How risky is Med school student loan debt?

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
raisinsaregrapes
Posts: 124
Joined: Thu Dec 21, 2017 4:24 pm

How risky is Med school student loan debt?

Post by raisinsaregrapes » Wed Jan 31, 2018 8:26 pm

I see lots of posts from Docs on this site with mounds of student loans, and following that mounds of income. How many people end up saddled with 150k+ debt but miss out on the high income jobs afterwards?

RRAAYY3
Posts: 926
Joined: Thu Jan 17, 2013 12:32 pm

Re: How risky is Med school student loan debt?

Post by RRAAYY3 » Wed Jan 31, 2018 8:29 pm

Probably none on here; I know a 30 y/0 doctor I just helped move back home with his parents so he can attempt to rid himself of his loans

He does pretty well, but that level of debt terrifies me. Over the long haul it’ll likely be worth it

decapod10
Posts: 72
Joined: Thu Dec 28, 2017 6:46 pm

Re: How risky is Med school student loan debt?

Post by decapod10 » Wed Jan 31, 2018 8:29 pm

Depends what you consider high income, but if you are flexible with where you live, I suspect employment is nearly 100%.

123
Posts: 3489
Joined: Fri Oct 12, 2012 3:55 pm

Re: How risky is Med school student loan debt?

Post by 123 » Wed Jan 31, 2018 8:30 pm

Some may opt for the Public Service Loan Forgiveness program so for at least a few years they are likely to be n lower income positions.
The closest helping hand is at the end of your own arm.

Jack FFR1846
Posts: 7403
Joined: Tue Dec 31, 2013 7:05 am

Re: How risky is Med school student loan debt?

Post by Jack FFR1846 » Wed Jan 31, 2018 8:33 pm

There have been a few threads here with posters or spouses or friends who have finished medical school and some amount of follow on work and decided they didn't want to be MDs and were asking advice. How someone can rack up $350k to $500k in student loans with the goal of becoming an MD and not following through, I don't know.
Bogle: Smart Beta is stupid

Nate79
Posts: 3025
Joined: Thu Aug 11, 2016 6:24 pm
Location: Portland, OR

Re: How risky is Med school student loan debt?

Post by Nate79 » Wed Jan 31, 2018 8:34 pm

If graduation rate is 100% and everyone who graduates has a wonderful income then there is low risk.

Allixi
Posts: 150
Joined: Sat May 09, 2015 4:01 am

Re: How risky is Med school student loan debt?

Post by Allixi » Wed Jan 31, 2018 8:35 pm

It happens, not as often as with law students.

It might just be kind of a sad situation:

http://notadoctorjustamd.blogspot.com/2 ... m.html?m=1

Or truly tragic:

https://www.thestar.com/news/canada/201 ... grads.html

raisinsaregrapes
Posts: 124
Joined: Thu Dec 21, 2017 4:24 pm

Re: How risky is Med school student loan debt?

Post by raisinsaregrapes » Wed Jan 31, 2018 9:01 pm

I read those two articles and they were so sad. It was interesting though. I am a pilot and see many parallels between the career progression described in the blog. Pay lots of money for school, get a crappy paying high stress job in a residency (if you are lucky), then eventually get to practice and be successful. In the pilot world it's pay lots of money to take flight lessons, get a crappy job gaining hrs then flying for a regional airline, eventually get to a major airline.

User avatar
Pajamas
Posts: 6015
Joined: Sun Jun 03, 2012 6:32 pm

Re: How risky is Med school student loan debt?

Post by Pajamas » Wed Jan 31, 2018 9:05 pm

The risk from the high levels of debt may be one of the reasons so many new physicians actively seek disability insurance compared to many other people starting their careers out of school.

jayk238
Posts: 390
Joined: Tue Jan 31, 2017 1:02 pm

Re: How risky is Med school student loan debt?

Post by jayk238 » Wed Jan 31, 2018 9:08 pm

It depends on how you obtain your residency and schooling. Go to the Caribbean then yeah its a big risk.
Also, there has been rising med school admissions with stagnant residency slots- another challenge but I think with fewer foreign admissions (politics et all these days) this may be a wash.

Also, politics and economic climate play a big role. Jobs can easily shrink or become lucrative on the whims of public policy. Non physician providers are constantly threatening physicians and the technological future will not leave doctors untouched.

I dont think all of these things should scare a doctor away but knowing what I know today and where I am, I would strongly encourage all to only go if they are 1. confident they can succeed in this endeavor and 2. if their debt loads are manageable (< 200k graduating).

decapod10
Posts: 72
Joined: Thu Dec 28, 2017 6:46 pm

Re: How risky is Med school student loan debt?

Post by decapod10 » Wed Jan 31, 2018 9:09 pm

raisinsaregrapes wrote:
Wed Jan 31, 2018 9:01 pm
I read those two articles and they were so sad. It was interesting though. I am a pilot and see many parallels between the career progression described in the blog. Pay lots of money for school, get a crappy paying high stress job in a residency (if you are lucky), then eventually get to practice and be successful. In the pilot world it's pay lots of money to take flight lessons, get a crappy job gaining hrs then flying for a regional airline, eventually get to a major airline.
I briefly skimmed that article about the OHSU student. Family Practice is not considered an extremely competitive residency. It’s extremely uncommon for a US MD grad to be unable to match into an FP or internal medicine residency. I wouldn’t let that scare you OP.

If you graduate from a foreign medical school, yes much more difficult.

bubbadog
Posts: 614
Joined: Wed Mar 26, 2014 9:17 pm

Re: How risky is Med school student loan debt?

