Let's talk Money

Hi everyone! So, let’s talk money. I’m starting my M-1 year in August and so now I have put the MCAT behind me, am blissfully done with physics and have pretty officially exited the pre-med world. This naturally brings me to the fantasies of the early medical student. Dreams of specialties and residencies and clerkships in my head and naturally the potential financial gain of this vs. that.


It goes without saying, almost, that the nontraditional student is sort of expected to enter primary care, psychiatry, etc. because we are old and mature and don’t have the time for long residencies or fellowships or just don’t want to face veiled ageism in going after a competitive specialty/fellowship. However, we all know that not all of us old folks entering medicine want to practice IM or Family Med, etc, etc. I have never wanted to be a primary care doc to be honest. Though, I haven’t been hugely vocal about this fact. It’s one thing to tell people you are in your mid-30’s and are a pre-med; it is quite another to say that you are in your mid-30’s and want to be an ENT, a gastroenterologist, or general surgeon. Gas alone is highly competitive and requires at least 6 years for most programs. That is of course after doing a IM, Med/Peds, or Peds residency first and then having to be compete for a fellowship. So, it’s hard to face the fact that if I can get into the residency/fellowship I really want (that will make me happy-I’ve gone this far why choose a spec. I don’t want at this stage, right?) I will be making essentially bubkis for the first 5-6 years post medical school. Fellows are still compensated PGY-4, 5, etc. and not salaried physicians from what I understand. So, I’ll be a full fledged doc somewhere around 10 years from now.


The way it looks now given the lack of free money for school (I cannot even think of joining the military) and given the high cost of a) a private medical education and b) doing this as a single mom with more expenses than the average med student but no extra help because of it, I will probably be in $300,000 of educational debt when I leave medical school. 6 years on a resident/fellow salary will clearly not get me far with regard to paying off loans so then I’ll be in my late 40s with $300,000 of educational debt. So, yeah, if the motivation to go into a higher paying specialty is high for the average “young” doctor who went the traditional route, well it’s much higher for me. That being said, I cannot guarantee I’ll get a coveted residency/fellowship either. I love the idea of doing a peds residency and then applying for a gas or neuro fellowship. But, I certainly know I’ll never get out of debt if I’m a general peds and I don’t want to do that anyway.


So, what’s a girl to do? At this point, I’m just hoping I have enough to live on and support my child (I do get child support from her father but it’s measly and I’ve known whether he and I were together or not that I couldn’t rely on him) for the next 4 years and then I’ll see where things lie, but I’d be foolish not to think ahead even if residency and fellowships seem far, far away. We all know how time flies and we all know that in the medicine game preparing early is key. Especially if you are old and want to (remain) competitive even after you gotten accepted you to your #1 choice school after excelling in premed.


I do have a strong desire to teach and hope to enter into academic medicine on some level. I see myself very much working in an academic hospital. That being said, if public service loan forgiveness still exists in the future, I may get some help that way. If it does exist when I’m practicing then I may be eligible after 10 years, but that may be 10 years from the end of residency/fellowship, so it’s still not looking so hot. Even if I get my residency/fellowship of choice I worry about the future. I worry about “retirement” (not planning on retiring per se because let’s face it I’ll be working as long as I can, but maybe someday will want to cut back). I just am now worried. Now that I’ve done what I’ve set out do, the financial implications of a medical education in the US at any age, but especially as a nontrad, is getting REAL.


I am a modest person, too. I don’t expect or want the big house or the fancy car, but I’ve also worked my tail off, will continue to be working my tail off, will be getting a pretty heavy-duty education that will give me immense skills and a lot to offer society and so I also don’t want to be living chasing the dollar the rest of my life either just to pay off student loans.


So, while I’ve never been in denial about this reality, now that I’m done with the pre-med stuff and got into medical school this is no longer a “I’ll deal with it when the time comes” issue. The time is here and I don’t know if I should adopt the “I’ll deal with it when the time comes to apply for residency… or I’ll deal with it when the time comes to apply for a fellowship… or I’ll deal with it when I’m “done” in ten year” attitude either.


