Will your student loans affect what residency you go into?

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You guys are depressing me with all of your calculations.:oops: :smuggrin: :laugh:

The money goes quick.

My fiancee makes a good salary and we never seem to have tons of cash in the bank.

We own a house, 2 cars and nice things...all of which cost money. Not to mention monthly vacations. (which are a thing of the past come July!)

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The money goes quick.

My fiancee makes a good salary and we never seem to have tons of cash in the bank.

We own a house, 2 cars and nice things...all of which cost money. Not to mention monthly vacations. (which are a thing of the past come July!)


Believe me, I know it goes fast. I never seem to have enough; too many kids and too many bills! But, I am confident that I will be able to live the lifestyle that I want on a rural FMs salary.:)

It is rather depressing though. :rolleyes:
 
Believe me, I know it goes fast. I never seem to have enough; too many kids and too many bills! But, I am confident that I will be able to live the lifestyle that I want on a rural FMs salary.:)

It is rather depressing though. :rolleyes:



It is depressing when I realize that if I go into FP and take a 30yr loan repayment schedule, it won't be paid off until I reach retirement age. I know you can pay it off faster, but the odds of that aren't that great unless I have some great investments that pan out.
 
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It is depressing when I realize that if I go into FP and take a 30yr loan repayment schedule, it won't be paid off until I reach retirement age. I know you can pay it off faster, but the odds of that aren't that great unless I have some great investments that pan out.

If you do OMT you can make enough additional salary to cover your loan payment.

Medicare pays $25.00 for treating a patient with OMT in 1-2 body areas.

Key is you need to be good at OMT in order to get the clinical results and be fast enough to make it worth your time.
 
Moonlight can help you pay of your loans during residency.
 
Moonlight can help you pay of your loans during residency.
but you probably won't pay them off and remember that moonlighting has tax implications as well ...

I also want to mention that the whole premise of some of these calculations will lead you to conclude .... GET A GOOD ACCOUTANT. Get diversified investments to help lower your taxable income. ;) After the majority of tax deductions that you can get you should have more "take home" income if you play your numbers right.
 
Orthopedic surgeons that drive Toyotas are doing so as a matter of choice.
 
Or they have 6 kids and a VERY large house!

But anyway I argued against myself on that one, so, never mind.....!
 
It is depressing when I realize that if I go into FP and take a 30yr loan repayment schedule, it won't be paid off until I reach retirement age. I know you can pay it off faster, but the odds of that aren't that great unless I have some great investments that pan out.

If you go into FM, there is no reason that you need to pay your loans back yourself. There are plenty of programs out there for primary care doctors. They are not just in rural areas either. I am close to being able to have someone pay for med school while I am IN school. If that doesn't work out, I think almost all of the hospitals in the area are offering loan repayment. I agree that 150,000 does not go that far once you start adding in everything else, but for the primary care doctors there are a lot of options. Don't despair! It will work out.:)
 
Harvey,

In the state of MO (I realize you might want to head back to Chicago, but since you're going to KCUMB and I know the state a little bit, I'm going to give you what I know).

In the entire state of Missouri, there are FIVE, yes FIVE counties that are currently NOT considered underserved (meaning the other however many counties are all underserved). (I'm just hoping I didn't get my states confused, but I think both KS and MO have 5 counties that are NOT considered underserved).

These counties include two in KC and 3 in STL if I'm not mistaken. You go work primary care in virtually any of the other counties, and I'm quite sure you can work out a deal.

My IM physician came here straight from his residency at Mayo Clinic and part of the deal was he wanted his loans "taken care of"...they were more than happy to do it.

Now, St. Joe is nothing special, but it's a town of 80-100K that is easy driving distance to a much larger city (30 minutes). To me, that's the ideal situation...you get a less stressful environment, you get your loans paid, good schools, less crime, lower COL, etc...

I've been told my numerous docs (even at my age) to not worry about it too much because it will take care of itself. If you go into a high paying specialty, you will have the funds to pay it off...if you go primary care, someone will be more than willing to pay it off for you.
 
Or they have 6 kids and a VERY large house!

But anyway I argued against myself on that one, so, never mind.....!

