BlueDevilMike - Question About Paying off loans

Pre-Med & Medical School Pre-Med Topics
1

<p>BDM, I read a post by you when doing a search for residency threads about how long it takes to pay off loans. To summarize, you assumed a person was $250K in debt when all said and done after med school and undergrad going into their residency. This debt turned to $360K after a 5 year residency. Then you explained after taxes and malpractice insurance the physician for the specialty would come out making roughly $95K to live off of and to pay back in debt.</p>

<p>Then you said to assume they lived in poverty type conditions at roughly $25K/year so they could use $70K/year to pay back loans and then they would be finish paying back 7 years after their residency.</p>

<p>If this is truly the case, what is the incentive of going into medicine? And before people respond with the typical, "don't go into medicine for money" I'm not planning on it. However, is it too much to ask for after giving up roughly 12 years of your social life enslaving in your studies, being treated as a slave as a resident for 4 of those years to expect not to live in poverty? Is it too much to ask to expect to be living middle class? What is the incentive we are giving our future generation to become physicians which may be regarded as one of the most important contributing fields to society?</p>

<p>Not to mention that healthcare reform may drive physician salaries much lower than where they are at. But I would assume the amount of student debt would lag such a salary decrease so by the time I finish school, I will have accumulated the max debt to come out making a decreased salary to try to pay it off?</p>

<p>I don't know about everyone else but I would like to one day have a family. I understand that I am a little older than most applicants at 25 years old right now about to turn 26, but I made a career change after spending 4 years as an Engineer. By the time I would matriculate and finish a 4 year residency after medical school, I will be 35 years old. So you are basically saying that I would have to live in poverty until I am roughly 45 years old. Why would anyone want to do this? Where is the incentive?</p>

<p>BDM, by the scenario you painted, I am seriously considering giving up on my dream of becoming a physician and re-entering the world of Engineering, not because I don't desire to contribute to this field and society as I believe I can, but because I have other personal goals/dreams including finding a wife and being able to provide for a family. And I don't want to start this at the age of 45 years old.</p>

<p>Anyone have any thoughts/opinions on this topic? And before someone states "well if you want to give up your dream then you shouldn't be a doctor" please be objective. Although money is not everything, there is a point where it does become a factor. I'm sorry if I don't want to live in poverty until I am nearly 50 years old.</p>

<p>Thanks for thoughts/opinions.</p>

2

<p>You're probably thinking of [url=<a href="http://talk.collegeconfidential.com/pre-med-topics/307704-how-long-does-take-pay-off-loans.html%5Dthis%5B/url"&gt;http://talk.collegeconfidential.com/pre-med-topics/307704-how-long-does-take-pay-off-loans.html]this[/url&lt;/a&gt;] thread.</p>

<p>Of course, you'd have to evaluate the numbers for yourself. For example, you'll notice that the scenario we discussed had the student carrying some undergrad debt as well. If you can pay in-state tuition at a medical school, or if you have some savings, or if your parents can help, etc., then this all changes. If your spouse has an income, that can help -- although I understand that this is a little awkward in the courtship phase.</p>

<p>More importantly, there's no need to pay off the loans immediately, and hence no need to live "in poverty" while doing so. Loans can be refinanced, etc., so that payments are much more manageable than the $70K per year. Nobody pays off their house in such a manner, for example. The OP in that thread specified that he wanted to pay it back as soon as possible, which is really rather unnecessary.</p>

3

<p>250,000 would be worse-case scenario. Average debt is in the 130,000-160,000 range (depending on if you go to a public or private med school)</p>

<p>$95k is also pretty low, even after taxes for a specialist. Most US grads are choosing to specialize for the higher salaries. A large percentage of our primary care docs went to foreign med schools and therefore don't have a substantial debt-load. And, yes, amount of debt has been shown to influence specialty choice. In other words, if you have a larger amount of debt, you are more likely to enter into higher-paying specialties. </p>

<p>You can probably live a middle class lifestyle while paying off your debt. Living on 25k with a family is pretty extreme. You can always take longer to pay off your loans. 7 years is a pretty accelerated pace especially if you have 250k in loans. But, I think the idea was that you shouldn't be expecting to drive 3 BMW's and own a mansion anytime soon after residency. I'm sure most physicians can afford a decent house in a nice suburb and drive a Camry.</p>

4

<p>Well, our guy was a neurologist. I don't think it's the case that "most US grads" make more money than the average neurologist. Our dude made $208,000 a year, which is probably much higher than normal -- especially when you consider that starting salaries are typically lower.</p>