So, I’m thinking/typing out loud here, but let’s face it even if I wanted to go into primary care it just wouldn’t be feasible. My own internist told me primary care was out for me anyway just given the financial implications. But, fortunately I never wanted primary care so at least I’m not squashing those dreams. lol. But, I’m in for quite a ride!


Anyone else out there not planning on primary care/not wanting primary care, etc? Anyone who has traveled this road already and knows first hand how hard it is to get a residency/fellowship outside of primary care have some thoughts to share? Ageism is illegal we all know, but we all also know that there are ways around it if a program just doesn’t want you because you are old they can certainly find other reasons to make it legit. So, what gives? How the old medical school graduates fairing out there in non-primary care specialties whether straight out of the gates or after an IM/Peds residencey and into fellowships?


Give me hope!

Hey there.


I don’t have children. But to me it comes down to how much money I have needed to live pre-medicine. At $34,000 in NYC I was comfortable, at $40,000 more than comfortable. You have your own numbers that include your child (I think daughter–not sure?).


Running the numbers for me looks like this:


Gross $180,000


Taxes $60,000


401k $20,000


Living expenses $45,000 (more than I ever made in my previous life!)


And that leaves $55,000 for loan payoff, with a higher standard of living than I have at present.


To me the real problem is childcare while a resident. That will not be fun to pay for on a resident’s or fellow’s salary. But (and I mean this in an encouraging way, not a dismissive way, as an only child of a single mother) raising a child on $50,000/year over a 7-year residency and fellowship period is not the worst thing in the world. No kid is going to say, wow, I grew up poor, my mother was a resident for most of my childhood. So there are less stressful ways to MAKE your $50,000. But you still get paid.


As for ageism in the specialties…that’s another matter. There are outliers. I guess you’ll have to be one of them. :wink:


I am confident that you will find a way.

Just had financial exit interview. Can give you some ideas.


During med school, the interest on non-subsidized student loans accrues. It is capitalized at the end of medical school, when you graduate.


During residency, you can pay the standard payment (based on paying off your loan in 10 years). That looks like well over 3,000/month for a 300,000 dollar debt. Not leaving enough to live on. The “extended payment” figures 20 years to repay, but is still a huge chunk out of residency salary. OR, you can file for “income-based repayment”. In my case (owe MORE than 300,000), they figure that as about 400/month. It’s 10 percent of your take-home pay, about. It will not be covering all the interest, but the interest during residency is not capitalized till the END of residency. So I can save as much as possible, have it available as an emergency fund during residency, and put everything I’ve saved and not needed for an emergency down on the interest at the very end of residency, limiting the increase in my loan amount.


Once out as a physician, you can continue to do income-based repayment. As long as you make ALL the payments on time (automatic withdrawel, anyone?), after 20 years, anything left over is cancelled. HOWEVER, this will count as INCOME (taxable income) that year, so if it is a lot, you could really be up a creek!


If you do the public service debt forgiveness, you have to make all your payments on time. However, they can be income-based repayment. After 10 years working for a non-profit, whatever is left on your debt is forgiven, and this does NOT count as taxable income! Also, if your residency is at a non-profit or not-for-profit institution, your residency years can count towards the 10 years.


Hope that provides some more concreteness to the discussion.


Kate

Thank you both so much for your input! Kate, your “frontline” experience is so valuable to me right now! I feel much less worried. I was looking over my financial aid package again and realizing that I, too, will probably be OVER 300 grand in educational debt when I leave med school.


EthelR, I am less worried about things like child care as my daughter is school-aged and will be in school while I’m in school and then for all the times outside of her normal school hours I have loads of family help. My parents are literally 2 minutes away and have a very flexible schedule and were the first to “volunteer their services” to help out me and her. Her other grandparents aren’t super far and also very involved in her life and her father, while financially unable to do much of anything, is not far away and they spend weekends together for one giving them time together and freeing myself up for studying and miscellany. If I would require child care outside of her normal school hours, I can get financial aid help for it if I give school proof of expenses (this won’t help with my debt upon exiting but will help during school if I need it).


