an uneducated decision. As I said before, I have no skin in the game and don't care about the choices people make. However I will do my absolute best to challenge the assertion that you should attend an expensive school that "makes you happy" or for whatever reasons others come up with even if it only causes someone to spend just 5 or 10 minutes to learn about the cost of medical school loans and ponder the reality of their future financial situation. I understand I might come across as dismissing people's individual choices for what's important, but the reality is that you will almost certainly be happy no matter where you attend. Given that, it seems to me the best choice would be to strike the best balance of cost and happiness, perhaps putting more focus on cost. I know that others don't share my priorities with respect to picking a school, but anyone who is taking loans out to pay for their education should educate themselves about the cost and be aware of the real and tangible impact that they will have on their daily lives in the future. Since most premeds don't have that knowledge, that's my goal. There's a ton of excitement around medical admissions and schools, other students, and things like SDN do a good job of keeping that whirlwind going. It can be easy to make an emotional decision with no rational input. Again, I'm not saying that one is necessarily better than the other, but only that BOTH should have a place at the table.

(sent from my phone)

 

[impact2d]

A few things:

-I don't think anyone is advising people with "religious zeal" or to "make money the centerpiece of every decision." That's a bit hyperbolic. What people ARE doing (myself included) is trying to put those costs in context.

-It should be obvious from this thread there is a pretty huge lack of understanding about how compound interest works. You don't simply pay off $80k in loans by paying $30k/yr for three more years. This is also a significant problem. Many premeds THINK they're making a good decision ("oh, it's only $80k more, that's no prob when I'll be making $400k/yr as a cardiologist") when in reality they aren't because they don't understand some basic personal finance and/or are basing their decision on blatantly incorrect information.

-Finally, people are going to make the decisions they're going to make. However, they would also do well by listening to the advice from others that have gone through the process. By no means should you follow that advice unconditionally, BUT medical students, residents, and physicians that have already done this research and made these decisions have more wisdom about both 1) the consequences of such a choice and 2) prioritizing what is actually important and what isn't. Of course everyone is looking for different things in schools, however I find it highly unlikely that anything at a school is worth spending $100k more to get. Thinking that way is being either short-sighted or thinking that things are more important than they actually are. I'm a huge advocate for P/F and unranked grading schemes, but even I wouldn't go pay $100k+ to go to a school with those very desirable features if I had a much cheaper option. I guess I'm just at a loss for what you could possibly discover in the course of an interview day, MAYBE a second look weekend, and somewhat superficial discussions with students and faculty that would convince you, "yes, I would love to pay thousands more dollars per month for years because of this/these lovely feature(s)!" Perhaps the only exceptions to this I can think of are if living near family is a must OR if you're moving with a significant other and must consider his/her preferences as well.

I guess my point is that no one is begrudging you for the decisions you make - I (and I'm sure everyone else) certainly don't care if you take yourself into a financial ****hole. In my experience, however, an overwhelming majority of pre-meds 1) don't understand the consequences of acquiring so much education debt, ESPECIALLY if you already have a ton of undergrad debt, and 2) are myopically focused on utterly unimportant things in the long run such that they're willing to acquire that debt for nonsensical reasons.

Couldn't have said it better

Sent from my ADR6400L using SDN Mobile

 

[Praefectus]

A few things:

-I don't think anyone is advising people with "religious zeal" or to "make money the centerpiece of every decision." That's a bit hyperbolic. What people ARE doing (myself included) is trying to put those costs in context.

-It should be obvious from this thread there is a pretty huge lack of understanding about how compound interest works. You don't simply pay off $80k in loans by paying $30k/yr for three more years. This is also a significant problem. Many premeds THINK they're making a good decision ("oh, it's only $80k more, that's no prob when I'll be making $400k/yr as a cardiologist") when in reality they aren't because they don't understand some basic personal finance and/or are basing their decision on blatantly incorrect information.