<p>NCG's other points -- that $250K is on the high end and that 7 years is "pretty accelerated" -- are of course valid.</p>

5

<p>When it comes to student loans and the ability to manage educational debt, DVMs have it a lot tougher than MDs. Even with equivalent levels of education, most vets earn far less than physicians do, and the tuition/student loan debt is about the same. Although many medical school students certainly don't become physicians primarily for the income, I would venture to guess that money is a motivation for very few veterinary students.</p>

6

<p>I have the median salary of physicians at around 220,000 (I think that figure came from Iserson's). Obviously, that includes both primary care and specialists. Neurology is not a competitive speciality and neurologists definitely do not make in the upper or even middle end of specialists. Considering the fact US grads are overrepresented among specialists, I don't think it's a stretch to say that the median salary of US grads is even higher than 220,000.</p>

7

<p>Well, consider me convinced, then.</p>

8

<p>Hubbells' dad here:</p>

<p>Ahem,</p>

<p>I am a neurologist and make >$300K(not counting my >$100K military retirement), average neurologist in my city is much higher than that; several run their own infusion centers(akin to owning a private money printing press)-one of them makes $50K a month! Neurologists can do quite well.</p>

9

<p>Pardon my ignorance, but as an MS3, always trying to learn. =) What's an "infusion center"?</p>

10

<p>for giving IVIG, tysabri, chemotherapeutic agents and othe intravenous drugs-all the rage in neurology and rheumatology these days(the oncologists used to have the market in this venue), there is a tremendous mark-up over the cost of the drug to give it. I personally oppose physicians owning their own infusion centers because I think it may cause some to overuse some meds(if you own a hammer everything begins to look like a nail sort of thing.) I am sure a future carckdown on the practice will come, but for now, it's extremely remunerative.</p>

11

<p>I hadn't realized tysabri needed such a long infusion time. Thanks, Hubbell's Dad. =)</p>

12

<p>Don't get me wrong. With all due respect to hubbell's dad, I think BDM's neurologist is the norm. Most sites have neurologist salaries at around $200,000 on average. I just don't think neurology, on average, is a high paying speciality.</p>

13

<p>I should clarify that "our guy" ("BDM's neurologist") was a hypothetical construct obtained from salary.com.</p>

14

<p>lol, i hear so many ppl saying - dont go into med field for the money... i guess those ppl are not necessarily humanitarians, but they've known doc's who have gone bankrupt due to lawsuits and stuff (but thats what insurance is for, right?).. even my dad makes 140 K a yr with 4 yrs of college and thats it... although i must admit, he's hasnt got a significant raise since ten years - which will be rare in the med field..</p>

<p>and the for amount of educ. doc's need to get, the pay is almost a joke..lol.. unless ur a plastic surgeon with excellent luck and u make a million a year...</p>

<p>but this is reasonable because poorer people probably get sick more often then richer folks... i would guess so... and so poor people wont have that much money to pay the docs anyways...</p>

<p>But a mid-high class life is gauranteed if ur a doc...</p>

15

<p>Well BDM, the original poster is somewhat similar. I will be roughly $60K in debt entering med school and my home state (Michigan) does not offer much regarding an in-state tuition decrease in premium compared to out of state. University of Michigan, Wayne State University and Michigan State University still project >$45K/year in tuition/housing just for in-state. Meaning ~200K plus the original $60K that will be accumulating interest over those 4 years of med school plus the 4 or 5 years of residency interest.</p>

<p>And with all the politics involved in the matching of residency (who you know not what you know for many of the most desired specialties) just makes this whole process a joke. </p>

<p>You would think as a society we would want to promote those willing to work as physicians as we all get sick, many will suffer from disease, old age, etc... The progression of the medical field should be a priority for society. After volunteering for hours, doing free research, busting your ass for MCAT scores and good grades as an undergrad for 4 years, busting your ass through rigorous medical school for 4 years and praying you know the right people to match in a specialty of choice on match day and not be left with a Primary Care salary that won't pay back those bills in time, then essentially working as slave labor as a resident for 4 or 5 years (80-100 hrs/week, 30 hrs/shift at times), all while accumulating an enormous debt and giving up your social life for the 12+ years... What are we telling aspiring doctors?</p>

<p>I am having significant doubts if this field is worth the deterioration of my health, the amount of years busting my ass, the sacrifice of my social life which may force myself to give up any aspirations of having a family, and in the end being handed over a lifelong deficit to pay off. I may not have enjoyed my day-to-day job as an engineer but at least after my 50 hrs/week I can have a normal life and a very solid salary. Don't get me wrong, there was a reason I left my job to pursue this, I am passionate about medicine and really felt I could use my unique background to make a significant contribution to the research oriented portion of this field. But at some point you have to take in the other factors and weigh out the entire decision and ask yourself, is this really worth it?</p>