I am worried about being able to live during medical school. I am one of the most frugal people around, but I cannot move into a four bedroom house or apartment with a bunch of other students to offset my living expenses. As such, my monthly rent alone is $229 over the amount budgeted per month for rent AND utilities by my school. So, the other cost of attendance allowables, if you will, (car expenses they budget for, food expenses, etc.) I have to cut into to make sure I can pay the rent and utilities. I will also have no choice but to work over summer between M-1 and M-2 because first year the financial aid only covers 10 months worth. I have not much issue with working summer, but I can say also that having just finished pre-med and looking to have maybe a month off before med school starts to re-charge may not be possible because I may have to work most of the summer to give me a tiny cushion when school starts. And, it really will be a tiny cushion. So, I am already afraid of being burnt out before I start and so I’m trying now to figure out if I can financially manage to stop working a month prior to the beginning of school (we start 8/11) so I can take some deep breaths before diving in. I just finished my B.S. degree this week and I need some time off.


I don’t mind working over summer after M-1, though , I won’t lie, I would like a little R & R with my daughter then, too. We all deserve a break in the end. I am hoping to find something part time or I could go back to my current job for the summer (they’ll have me back any time). I would like to find a summer research position on campus, but I don’t want it to take up the full summer and I have to try to get one that pays and not just with experience. lol.


So, my main concerns are:

  1. living through med school on the aid that I am getting w/o taking out private loans.

  2. Not having to work every free day (or at least summers) I do have during medical school so I can keep some sanity and not constantly be chasing the dollar during med school just to help pay the most basic of bills.

  3. Putting money away for “retirement” when I do exit medical school. More of a “just in case” anything happens to me fund than a “retirement” fund, but let’s just call it retirement and hope that some day I can use it for that!

  4. Paying off student loans reasonably so that #3 is possible also, but also so I don’t have to live like a college student the rest of my life either. Yes, I’m frugal, but having to watch every penny does get old and into my 50’s I’d like to feel some sense of security and be able to take a vacation! I am not someone to live beyond my means, but after a certain age, don’t we all want to be able to spend a little w/o freaking out every second. I’ll be frugal forever, but I’d like to feel I’m somewhat established at some point in my life, too.


    I am not super concerned about residency/fellowship pay so long as I can still save and pay down on loans. Kate, your advice and thoughts are very helpful on this also! I can certainly live on $50,000-60,000 for PGY-1-? salaries, but after all is said and done, loans will cut into that for sure, but can I live? YES! Can I provide for my daughter! YES! I, too, EthelR have never made $50,000/yr so this will be something that, to me, is a very decent salary. It’s just that taking into account a child to raise, my age at the time, over $300,000 debt, and long hours for that pay, it does start to look like “bupkis” in the grand scheme of things. If I was in my 20s now I wouldn’t care a bit to be honest, but I’m starting to feel my age when I think about things in terms of finances and it’s a little daunting. But, I have to keep confident that I will get through it and come out the other end with some savings, some dent in my loans, and some retirement put away.


    I hope the public service loan forgiveness program lasts and that I do end up in an organization that will allow me to benefit from this. I also hope that really in the end I do end up doing what I love. I have come this far and worked so hard (like all of us here have) and to feel at any point that I may have to “settle” for a specialty I don’t want because of my age (and fear of real or perceived ageism) or because of money would be beyond unfortunate.


    Thank you EthelR and Kate for chiming in. I’m a long winded person even in print so thanks for bearing with my personal financial therapy here.

Ah. Now I understand better. Your immediate concern is the 20something-style student budget DURING school, plus family time. Yes, I feel you there. Though I know it’s not the same, I have a fairly traditional-minded SO who (while having been a huge source of emotional support) also expects me home. If I want it to work out between us, I have to at least TRY for a domestic life.


Think about a carefully controlled cash tutoring job during the year. Religiously-mandated day of rest permitting, how about Saturday or Sunday morning? The high school kids don’t love it, but yes, their parents will hire you for the 9-11 slot. I don’t know what the top of the market is in Milwaukee, but hold out for the top (it has to be worth your while). Or of course you could pick a weekday evening (ONE weekday evening). People do do this during years one and two. The problem IME would be if you allow yourself to extend to more than ONE student.


Two legitimate online tutoring outlets are nextsteptestprep.com (MCAT) and prepnow.com (SAT and other). Next Step offered me above $30 online. Don’t know about PrepNow. When factoring in the commute, it may be a better idea.