True! :D

But kids = choice (for most people) :)
 
wow, what a depressing thread... So I guess this means I can't continue deferring my loans 'til I'm 50? :rolleyes:
 
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wow, what a depressing thread... So I guess this means I can't continue deferring my loans 'til I'm 50? :rolleyes:

If you find a way, let the rest of us know! :D

In the meantime, I am ignoring the calculations, because they don't help anything, they just make me worry.
And my answer to the original question is NO, I will not let loans affect what residency I go into.
I want to be happy to go to work - there are too many miserable people in the world, and I don't want to be one of them!
What I go into will depend on what I love, and hopefully it is the same as what I am good at!
 
If you find a way, let the rest of us know! :D

In the meantime, I am ignoring the calculations, because they don't help anything, they just make me worry.
And my answer to the original question is NO, I will not let loans affect what residency I go into.
I want to be happy to go to work - there are too many miserable people in the world, and I don't want to be one of them!
What I go into will depend on what I love, and hopefully it is the same as what I am good at!

:clap: :banana: :D :thumbup:
 
If you find a way, let the rest of us know! :D

In the meantime, I am ignoring the calculations, because they don't help anything, they just make me worry.
And my answer to the original question is NO, I will not let loans affect what residency I go into.
I want to be happy to go to work - there are too many miserable people in the world, and I don't want to be one of them!
What I go into will depend on what I love, and hopefully it is the same as what I am good at!

I agree with you orthodoc... we will have to ignore calculations-- especially since you really can't consider all the variables-- such as considering $7500 a month income and not including tax benefits for dependents, or adding your SO's income into the variable...

But having said that, debt is something my husband and I have discussed, and this is what we plan--- and no, I wouldn't mind being a sugar momma either :D --- Figure if I make $150k, which seems to be attainable no matter what profession you choose, that money is used for living expenses (mortgage, cars, dependent care, whatever). Whatever my husband makes, let's say he brings home $50k a year, we put his income into a separate account. I can quite easily set up a direct pay from that account from his salary to pay student loans we both have incurred. If we owe $300k in student loans after it's all said and done including interest, we can have these paid off in only 6 years.

And why do I say putting his salary into a separate account? Cause if you're like us, you'd think twice every month b4 sending out such big payments. But as we all know, what you DON'T SEE, you DON'T MISS, and you DON'T SPEND. So now, each year (hopefully) when both of our salaries increase, we can increase the amounts we pay towards debt to come out automatically, or use it as "cake" money... and still have our debt paid in 6 years, or less.

I have 2 small kids, work part time and make barely nothing. We do just fine now on mainly one income, including a mortgage ($200k house), 2 car payments, and everything else that comes with paying for life. As far as setting up additional savings or 401k in the beginning, I just don't think it's wise-- unless you're making more than 7% on you're investments you're losing money if you're paying that much in student loan interest. Once debt is paid, use the same strategies for direct debits for savings... at that point you could put away only $30k a year ($20k less than what you were paying out towards loans), and you and your SO can live quite nicely when it's time to retire.

So, my less wordy version :rolleyes: ...do what you love and use your money wisely... the payoff will be great both personally and financially!
 
Whatever my husband makes, let's say he brings home $50k a year, we put his income into a separate account. I can quite easily set up a direct pay from that account from his salary to pay student loans we both have incurred. If we owe $300k in student loans after it's all said and done including interest, we can have these paid off in only 6 years.

And why do I say putting his salary into a separate account? Cause if you're like us, you'd think twice every month b4 sending out such big payments. But as we all know, what you DON'T SEE, you DON'T MISS, and you DON'T SPEND. So now, each year (hopefully) when both of our salaries increase, we can increase the amounts we pay towards debt to come out automatically, or use it as "cake" money... and still have our debt paid in 6 years, or less.

So, my less wordy version :rolleyes: ...do what you love and use your money wisely... the payoff will be great both personally and financially!

Wow - I like you're plan!
Definitely true that what you don't see, you don't miss, and you don't spend.
 
hmm I wonder if I could do that with my fiance's 40k...

Just have to keep her from spending it on purses and shoes...

:laugh: Well you see, that's why you're putting that $40k into a separate account, and yes, with debit cards tucked away in a cabinet, to keep you both from dipping into there!
 
As far as setting up additional savings or 401k in the beginning, I just don't think it's wise-- unless you're making more than 7% on you're investments you're losing money if you're paying that much in student loan interest. Once debt is paid, use the same strategies for direct debits for savings... at that point you could put away only $30k a year ($20k less than what you were paying out towards loans), and you and your SO can live quite nicely when it's time to retire.