-Finally, people are going to make the decisions they're going to make. However, they would also do well by listening to the advice from others that have gone through the process. By no means should you follow that advice unconditionally, BUT medical students, residents, and physicians that have already done this research and made these decisions have more wisdom about both 1) the consequences of such a choice and 2) prioritizing what is actually important and what isn't. Of course everyone is looking for different things in schools, however I find it highly unlikely that anything at a school is worth spending $100k more to get. Thinking that way is being either short-sighted or thinking that things are more important than they actually are. I'm a huge advocate for P/F and unranked grading schemes, but even I wouldn't go pay $100k+ to go to a school with those very desirable features if I had a much cheaper option. I guess I'm just at a loss for what you could possibly discover in the course of an interview day, MAYBE a second look weekend, and somewhat superficial discussions with students and faculty that would convince you, "yes, I would love to pay thousands more dollars per month for years because of this/these lovely feature(s)!" Perhaps the only exceptions to this I can think of are if living near family is a must OR if you're moving with a significant other and must consider his/her preferences as well.

I guess my point is that no one is begrudging you for the decisions you make - I (and I'm sure everyone else) certainly don't care if you take yourself into a financial ****hole. In my experience, however, an overwhelming majority of pre-meds 1) don't understand the consequences of acquiring so much education debt, ESPECIALLY if you already have a ton of undergrad debt, and 2) are myopically focused on utterly unimportant things in the long run such that they're willing to acquire that debt for nonsensical reasons.

👍 A personal finance course should be required to graduate from college. It's a crying shame that people are so ignorant about compound interest. A nice little fact to think about is that the vast majority of workers over the age of 50 in this country have less than $25k in their 401k's and IRAs. I rarely share this personal bit of information, but I've maxed out my Roth IRA every year since 2009 and I've made a killing because the Dow has nearly doubled in that time period. Even if you can't manage that, contribute as much as you can and try to limit your spending. People tend to grow into their incomes when they come into money, so take any excess and dump it into savings and investments.

 

[Geebeejay]

I see the argument that there isn't anything that happens on interview day that should convince you to drop an extra 100k+, but I don't think that's true. Besides touring facilities and seeing which ones are better, seeing if you gel with the medical students and seeing whether or not the medical students seem HAPPY or MISERABLE is a huge consideration. I would happily cough up money that I will certainly be able to pay back on a physician's salary with responsible budgeting (might have to wait 10 years before buying that bmw, that house in the suburbs, and having 5 kids that might possibly get cancer) for four years that are pleasant as opposed to awful. I'm not even touching the fact that certain schools that probably cost more money tend to match students into better residencies.

Maybe my view is skewed because I don't have any undergrad debt, but as someone who has survived most of my life in a family that did not make close to six figures, and with a ****-paying job, I think I'll do okay with a physician's salary minus a substantial, yet comparably small debt repayment. I have met doctors (few) that complain about money issues, underpayment, blah blah blah before driving home in their corvettes to their suburban paradise, but have never met a doctor who is broke.

 

[sector9]

I see the argument that there isn't anything that happens on interview day that should convince you to drop an extra 100k+, but I don't think that's true. Besides touring facilities and seeing which ones are better, seeing if you gel with the medical students and seeing whether or not the medical students seem HAPPY or MISERABLE is a huge consideration. I would happily cough up money that I will certainly be able to pay back on a physician's salary with responsible budgeting (might have to wait 10 years before buying that bmw, that house in the suburbs, and having 5 kids that might possibly get cancer) for four years that are pleasant as opposed to awful. I'm not even touching the fact that certain schools that probably cost more money tend to match students into better residencies.

Maybe my view is skewed because I don't have any undergrad debt, but as someone who has survived most of my life in a family that did not make close to six figures, and with a ****-paying job, I think I'll do okay with a physician's salary minus a substantial, yet comparably small debt repayment. I have met doctors (few) that complain about money issues, underpayment, blah blah blah before driving home in their corvettes to their suburban paradise, but have never met a doctor who is broke.