It will take some digging, but I think there are programs here and there that MAY offer loan repayment to specialists in underserved areas. New Jersey’s new (recently passed) loan redemption program is designed to allow a specialist option…let’s see how it pans out.


For after school–here’s hoping–at least I am hoping–that after getting used to a resident salary AND hours, it will be possible to continue at a resident standard of living with many fewer hours for the first few years afterwards.

I am putting PSLF out of my mind, btw. There is some fine discussion over on SDN on this matter.


http://forums.studentdoctor.net/threads/pslf-proposed -cap-of-57k-2015-budget.1058539/

  • EthelR Said:
I am putting PSLF out of my mind, btw. There is some fine discussion over on SDN on this matter.

http://forums.studentdoctor.net/threads/pslf-proposed -cap-of-57k-2015-budget.1058539/



Outside of the Residency forums, I find little on SDN to be more than the chicken little screaming the sky is falling, LOL!!!

Affirmative action? The sky is falling!!!

No PSLF? The skiy is falling!!!

Obamacare?? The sky is falling!!!

My Daddy took away my Porche? The sky is falling, ROTFL!!!!!


Hey Shanport


I do understand your concerns, this my take on the issue.


I will be graduating with about $160-180K of debt. My wife works but I currently have one kid in daycare. I also have to work my Saturdays and the entire summer. The first half I will be working 6 days a week. The second half only Friday and Saturday. MS2 starts 8/4. The job ends 8/17, so there will be some problematic overlap.


I intend not to work during the MS2 year for two reasons. First we were told (by students) that the amount of info is more important (which is beyond my comprehension, as this first year was already insane). And second there is step 1.


I am targeting something other than primary for sure, so I have to get the grades, rank and good Step Score. This is why I decided not to work. We are living quite well now, so we’ll have to adjust. I just wanted to make sure not to add financial duress to the situation, so I borrowed all I could, WITHOUT resorting to private loans.

  • shanport7300 Said:


1. living through med school on the aid that I am getting w/o taking out private loans.



You might be able to make, especially if you work. However, between studying, work and daughter it will be a stretch. So you might have to consider the private loan option. What I would do is just apply, get money, see for a few months how you are doing and decide. You can always return the money. Yes it will cost, but at least it is better to be prepared. Poor financial planning may get in the way of your education. Yes you will borrow more, but when you make it, you will repay it.

  • shanport7300 Said:


2. Not having to work every free day (or at least summers) I do have during medical school so I can keep some sanity and not constantly be chasing the dollar during med school just to help pay the most basic of bills.



I think you should seriously consider borrowing what you need. You have your daughter, your health, and Med School is truly grueling. It takes so much that being overworked and tired all time is miserable. I have my wife to help. We feel the stress and strain. It is hard being two, I can't imagine what it will be being alone.

  • shanport7300 Said:


3. Putting money away for "retirement" when I do exit medical school. More of a "just in case" anything happens to me fund than a "retirement" fund, but let's just call it retirement and hope that some day I can use it for that!



Big issue for me as well, unfortunately I have to worry about putting food on the table. One step at a time.

  • shanport7300 Said:


4. Paying off student loans reasonably so that #3 is possible also, but also so I don't have to live like a college student the rest of my life either. Y



Or you can consider your education repayment a bit like an insurance. A friend of mine, well into his 40s always took the issue lightly. He kept saying, he would pay the minimum amount every month until it is either paid or he dies. It is something that you should be able to afford and still live decently

So right now, you should focus on setting a viable situation (finances, time to study and time with daughter). You should also think about your performance if you want to avoid primary care, then you will have to do better because the competition is tough. It is better to loose some now (i.e. more money to borrow, more interest to pay off), but end up doing what you want and what you like.

Now I avoided private loans, because I can and I don't pretend to know what it is like to have to resort to these. But again, you can always get the money and give it back if you feel you don't need it. Or keep it if you feel things are too rough otherwise.