Good plan except for this part ... there are benefits to taking advantage of Roth IRA during residency/fellowship and 401k (or 403b) afterwards

Keep in mind a 7% yield on your investment is actually under performing. The average SP500 return (average over winning years and losing years) is around 8-10%. The Dow Jones average is slightly higher than that. Also realize that your student loans interest gets compounded (at certain frequency depending on your contract) so you end up paying interest on the interest accrues.

The advantage of a Roth IRA during residency/fellowship is that since the money you put in is post-tax, any money you withdraw at retirement is free of federal taxes. So while you are in the lower tax bracket, you put money it ... it sits and grows during your productive years as an attending, and when you are at the prime of your life (and top tax bracket), you can withdraw the money from your Roth IRA tax-free.

Also during your attending years, a 401k or 403b will be taken pre-taxed, and if you contribute enough, it may bump you down a tax bracket, so you end up paying less federal taxes. If you just take the money and put it in a savings account (or some sort of investment vehicle outside of retirement), you end up paying more in federal tax on your income but also you get taxed on your investment/saving returns. And if it is a 401k or 403b, there may be employer matching ... basically free money for retirement.

A wise investment once you start residency is to talk to a financial planner who can customize the right strategy for you and your family, taking into account what is important. The difference could be thousands if not hundreds of thousands of dollars over one's lifetime.
 
Good plan except for this part ... there are benefits to taking advantage of Roth IRA during residency/fellowship and 401k (or 403b) afterwards

Keep in mind a 7% yield on your investment is actually under performing. The average SP500 return (average over winning years and losing years) is around 8-10%. The Dow Jones average is slightly higher than that. Also realize that your student loans interest gets compounded (at certain frequency depending on your contract) so you end up paying interest on the interest accrues.

The advantage of a Roth IRA during residency/fellowship is that since the money you put in is post-tax, any money you withdraw at retirement is free of federal taxes. So while you are in the lower tax bracket, you put money it ... it sits and grows during your productive years as an attending, and when you are at the prime of your life (and top tax bracket), you can withdraw the money from your Roth IRA tax-free.

Also during your attending years, a 401k or 403b will be taken pre-taxed, and if you contribute enough, it may bump you down a tax bracket, so you end up paying less federal taxes. If you just take the money and put it in a savings account (or some sort of investment vehicle outside of retirement), you end up paying more in federal tax on your income but also you get taxed on your investment/saving returns. And if it is a 401k or 403b, there may be employer matching ... basically free money for retirement.

A wise investment once you start residency is to talk to a financial planner who can customize the right strategy for you and your family, taking into account what is important. The difference could be thousands if not hundreds of thousands of dollars over one's lifetime.

Agree with above (though I didnt read all of it)

Paying off your student loans faster isnt financially smart, especially if the interest rate is between 7-8%

Paying the minimums and taking extra income and putting it towards investments that will likely yield >8% is the way to go.

It would be a nice feeling to have student loans paid off in 6 years...but 10 years later when you find out that the $200,000 extra you put towards you loans up front could be $350,000 right now...thats a bad feeling.
 
hmm I wonder if I could do that with my fiance's 40k...

Just have to keep her from spending it on purses and shoes...

Well, it could be worse. She could have a love of collecting farm animals like certain people I know....:rolleyes: :laugh: ;)

(My horses will probably eat more money in hay and grain this year than those purses and shoes cost.):smuggrin: :laugh:
 
Good plan except for this part ... there are benefits to taking advantage of Roth IRA during residency/fellowship and 401k (or 403b) afterwards

The advantage of a Roth IRA during residency/fellowship is that since the money you put in is post-tax, any money you withdraw at retirement is free of federal taxes. So while you are in the lower tax bracket, you put money it ... it sits and grows during your productive years as an attending, and when you are at the prime of your life (and top tax bracket), you can withdraw the money from your Roth IRA tax-free.
Also want to add that as of right now, For Roth IRA if you make over:
Single:
Less than $95,000 Eligible for full contribution
$95,000 - $109,999 Eligible for partial contribution
$110,000 - $149,999 Not eligible to contribute
$150,000 - $159,999 Not eligible to contribute