I think that most of my issue with some of the posts on here are that some posters, including yourself, seem to be painting a picture of picking between some imaginary, top-ranked med school that is your only possible route to happiness and a med school that will cause you such insufferable pain and suffering that you couldn't possibly hope to do well. And the perfect med school is worth any amount of money to end up at.

I mean, is four years really that long? And do you really think that at some imaginary "perfect" med school that you'll get along with all of your classmates, your studying will be blissfully perfect, and you'll automatically get AOA and your top residency? Such a pipe dream is totally unrealistic.

Med school is only 4 years. You'll find your clique in your med school class no matter where you go, some students in your class are bound to annoy you, and you'll all come out at the end doctors with the same degree. If you have the opportunity to save some money along the way, then that should factor into your decision. I won't say that it is the top or only consideration, but I would definitely be open to the notion that your best choice when picking a med school may not be your absolute favorite school. Money should play some role in your decision.

 

[circulus vitios]

Maybe my view is skewed because I don't have any undergrad debt, but as someone who has survived most of my life in a family that did not make close to six figures, and with a ****-paying job, I think I'll do okay with a physician's salary minus a substantial, yet comparably small debt repayment. I have met doctors (few) that complain about money issues, underpayment, blah blah blah before driving home in their corvettes to their suburban paradise, but have never met a doctor who is broke.

Today's attendings had much lower tuition rates and interest rates on their med school loans. Even today's residents had a better time as they could get med school loans at ~5% interest rates, and I think Congress recently removed subsidized loans for grad school loans. If you take out $380,000 in loans for med school, you won't be able to drive a Corvette until you're in your mid 40s.

 

[Geebeejay]

I think that most of my issue with some of the posts on here are that some posters, including yourself, seem to be painting a picture of picking between some imaginary, top-ranked med school that is your only possible route to happiness and a med school that will cause you such insufferable pain and suffering that you couldn't possibly hope to do well. And the perfect med school is worth any amount of money to end up at.

I mean, is four years really that long? And do you really think that at some imaginary "perfect" med school that you'll get along with all of your classmates, your studying will be blissfully perfect, and you'll automatically get AOA and your top residency? Such a pipe dream is totally unrealistic.

Med school is only 4 years. You'll find your clique in your med school class no matter where you go, some students in your class are bound to annoy you, and you'll all come out at the end doctors with the same degree. If you have the opportunity to save some money along the way, then that should factor into your decision. I won't say that it is the top or only consideration, but I would definitely be open to the notion that your best choice when picking a med school may not be your absolute favorite school. Money should play some role in your decision.

I think what you posted is a little extreme, but I understand your sentiment....I'm sure I'll do "fine" in any medical school I get into, but if I'm gonna be spending all of this money (I'd still be taking out 200k in loans at my state school), why not take out another 80k for an education that I think will just be better. Schools have different philosophies (or so they say they do) in their education and the type of doctor they try to produce, so I think I would do better in a school where I agree more with their philosophy. I do want to save money if it makes sense to, but I think there is still a bit of an exaggeration onto how much burden it's gonna cost me if I spend that extra 80k on medical school. I know that subsidized stafford loans don't exist anymore, and I know I'm going to have to eventually pay a little more than double whatever loan I take out, but I'll be able to. I think 4 years is a long time (currently, 4 years = 16.67 percent of my life) and I want those 4 years to be as good as possible at a school I think I will succeed best in.

I don't want to seem argumentative, I think you're right on most of your points, I only think the other perspective I'm providing isn't entirely foolish.

I'll end with this fact (unfortunately for both of us, neither what I say or what you say are facts): Of the 40 or so residents I work with (a top residency program) one student went to U of Illinois, one to UVM and one student went to our state school. As far as the others, there's certainly a trend. The schools they represent are Wash U, Penn, Pitt, HMS, BU, Michigan, Yeshiva, NYU, Stanford, Case Western, NU etc. While I think you can pave your own road to a degree, I 100% don't believe that where you went to med school has no real influence on where you match, and I think it's reasonable to consider which school will give you the best chances of matching into your top residency choice, whatever that choice ends up being.