<p>Hell, a doctor in my parent's neighborhood that I talked to doesn't practice anymore and is working in his wife's dentist office because he said that before he left being a physician, he had a 9 year old son that he never really knew because of the hours required, and that's AFTER residency. </p>

<p>I will admit that after this eye opening experience that I will have an even greater amount of respect for those that are physicians after realizing what they have to go through to get to where they are at. And I believe they are really underpaid and I do believe there should be a mandated restructuring of the education process to become a physician to reduce loans and hours required in one shift for residency. But I have seen that these are hot topics already being discussed.</p>

<p>Good luck to all you residents, those in med school, and those pre-meds. Looks as if you have a long road ahead of you and if/when you make it through it you have the utmost respect from myself for what you accomplished. </p>

<p>Now time to brush up that resume and interviewing skills. Going to be tough to finish this semester (I still should) now that I am about to re-enter the engineering industry.</p>

<p>~MichEngGrad</p>

16

<p>Michigan -- I wish I could disagree with your decision, but the truth is that in that financial situation, the numbers are pretty ugly.</p>

17

<p>Yeah, my home state sucks. Our economy is a POS, our state institutions tuitions are a joke. University of Michigan undergrad tuition when I started in 2001 was 4500/semester IN STATE. Now it is 8500/semester IN STATE. It has almost doubled. I'm paying $9500/semester for GRADUATE tuition. And as I stated, they give no breaks to in-state aspiring doctors for med school tuition. This is Michigan, a good public university, but not a private IVY league institution. I've gotten to the point of telling my friend's parents kids not to bother with college unless they are really going to get a degree worth paying for. No reason to go into $75K in debt to get a general studies degree then go work in retail when you can work in retail out of high school without the debt. </p>

<p>Unless you are going into Engineering, Nursing, Business, or getting an advanced/professional degree after your undergrad, not worth it here in Michigan.</p>

<p>I might as well bail out with only $35K of debt which I can pay off as at least I have a Masters in Engineering. I'm leaving this state too!</p>

18

<p>
[quote]
I've gotten to the point of telling my friend's parents kids not to bother with college unless they are really going to get a degree worth paying for. No reason to go into $75K in debt to get a general studies degree then go work in retail when you can work in retail out of high school without the debt.

[/quote]
</p>

<p>Quoted for truth. </p>

<p>Some days, I wonder what my life would've been like if I'd gone into carpentry or welding. Especially welding - some of the specialized work could net you $50+ an hour, or so I've heard. Of course, the trades don't look so good now that the economy's bad, but still. Sometimes, I wonder.</p>

19

<p>huh.. u guyz seem convinced that u'll be in unrepayable debt..</p>

<p>debt is something that can be paid off and will also increase ur credit score..lol..</p>

<p>Like BDM said, u dont have to live under poverty line circumstances to pay off the debt... u dont have to pay them off right away.. besides, since Obama is investing more in the youth, i think more federal loans will be given out for education and thus lower interest rates...</p>

<p>for some reason, i've never thought abt not getting a loan when in med school.. i've gotten my dad to promise me that he wont pay my tuition.. i'd rather pay my own tuition as a loan get some credit going for my self..</p>

20

<p>this thread is great....</p>

<p>MichEngGrad, i applaud your very mature and well informed decision. it seems to me that there are alot of people out there who are so caught up in their "dream" to become a physician that they suspend logical reasoning. You see people on SDN who drop tens or hundreds of thousands of dollars to "fix" their GPA with post bacc classes and/or a special master's program so they can have the privilege of being hundreds of thousands of dollars in debt. The mantra on SDN seems to be that if you keep trying and keep spending money you will eventually get into med school...no matter how unqualified you may be. </p>

<p>Going to med school should be viewed as a calculated risk and whoever comes to the conclusion that going into $200k+ debt is a good idea is doing the calculations wrong IMO. I think this idea that massive debt is ok is a strictly american ideal that has taken hold more in the generation that grew up in the 90s. </p>

<p>to be completely honest, if i had to go into > $200k debt in order to attend med school the choice would be very easy.....i absolutely wouldn't do it. luckily though i project only having ~51k in subsidized debt when i graduate med school. </p>

<p>i wish you the best of luck (fellow engineer) and congrats on making a sound decision.... i'm sure you will have a successful and rewarding engineering career and look back at your decision to not attend medical school with relief</p>