Hello all fellow dreamers. I have been thrilled to discover this web resource. My story is similar to many of the other people why have posted tales of late-blooming and dreams delayed - but not forgotten.
If my plans work out, I hope to be a M1 in the Fall of 2010. I would be 41. A life’s dream fulfilled! But, like many of you out there, paying for that dream is more like a nightmare. Despite all my research, reading on financial aid, and hoping for something better, in the long run I see that the vast majority of people - and I may be one of them - go into massive debt to finance medical school. Grant aid seems to be a relatively small percentage of the package at most schools, and those golden, full-scholarships are frequently age limited (I realized last night, much to my horror, that the National Health Corps has a cut-off age of 44 for graduation from medical school. This not only seems arbitrary, in terms of age, but in my mind hurts the program, as studies show that a higher percentage of non-trats go into primary care. My point was that I realized that yet another potential source of major funding has been denied me because of my age and nothing else. Any thoughts on this digression?)
So, in terms of funding medical school, for the past several years, while I pursue this dream, I’ve periodically considered this idea about a possible, unusual source of funding for school, and I wanted to get feedback from the non-traditional community, as to whether this thought is looney, I’m incredibly naive, it has possibilities etc…
My thought centered around the general premise of many of the state and federal primary-care, underserved physician programs. You all know the basic idea: the doctor agrees to serve in a rural/underserved area for X period of time in exchange for loan forgiveness / loan cancellation. But, what if a person could arrange for their very own, private, underderved physician program? Despite the U.S. Health Corps and many similar programs, there are still vast areas of the U.S. where health-care is either very limited or virtually non-existant. What if a prospective medical student, such as myself, or any of you out there, were to approach the local governments of small municipalities, rural areas, (after careful research) and present the town council, county government etc… this simple proposal:
- Your town, city, county has no physician, and the nearest family practice is (20-30-40 miles)
- In exchange for your local govt. funding my medical education, I would agree to live and practice in ____________ for a minimal period of two years for every year of education financed. (Two years is more than military docs are required to pay back when the military funds medical education, as I understand, unless the rules have changed)
- Funding would include full tuition, books, room and board (I’m single, no kids), and a monthly stipend.
- The agreement would provide that if I default on the agreement, I would be obligated to repay the funding source in full, plus penalties etc…
Is this the craziest idea you all have seen presented? It may be, but what if it could work? I actually think it’s fair, although not being an attorney, I know nothing of the legal complexities involved in such a deal. When we’re taling about going $150 - $250K or more into debt to finance a medical education, even a crazy idea seems at least worth the thought. I have actually found a few examples where similar ventures worked, although admittedly on a much smaller scale, and not involving medical education.
I would really appreciate some feedback on this. Does anyone know if this has actually been done for medical school somewhere in the U.S.?
Sorry for the convoluted presentation. Have benefitted greatly from reading many terrific posts. I hope you all will now share some thoughts with me.
Thanks, Craddock. State of Colorado, M, BS, 1994.
I don’t have any experience with this but it sounds good. They have to understand that you will need 3-4 years for your residency. And what about your salary when you start working for them?
Rachel Yealy
First, search for megboo’s posts on just this subject. If I remember right, her own hometown had some sort of arrangement like this and there was a scholarship she was able to apply for. But please get the details from her posts; don’t rely on my fault memory.
(I have to say that if I were a taxpaying member of a community, or a politician in that community, I wouldn’t be keen on taking the chance with an unknown quantity from out of town. Your personal relationships with people, in proposing something like what you’ve sketched out, would be key, I would think.)
Second, I know this will sound weird, but chill out a bit on the debt. Even though the interest rate for student loans has gone up, it’s still only a little over 3%. Student loans are a great deal if you ask me. My loan at this point (4 yrs after graduation) is at about $143K. I am paying about $600/month in loan payments - that’s not that much more than a car. I take a LOT of deductions out of my biweekly paycheck in order to maximize my 401(k) contribution and the $600 is still less than a third of a paycheck. (that is, the net pay, not a third of my salary) In other words, it’s hard NOT to make $100K or more per year as a doctor once you’re out of residency, and the loan burden at that point becomes less of an issue.
Third, look at the American Academy of Family Physicians website here. I haven’t looked at the main website in awhile but at one time there were some articles on there about how to land just the sort of gig you’re talking about - sole physician for an underserved area. You might have to poke around a bit but I bet you’ll find something.
Finally, maybe the NHSC has changed but I KNEW someone who was getting an NHSC scholarship in med school and she was in her fifties. Check again. Also read up on the loan forgiveness programs run by the NHSC. Even if you don’t get an NHSC scholarship, once you are looking for a “real” job after residency, you can work in positions in underserved communities that qualify for loan payoffs of various sorts.
Oh, and one other thing. How’s your Spanish? If you are bilingual or at least able to understand and be understood , you will have many more choices in terms of positions with government-run health clinics.
Welcome to OPM!
Mary
Nope its not a crazy idea at all. I am looking at the military options available to me, as I will be a mom doing this med school thing ( in about 2.5 yrs from now). My hubby being the gem he is, said he’d re-enlist if I did it, as he is former Army. The debt is daunting but not impossible as there are millions of docs doing it and they still eat. The worst thing you could do is chose something just for the benefit of the program then hate your specialty.
Be careful with the whole military thing. I was in for 13 years (active & inactive) and thankfully only had a few scares about being deployed & never did. We are in a time where physicians in the military are on their 2nd & 3rd tours to Iraq. You probably already know this with a spouse that was in the military…but it is hard on everyone in your family if you get deployed. My sister (Emergency doc) & her husband (FP) are stationed in Italy - they were not supposed to be deployed because of the size of their unit,…my sister was in Iraq for 9 months, and her EM partner followed her. They are already asking about tour #2, but her time is running out and to help out at the hospital she re-signed for a year but she was not to be deployed. She, a dentist, & a FP nurse practicioner were in a forward area - treating Marines - when trauma pts came in there were 1-4 at a time and she was basically by herself. Thankfully she had trauma exp from Cook Co & various other gang hospitals in Chicago & did wonderfully. She had joined the military to keep away from the debt - but if she could go back she would never have done it. You are paid a small amount a $/yr (same as a O-3) and once you become board certified - you can get a bonus based on your speciality (that usually takes 1-2 years)- which is still no where close to what you can make on the outside.
Yes, the debt is unbelievable, but it is do-able. And with a husband that is working at least you will have some money coming in so you can pay for expenses and help when you are paying off loans during/after residency.
Rachel Yealy, DO