 

[Geebeejay]

Today's attendings had much lower tuition rates and interest rates on their med school loans. Even today's residents had a better time as they could get med school loans at ~5% interest rates, and I think Congress recently removed subsidized loans for grad school loans. If you take out $380,000 in loans for med school, you won't be able to drive a Corvette until you're in your mid 40s.

I still stand by my point...with smart spending and a reasonable budget and repayment plan, I see repaying even 380000 in loans on a physicians salary as a burden but not a real problem.

 

[JJMrK]

Are you dead-set on a competitive specialty or big name academic residency? If so, 80k and Iowa's name might be worth it. OTOH, the 2 biggest factors that determine your future after med school: 1) step 1 2) are you normal/cool/a team player during MS3. The first you can kill at any school, and the second probably won't change much no matter where you go.

 

[FSU2013]

I would go to medical school in Guantanamo bay if it saved me 80k. I sacrifice some happiness, but imagine how much happiness for how many people 80k in charity could do. I am willing to be a little less happy with how the building smells or what color the walls are painted or how much traffic there is around campus or the options in the cafeteria if it means 80k in cancer research or 80k in African wells or 80k for a scholarship fund for underprivileged youth.

Shoot, my brother-in-law just got back from serving there. He said they (the prisoners) were loving the good life - no joke.

 

[Bumbl3b33]

Jumping in kind of late, I guess, but wanted to make 2 points

1) this thread reminds me that the old stereotype that doctors are bad with money starts well before their careers start haha

2) Many people echo QuesoAndFromage's sentiment that "when I am happy I will perform MUCH better, leading to better grades and residency options"

I respect this. BUT what you don't account for is--what if you get there, think you'll love it, then end up not loving it because..well...it's medical school...OR get an experience comparable to what your state school would ultimately have given you. You guys forget that debt is still capital. Someone earlier made the argument "you can't place a price on happiness"...well, didn't you just place a price on it by agree to pay 80k/year in an expensive city when you could have gone to a cheaper one? My point is, In an instant your debt will be for naught if the price that you placed on your happiness was too high, as guaged by the return you get vis-a-vis your happiness at the school. And how do you know you won't be happy at another school that is cheaper? What intrinsic factor makes an INSTITUTION a gatekeeper of your happiness and its levels? Either way, the guy who went to the cheaper school, still made friends, still did well at said cheaper school? He's laughing all the way to the bank, woo!

Frankly this mentality that "oh if i'm at X SOM where 100 neurosurg residents are pumped out every year I'll love my life!!!!" (i'm looking at you georgetown) is usually echoed by people who are searching for something superficial (aka aren't entirely happy people) or are, put bluntly, super immature which is probably why they are unable to find happiness from within. Or looking for tail in a big city haha. I saw a lot of this at a certain 80k/year school. Besides, this notion that "if i go to a good school i'm 99% more likely to match into neurosurgery" is, as Joe Biden would say, milarkey and a myth perpetuated by pre-meds because they are honor and accolade ******. I've met some completely badass residents from EVMS and Drexel that are in RadOnc and Ortho---you couldn't convince me in a million years to take on thousands of dollars of debt at 6.8% INTEREST (I mean seriously, the banks just got as good a return from you as a player in the stock market) but that's just me.

In my opinion, this is argument will go no where. People will go where they go and their decisions are based off of their socioeconomic standing and comfort with debt. Some people are just good with knowing they have debt and can sleep at night because they've never seen a day with financial troubles. I'm not one of those people: my family was dirt poor when I was young. So....yeah...haha, to each his own! 🙂

 

[HSUReddie]

I'm going to give my two cents since I'm an Arkansas resident too....