Married:

Less than $95,000 Eligible for full contribution
$95,000 - $109,999 Eligible for full contribution
$110,000 - $149,999 Eligible for full contribution
$150,000 - $159,999 Eligible for partial contribution

You aren't eligible for Roth IRA after residency. Now ... in 2010 those rules will change because of a "loophole" and you can convert traditional IRAs (which have NO income requirement) into Roth IRA's but we'll see how long that lasts :cool:

Also during your attending years, a 401k or 403b will be taken pre-taxed, and if you contribute enough, it may bump you down a tax bracket, so you end up paying less federal taxes. If you just take the money and put it in a savings account (or some sort of investment vehicle outside of retirement), you end up paying more in federal tax on your income but also you get taxed on your investment/saving returns. And if it is a 401k or 403b, there may be employer matching ... basically free money for retirement.

A wise investment once you start residency is to talk to a financial planner who can customize the right strategy for you and your family, taking into account what is important. The difference could be thousands if not hundreds of thousands of dollars over one's lifetime.

I can't stress this enough. Everyone is so scare of debt that people don't realize there is GOOD debt and BAD debt. You are investing in your future make the MOST out of that investment.
 
I keep checking this thread to see if it gets more encouraging, but I am always disappointed....ugh!:(
 
Good plan except for this part ... there are benefits to taking advantage of Roth IRA during residency/fellowship and 401k (or 403b) afterwards

Keep in mind a 7% yield on your investment is actually under performing. The average SP500 return (average over winning years and losing years) is around 8-10%. The Dow Jones average is slightly higher than that. Also realize that your student loans interest gets compounded (at certain frequency depending on your contract) so you end up paying interest on the interest accrues.

The advantage of a Roth IRA during residency/fellowship is that since the money you put in is post-tax, any money you withdraw at retirement is free of federal taxes. So while you are in the lower tax bracket, you put money it ... it sits and grows during your productive years as an attending, and when you are at the prime of your life (and top tax bracket), you can withdraw the money from your Roth IRA tax-free.

Also during your attending years, a 401k or 403b will be taken pre-taxed, and if you contribute enough, it may bump you down a tax bracket, so you end up paying less federal taxes. If you just take the money and put it in a savings account (or some sort of investment vehicle outside of retirement), you end up paying more in federal tax on your income but also you get taxed on your investment/saving returns. And if it is a 401k or 403b, there may be employer matching ... basically free money for retirement.

A wise investment once you start residency is to talk to a financial planner who can customize the right strategy for you and your family, taking into account what is important. The difference could be thousands if not hundreds of thousands of dollars over one's lifetime.

I guess I should've made myself clearer-- when I was talking about "from the beginning" I was referring to when you've begun making atleast $150 a year, certainly not during residency. I don't think there's a resident out there than can put away $50k a year to pay off loans... But if you're able to swing it, by all means put away money during your residency in a Roth IRA or employer matched 401k-- but I think the amount that most will have extra during this time is minimal.

And you're absolutely right to meet with a financial planner-- the one I worked for always made plans to pay off debt in the short term. The fact that you mention that interest compounds on student loans adds to my point.

Agree with above (though I didnt read all of it)

Paying off your student loans faster isnt financially smart, especially if the interest rate is between 7-8%

Paying the minimums and taking extra income and putting it towards investments that will likely yield >8% is the way to go.

It would be a nice feeling to have student loans paid off in 6 years...but 10 years later when you find out that the $200,000 extra you put towards you loans up front could be $350,000 right now...thats a bad feeling.

I definately agree, but the trick will be finding an investment that yields over 8% in just 6 years time... the average of higher yielding investments does occur, but when you're looking at a longer time frame (not just 6 years). So if it's a risk you're OK with taking, go for it.

Also want to add that as of right now, For Roth IRA if you make over:
Single:
Less than $95,000 Eligible for full contribution
$95,000 - $109,999 Eligible for partial contribution
$110,000 - $149,999 Not eligible to contribute
$150,000 - $159,999 Not eligible to contribute

Married:

Less than $95,000 Eligible for full contribution
$95,000 - $109,999 Eligible for full contribution
$110,000 - $149,999 Eligible for full contribution
$150,000 - $159,999 Eligible for partial contribution

You aren't eligible for Roth IRA after residency. Now ... in 2010 those rules will change because of a "loophole" and you can convert traditional IRAs (which have NO income requirement) into Roth IRA's but we'll see how long that lasts :cool:



I can't stress this enough. Everyone is so scare of debt that people don't realize there is GOOD debt and BAD debt. You are investing in your future make the MOST out of that investment.