Thank you redo-it-all! Your perspective is a great addition to this conversation. I also am happy to hear I am not the only old med student focusing on a non-primary care career. Having shadowed a Peds ENT and loving it and then looking into how competitive ENT is I knew I’d have to be on top of my game for sure. I did extremely well in undergrad, but who of us didn’t, right? We got in which tells us something right there. So, to be honest, I’ve already got some Step 1 books and am already sort of planning on how I will use these books to guide my studies in M-1 and M-2. I’ve already put feelers out there with my PEDS ENT mentor in order to make some connections and maybe get some additional experience over the summer (next summer after M-1 that is). I also know I have an interest in GAS and neurology (Peds specifically) and so I’m working the resources to make those connections early on as well.


I may have a lot of time before I have to make the decisions about residency and fellowship but I’m an uber-planner and it’s never too early to start setting things in motion. In my world, times goes fast and I don’t like to be unprepared.


That being said, I’m going to med school, and chances are there will be many others who are just like me and plan ahead and work extra hard to stay on top of their game. Many of them do not have a child, either. So, we all know that it is harder for us non-trad’s. It just is.


As such, the more I think about working at all during medical school the more I realize that I may not want to do this. As you mentioned, redo-it-all, it may be a good idea to just line up the private loans and not necessarily use them, but have them at the ready, just in case. I really want to avoid private loans at all costs, but I also don’t want to be consumed with financial worries when I have other things that need my energy far more. There is nothing worse to me than that sinking, horrible doom and gloom of lack of money just to get by. I cannot have that on top of trying to make it in medical school and keep my daughter’s happiness and well-being central also.


I have so much help, so I know I’m not alone. I may be a divorced mother, but my family is a huge help. They just can’t help me financially in any significant way, and that’s okay. If I didn’t have them, I’d be forced to take on private loans and hire a nanny for those times when I just need a little extra help (lots of times!). I’m very fortunate. Very fortunate!


So, my plan now is to devise a more serious budget. I have a pretty strict one as it is, but to be honest as I finished my degree I had a lot of wiggle room financially. Thanks to Pell Grants, a $2,000 per semester scholarship I had, federal aid, and more flexibility to work, I have been doing alright. There isn’t so much wiggle in the medical school financial aid. I got zero free money from my medical school despite a stellar undergrad record, a 0 EFC, being a single mom, etc.


So, yeah, if you think you were something special in undergrad think again in medical school because everyone is special in med school. lol. I do also understand that M-1 is not the year to get scholarships anyway. Not until you prove yourself in medical school do some of those opportunities come available. Though, my school also offers institutional aid which in some cases is scholarships (small ones, but still) and in some cases are small loans with very favorable terms.


I may still get something from this for M-1, but I’m not holding out hope. I’ve been told that all merit aid has already been offered (I hate to say it, but I’m wondering just how great those who got that aid are. I have a 3.9 undergrad, 4.0 in my major all while going through a divorce, having a young child, working two jobs at times! First in my fam. to get a college degree, etc. Ok, stop complaining, I know. Just needed a little pity party) and that some non-merit institutional aid is still available, but will probably go to M-2’s and up first. I was offered a GRAD Plus, and two un-subsidized loans thus far. Of course, these equal the cost of attendance and no more. We all know that there is very little room in the COA figures for anything extra.


So, serious budget is #1. More serious than it already is which is saying something. #2: Investigate private loans just in case. #3 Focus on my child and my school performance and use #2 if necessary so I can stay on top of my game w/o getting sick over money. #4 Do my best to get a paid summer research opportunity during summer between M-1 and M-2 to get connections and money. If #4 doesn’t work, go back to my job for the summer. #5 Take things one step at a time! and Breathe. I’m not the first and I won’t be the last so options are out there and will be out there.


I appreciate everyone’s thoughts thus far as they have been a huge help as I ponder the best path for me in navigating the financial roads of medical school and beyond for a non-trad.


I do still welcome further thoughts and would still love to hear more from non-trads seeking non-primary care careers and those who have already achieved this! I just don’t see myself in primary care and I know there are others out there who are over 30 (over 35) who feel the same.


Thanks again! I can always count on OPM to listen to me and respond respectfully and with great thoughts.

  • shanport7300 Said:


I may have a lot of time before I have to make the decisions about residency and fellowship but I'm an uber-planner and it's never too early to start setting things in motion. In my world, times goes fast and I don't like to be unprepared.