I've been having similar thoughts myself (although, at this point, this year, I think my only shot is in-state). However, if I have to apply next year, I think I will be finding myself making similar decisions so I've been musing about this too.

To the person who said anywhere is better because, face it, it's Arkansas - yes, we know. Lately we don't have the greatest reputation as far as state politicians go, and everyone thinks we're backwards hicks. 🙄 Thank you for reminding me. That being said, I would venture to argue that UAMS could be considered a better option than some states with multiple state schools. Fact of the matter is, Arkansas can only pump money into one medical school - and really, in my opinion, the facilities are quite nice considering the price of the education. That being said, TipToad, if you're wanting to pursue some sort of prestigious research career or something, I might venture to say UAMS isn't the best option - of course. For me, there a lot of things to consider... I actually do happen to like Little Rock very much (seriously missing the mountains down here in New Orleans so far) - and ultimately, if I do pediatrics, I would love to do a residency with UAMS at Arkansas Children's Hospital. I have a lot of personal ties there, and it's actually one of the largest pediatric hospitals in the nation - #13 as of 2011 - and I'm sure with the addition of the South Wing this year, it has to break top ten. And believe it or not, we're nationally ranked in pediatric cardiology. For me, that's a big draw to UAMS. For you or someone else, maybe not so much.

I guess, overall, it depends on if what you want to do in medicine outweighs the value and location. I'm not sure how you feel about Arkansas - I mean I miss certain aspects now that I've moved, but I cringe at certain things as well. I think places are going to have their positives and their negatives for sure. Before I decided on a grad school, I made a list of factors and assigned them numerical values and "gave points" to each school. In my opinion, it really helped.

 

[TipToad]

I'm going to give my two cents since I'm an Arkansas resident too....

I've been having similar thoughts myself (although, at this point, this year, I think my only shot is in-state). However, if I have to apply next year, I think I will be finding myself making similar decisions so I've been musing about this too.

To the person who said anywhere is better because, face it, it's Arkansas - yes, we know. Lately we don't have the greatest reputation as far as state politicians go, and everyone thinks we're backwards hicks. 🙄 Thank you for reminding me. That being said, I would venture to argue that UAMS could be considered a better option than some states with multiple state schools. Fact of the matter is, Arkansas can only pump money into one medical school - and really, in my opinion, the facilities are quite nice considering the price of the education. That being said, TipToad, if you're wanting to pursue some sort of prestigious research career or something, I might venture to say UAMS isn't the best option - of course. For me, there a lot of things to consider... I actually do happen to like Little Rock very much (seriously missing the mountains down here in New Orleans so far) - and ultimately, if I do pediatrics, I would love to do a residency with UAMS at Arkansas Children's Hospital. I have a lot of personal ties there, and it's actually one of the largest pediatric hospitals in the nation - #13 as of 2011 - and I'm sure with the addition of the South Wing this year, it has to break top ten. And believe it or not, we're nationally ranked in pediatric cardiology. For me, that's a big draw to UAMS. For you or someone else, maybe not so much.

I guess, overall, it depends on if what you want to do in medicine outweighs the value and location. I'm not sure how you feel about Arkansas - I mean I miss certain aspects now that I've moved, but I cringe at certain things as well. I think places are going to have their positives and their negatives for sure. Before I decided on a grad school, I made a list of factors and assigned them numerical values and "gave points" to each school. In my opinion, it really helped.

TBH, I really like UAMS. I really really do. I know that I can be happy here. I'm not planning on having a high-power academic career or anything like that. I just wanna go into Peds. What's attracting me to Iowa is not just the school but the atmosphere of the state. It's just a lot more accepting of LGBT people. I live in central AR, and I can't go outside with my significant other without getting a handful of stares. It gets old.

 

[sodarayg]

It seems like people who think price doesn't really matter look at the difference between their possible debt and their possible upcoming salaries and say, wow i can pay this off easily. but in reality your salary doesn't magically appear in your bank account right when you finish all of your training and when you work hard during those 40-80 hour weeks in the future you'll wish you could keep more of each paycheck instead of using a big chunk of it paying back your loans.