Interesting info about rule changes in expected in 2010... thanks

I agree that med school is an investment in your future, in both money and time. Student loans, however, are not GOOD debt, such as a house or something that is actually going to grow in value on its own. If something were to happen to me after med school, my family couldn't sell my loans to cover what I borrowed and put something in their pocket. Like I wrote above, unless you can guarantee that during the 6 years (during which you could aggressively pay off the loans) you will average more than the interest your paying, I'd still pay off the student loans.

This is giving me a headache... maybe I'll go ride some of docmom's horses :D
 
Actually, on Yahoo finance, there is a calculator that determines if you should put extra money towards debt or invest.

Here's the site:
http://finance.yahoo.com/calculator/banking-budgeting/bud-04

I put in 7% interest on debt, with 10% before tax return on investment, with a tax bracket of 28% (where most will fall if making $150k a year). Your after tax ROI will be 7.2%, IOW, you'll be making only .2% off investments that must make 10% before tax return, or you're in the hole. This is also not including if student loan interest payments are tax deductible (I know as an undergrad they are, I'm not sure about the loans we're talking about)-- if they are tax deductible, you'll definately be in the hole. :rolleyes:
 
I definately agree, but the trick will be finding an investment that yields over 8% in just 6 years time... the average of higher yielding investments does occur, but when you're looking at a longer time frame (not just 6 years). So if it's a risk you're OK with taking, go for it.

Agreed. Right out of school is the perfect time to take risks
 
I can't stress this enough. Everyone is so scare of debt that people don't realize there is GOOD debt and BAD debt. You are investing in your future make the MOST out of that investment.

If you figure out how I can get my wife to understand this, I would GREATLY appreciate it...I simply can't get through. Very smart woman, but this is something she just doesn't seem to get.
 
I'm going to show all you premeds a little secret


There's something everybody has forgotten: OMT

Suppose you did OMT just 5 times a week - 5 times a week would be very very little use of your OMT training. These can be simple techniques that I have found to be effective like sub-occipital release and rib raising, or counterstrain. Your patient's will apreciate these simple things - cause they work. It doesn't have to be a difficult techinique like myofascial release.


Now what if you charged $30.00 for each time you used OMT?

5 OMT a week

20 OMT uses a month, means $600 more.

$600 x 12 months = $7,200

So there you have it, $150,000 + $7,200.

So pay attention in OPP class. I know its tempting to study pharmacology or anatomy in OPP class, but OMT will pay off handsomely in the end. And you don't have to be an OMT guru either. Counterstrain isn't overwhelmingly hard to do - and many times is effective if you do it right.
 
I'm going to show all you premeds a little secret


There's something everybody has forgotten: OMT

Suppose you did OMT just 5 times a week - 5 times a week would be very very little use of your OMT training. These can be simple techniques that I have found to be effective like sub-occipital release and rib raising, or counterstrain. Your patient's will apreciate these simple things - cause they work. It doesn't have to be a difficult techinique like myofascial release.


Now what if you charged $30.00 for each time you used OMT?

5 OMT a week

20 OMT uses a month, means $600 more.

$600 x 12 months = $7,200

So there you have it, $150,000 + $7,200.

So pay attention in OPP class. I know its tempting to study pharmacology or anatomy in OPP class, but OMT will pay off handsomely in the end. And you don't have to be an OMT guru either. Counterstrain isn't overwhelmingly hard to do - and many times is effective if you do it right.

You're in DO school currently? I thought you were pre-med.
 
If you figure out how I can get my wife to understand this, I would GREATLY appreciate it...I simply can't get through. Very smart woman, but this is something she just doesn't seem to get.

My girlfriend is in the same boat as your wife. I try my hardest to explain this concept to her, but sometimes it just gets to frustrating for me to even continue.
 
I'm going to show all you premeds a little secret


There's something everybody has forgotten: OMT


Now what if you charged $30.00 for each time you used OMT?

5 OMT a week

20 OMT uses a month, means $600 more.

$600 x 12 months = $7,200

So there you have it, $150,000 + $7,200.