Post by bubbadog » Wed Jan 31, 2018 9:30 pm

It seems like a lot of medical students are counting on the PSLF program to wipe out their school debt for them. I am curious how this is going to play out in the next few years.

User avatar
Pajamas
Posts: 6015
Joined: Sun Jun 03, 2012 6:32 pm

Re: How risky is Med school student loan debt?

Post by Pajamas » Wed Jan 31, 2018 9:35 pm

bubbadog wrote:
Wed Jan 31, 2018 9:30 pm
It seems like a lot of medical students are counting on the PSLF program to wipe out their school debt for them. I am curious how this is going to play out in the next few years.
Many residents are freaking out about it, to say the least.

TheNightsToCome
Posts: 335
Joined: Fri Jun 30, 2017 11:48 pm

Re: How risky is Med school student loan debt?

Post by TheNightsToCome » Wed Jan 31, 2018 10:58 pm

bubbadog wrote:
Wed Jan 31, 2018 9:30 pm
It seems like a lot of medical students are counting on the PSLF program to wipe out their school debt for them. I am curious how this is going to play out in the next few years.
Some young physicians miss that boat. White Coat Investor recently described a fellow (in sixth year of training after med school) with $600,000 in school loans:

https://www.whitecoatinvestor.com/forum ... d-with-me/

Kencufc
Posts: 133
Joined: Sat Jul 30, 2016 9:36 am

Re: How risky is Med school student loan debt?

Post by Kencufc » Thu Feb 01, 2018 12:03 am

jayk238 wrote:
Wed Jan 31, 2018 9:08 pm
It depends on how you obtain your residency and schooling. Go to the Caribbean then yeah its a big risk.
Also, there has been rising med school admissions with stagnant residency slots- another challenge but I think with fewer foreign admissions (politics et all these days) this may be a wash.

Also, politics and economic climate play a big role. Jobs can easily shrink or become lucrative on the whims of public policy. Non physician providers are constantly threatening physicians and the technological future will not leave doctors untouched.

I dont think all of these things should scare a doctor away but knowing what I know today and where I am, I would strongly encourage all to only go if they are 1. confident they can succeed in this endeavor and 2. if their debt loads are manageable (< 200k graduating).
There are less residency spots in the USA than there are graduating 4th year medical students. That includes MDs and DOs. That does not include foreign and Caribbean grads. There is a push in GME to open more residency spots. Still, some residency positions go,I filled because more people are chasing the competitive programs. Less competitive residency like family Medicine will open more and more programs because they are highly in demand.

User avatar
chasingbutterflies
Posts: 60
Joined: Fri Apr 17, 2015 1:19 pm

Re: How risky is Med school student loan debt?

Post by chasingbutterflies » Thu Feb 01, 2018 12:08 am

The stagnant numbers of residency slots are becoming a big problem with increasing numbers of MD and DO schools. I finished my first year of residency in Family Medicine in 2007 and then had to leave for personal issue. I was never able to get back in though I interviewed all over the country, several years running. I managed to get my license in one of the states that doesn't require a full residency in 2009 and spent the next several years working in a free clinic for the uninsured. I was able to garner enough experience to get my first paying job as a doctor in 2013 and am currently paying off my loans. I still review for residency spots as my job opportunities are limited as a non board eligible physician, but I haven't seen any residency that will now consider anyone more than 5 years out of medical school. Med school debt in my opinion is just getting riskier by the year. You need to be very sure that this is what you want to do, you need to pass your first two out of 3 licensing exams with good marks. More than two failures and your chances of garnering a residency, even family practice, are very, very low.

User avatar
chasingbutterflies
Posts: 60
Joined: Fri Apr 17, 2015 1:19 pm

Re: How risky is Med school student loan debt?

Post by chasingbutterflies » Thu Feb 01, 2018 12:14 am

Another thing to keep in mind is that residency programs are not money making operations and rely on government funding through medicare to run. That money is not free flowing, and so the number of new residencies is still pretty low whatever the demand.

BigMoneyNoWhammies
Posts: 95
Joined: Tue Jul 11, 2017 11:58 am

Re: How risky is Med school student loan debt?

Post by BigMoneyNoWhammies » Thu Feb 01, 2018 12:27 am

raisinsaregrapes wrote:
Wed Jan 31, 2018 8:26 pm
I see lots of posts from Docs on this site with mounds of student loans, and following that mounds of income. How many people end up saddled with 150k+ debt but miss out on the high income jobs afterwards?
Anecdotally, the handful of doctors I know who graduated from US med schools racked up some serious debt in the 150-250k range, but once their residencies were done were easily making well above their total debt load in yearly gross income. All were able to pay off most/all of the debt within a handful of years by living cheaply the first few years after school. Even the one MD I know who did his med school int he Caribbean ended up making nearly 400k per year after residency and paying off his debts within 2 years of completing his residency (granted his practice area is anesthesiology, which is one of the higher paying specialties). Assuming you actually graduate, are at a US school, and follow through on practicing medicine, the risk seems pretty low.

mudphudder
Posts: 6
Joined: Wed Mar 16, 2016 11:28 pm

Re: How risky is Med school student loan debt?

Post by mudphudder » Thu Feb 01, 2018 12:42 am

It is not very risky for students who attend American MD programs or well established American DO programs. For those who attend an off-shore medical school in the Caribbean or elsewhere it is very risky.

The average medical student debt is ~170,000K although higher amounts are not unheard of. That compares to average earnings of 150-200K+ in primary care specialties and 250K+ in specialties after completing residency training. The greatest bottleneck in training is residency but nearly every American medical school graduate will match to a residency when they apply. This is not the case for those graduating from offshore medical schools where it is not uncommon to graduate and take multiple years before matching to a residency if they ever do. Without completing a residency you can't become licensed and practice independently.

