<p>I agree about the “disconnect.” Some people think that having graduated from medical school, a doctor should expect to be livin’ the life from day 1 through retirement. That’s unrealistic and, in my opinion, undesirable. As a young lawyer, I repaired my own old cars and practically rebuilt my first house - 1 BR, 1 bath - myself. I don’t regret a minute of those years. I managed to build a successful career over the years, but it took time and effort. I think that’s okay.</p>
<p>People who think that the day they’re handed that license they should automatically be raking it in financially are in for a (well-deserved) surprise. A medical degree is the only credential I know of that virtually guarantees it’s earner a six-figure income as long as they don’t totally screw up. The only one.</p>
<p>I think doctors deserve to be among the highest-compensated occupations. It’s along hard road to the day one can practice. They have to be smart, dedicated and hard-working to get there. They deserve respect and they get respect. But spare me the hand-wringing.</p>
<p>I agree about the “disconnect.” Some people think that having graduated from medical school, a doctor should expect to be livin’ the life from day 1</p>
<p>Right…and if you have $200k-300k in student loan debt at the time of the beginning of pay back time, the monthly payments are going to be crazy…like 2500-3500 per month. Like another big mortgage.</p>
<p>I’m not sure when the payments begin. Do they begin when you’re done with your specialty? That means the debt has been accumulating deferred interest, of course.</p>
<p>Intriguing post mom2, makes me think A LOT about how I should plan things. If I can get good aid through med school I will be very grateful lol.</p>
<p>^Yeah I heard. My aim is Mayo clinic. I want to stay in state and they give a HUGE amount of FA. But their acceptance rate is preposterous. I heard cleveland clinic is free. The U of MN would only cost 82k total, and I already have scholarships that follow me well into grad school. I would probably leave with 40-50k in debt at most at the U. Not ideal, but much lower than most. I could pay that of within 2 years of completion of residency (with help from spouse of course) lol.</p>
<p>Dwalker,
I agree with you completely. This is the whole point. Kid graudated at the top her HS class or ranked #1 could definitely choose which UG, she goes. Yes, most likely she will get almost full ride or full tuition at state, but not at Ivy. So, here you go. It is still a kid’s choice, family is very much in control of total cost of education. Most future Med. School applicants (not all, there are geniuses who goofed off at HS and pulled in UG), but most are pretty much in control of cost. That is why I said, it is easier than you might think. My obseravations are based on very many cases, D. has many pre-med friends both from her HS and UG. There are rich families, there are physician’s families with access to free Med. Schools, there are families who send kids to big name schools at any cost and there are families who rely on fact that kid will do very well at any place, she will have opportunites everywhere becuase of her hard working ethic.</p>
<p>@ Mom…lol I already do. I have a GF already, for quite a long time now. And I know her financial situation. Y would I say that if I didn’t lol? I’m not that weird am I? I could pay it off by myself anyway :-). On a side note, there are many loan deferment opportunities around here. I didn’t know this until I talked to this somnologist. Those programs need to be utilized. But usually, they have 7x the amount of apps than spots. No hurt in applying though.</p>
<p>^Yeah I’m in college. We both are sophomores. I am really a junior, due to credits I received during HS (PSEO so they will count to AAMC), and I might take the MCAT this school year. But I really don’t think I will so I consider myself a sophomore. Why do you ask?</p>
<p>Admittedly, I only read the first page and some of the second page, but I think it’s pretty absurd to say that a student must do well in HS to become a happy and successful physician. Maybe that is not what is being said–I also could interpret it as “It is difficult to go to UG debt-free unless you do well in HS,” which is true. However, I’d like to point out one major perspective here:</p>
<p>Not everyone in HS knows what they want to do/be, and thus not everyone in HS does well. Some figure it out in college, and do better. Some don’t. Reiterating a point made earlier (and expanding it), everyone is different. I did very well in HS, but the top 10% of the class was so competitive, it really didn’t help me (unless I had chosen to go to a Catholic college, which was not what I wanted).</p>
<p>Anyway, just wanted to give a shout out to all of the folks that didn’t figure out their life in HS. Keep on truckin’, we’ll figure it out someday, debt-free or otherwise.</p>
<p>(Obviously it is ideal to try to be debt free, I just wanted to point out that not everyone gets their act together by age 14, or 44/64/104, for that matter).</p>
<p>People get to medical school in different ways. My neighbor and best childhood friend was smart, but decidedly not academically inclined as a kid. He went into the national guard during the Vietnam conflict and promptly got married and had kids. He then put himself through college (public university) and got a masters in chemistry. Took him two tries to get into medical school, but he succeeded, and is now a well respected OB/GYN in my home town. My mother who had him as a student in one of her grade school classes was amazed. </p>
<p>My wife is a physician as a second career. Started out in environmental science and picked up a couple of masters degrees in zoology and public health. Hated her job with an environmental agency and took the MCAT on a whim as there was a medical school in the town we were then living in (an osteopathic school). She did well on the MCAT (had very good college grades) and got in, quit her job and went to med school. Did her residency at Mayo (we had a commuting marriage for 3 years), and is now in private practice. As I worked the whole time she was in training, we only had $20K in loans when she finished med school (we were fortunate to have no UG or graduate school loans) - long ago paid off. A totally serendipitous decision. We now have a D in college who is thinking about pre-med as a backup to theatre - she will major in theatre and take all the pre-med classes as well. We’ll see.</p>
<p>I have a college friend who took 5 years to get through undergraduate as an English major. He and I were not the best of students together, although I miraculously graduated on time. He went and got an MFA and a PhD in writing from Cornell and was a professor on tenure track at Rutgers. He decided he wanted to be a physician after all (his father and his brother were physicians), so he quit his job, took 2 years of UG premed courses, and applied to medical schools. Got into UNC-Chapel Hill. He is now finished with his residency, is in practice and recently had a book of short stories published (with good reviews). His wife is a professor. </p>
