Hi Everyone,
This post is a bit premature, but I can’t help but think this far ahead because of my family situation. Currently, I am 29 years old, married, and I have a 14 month-old son. I am about to enter an MSMS program (Masters in Medical Sciences) in which I may (read: will) get linked directly to the school’s DO program. By the time I will be done with DO school, I will be 35 years old. I am concerned I will not be able to pay back my student loans because the cost of tuition and living would be $75K/year (x 4 yrs, and another $48K for MSMS) for a single student, not including his/family. Of course, my wife plans on getting a job (we will be relocating), and my son will enter preschool/kindergarten by then. By the time I will complete the surgical residency (5 general / 2 vascular), I would be 42 with a student loan of ~$300K. Would it be possible to pay this off within a reasonable amount of time, say 15 years and still be attentive to my family? I’ve been told by a surgeon that I should be fine, although the tuition seems a bit high.
Sincerely,
Mick
It won’t be easy, but it’s certainly doable. Honestly, that’s not an unreasonable number. Most current medical students are racking up debt in the $200-300K range. Expect that number to continue rising. Subsidized loans are still available to get you through medical school, and as far as I know you can still defer payment until you finish residency (although the interest accumulates) so your family won’t starve while you’re training. Vascular surgery pays well and you shouldn’t have too much trouble paying back that amount as long as you’re not compelled to jump into the seven-digit mortgage right out of residency. Depending on where you’re willing to practice you might qualify for some loan forgiveness as well.
- jmdmd Said:
Deferment during residency was a feature of federal student loans made under the old FFEL program which has since been discontinued. Under the new rules, you are required to begin repayment during residency which could put a financial squeeze on a PGY-1 making $40,000/year who owes $12,000/year in student loan payments. It is still possible to get a forebearance that would allow an income-graduated repayment plan during residency. This lowers your monthly payments somewhat during residency then increases to much higher monthly payments after residency.
- TicDocDoh Said:
As mentioned above, they have changed the deferment/forbearance policy somewhat. Currently, you have to choose a payment plan upon exit counseling. Options include the traditional 10 year repayment plan (which has ridiculous payments but they are the same every month for 10 years), extended payment plan (over 20 or 30 years, the payments are the same every month), graduated extended repayment plan (30 years, but the payments are lower initially and then increase every year), and income-contingent repayment plan (where your payment is based on your income over a certain $$$ amount).
So, what I was told (and it's subject to change) is that if you planned to ask for forbearance during residency (no payments), you couldn't/shouldn't choose the income-contingent plan. Choosing that plan would require you to make payments during residency. If you choose any of the other repayment plans, you can request forbearance. Forbearance requests are granted for 12 months. Interest continues to accumulate and capitalize. You can make payments if you wish.
Your payments are not necessarily much, much higher after residency if you choose forbearance. Honestly, most residents can't afford to make even the extended graduated plan payment during residency. The ICR plan does make payments more reasonable during residency and lower the total that you end up paying compared to forbearance.
The AAMC has some great info on budgeting, loan repayment, calculators, etc. There's a great online flash slide show describing common repayment strategies (with numbers) and what payments/total costs would be like for the average medical school grad at https://www.aamc.org/video/first/mdeconomi cs.htm. It does take a while to load.
Other resources are available at: https://www.aamc.org/services/first/first_ for_residents/
Woops…I stand corrected and should have clarified. Deferment is no longer an option but forebearance is. As Emergency pointed out, sometimes it’s the only option because the minimum payment, even on a 30-yr note, is too much on a resident’s salary. Also agree that the AAMC website is an excellent source for all questions financial.
Income-based repayment is a viable option during residency, though. The minimum payment is based on your income. If the interest that accumulates is more than your payments, I believe the feds cover the difference on your subsidized loans. (Remember that parts of your loans are unsubsidized). This can give you a little bit of breathing room.
I’m going to focus on the actual path of getting to surgical residency instead of the money (unless I misinterpreted the original question).
So I’ll be 33 when I graduate med school and am going to apply for ENT. With a possible fellowship, that puts me at 7 years, so 40 years old. I’m definitely accruing a ton of debt at this point and because I want to get into academics, there are some loan-repayment programs. I haven’t been given any issues with support from my faculty. They’ve asked about my opinion about being junior faculty at age 40 and I tell them definitively that this is the path that’s right for me. The way I see it, I waited this long to get to this career, why choose something that’s not enjoyable?
Also, you have plenty of time to figure out what you want to specialize in. If you asked me what I thought I’d be specializing in on my 1st day of med school, I think ENT would have been the last thing on the list (and peds being first, offhand).
- EqualPressure Said:
IMHO, this is the dumbest "nontrad premed" question EVER!!! URGH!!!!!
"So, how do you feel about being a Doc at age X"?
Isn't the answer usually the same way I'd feel if I were age X-Y?
Just saying'..................
Yeah, I kind of think it is a BS question, especially with the fact that most of us under 50 will have no form of retirement and will probably be working in some capacity til we die. If I get asked that I will probably say something to that effect.
I think what they are trying to ask is: “Will you have a problem taking orders from young whippersnappers 10 or more years younger than you.”
Which also shouldn’t matter, since that’s basically what is happening in almost all fields.
I could see the occasional member of us Old Skool League get a little peeved by the age/authority difference, but most of us have that sort of ego in check. Also, people who have enough ego to not like taking orders from people younger than them, probably would have found another reason to not like taking orders even when they were younger. 
I have a feeling they were just checking to see if your personally would mesh with the team, and not a sign that they were doubting the abilities of us on Team Old Skool.
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Oh and something that wasn’t brought up… if you have any fears of not making enough money before you are forced to retire, studies are showing that as long as you are doing the procedures with the bad possible complications regularly, you keep your skills up, and perform them efficiently without needing to give them up by X age.
But if your 65 and think “Oh I did that surgery 5 years ago, I’ll be fine.” you might not be.