User avatar
White Coat Investor
Posts: 13329
Joined: Fri Mar 02, 2007 9:11 pm
Location: Greatest Snow On Earth

Re: How risky is Med school student loan debt?

Post by White Coat Investor » Thu Feb 01, 2018 1:02 am

raisinsaregrapes wrote:
Wed Jan 31, 2018 8:26 pm
I see lots of posts from Docs on this site with mounds of student loans, and following that mounds of income. How many people end up saddled with 150k+ debt but miss out on the high income jobs afterwards?
Ha ha, you think $150K is a lot. Ha ha. That's a good one.

Typical is graduate med school with $220K and finish residency with > $300K. My record is $1.2M for a single doc and I run into couples all the time that are $900K+.

So if you've got $450K in debt and you're a pediatrician making $150K, you've got a problem.

But how many people don't end up being able to practice at all? That number is easily obtained from the match data. 5.9% of US med school grads and and 50% of IMGs (i.e. US citizens who went to med school in the Caribbean or elsewhere). It's better at the "big 3" Caribbean schools- like in the 15-20% range.
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course

decapod10
Posts: 72
Joined: Thu Dec 28, 2017 6:46 pm

Re: How risky is Med school student loan debt?

Post by decapod10 » Thu Feb 01, 2018 2:05 am

White Coat Investor wrote:
Thu Feb 01, 2018 1:02 am
raisinsaregrapes wrote:
Wed Jan 31, 2018 8:26 pm
I see lots of posts from Docs on this site with mounds of student loans, and following that mounds of income. How many people end up saddled with 150k+ debt but miss out on the high income jobs afterwards?
Ha ha, you think $150K is a lot. Ha ha. That's a good one.

Typical is graduate med school with $220K and finish residency with > $300K. My record is $1.2M for a single doc and I run into couples all the time that are $900K+.

So if you've got $450K in debt and you're a pediatrician making $150K, you've got a problem.

But how many people don't end up being able to practice at all? That number is easily obtained from the match data. 5.9% of US med school grads and and 50% of IMGs (i.e. US citizens who went to med school in the Caribbean or elsewhere). It's better at the "big 3" Caribbean schools- like in the 15-20% range.
I would say that 5.9% for US grads is still probably a little high. Some percentage of those people will match in the supplemental match. Also, it looks like the NMRP data only looks at “medical school seniors”, so i assume it doesn’t include people who match the second time around? And if someone is really worried about matching, they could avoid the more difficult residencies and stick with something like Internal Medicine, which has 98% match rate.

jayk238
Posts: 390
Joined: Tue Jan 31, 2017 1:02 pm

Re: How risky is Med school student loan debt?

Post by jayk238 » Thu Feb 01, 2018 7:30 am

decapod10 wrote:
Thu Feb 01, 2018 2:05 am
White Coat Investor wrote:
Thu Feb 01, 2018 1:02 am
raisinsaregrapes wrote:
Wed Jan 31, 2018 8:26 pm
I see lots of posts from Docs on this site with mounds of student loans, and following that mounds of income. How many people end up saddled with 150k+ debt but miss out on the high income jobs afterwards?
Ha ha, you think $150K is a lot. Ha ha. That's a good one.

Typical is graduate med school with $220K and finish residency with > $300K. My record is $1.2M for a single doc and I run into couples all the time that are $900K+.

So if you've got $450K in debt and you're a pediatrician making $150K, you've got a problem.

But how many people don't end up being able to practice at all? That number is easily obtained from the match data. 5.9% of US med school grads and and 50% of IMGs (i.e. US citizens who went to med school in the Caribbean or elsewhere). It's better at the "big 3" Caribbean schools- like in the 15-20% range.
I would say that 5.9% for US grads is still probably a little high. Some percentage of those people will match in the supplemental match. Also, it looks like the NMRP data only looks at “medical school seniors”, so i assume it doesn’t include people who match the second time around? And if someone is really worried about matching, they could avoid the more difficult residencies and stick with something like Internal Medicine, which has 98% match rate.
This.

camden
Posts: 216
Joined: Sun Sep 27, 2009 12:22 pm

Re: How risky is Med school student loan debt?

Post by camden » Thu Feb 01, 2018 9:33 am

Would reiterate that if you go to a US based MD program the loan risk is very low in most instances (though if you go to expensive private undergrad and med schools and borrow it all, then wind up in one of the lower paying specialties, maybe not so low). If you go to the Carribean for med school, you are taking a serious risk.

There has been an increasing problem in the last couple of decades with the disconnect between the growing numbers of medical school graduates and the shrinking numbers of residency slots, but the situation in which a new US based school graduate cannot find ANY residency position is quite rare---- though the available residency slot may not be in their preferred specialty. Those reading this forum who have never been associated with medicine may not know what those of us in medicine take for granted; that some medical specialties are far, far more competitive for residenciy slots than others, and a senior med student who steps his/her sights on one of the most sought after specialties runs a much greater risk of not matching at all. That does not mean all that training is wasted, just that you may have to do something other than your first choice specialty.

blueman457
Posts: 382
Joined: Sun Jul 26, 2015 12:19 pm

Re: How risky is Med school student loan debt?

Post by blueman457 » Thu Feb 01, 2018 12:46 pm

I have residents/fellows who have 300k-400k of debt because of undergraduate and medical school loans, which little family support or grants. And not all specialties are high paying so it's not necessarily easy to pay them off.

