What are the negative consequences of choosing to invest $200K + in med school?
I know that it’s a lot to pay back, but a lot of people don’t think twice about paying that much for real estate. I figure I’m being naive though, especially considering how saving for retirement is going to be challenging, much less buying a house, etc.
I could live without owning real estate and renting for the rest of my life. I’m not going into this for the money. I’d be happy to be a physician and live lean and mean. However, I figure that I won’t finish residency until my mid-40s. That means only 25 years to save for retirement, and although I plan to work beyond 65 years old, I wonder if there are other things I’m not considering, that I should.
I’m also guessing the cost of malpractice insurance is an issue. I got some general figures that it can cost from $100K to $200K+ per year, depending on your specialty!
I disagree - this is a very reasonable & rational set of questions that EVERY applicant, irrespective of age, should be asking themselves. Medical education and training is damned expensive & you can compile a boat-load of debt in the process. I think you are demonstrating the maturity & insight of an older, more experienced person by asking them.
Of course, with all of the “good questions”, the answer is convoluted. Frankly, there is no one correct answer and THE answer will vary person and their individual circumstances. Off the top of my head, there are about 3 primary variables: 1 - how long you can potentially practice, 2 - your discipline’s earning potential & 3 - private vs. non-private. These factors will apply very broadly - essentially to everyone. More individualized factors would be your current debt status, presence of family (esp children) and how much you have in liquid/cash assets.
How long can I potentially practice? The answer will incorporate your age and length of training. If you graduate at 60 and try to undertake 6 year training program, your practice life is not likely to be very long. However, if you choose a more generalist discipline, you could add 3 years to your practice life thru shortening your training.
What is earning potential of my chosen discipline? A surgeon or anesthesiologist will make substantially more than an FP or a pediatrician. So, you are striking a balance b/t longer training program and increased pay potential.
Private vs. Non-private? Private schools tend to cost a lot more/year, but there are some state schools who really ream you for out-of-state tuition - may be even more than it is for a private program. This + your cost of living (in context of total amt borrowed) will determined you net debt.
Also, be sure to look into the new loan payback rules that go into effect 1 July 2009. They are RADICALLY different than the log-standing rules I functioned under. These change will prfoundly affect how you pay back your loans and you absolutely better know them prior to getting into this situation.
Side note. . .I was in a med school premed workshop last month and the school’s premed director spouted off the information that you could defer loan repayment throughout your residency. Nerdy non-trad that I am, I had to raise my hand and point out that that is not exactly true under the new rules, so thanks OldManDave for keeping us informed. I don’t know if it was you, but someone in a previous post mentioned the new rules.
I do agree that you should consider the substantial debt that is involved with this decision BUT you also could die from cancer 3 years from now making all of this throught irrelevant. I am 31 years old now and I doubt I will make it past 50. My generation will be lucky to live as long as our grandparents did…
And by the way, I run 3 miles a day, don’t smoke nor drink. Unforuntantly cancer could care less about all of this stuff and the medical community is no where near a cure.
SO just go with what makes you happy and try to keep the debt side of the situation in the far back of your mind.
Besides, you could always get a full ride from the military. They have a scholarship which pays full tuition plus a stipend of 2k a month to live on. You can join up to 46 y.o WITHOUT a waiver…but you can get waivered in no matter how old you are.
Okay…lets say you don’t want to be a military doc…practice rural medicine then. The state of West Virginia practically throws money at you for medical school if you agree to practice in a rural area for a period of time.
Malpractice for a family doctor who does not include OB in her practice is about $12,000/year.
Mary
- SomeDaySomeWay Said:
I do agree that you should consider the substantial debt that is involved with this decision BUT you also could die from cancer 3 years from now making all of this throught irrelevant. I am 31 years old now and I doubt I will make it past 50. My generation will be lucky to live as long as our grandparents did...
Really? Why do you say this? I'm mean, of course, there are never any guarantees...but why do you make the comment that you doubt you will make it to 50? Is this due to family members having a shorter life span?
See I actually feel the opposite...if I look at my family lifeline, I'm looking at a long life unless I take risks with my health.
Great grandmother lived to 88, grandmother to 93 and mom still going strong at 71...even my dad who isn't in the best health due to smoking and drinking in the past is 72.
Also cancer isn't necessarily a death sentence in many cases.