 

[Aerus]

Jumping in kind of late, I guess, but wanted to make 2 points

1) this thread reminds me that the old stereotype that doctors are bad with money starts well before their careers start haha

2) Many people echo QuesoAndFromage's sentiment that "when I am happy I will perform MUCH better, leading to better grades and residency options"

I respect this. BUT what you don't account for is--what if you get there, think you'll love it, then end up not loving it because..well...it's medical school...OR get an experience comparable to what your state school would ultimately have given you. You guys forget that debt is still capital. Someone earlier made the argument "you can't place a price on happiness"...well, didn't you just place a price on it by agree to pay 80k/year in an expensive city when you could have gone to a cheaper one? My point is, In an instant your debt will be for naught if the price that you placed on your happiness was too high, as guaged by the return you get vis-a-vis your happiness at the school. And how do you know you won't be happy at another school that is cheaper? What intrinsic factor makes an INSTITUTION a gatekeeper of your happiness and its levels? Either way, the guy who went to the cheaper school, still made friends, still did well at said cheaper school? He's laughing all the way to the bank, woo!

Frankly this mentality that "oh if i'm at X SOM where 100 neurosurg residents are pumped out every year I'll love my life!!!!" (i'm looking at you georgetown) is usually echoed by people who are searching for something superficial (aka aren't entirely happy people) or are, put bluntly, super immature which is probably why they are unable to find happiness from within. Or looking for tail in a big city haha. I saw a lot of this at a certain 80k/year school. Besides, this notion that "if i go to a good school i'm 99% more likely to match into neurosurgery" is, as Joe Biden would say, milarkey and a myth perpetuated by pre-meds because they are honor and accolade ******. I've met some completely badass residents from EVMS and Drexel that are in RadOnc and Ortho---you couldn't convince me in a million years to take on thousands of dollars of debt at 6.8% INTEREST (I mean seriously, the banks just got as good a return from you as a player in the stock market) but that's just me.

In my opinion, this is argument will go no where. People will go where they go and their decisions are based off of their socioeconomic standing and comfort with debt. Some people are just good with knowing they have debt and can sleep at night because they've never seen a day with financial troubles. I'm not one of those people: my family was dirt poor when I was young. So....yeah...haha, to each his own! 🙂

You make really good points. Sometimes, it is pretty easy to determine if you'll be happy there or not, not because of the school itself, but because of other factors (Close to family, weather, city-life [not that you will enjoy this very much], significant other, etc.)

The factors mentioned above are very easy to spot by going to X school and not Y school.

Tl;dr I'm all for paying more money if you know you're going to be significantly happier at a certain school than another.

 

[HSUReddie]

TBH, I really like UAMS. I really really do. I know that I can be happy here. I'm not planning on having a high-power academic career or anything like that. I just wanna go into Peds. What's attracting me to Iowa is not just the school but the atmosphere of the state. It's just a lot more accepting of LGBT people. I live in central AR, and I can't go outside with my significant other without getting a handful of stares. It gets old.

I hear you. I'm not LGBT myself, but the lack of acceptance is one of those things that really bothers me about Arkansas. And in reality, it's not just that - there's a list of other things the majority of people are unaccepting towards. Living in New Orleans so far has made me realize how conservative Arkansas can be. I know there a little pockets of wonderfully progressive and moderate people back home though. And in a way, I guess I sort of want to be that minority because I know if we all moved out of Arkansas because of the majority, well, according to the news as of late, slavery would still be okay and parents should give their kids the death penalty. Someone has to stick around to make sure the state doesn't fall into the wrong hands. 😎

 

[FSU2013]

2) Many people echo QuesoAndFromage's sentiment that "when I am happy I will perform MUCH better, leading to better grades and residency options"

It doesn't matter where you are, you will be unhappy during parts of med school. Second year comes to mind....