It sounds a bit "first-world, upper class" snobbery to say that $150-200k salary is a bit low, but when you've invested your prime health years (early 20's to 30's) and have 300k-500k of loans, $150k/year doesn't look stellar.

Blue Man

Boglegrappler
Posts: 1045
Joined: Wed Aug 01, 2012 9:24 am

Re: How risky is Med school student loan debt?

Post by Boglegrappler » Thu Feb 01, 2018 12:59 pm

While debt has its own special problems when you have too much relative to your income, this discussion is really a proxy for whether medical school is worth it economically.

inbox788
Posts: 5268
Joined: Thu Mar 15, 2012 5:24 pm

Re: How risky is Med school student loan debt?

Post by inbox788 » Thu Feb 01, 2018 12:59 pm

Kencufc wrote:
Thu Feb 01, 2018 12:03 am
There are less residency spots in the USA than there are graduating 4th year medical students. That includes MDs and DOs. That does not include foreign and Caribbean grads. There is a push in GME to open more residency spots. Still, some residency positions go,I filled because more people are chasing the competitive programs. Less competitive residency like family Medicine will open more and more programs because they are highly in demand.
It's not clear to me graduating medical student numbers exceed residency spots. Total applicants do, but:
Applicant Highlights
Although the 43,157 Match registrants was the most ever, the increase was due primarily to growth in U.S. allopathic medical school seniors and students/graduates of U.S. osteopathic medical schools.

The number of U.S. allopathic medical school senior registrants was 19,030, 362 more than last year; of those, a record-high 18,539 submitted program choices, and 17,480 (94.3 %) matched to first-year positions. The 94 percent PGY-1 match rate for U.S. seniors has been consistent for many years.
The number of U.S. osteopathic medical school applicants was a record high 5,000, and 3,590 submitted program choices, an increase of 608 over 2016; 2,933 (81.7%) matched to PGY-1 positions, also a record high.
http://www.nrmp.org/press-release-2017- ... on-record/

Arguably, it's less risky than the interest rates being paid, which is why companies like Sofi are taking a chance and refinancing. You don't see that with college loans.
https://www.sofi.com/medical-resident-refinance/
Last edited by inbox788 on Thu Feb 01, 2018 1:08 pm, edited 1 time in total.

clutchied
Posts: 547
Joined: Mon Jan 05, 2015 12:11 pm

Re: How risky is Med school student loan debt?

Post by clutchied » Thu Feb 01, 2018 1:05 pm

raisinsaregrapes wrote:
Wed Jan 31, 2018 9:01 pm
I read those two articles and they were so sad. It was interesting though. I am a pilot and see many parallels between the career progression described in the blog. Pay lots of money for school, get a crappy paying high stress job in a residency (if you are lucky), then eventually get to practice and be successful. In the pilot world it's pay lots of money to take flight lessons, get a crappy job gaining hrs then flying for a regional airline, eventually get to a major airline.
am CPA and it's similar as well. It's almost like you have to pay your dues...

afan
Posts: 3649
Joined: Sun Jul 25, 2010 4:01 pm

Re: How risky is Med school student loan debt?

Post by afan » Thu Feb 01, 2018 1:38 pm

There is attrition at every step. The rates are low but not everyone who gets admitted to med school ends up practicing medicine. Some people just cannot do the work in med school. Admission is so competitive that med schools try to keep the flunk out rate as low as possible. But these are people right out of college and it can be difficult to predict how they will react when abruptly forced to work much harder and challenging material.

Some people do so badly, often with psychological, medical or behavioral problems in med school that only desperate residencies will consider them. But even those peolple can get training slots if they tailor their ambitions to reality.

The people who are screwed are those who flunk out and never become eligible for residency. They may have huge debts but no medical careers.

People who don't match usually start their training on time, without taking a year off, as they take positions at residencies that did not fill their slots in the match. These are not the prestigious residencies in high demand fields. But docs who complete them can practice medicine.

The proportion of people accepted to medical school who end up practicing is definitely not 100%. It is almost certainly over 90%. You could probably find the ratio who flunk out of medical school and the proportion who never complete training. It could be hard to find out how many enter practice but health or conduct makes it impossible to practice. Unless someone has done a study it could be hard to get those data.

College students can develop more customized estimates of their risk. If they are healthy and doing very well in college, much better than most people who get in, then they are highly likely to succeed in med school. The bottom few percent who get into med school, although by any other measure excellent students, are at a lot higher risk.

Psychological problems can hit even the best students. At the very top you get people whose abilities are so far above what is required that they can be severely depressed, for example, but still learn enough to do fine. As long as they don't make successful suicide attempts they can end up practicing.

Med students are also at the age where psychoses become manifest. Some can be controlled with medication. If not then they will be unable to practice.
We don't know how to beat the market on a risk-adjusted basis, and we don't know anyone that does know either | --Swedroe | We assume that markets are efficient, that prices are right | --Fama

blueman457
Posts: 382
Joined: Sun Jul 26, 2015 12:19 pm

Re: How risky is Med school student loan debt?

Post by blueman457 » Thu Feb 01, 2018 1:54 pm

Boglegrappler wrote:
Thu Feb 01, 2018 12:59 pm
While debt has its own special problems when you have too much relative to your income, this discussion is really a proxy for whether medical school is worth it economically.
I remembered this from years ago, and put medical school costs and physician income in perspective. The assumptions aren't perfect, but it made me think:

Image

http://www.er-doctor.com/doctor_income.html

User avatar
goodenyou
Posts: 1267
Joined: Sun Jan 31, 2010 11:57 pm
Location: Skating to Where the Puck is Going to Be..or on the golf course

Re: How risky is Med school student loan debt?