I'm pretty much planning on working as long as I can in whatever capacity I can best use my medical degree.
Since I am used to living on an income of about $30K and living comfortably, I figure that when I get to my residency, anything over will be divided equally between retirement and paying back my student loan. If I decide to just stay with IM and not go further to specialize, I'll probably see if I can take advantage of working in an underserved area, and maybe try to get some tuition reimbursement options.
- SomeDaySomeWay Said:
Besides, you could always get a full ride from the military. They have a scholarship which pays full tuition plus a stipend of 2k a month to live on. You can join up to 46 y.o WITHOUT a waiver....but you can get waivered in no matter how old you are.
I have a couple comments about this. First thanks to the economy, I expect the military to become far more competitive than it had been in previous years. Second, yes you can enter at a later age but doesn't the military have a mandatory retirement age? If that's the case, I find it rather unappealing to go military, stay in for say 16 years, and be unable to retire with pay. OTOH, I don't know how serious being able to pull a retirement chaeck is to most nontrads over the age of say 40.
- pathdr2b Said:
- SomeDaySomeWay Said:
Besides, you could always get a full ride from the military. They have a scholarship which pays full tuition plus a stipend of 2k a month to live on. You can join up to 46 y.o WITHOUT a waiver....but you can get waivered in no matter how old you are.
I have a couple comments about this. First thanks to the economy, I expect the military to become far more competitive than it had been in previous years. Second, yes you can enter at a later age but doesn't the military have a mandatory retirement age? If that's the case, I find it rather unappealing to go military, stay in for say 16 years, and be unable to retire with pay. OTOH, I don't know how serious being able to pull a retirement chaeck is to most nontrads over the age of say 40.
The military is still not very competitive at all. For example, this years scholarship winners for the U.S. Army filled only 18 spots. They have another 220 available. People are NOT going to go this route just for the money. There is far to much risk and committment involved and they will never make it if they do it for the wrong reasons. There is no mandatory age requirement for retirement for health professionals. Military Medicine is far different from any other military rules and requirements. They have their own set rules and agenda. The demand for all medical professions in any branch of service is extremely high. My friend, who is 41, got a waiver for asthma and cancer and has accepted the scholarship.
- Krisss17 Said:
- SomeDaySomeWay Said:
I do agree that you should consider the substantial debt that is involved with this decision BUT you also could die from cancer 3 years from now making all of this throught irrelevant. I am 31 years old now and I doubt I will make it past 50. My generation will be lucky to live as long as our grandparents did...
Really? Why do you say this? I'm mean, of course, there are never any guarantees...but why do you make the comment that you doubt you will make it to 50? Is this due to family members having a shorter life span?
See I actually feel the opposite...if I look at my family lifeline, I'm looking at a long life unless I take risks with my health.
Great grandmother lived to 88, grandmother to 93 and mom still going strong at 71...even my dad who isn't in the best health due to smoking and drinking in the past is 72.
Also cancer isn't necessarily a death sentence in many cases.
I'm pretty much planning on working as long as I can in whatever capacity I can best use my medical degree.
Since I am used to living on an income of about $30K and living comfortably, I figure that when I get to my residency, anything over will be divided equally between retirement and paying back my student loan. If I decide to just stay with IM and not go further to specialize, I'll probably see if I can take advantage of working in an underserved area, and maybe try to get some tuition reimbursement options.
No, I am in top shape right now. My mother started fighting Ovarian cancer at age 53. She is now 61 years old and is at the end of her journey. Yes, cancer is a death sentence. I have seen her suffer through countless chemo and radiations treatments along with a ton of other side effects which I will not go into on the forum. Once you are diagnosed with cancer your quality life is gone...even if you do survive you are always scared when the next reoccurence will come about...and YES it always comes back.
My father is still healthy at 61 but both sets of my grandparents lived to 98, 96, 94 and 94. What people do not understand is that the older generations lived longer because they ate better food and prepared it theirselves. We eat processed food with a ton of chemicals in it, have more pollution than they did and not to mention things will may find out in the near future which are killing us and causing cancer (cell phones, computers, etc).
Doctors have no idea what causes cancer. One day in the news its oranges, then its sugar...then tobacco...then alcohol...then vitamins....then running in the sun....then tanning beds....then processed meat.....then toothpaste...and the list goes on.