You are doing everything just well. You know how time works and that's why you are starting now.

  • shanport7300 Said:


That being said, I'm going to med school, and chances are there will be many others who are just like me



I do not think so. Kids in Med School don't have kids and they can take the time they want when they want to do what they want (unlike us). So actually I'd say that the activities that students tend to be involved in evolve more on going on fun volunteering trips (which are great), and various other activities that are more to discover rather than to prepare. Sure it adds to the CV, but many are not so focused yet. As for Step 1, I don't even know what it is right now!. I have some books, but keeping up with the material is hard enough. There is no way I can add to my plate now. I will have to eventually.

  • shanport7300 Said:


I have so much help, so I know I'm not alone.They just can't help me financially in any significant way, and that's okay. If I didn't have them, I'd be forced to take on private loans and hire a nanny for those times when I just need a little extra help (lots of times!). I'm very fortunate. Very fortunate!



You have no idea how valuable and important this is. If I had to chose help in from of money or time from my family, I would take time and by a long shot.

No family here, so we have to constantly struggle to make sure kids are picked up and that there is always one of us. This is THE struggle for me, more than that 200K or so of debt.. You may say, well money would solve all the problems. Well not really, try to leave your kid with someone you don't know over family... That's a totally different experience. So you are lucky and I'd say, that the stage is set for you to do well if you wish to do so. Just plan it and don't let money be in your way.

It's all about balance. Get what you need. Make life for you and your daughter comfortable, that doesn't mean it has to be eccentric either. You have to focus on doing well at the lowest possible cost. That means psychological sanity and good health. These can't be achieved if you worry all the time for everything.

Keep us posted. And by the way, Congrats again. You are doing great!


Thanks again, redo-it-all! And congrats to you as well as it sounds like you’re managing and doing what is right for your family!


The step 1 thing is a “Trick” I learned from a YouTube poster who is either in medical school or is done with it. In his “how to study x in medical school” videos insert “biochem” or “physiology” or whatever for x he recommends getting the step 1 books in M-1 and using these books to help focus your studies in those courses. He said with biochem in particular that he didn’t do this as an M-1 and wished he had. So, I have “First Aid for the USMLE Step 1”, and a few Board Review Series books (all cheap and used, btw!). Of course, until I start M-1 I don’t know how I’ll structure my studies to keep focused on both what my prof wants me to know and what Step 1 is going to want me to know. However, I think a lot of schools try to structure courses to coincide well with Step 1 focused questions, etc.(I know that current M-1s and M-2s at my school say that MCW does this and often uses Step 1 type questions in lectures, exams, etc.) Though, it’s a balance because as one of the docs at Second Look Day at my school pointed out, patients won’t ask us multiple choice questions, of course, so they have to teach us with an eye on the step exams but also in a way that teaches us how to be great clinicians and treat patients. (duh. lol.) So, getting some Step 1 books, I’m told, to help guide what you really want to “take home” from these courses for the Step 1, is supposed to help. Now, I don’t know yet that this will work for me, but I’m willing to give it a shot.


You’re right, time and help from family is so important. I feel for you and your family because having people you know and love and trust around to help with your kid is a major benefit. It does trump money.


That being said, like you said, I cannot let money be in the way of my success and my sanity and my daughter’s well being. So, I’ll figure out a way to make it work. I never thought three years ago when I was pondering how to go full time at school that I could do it. I didn’t think there’d be any way imaginable that I could work part time, do school full time, and still live where I was and be a good provider for my daughter. But, I did it! There’s always a way…

My apologies to the OP, I missed the original post, thinking this post began with EthelR’s post.


My bad!

Read my horoscope today for fun and just had to post. Not that I necessarily believe in astrology, but sometimes the horoscope is just too apropos.


“Strive for financial stability,using plenty of discipline and a fixed budget.”


Well, okay then.

pathdr2b, I know SDN is a wacky place, but the matter of the PSLF cap is no joke. As of now people borrowing for the first time in 2014 would appear to have an uncapped PSLF as an option, but it’s quite unclear what will happen in the future.


http://educatedrisk.org/analysis/official-sta tements-obamas-2015-propo sed-budget-pslf-caps-paye -benefits-limitations


So this really has nothing to do with SDN’s atmosphere…it’s a concern to anyone considering PSLF, which OP mentioned in her post.