Post by goodenyou » Thu Feb 01, 2018 2:02 pm

The stakes are very high at the numbers now. Upward of $85k per year to attend medical school. Remember, you have to borrow ALL living expenses for 4 years since school is year round for most of the 4 years. What many do not realize is that you may not be able to choose your specialty. If you want a high paying specialty you better first like it and second be at the top of your class. Not easy. Primary care is being savaged by PAs and NPs that “practice” right out school. No need to be well trained with a Residency where you are paid a fraction of a nurse and your loans get to compound the interest. I know because my wife is NP Dermatology Certified and can make nearly what a Pediatrician can make. There is a push for NP to get “Doctorates” so they can have it all by being called “Doctor” too .
"Ignorance more frequently begets confidence than does knowledge" | "The best years you have left are the ones you have right now"

DrGoogle2017
Posts: 1322
Joined: Mon Aug 14, 2017 12:31 pm

Re: How risky is Med school student loan debt?

Post by DrGoogle2017 » Thu Feb 01, 2018 2:26 pm

It’s risky if you somehow don’t end up working as an MD. I can think of two examples in my brother and his in laws. One already finished the MD program but I believe she had to take an exam, she got burned out. She ended up being a teacher.
The other case is the female got through and being a surgeon, married to a surgeon, but after 3 kids, she decided to stay home to raise these kids. I’m sure she still had the large loan, but with only has one surgeon income.

User avatar
goodenyou
Posts: 1267
Joined: Sun Jan 31, 2010 11:57 pm
Location: Skating to Where the Puck is Going to Be..or on the golf course

Re: How risky is Med school student loan debt?

Post by goodenyou » Thu Feb 01, 2018 3:43 pm

DrGoogle2017 wrote:
Thu Feb 01, 2018 2:26 pm
It’s risky if you somehow don’t end up working as an MD. I can think of two examples in my brother and his in laws. One already finished the MD program but I believe she had to take an exam, she got burned out. She ended up being a teacher.
The other case is the female got through and being a surgeon, married to a surgeon, but after 3 kids, she decided to stay home to raise these kids. I’m sure she still had the large loan, but with only has one surgeon income.


Happened to my best friend. Met wife when she was in private medical school after private college. He was surgical resident. She finished and did Peds residency. They got married and had 3 kids and she never practiced. That was 25 years ago. They just ended up paying off her student loans without her ever working at all let alone as a physician.
"Ignorance more frequently begets confidence than does knowledge" | "The best years you have left are the ones you have right now"

DrGoogle2017
Posts: 1322
Joined: Mon Aug 14, 2017 12:31 pm

Re: How risky is Med school student loan debt?

Post by DrGoogle2017 » Thu Feb 01, 2018 4:17 pm

goodenyou wrote:
Thu Feb 01, 2018 3:43 pm
DrGoogle2017 wrote:
Thu Feb 01, 2018 2:26 pm
It’s risky if you somehow don’t end up working as an MD. I can think of two examples in my brother and his in laws. One already finished the MD program but I believe she had to take an exam, she got burned out. She ended up being a teacher.
The other case is the female got through and being a surgeon, married to a surgeon, but after 3 kids, she decided to stay home to raise these kids. I’m sure she still had the large loan, but with only has one surgeon income.


Happened to my best friend. Met wife when she was in private medical school after private college. He was surgical resident. She finished and did Peds residency. They got married and had 3 kids and she never practiced. That was 25 years ago. They just ended up paying off her student loans without her ever working at all let alone as a physician.
I can see that for other pediatricians but surgeons, it takes a long time to become a good one. It’s not for the faint of heart. And then you can’t come back easily as a surgeon either, who wants to be operate by someone who has not operate for a while.

afan
Posts: 3649
Joined: Sun Jul 25, 2010 4:01 pm

Re: How risky is Med school student loan debt?

Post by afan » Thu Feb 01, 2018 6:59 pm

https://www.google.com/url?q=https://ww ... dvfffW7-nZ

Only a little over 80% of medical students graduate in 4 years. But by 8 years the graduation rate is about 97%.

College students have little chance of predicting their odds of getting into a high paying specialty. One rather poor predictor is the medical school they will attend. Someone headed for Stanford has a better chance of getting into neurosurgery than someone going to a bottom third medical school. But even at elite schools students have to do very well to get into the high demand residencies.
We don't know how to beat the market on a risk-adjusted basis, and we don't know anyone that does know either | --Swedroe | We assume that markets are efficient, that prices are right | --Fama

Helo80
Posts: 706
Joined: Sat Apr 29, 2017 8:47 pm

Re: How risky is Med school student loan debt?

Post by Helo80 » Thu Feb 01, 2018 8:01 pm

Jack FFR1846 wrote:
Wed Jan 31, 2018 8:33 pm
There have been a few threads here with posters or spouses or friends who have finished medical school and some amount of follow on work and decided they didn't want to be MDs and were asking advice. How someone can rack up $350k to $500k in student loans with the goal of becoming an MD and not following through, I don't know.
Because the dream is better than the reality for some. The profession can jade you really quickly.

I say this in a friendly way, :) , but if you have never been to medical school, there is really no way for you to appreciate the suck... medicine by proxy through a SO, parent, child, etc. gives one a closer glimpse than most, but not the true reality.

If you are a resident, fellow or attending, I hope for you're on sake that you're not blinded by the reality of what you do on a daily basis.