I just try to live a healthy life but I dont have a very optimistic view on the life spans of my generation even with all this new technology docs have. Just my thoughts and opinion
- SomeDaySomeWay Said:
- Krisss17 Said:
- SomeDaySomeWay Said:
I do agree that you should consider the substantial debt that is involved with this decision BUT you also could die from cancer 3 years from now making all of this throught irrelevant. I am 31 years old now and I doubt I will make it past 50. My generation will be lucky to live as long as our grandparents did...
Really? Why do you say this? I'm mean, of course, there are never any guarantees...but why do you make the comment that you doubt you will make it to 50? Is this due to family members having a shorter life span?
See I actually feel the opposite...if I look at my family lifeline, I'm looking at a long life unless I take risks with my health.
Great grandmother lived to 88, grandmother to 93 and mom still going strong at 71...even my dad who isn't in the best health due to smoking and drinking in the past is 72.
Also cancer isn't necessarily a death sentence in many cases.
I'm pretty much planning on working as long as I can in whatever capacity I can best use my medical degree.
Since I am used to living on an income of about $30K and living comfortably, I figure that when I get to my residency, anything over will be divided equally between retirement and paying back my student loan. If I decide to just stay with IM and not go further to specialize, I'll probably see if I can take advantage of working in an underserved area, and maybe try to get some tuition reimbursement options.
No, I am in top shape right now. My mother started fighting Ovarian cancer at age 53. She is now 61 years old and is at the end of her journey. Yes, cancer is a death sentence. I have seen her suffer through countless chemo and radiations treatments along with a ton of other side effects which I will not go into on the forum. Once you are diagnosed with cancer your quality life is gone...even if you do survive you are always scared when the next reoccurence will come about...and YES it always comes back.
My father is still healthy at 61 but both sets of my grandparents lived to 98, 96, 94 and 94. What people do not understand is that the older generations lived longer because they ate better food and prepared it theirselves. We eat processed food with a ton of chemicals in it, have more pollution than they did and not to mention things will may find out in the near future which are killing us and causing cancer (cell phones, computers, etc).
Doctors have no idea what causes cancer. One day in the news its oranges, then its sugar...then tobacco...then alcohol...then vitamins....then running in the sun....then tanning beds....then processed meat.....then toothpaste...and the list goes on.
I just try to live a healthy life but I dont have a very optimistic view on the life spans of my generation even with all this new technology docs have. Just my thoughts and opinion
Sorry about your mom. Actually, my own mom had been diagnosed first with a Stage IV breast cancer when she was 64 and than a few years ago, with ovarian and colon cancer...luckily all three were primary sites, and after 2 surgeries (1 for the breast, and 2 for the ovarian and colon), 1 round of radiation tx for the breast and 2 separate rounds of chemo, she is doing great...so for that I have the faith of medical technology...if it weren't for an intuitive doctor that noticed an area of concern on an abdominal ultrasound while checking the colon, the ovarian might never have been caught.
I do agree that we do have issues with processed food being eaten more, and basically poorer habits...but we also have more knowledge now and if we use that knowledge for good, that should be passed along.
- In reply to:
Once you are diagnosed with cancer your quality life is gone...even if you do survive you are always scared when the next reoccurence will come about...and YES it always comes back.
I'm sorry about your mom and family, but I have to disagree with the above statement of it always coming back. Yes, it often will return. BUT it depends on the type of cancer, the staging of the cancer when it's found, and a lot of other factors.
I say this as a 3.5 year cancer survivor just beginning my residency. I say this as a person who has had several family members lose the battle with cancer.
Don't let the fear of cancer be an excuse for not trying to live your dream. The potential for cancer is not a valid reason to not attain your goals.
Of course there are times when something makes me ill that I think about it. But for me, I prefer to have a positive approach and keep on moving forward and enjoying my life.
--Linda
Thanks everyone for the encouragement. It has been hard watching my mother fight cancer over the past 9 years. I am an only son and the sole caregiver for her. Its much harder to watch family members suffer with a disease than someone who is not related to you…this is the only logical way I can think of which allows Doctors to treat patients and not allow their emotions to be involved.
- Linda Wilson Said:
- In reply to:
Once you are diagnosed with cancer your quality life is gone...even if you do survive you are always scared when the next reoccurence will come about...and YES it always comes back.