It would appear that the Indian Health Service offers loan repayment ($20,000/year with possibility of payment in full) to ENTs, among other specialties.


http://www.ihs.gov/physicians/index.cfm?module=job…


http://www.ihs.gov/loanrepayment/extendi ng_partici…


If you would consider the IHS/USPHS, then there is also a paid summer opportunity:


http://www.usphs.gov/student/jrcostep.aspx

  • EthelR Said:
So this really has nothing to do with SDN's atmosphere...it's a concern to anyone considering PSLF, which OP mentioned in her post.



I may be in the minority here, but I think panicking about the future has everything to do with the atmosphere of SDN.

No one knows what the future holds, so choosing a career based on the unknown future of the PSLF seems VERY unwise to me. I say go with what you love, make smart money choices, and let the chips fall where they may.

Thanks for the IHS info, EthelR. May be something to look into when the time comes.


As for PSLF, who knows, but I agree with pathdr2b in the do what you love, “make smart money choices, and let the chips fall where they may” attitude. There is, of course, some value in trying to project the future of programs that may or may not affect our career decisions, but it’s all conjecture in some respect. Who knows maybe more favorable programs will be coming up down the pike. Unlikely? Sure, but it’s no more skin off my back to be hopeful than not!


However, I do understand not wanting to do x or y because the financial cards don’t look good. I tell everyone, though, that the days of going into medicine for the money are long gone anyway, but certainly to go into medicine as a nontraditional student, well, it’s just not the goal for us old folks. These days, there are more yahoos with dubious ethics making loads of money in other more lucrative careers that do not require as much hoop jumping, years in training, and money to just get to the door and knock much less to get let in. So, medicine isn’t a money game (at least not across the board). I’m far from naive though, I also know that Docs don’t make chump change, either, but for those of us with years of life in our favor, we know the importance of not regretting and going after dreams, and doing what we love, too. A lot of younger students (though not all) certainly have no clue what they are getting into by choosing medicine and for some of them it shows and they are green as all heck. Some of these may or may not make it. Some of them already have turned away the idea of med school and are going to PA school (not that there is anything wrong with that, btw!)I really haven’t met an older student with many delusions about the career and we can work this to our advantage (and many of us already have). Perhaps our experience will also help us get out of the mounds of debt we are willingly creating for ourselves in a smarter, better way. Time will tell. Best of luck to all of us that have chosen this path!


Let’s hope there are smarter, better ways to help us all (even the young ones, too) get out debt after we’ve put so much into this path.

The issue with PSLF is the potential large savings of small payments + forgiveness vs. the guaranteed small-to-medium savings of large payments + less interest. It need not concern us at the moment, but when picking a repayment plan, there’s that.

I think it’s important to keep an eye on what’s going on with PSLF even if it isn’t immediate relevant to us. Thanks for the additional info, EthelR!

If you were brought to it, you’ll get through it. I was told if you live like a doctor in med school, you’ll live like a student as a doctor.


I have lived dirt poor, for so long, that I can make soup from an onion peel and a string bean.


My goal is to stay as frugal as I am right now, then go work at an NHSC site.


No fancy cars or houses. No eating out. No accumulation of THINGS. Having raised my children on a fixed income, then lived as a poorly paid social worker for YEARS, Not fearful.


If I end up at an inner city site where there is public transit, I don’t even need a car, for a while.


I know how to be frugal, and get things paid off, and then enjoy…afterwards…


But I am the weirdo that is not in this for the salary anyways…just want to help people, and if I succeed at doing it better than I did it before as a social worker…it’s all good.


In my 52 years I have been a welfare recipient, and also had owned 3 homes and 3 cars at one point. Money comes, and it goes. Houses come, and are sold. Cars are bought, and sold. When you are elderly, if you do not have long term care insurance, you must impoverish yourself to get medicaid to pay for long term care, and they will seize all your assets anyways.


If it is meant to happen, it will be…and you will get through it and come out the other side.


Seen people on this site get floored by scholarships and fellowships, and money they never expected.


Take a deep breath, and stride boldly forward.


It WILL be OK.