What happens with medicine is that like you said, you get $250k to $500k (or more) in debt and you become an indentured servant. If you hit all of the milestones as early as possibly, you're generally 30-ish by the time you get your first real paycheck to compensate you. Now, you have all of those student loans to pay back, as well as, having a full-time schedule work week that is probably more than the typical 40 hours us normal folk work.

Helo80
Posts: 706
Joined: Sat Apr 29, 2017 8:47 pm

Re: How risky is Med school student loan debt?

Post by Helo80 » Thu Feb 01, 2018 8:11 pm

Boglegrappler wrote:
Thu Feb 01, 2018 12:59 pm
While debt has its own special problems when you have too much relative to your income, this discussion is really a proxy for whether medical school is worth it economically.

Here are a couple of thoughts on that from my own viewpoint:

1. Very few people would take on the debt and education time to become a physician if it paid social worker salaries in the end.
2. That being said, I'd say 30% of any medical school glass is there purely because of the good money in the end


My honest viewpoint is that if you really just want to make a lot of money, freakin' be a business finance major or computer science major. If you work half as hard in those fields (okay, investment banking may be on par), as you do in medicine, you're going to do really, really well and earn MD level monies without the headaches of taking care of patients. It's obscene how much money there is flowing on Wall Street and in corporate finance. Also, your finance jobs can be just as cut-throat, if not more cut-throat than medical school classes and residencies... so hey, a lot of med students would fit right in.

Helo80
Posts: 706
Joined: Sat Apr 29, 2017 8:47 pm

Re: How risky is Med school student loan debt?

Post by Helo80 » Thu Feb 01, 2018 8:15 pm

blueman457 wrote:
Thu Feb 01, 2018 12:46 pm
It sounds a bit "first-world, upper class" snobbery to say that $150-200k salary is a bit low, but when you've invested your prime health years (early 20's to 30's) and have 300k-500k of loans, $150k/year doesn't look stellar.

Unfortunately, that's why Primary Care specialties continued to get panned by many a medical student..... it's not so much that people do not like the fields, I know some that would be very good and love outpatient PC, but you have to pay the student bills down and you don't want a job being outsourced to PAs and NPs.

As it stands now, Medicare and insurance cos reward services... not clinical visits. Part of me gets frustrated that PCP get the proverbial s*** on by both practicing physicians, residents and med students for being the "easy" fields to match into... but the other part of me realizes that you cannot fault people for chasing the money. For you older physicians on here, you've personally seen what's happened to Dermatology and Orthopedic Surgery from what it was 30 years ago to what it is now.

jayk238
Posts: 390
Joined: Tue Jan 31, 2017 1:02 pm

Re: How risky is Med school student loan debt?

Post by jayk238 » Thu Feb 01, 2018 8:26 pm

blueman457 wrote:
Thu Feb 01, 2018 1:54 pm
Boglegrappler wrote:
Thu Feb 01, 2018 12:59 pm
While debt has its own special problems when you have too much relative to your income, this discussion is really a proxy for whether medical school is worth it economically.
I remembered this from years ago, and put medical school costs and physician income in perspective. The assumptions aren't perfect, but it made me think:

Image

http://www.er-doctor.com/doctor_income.html
This is incredibly misleading quote- also it looks like a crappy website hawking nonsense.

I remember when UPS went public and drivers made a killing- totally get that part but if you weren't part of that cohort all I ever remember is that UPS drivers have struggled since.

Few issues. 1 UPS doesnt allow most people to work absurd hours. They require most new employee drivers to drive a fewer hours in a part itme basis- with overtime they are lucky to hit 80 90 a year- this equals 55-60 hrs a week- clearly doctors hours already. Usually its the doctors with longer years to have extra shifts/hours to make more money

next they peg doctors wages at 180k and then on top of that keep it at the same 180k even when implying really long hours. I dunno who this doctor is but he clearly was terrible at negotiating.

Rubbish all around.

Helo80
Posts: 706
Joined: Sat Apr 29, 2017 8:47 pm

Re: How risky is Med school student loan debt?

Post by Helo80 » Thu Feb 01, 2018 8:27 pm

DrGoogle2017 wrote:
Thu Feb 01, 2018 4:17 pm
I can see that for other pediatricians but surgeons, it takes a long time to become a good one. It’s not for the faint of heart. And then you can’t come back easily as a surgeon either, who wants to be operate by someone who has not operate for a while.
*cough* county hospital *cough*

That's not to disparage people that actually work at county hospitals here. But rather, there is going to be some hospital some where that needs a surgeon and the economics of what somebody is willing to work for and what the role offers will match up. Usually, county hospitals see a large indigent population that cause decreased operating revenues.

jayk238
Posts: 390
Joined: Tue Jan 31, 2017 1:02 pm

Re: How risky is Med school student loan debt?

Post by jayk238 » Thu Feb 01, 2018 8:33 pm

goodenyou wrote:
Thu Feb 01, 2018 2:02 pm
The stakes are very high at the numbers now. Upward of $85k per year to attend medical school. Remember, you have to borrow ALL living expenses for 4 years since school is year round for most of the 4 years. What many do not realize is that you may not be able to choose your specialty. If you want a high paying specialty you better first like it and second be at the top of your class. Not easy. Primary care is being savaged by PAs and NPs that “practice” right out school. No need to be well trained with a Residency where you are paid a fraction of a nurse and your loans get to compound the interest. I know because my wife is NP Dermatology Certified and can make nearly what a Pediatrician can make. There is a push for NP to get “Doctorates” so they can have it all by being called “Doctor” too .
I've heard of CRNas make similar money- 160-200 with good hours and I've heard of PAs working for successful private psychiatry practices make 200k.