I'm sorry about your mom and family, but I have to disagree with the above statement of it always coming back. Yes, it often will return. BUT it depends on the type of cancer, the staging of the cancer when it's found, and a lot of other factors.
I say this as a 3.5 year cancer survivor just beginning my residency. I say this as a person who has had several family members lose the battle with cancer.
Don't let the fear of cancer be an excuse for not trying to live your dream. The potential for cancer is not a valid reason to not attain your goals.
Of course there are times when something makes me ill that I think about it. But for me, I prefer to have a positive approach and keep on moving forward and enjoying my life.
--Linda
Linda, did I ever tell you what an inspiration you are! Your positive approach definitely shows through when you shared your experiences but wouldn't give up no matter what. I'm sorry I'm not able to make the conference because I would have really wanted to meet with you.
Kris
I did not know about the new loan payback laws - are you referring to the below? It seems these are positive changes, but I inferred from you post there might be something negative – anything else that I might be missing from the new laws?
http://edlabor.house.gov/blog/2009/05/managing -you…
Managing Your Student Loans: Upcoming College Affordability Benefits Every Borrower Should Know About
The cost of paying for college is becoming even more burdensome for Americans in this economy. While families are losing income, benefits and jobs, college tuition prices continue to rise. The average student now graduates with over $22,000 in total student debt, including federal and private student loans.
This year’s class of graduating college seniors also enters one of the toughest jobs markets in decades for recent graduates. Of the 1.2 million jobs lost last year, 60 percent were held by workers aged 25 or younger. Their wages may also suffer: Economists have found that workers who graduated during recessions typically earn less over a lifetime than workers who graduate in better economic times. Many borrowers already spend high percentages of their paychecks making student loan payments – and it’s only likely to get worse.
Given these challenges, it’s critical for current college students, new or soon-to-be graduates, and workers to know about new benefits going into effect July 1 that will make student loan payments manageable for millions of Americans. (These benefits were signed into law in 2007 as part of the College Cost Reduction and Access Act.) They include:
- Cheaper interest rates on need-based (subsidized) federal student loans. On July 1, the interest rates on subsidized federal student loans will decrease from 6 percent to 5.6 percent. This is the second of four annual cuts in this interest rate; it will continue to drop until it reaches 3.4 percent in 2011.
- Reasonable and affordable monthly college loan payments for borrowers. On July 1, a new Income-Based Repayment program will go into effect that caps borrowers’ monthly loan payments at just 15 percent of their discretionary income (15 percent of what a borrower earns above 150 percent of the poverty level for their family size). Any current or future borrower whose loan payment exceeds 15 percent of their discretionary income is eligible. After 25 years in the program, borrowers’ debts will be completely forgiven.
- Higher Pell Grant scholarships that cover the average tuition at public universities. Due to funding provided by both the College Cost Reduction and Access Act and the American Recovery and Reinvestment Act, the maximum Pell Grant scholarship for the 2009-2010 school year will be $5,350 – more than $600 above last year’s award.
In addition, students and borrowers will be able to continue to take advantage of other recent programs enacted under the law that will make it easier for graduates to go into public service fields while grappling with student debt. To encourage more students to become teachers, the law provides up-front tuition assistance, known as TEACH Grants, of $4,000 a year – for a maximum of $16,000 – to students who commit to teaching high need subject areas in high need schools for four years after graduation. (These grants first went into effect for the 2008-2009 school year).
Recent surveys also show students’ interest in public service jobs is surging. Graduates who enter into public service careers, such as teachers, public defenders and prosecutors, firefighters, nurses, non-profit workers and more, will be eligible for complete loan forgiveness after 10 years of qualifying public service and loan payments. (This program began on October 1, 2007.)
WHO BENEFITS? A SNAPSHOT…
The interest rate cut…
- Nationwide, about 5.5 million students borrow need-based federal student loans each year. According to the Congressional Research Service, half of these borrowers come from families with incomes between $26,000-68,000.
- About 38 percent of African-American students take out need-based student loans each year.
- About 25 percent of Hispanic students take out need-based student loans each year.
The Income-Based Repayment program…
- While it’s difficult to estimate an approximate number of borrowers who could participate, at the end of 2008, there were almost $556 billion in outstanding federal loans, representing almost 95 million student loans to more than 30 million borrowers. In 2008, about 8.9 million students borrowed federal loans.