So pay attention in OPP class. I know its tempting to study pharmacology or anatomy in OPP class, but OMT will pay off handsomely in the end. And you don't have to be an OMT guru either. Counterstrain isn't overwhelmingly hard to do - and many times is effective if you do it right.

Uh - the guy I go to charges $80 for an hour.
(But yah - he's booked all day every day, sometimes sees people on weekends, 8 months out...)
 
Uh - the guy I go to charges $80 for an hour.
(But yah - he's booked all day every day, sometimes sees people on weekends, 8 months out...)

I believe it likely has to do with the regional familiarity of DOs/OMM. Not many people in the southeast know about DOs/OMM. We've got DOs who act like MDs any chance they get. Looks like I'm going to have to hope for a sign-on into a teaching hospital facility so I don't have to market on my own.
 
I believe it likely has to do with the regional familiarity of DOs/OMM. Not many people in the southeast know about DOs/OMM. We've got DOs who act like MDs any chance they get. Looks like I'm going to have to hope for a sign-on into a teaching hospital facility so I don't have to market on my own.

Not many DO's in the Northeast. He goes strictly by referrals of MD's that know his work.
But he is not a DO, he is a PT who is trained in OMT.
He trained privately w/Anne Wales for years & years.
 
Not many DO's in the Northeast. He goes strictly by referrals of MD's that know his work.
But he is not a DO, he is a PT who is trained in OMT.
He trained privately w/Anne Wales for years & years.

Oh .. a PT. Nevermind.

How are there not many DOs in the Northeast? One would expect otherwise with the massive establishment of osteopathic medical schools in the Northeast ...
 
Oh .. a PT. Nevermind.

How are there not many DOs in the Northeast? One would expect otherwise with the massive establishment of osteopathic medical schools in the Northeast ...

We hardly have any up around Albany, NY.
 
Uh - the guy I go to charges $80 for an hour.
(But yah - he's booked all day every day, sometimes sees people on weekends, 8 months out...)

To be well trained enough to provide this service, is it fair enough to say that the OMM that we learn in school is not enough? So either a 1yr fellowship or a pure OMM residency would be needed for this type of service?
 
Well, apparently the DCOM OPP professor was involved in the Anne Wales study group.
 
Well, that's not saying too much considering that apparently Albany doesn't have much of anything ... :laugh:

HEY!!! We have a lot of stuff up here...everything you could possibly need!:p :laugh: ;)
 
Oh .. a PT. Nevermind.

How are there not many DOs in the Northeast? One would expect otherwise with the massive establishment of osteopathic medical schools in the Northeast ...

You are kidding, right? What's in the northeast except UNE?
There aren't many DO's up here at all. Trying to find one to shadow was ridiculously hard to do.

To be well trained enough to provide this service, is it fair enough to say that the OMM that we learn in school is not enough? So either a 1yr fellowship or a pure OMM residency would be needed for this type of service?

Haven't had any training yet myself, but from the demo that some OMM fellows did at an interview day, I'd say that the guy I go to is a lot better at it. Then again, years of private study & experience in nothing else should do that...
 
You are kidding, right? What's in the northeast except UNE?
There aren't many DO's up here at all. Trying to find one to shadow was ridiculously hard to do.

I guess NYCOM, PCOM-PA, UMDNJSOM, LECOM-Erie (in addition to UNECOM) don't count ... :laugh:

Don't forget, soon to be Touro-NY, as well ...
 
I guess NYCOM, PCOM-PA, UMDNJSOM, LECOM-Erie (in addition to UNECOM) don't count ... :laugh:

Don't forget, soon to be Touro-NY, as well ...

Yah okay. Well to me Northeast = New England. Those other places don't count - HA HA. Just kidding. There aren't many DO's around here.
 
Yah okay. Well to me Northeast = New England. Those other places don't count - HA HA. Just kidding. There aren't many DO's around here.

NY, PA, NJ = Mid Atlantic

I agree...I am originally from New England and north of NYC there are very few DOs practicing...at least compared to PA and south Jersey!
 
You must understand that to many New Englanders, anything west of Boston is the "midwest". :)

I was going to use NYC as an example...dont forget about us Connecticut folk.

Although the rest of New England considers us "Northeastern New York"
 
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