But really though if a doctor is making nursing money its their fault. There is no reason to be in that position because there are many many jobs that offer high pay if they choose to. Family doctors who are willing to do ED work can make well over 500k a year. Its just up to their choices.

And to be honest, I would rather make less money and still be in a position where my choices make a difference for a human life as opposed to a NP who is always just following orders or making decisions for simple issues- UTIs, URTIs. Its a matter of perspective in this case (not a knock on the profession, just a matter of what kind of challenge you want in life).

ny_knicks
Posts: 193
Joined: Wed Jan 04, 2017 11:20 pm

Re: How risky is Med school student loan debt?

Post by ny_knicks » Thu Feb 01, 2018 8:56 pm

Medicine seems fairly low risk in the grand scheme of things. Once you have a job I feel like the prospect of losing your job is very low. Pay is high, stays high and you aren't forced out at 55.

US med schools seem so competitive that if you have the ability to get in you should have the ability to finish. I wouldn't bat an eye at $250k in debt to become a doctor but there is a lot more people on here who are much more familiar with the field that might offer better advice.
jayk238 wrote:
Thu Feb 01, 2018 8:33 pm
I've heard of CRNas make similar money- 160-200
Not sure what Doctors make in NYC but if it is anything below $300k they are doing something wrong. And I believe rural areas pay doctors even more.

Starting salary here for:
CRNA - $160k
NP - $130k
RN - $90k

Know multiple RNs here who clear $150k working 50 hour weeks w/ amazing health benefits, 6 weeks PTO and a pension. Have to imagine a NP/CRNA putting in similar hours would be well over $200k. Based on this doctors have to be well north of that to justify the additional education, training, hours and the fact that they drive revenue for the hospital.

staythecourse
Posts: 5812
Joined: Mon Jan 03, 2011 9:40 am

Re: How risky is Med school student loan debt?

Post by staythecourse » Thu Feb 01, 2018 8:58 pm

goodenyou wrote:
Thu Feb 01, 2018 2:02 pm
The stakes are very high at the numbers now. Upward of $85k per year to attend medical school. Remember, you have to borrow ALL living expenses for 4 years since school is year round for most of the 4 years. What many do not realize is that you may not be able to choose your specialty. If you want a high paying specialty you better first like it and second be at the top of your class. Not easy. Primary care is being savaged by PAs and NPs that “practice” right out school. No need to be well trained with a Residency where you are paid a fraction of a nurse and your loans get to compound the interest. I know because my wife is NP Dermatology Certified and can make nearly what a Pediatrician can make. There is a push for NP to get “Doctorates” so they can have it all by being called “Doctor” too .
Interesting as a physician married to one and from a family of ones (both dads, uncles, and sisters) I dare to say I would rather my kids be PA's or sub specialty NP. The difference in pay is not as extreme as it used to be and likely to narrow in the next 10-20 years outside of the highest paying sub specialty fields in medicine on an after tax basis. The work hours are a lot better. You are a true rank and file employees in corporate medicine where you do work on from x to y time. Love how employed docs are not even compensated for call or phone calls on off time (other docs, coordinating care, and talking to families). Also, a lot less years before making money AND a lot less debt. Throw in the fact you have A LOT less mental stress and medical liability since you are not the final one calling the shots.

This is likely to be taken sexist, but if my daughter wants to be in medicine I think I prefer that route over being an MD if there is a good chance she wants a family life (husband, kids, etc...). Going through ALL that to do part time or not work is a total waste of time on a financial sense.

Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” | -Jack Bogle

kmurp
Posts: 275
Joined: Fri Jun 01, 2007 1:53 pm

Re: How risky is Med school student loan debt?

Post by kmurp » Thu Feb 01, 2018 9:12 pm

People have been predicting the death of medicine since long before I graduated (1983). Like stock market predictions, one day they may be right. That said, I would do it all over again ( but I’d save more money and “stay the course”).

EnjoyIt
Posts: 1524
Joined: Sun Dec 29, 2013 8:06 pm

Re: How risky is Med school student loan debt?

Post by EnjoyIt » Thu Feb 01, 2018 9:16 pm

jayk238 wrote:
Thu Feb 01, 2018 8:33 pm
goodenyou wrote:
Thu Feb 01, 2018 2:02 pm
The stakes are very high at the numbers now. Upward of $85k per year to attend medical school. Remember, you have to borrow ALL living expenses for 4 years since school is year round for most of the 4 years. What many do not realize is that you may not be able to choose your specialty. If you want a high paying specialty you better first like it and second be at the top of your class. Not easy. Primary care is being savaged by PAs and NPs that “practice” right out school. No need to be well trained with a Residency where you are paid a fraction of a nurse and your loans get to compound the interest. I know because my wife is NP Dermatology Certified and can make nearly what a Pediatrician can make. There is a push for NP to get “Doctorates” so they can have it all by being called “Doctor” too .
I've heard of CRNas make similar money- 160-200 with good hours and I've heard of PAs working for successful private psychiatry practices make 200k.

But really though if a doctor is making nursing money its their fault. There is no reason to be in that position because there are many many jobs that offer high pay if they choose to. Family doctors who are willing to do ED work can make well over 500k a year. Its just up to their choices.

And to be honest, I would rather make less money and still be in a position where my choices make a difference for a human life as opposed to a NP who is always just following orders or making decisions for simple issues- UTIs, URTIs. Its a matter of perspective in this case (not a knock on the profession, just a matter of what kind of challenge you want in life).
Family practice docs working in the ED is becoming more and more rare as many hospitals are starting to require board certification. Hospitals that do allow family practice in the ER are more needy in outlying areas. Also FP docs doing ED work tend to get paid less. Lastly, there are very very very very very few ED docs making $500k/yr.