The Pell Grant scholarship…
- About 6 million students received the Pell Grant scholarship for the 2007-2008 school year. Of these students, 75 percent had family incomes below $30,000.
- About 47 percent of all African-American students receive Pell Grant scholarships each year.
- About 37 percent of Hispanic students receive the Pell Grant scholarship each year.
WHO QUALIFIES FOR INCOME-BASED REPAYMENT?
- Borrowers who currently are paying back federal student loans and new borrowers, whose debt exceeds 15 percent of their discretionary income. Borrowers with hefty debt loads or low-paying jobs are most likely to qualify.
- The program covers all federal loans – both Direct and Federal Family Education loans – made to students, including Stafford, Grad PLUS and federal consolidation loans, but not those made to parents (PLUS loans). Perkins loans are also eligible if a borrower consolidates them into a FFEL or Direct Loan.
- A borrower must also have enough debt relative to their income to qualify for a reduced payment. If a borrower earns below 150 percent of their poverty level for their family size, their payment will be $0. If they earn above it, their payment will be capped at 15 percent of whatever their income is over that amount.
- SomeDaySomeWay Said:
The military is still not very competitive at all. For example, this years scholarship winners for the U.S. Army filled only 18 spots. They have another 220 available. People are NOT going to go this route just for the money. There is far to much risk and committment involved and they will never make it if they do it for the wrong reasons. There is no mandatory age requirement for retirement for health professionals. Military Medicine is far different from any other military rules and requirements. They have their own set rules and agenda. The demand for all medical professions in any branch of service is extremely high. My friend, who is 41, got a waiver for asthma and cancer and has accepted the scholarship.
Are you saying there were 238 scholarship spots, and only 18 got filled ?! How is that possible?
I have been reading up on scholarships lately and there are more than a few threads on here and SDN about military scholarships. I wanted to know more (unbelievably) so I have been trying to find more info from actual military docs, but I haven’t been able to find very much of it that is objective (versus subjective patriotism, etc). If you want a sense of what some of them are doing at the moment, I suggest renting the HBO documentary “Baghdad ER” which I found on Netflix. One word: Wow. You have to see it to believe it. Of course, not all military docs will be stationed in Iraq/Afghanistan I suppose, but the documentary did raise my eyebrows quite a bit about military trauma medicine. An ER nurse on the DVD said he worked in an ER for years and had never seen anything like what they dealt with every day. And the show is quite graphic, so I can believe his statement.
Obviously, the combat ER experience is the most extreme one, but I’m curious about those who practice more traditional (non-trauma) military medicine. Personally speaking, I am beginning to think military medicine isn’t going to work for me for a number of reasons. Perhaps so few of the military scholarships are taken due to a number of intersecting issues that some just are not comfortable with. I found a blog online of a former military doc, and boy was he disgruntled. He pointed out some significant problems to working in that environment (and he was non-trauma). I misplaced the saved URL but you can probably Google it.
I’m still thinking of scholarships but the military is pretty far down the list at the moment.
This is what I was talking about regarding loans and deferment rules.
http://www.finaid.org/educators/20090505Eco nomicHa…
My head is spinning. Succinct summary, please?
The essence is below. Basically, prior to the new rule, residents could defer making any payments on their loans for 3 years (or longer) under the economic hardship clause. Now, we will have start paying back our loans while in residency, although we qualify for a reduced rate. The average 1st year resident makes in the $45-50,000 range.
- In reply to:
This mainly matters to medical and dental school students, who are ineligible for an in-school
deferment during their internship, residency and fellowship. Since medical and dental school
students typically have debt-to-income ratios ranging from 2:1 to 7:1 during this time period,
they are unable to make fully-amortized monthly loan payments and need temporary repayment
relief. Many previously qualified for an economic hardship deferment under the 20/220 rule and
will not qualify after July 1, 2009 when it is no longer effective.
deferment during their internship, residency and fellowship. Since medical and dental school
students typically have debt-to-income ratios ranging from 2:1 to 7:1 during this time period,
they are unable to make fully-amortized monthly loan payments and need temporary repayment
relief. Many previously qualified for an economic hardship deferment under the 20/220 rule and
will not qualify after July 1, 2009 when it is no longer effective.