Can Students from Lower-Income Backgrounds Afford Medical School?

Pre-Med & Medical School Pre-Med Topics
1

Hello everyone!

I am honored to have been accepted to Brown and UPenn this week. I am committed to UPenn, and I am thinking about a possible future career in medicine. As my mother makes less than 15k a year, I have been offered a full ride to both institutions. I would like to attend medical school afterwards, and I think this is attainable, given that I will not have any accumulated debt from my undergrad years. The problem is that my family is extremely poor (we are currently homeless & living with a religious organization). Having said this, I believe it would be somewhat selfish of me to attend medical school. Realistically, I should have a full-time job right after I graduate from Penn so that I can help my mother out.

My question is essential this-- if I manage to obtain admission to medical school, will I be financially stressed out in those four years? Having witnessed my father pass away due to the war in Syria, I have always wanted to practice medicine. The problem is that my mother will not be able to pay for the tuition or even my living arrangements, so I would be on my own in those 4 years. If I go into 200k+ debt for medical school, how long would it take for me to pay it off? In addition, would I need to start paying the debt right away during my residency?

Sorry if I sound extremely ill-informed. I really have no idea how any of it works. Thanks in advance!

2

Do you have a green card pr citizenship? If you do, then you will be able to attend medical school. However, it won’t be debt free.

If you get into one of the ivies, most likely you will have 120-140k debt because they expect you to borrow a unit loan. If you have a residency in a state like texas, your costs are much lower and you may get some scholarship which will reduce your cost.

A way around would be to aim for MSTP or an MD/PhD program where they give you a stipend while making your education free. However, this will be an 8+ year ordeal.

If you want to be able to support your mother, you probably should take a break of 3-4 years, earn some money, give it your mother and then apply to medical schools.

3

Those who intend to pursue medicine as a career have to be, at some level, selfish. Why? Because if you’re expected to help support your family, you won’t be able to for some 7-10 or more years post college graduation. Medical school is 4 years, then 3-6 years of residency. Add an additional year or two for a fellowship if you intend to subspecialize. (You are paid as a resident, but not much. Your average high school teacher makes more than a medical resident.)

Upon finishing residency, you will not only have your original loan debt, but also all the interest accrued on the debt during med school and residency. Your med school debt can easily have doubled or even tripled by the time you’re in a position to start making payments. There are no low interest or subsidized for medical students. Even if you attend a medical school that offer “good” need-based financial aid, expect to finish with around $180-$200K in loans. Current interest rates for med school loan are in the 6%+ range.

To get an idea of what your loan payment will look like and the income required to pay off those loans, try here:
http://www.finaid.org/calculators/

(When calculating how long it will take you to repay your loans, don’t forget to add in all capitalized interest accrued over 7-10 years.)

Also consider this-- the model for clinical practice is changing. Private practices are giving way to large group managed care practices and HMOs. Reimbursement is flat or declining and doctors’ salaries are flat or declining.

MSTP or MD/PhD programs do give you free med school tuition and modest living expenses stipend, but the time until you start actually earning money will be even longer. 8 years for the MD/PhD followed by 3-7 years of residency. Now you’re looking at 11- 15 years or more before you can start helping your family out financially. And in the long term MD/PhDs earn less than plain old MDs since most of them end up in academic research environments–which pays less than clinical medicine. (More like a biology PhD than a MD.)

If you are willing to serve in return for having your medical education paid for, there are 2 options:

  1. the military HPSP program–where a branch of the armed services pays for your medical education & your living expenses in return you accepting a military residency and then serving out a X years long commitment as a military doctor. Military doctors earn less than their civilian counterparts and their choice of specialties must must fill the needs of the service. (IOW, you may not be able to specialize in the field you want.)

https://en.wikipedia.org/wiki/Health_Professions_Scholarship_Program

  1. the NHSC --where you get up to $40K year in tuition plus a modest living expenses stipend. In return you sign a binding contract to work for a minimum of 4 years post residency in federally designated medically underserved area. To qualify for this program, you must specialize in a primary care field: family medicine, general internal medicine (no subspecialty), pediatrics, OB/GYN.

http://nhsc.hrsa.gov/scholarships/

ETA–HPSP and NHSC are open only to US citizen or permanent residents. Likewise MSTP programs are only open to US citizen or permanent residents.

4

MSTP programs are also more competitive to get into than regular MD. I would take 4 years working as a doctor on a military base over doing a PhD for a free MD any day if a research career is not the goal.

5

Another hurdle for low income students is the costing application process. Although there is some help with application costs if you qualify for it (FAP?), there is no help with interview costs. Traveling across the country for interviews or even traveling within a state (if you are in a big state like CA) can really add up. Flights, hotels, transportation. It is not cheap. This often limits low income students compared to their wealthier counterparts.

Moreover, many middle and upper class kids take costly MCAT prep courses that low income students cannot afford. These are not necessary- you can get MCAT books on Craigslist, etc. and self study. However, this also requires several hundred $$ upfront (although you can usually resell for almost the same amount you paid).

6

What is your home state? If you’re lucky, you live near a number of med schools. If not, then that can be a negative.

Are you the only child and the only person who can help your mom out? Who will be helping her while you’re in college?

I’ve known a few situations where the student has gotten excellent aid as an undergrad, can live off-campus, and the poor parent lives with them. Your mom could live with you while you’re in medical school. that could be a win win…she could cook and do your laundry, while you provide a place for her to live.

7

Thank you everyone for your informative responses. @mom2collegekids, I live in PA, which is why I picked Penn over Brown. Yes, I am the only child. Both my mother and I are here on green-cards, so the legality of applying to med schools wouldn’t be a problem.

8

Does penn allow you to live off campus if you are living with a parent and living nearby

9

There is no reason a lower income student cannot afford med school, many ‘middle class’ students are taking loans for the whole thing. As stated above, you would need to make sure that during undergrad, you accumulate a fund for med school apps & MCAT & interview travel costs. I recall many people stating that whole process took $5k-$10k, being in the northeast, you can save on some travel costs by applying in that area and not having to fly all over the country!

10

You would have to be a citizen by the time you applied but there is one more option for military, at least Navy. Some students go directly from med school into residency in an area of need for the branch of service. This reduces options for residency and results in a longer commitment to serve. Another option is to become a general medical officer where you work as an active duty physician for four years usually in an operational billet. Once you have fulfilled your initial obligation, you can leave the Navy and apply to whatever residency you want or apply to a residency through the Navy for an additional obligation to serve. You would find the pay quite good for those four years to help your mom prior to residency, especially with no med school debt.