<p>In all three cases, admittedly anecdotal, having a working spouse moderated any debt. Professional training isn’t easy on marriages, though, so be warned. My childhood friend and his wife did ultimately divorce. My marriage survived both medical school and law school (law is my second career - I went back to law school after my wife went into practice), and my college friend is still married. I did see lots of relationships fail during training though, and I saw a lot of classmates pick up large amounts of debt to get through (house payment size debt). </p>
<p>So, it can be done, even if you aren’t the perfect high school or pre-med student. However, the path may not be a straight line and might take you a little longer.</p>
<p>@Dwalker:
*Yeah I heard. My aim is Mayo clinic. I want to stay in state and they give a HUGE amount of FA. But their acceptance rate is preposterous. I heard cleveland clinic is free. The U of MN would only cost 82k total, and I already have scholarships that follow me well into grad school. I would probably leave with 40-50k in debt at most at the U. Not ideal, but much lower than most. I could pay that of within 2 years of completion of residency (with help from spouse of course) lol. *</p>
<p>A word about Cleveland Clinic. The Lerner College of Medicine is a good program and free (!) but is so insanely competitive. Surely some in Case Western’s medical school would disagree, but the CCLCM students are even more competitive than they are. But the admission rate is crazy. Like, BSCrazy. I met the director of admissions at a scientific conference for undergrads this past March and they take very few students because it is free and they give students a stipend. I think there’s 20-ish spots for a good amount of applications. </p>
<p>I met two of the students there, too, and I think they ranked in the high 90th percentile for the MCAT with 3.9+ GPA. But I guess when you’re essentially paying students to go to medical school, you can afford to be picky about who you chose to accept, lol.</p>
<p>I believe the general premise of the article is true. I cannot say that I have read it in detail but I would say that most of my friends would agree with the tone of the article. I do not think that one today carries $100,000 of undergraduate debt into medical school but would not be surprised if the cost of a good undergraduate education were to be in the neighborhood of $100,000. The cost through the top privates is now over $200,000. Most Universities and Colleges do not meet 100% of need although most of the best do. Some schools have caps on loans so that debt upon graduation is less than $25,000. A few have a no loans policy. Cost to the student/family is dependent upon family finances. Many of the top schools give little or no merit. Most private Universities that give out Merit awards seem to do so mostly to make their schools competitive to the cost of their competition. This generally does not seem to mean that there are no costs. There are no doubt scholarships that pay for everything to a small number of students in order to recruit them. Some top HS students will take these full scholarships but many if not most ambitious students of this sort will head to Brown, Amherst, Rice, Stanford, MIT, Penn, Northwestern, Pomona etc. Many states do not have a great flagship public university. Borrowing $25,000 or less to attend one of the nation’s elite Universities does not seem to be unreasonable for a student with financial need. The students who have good family financial resources are the ones who should be looking at taking these merit scholarships or attend the flagship public Universities as their families are on the hook for the entire cost. Money not spent for undergraduate expenses could than be used for graduate school. In any case undergraduate debt generally is just a small part of the costs of going into medicine as the cost of medical school tend to be much more significant.
The cost of a medical education has become exorbitant. I attended a top research medical school in California. Tuition has risen over 40X in 20 years. Texas public medical school tuition used to be about $500/year. Most of my loans were interest free until I finished my fellowship whereupon I consolidated my loans to one sum at an interest rate of around 3%. There were no time limits during my medical education so many could moonlight to pick up extra money. This is hard to do now due to training hour restrictions. There are also now thoughts in the Congress to decrease GME funding. I suspect that this will not happen but if it does it might mean less salary vs cutting out slots. The bottom line is that doctors are coming out with more and more debt. The physicians who have been out for say 10+ years came out with a different financial situation than those who are coming out now.
One last thing to talk about is physician income. Everyone I know expects income to continue falling in comparison to general inflation. I personally think we will have significant inflation return sometime within the next 5 to 6 years and that our charges (which now are mostly controlled by the government) will lose significant ground. Many of our reimbursements have not been keeping up with inflation for the past 15+ years. Our overhead will continue to increase with more and more government mandated expenses, as well as the need for new technologies and general inflation. We have for some part managed to deal with decreasing reimbursements and increasing costs by seeing more and more patients but most of us have come to a point that we cannot increase our workload without decreasing our quality.<br>
I also think we will see an acceleration of overall decrease in Physician income over the next 10 + years in comparison to inflation with specialists seeing the most dramatic decrease and primary care seeing less of a decrease. Radiology, Cardiology and Dermatology were three of the areas that were cut the most this year. There will be a new round of cuts next year. These cuts may not seem like much but if your overhead were to be 50% (which is very good) every one percent decrease in your reimbursement is a 2% reduction in your income. Losing just 1% in comparison to inflation every year means over a 20% loss of income over 10 years. It would not surprise me if someday income may not vary as much by specialty.<br>
The positives of medicine will hopefully still be there in the future. Hopefully we will still be spending quality time practicing medicine instead of spending more and more time in documentation and coding and following more and more rules. I do believe that job security will continue to be high. Income in comparison to most jobs will probably still be reasonable. That income however will as the article states, be the result of a lot of hard work and financial investment and not as much as you might think.</p>
<p>I’m a health care attorney whose clients are mostly physicians. It is not at all the case that Drs. are rich as hell. A unfortunately erroneous stereotype. Some specialties still do fairly well, but the trend for reimbursement is not positive. A comfortable living, sure. But I would not advise anyone to become a physician to get rich.</p>