EnjoyIt
Posts: 1524
Joined: Sun Dec 29, 2013 8:06 pm

Re: How risky is Med school student loan debt?

Post by EnjoyIt » Thu Feb 01, 2018 9:18 pm

One of my med school roommates was unable to finish school. He accumulated well over $100k in debt and failed out.

Generally speaking if a physician isn't financially illiterate and able to make a decent income they should be able to pay down their debt. Even if it takes them 20-30 years.

Brambor
Posts: 1
Joined: Thu Feb 01, 2018 9:17 pm

Re: How risky is Med school student loan debt?

Post by Brambor » Thu Feb 01, 2018 9:22 pm

Jeez, lots of depressing outlooks on this page but I guess most of them are realistic. I think the answer to your question is that it is low risk considering the overall job market and growing need for more physicians. I was lucky to go to medical school in state at a Texas medical school, about 12K a year tuition. Somehow ended up with 280K in debt?? I screwed that one up but luckily I chose a high paying specialty.

User avatar
StormShadow
Posts: 575
Joined: Thu Feb 09, 2012 6:20 pm

Re: How risky is Med school student loan debt?

Post by StormShadow » Thu Feb 01, 2018 9:50 pm


Those scenarios, fortunately, are rare. The closest I've seen to this is a mediocre-ish med student aiming for a super competitive specialty, and not willing to compromise... before realizing (by not matching/scrambling) it just isn't going to happen and they settle for a less competitive specialty.

My primary messages to future prospective med students:
1. Make absolutely sure you want to be a doctor before applying/starting med school.
2. If you get accepted to med school (congratulations!), don't take your foot off the gas once you start. From day one, aim to excel and never look back.
Last edited by StormShadow on Thu Feb 01, 2018 10:08 pm, edited 1 time in total.

jayk238
Posts: 390
Joined: Tue Jan 31, 2017 1:02 pm

Re: How risky is Med school student loan debt?

Post by jayk238 » Thu Feb 01, 2018 10:04 pm

EnjoyIt wrote:
Thu Feb 01, 2018 9:16 pm
jayk238 wrote:
Thu Feb 01, 2018 8:33 pm
goodenyou wrote:
Thu Feb 01, 2018 2:02 pm
The stakes are very high at the numbers now. Upward of $85k per year to attend medical school. Remember, you have to borrow ALL living expenses for 4 years since school is year round for most of the 4 years. What many do not realize is that you may not be able to choose your specialty. If you want a high paying specialty you better first like it and second be at the top of your class. Not easy. Primary care is being savaged by PAs and NPs that “practice” right out school. No need to be well trained with a Residency where you are paid a fraction of a nurse and your loans get to compound the interest. I know because my wife is NP Dermatology Certified and can make nearly what a Pediatrician can make. There is a push for NP to get “Doctorates” so they can have it all by being called “Doctor” too .
I've heard of CRNas make similar money- 160-200 with good hours and I've heard of PAs working for successful private psychiatry practices make 200k.

But really though if a doctor is making nursing money its their fault. There is no reason to be in that position because there are many many jobs that offer high pay if they choose to. Family doctors who are willing to do ED work can make well over 500k a year. Its just up to their choices.

And to be honest, I would rather make less money and still be in a position where my choices make a difference for a human life as opposed to a NP who is always just following orders or making decisions for simple issues- UTIs, URTIs. Its a matter of perspective in this case (not a knock on the profession, just a matter of what kind of challenge you want in life).
Family practice docs working in the ED is becoming more and more rare as many hospitals are starting to require board certification. Hospitals that do allow family practice in the ER are more needy in outlying areas. Also FP docs doing ED work tend to get paid less. Lastly, there are very very very very very few ED docs making $500k/yr.
Appreciate your perspective but you are not correct.
If you are in the medical field then you havent looked at the data recently.

Fp docs doing em is alive and well in many parts of the country. Its not anywhere in large urban and subruban areas but go out to a community thats pop 100k or less and more than 2 hrs from a large city and there are many many fm docs working the er shift.
How say am I this confident? Because my fm colleagues have routinely signed such contracts. Same can be said of my fellow IM residents. This is far more common.

On the other point, Ill just say I know what Im talking about as my colleagues and I have been comparing detailed notes on contracts offered and signed.

jayk238
Posts: 390
Joined: Tue Jan 31, 2017 1:02 pm

Re: How risky is Med school student loan debt?

Post by jayk238 » Thu Feb 01, 2018 10:11 pm

StormShadow wrote:
Thu Feb 01, 2018 9:50 pm
raisinsaregrapes wrote:
Wed Jan 31, 2018 8:26 pm
I see lots of posts from Docs on this site with mounds of student loans, and following that mounds of income. How many people end up saddled with 150k+ debt but miss out on the high income jobs afterwards?
Fortunately, the vast majority of US-based med students will graduate and "match" a residency (through an organization called the NRMP). Those few who don't match the first time, often will be able to "scramble" into a residency (literally a 24 hour mad dash to contact as many remaining available residency positions in the specialty you like and try to secure a contract over the phone). It is by no means a guarantee. I had to "scramble" for my internship year (first year of residency), even though I matched my remaining residency years (by being cocky and stupid by not "ranking" enough places on my intern match list). It was incredibly stressful and NOT fun.

One of my friends in med school didn't match the first time and wasn't successful in the scramble. He was trying to enter a relatively competitive specialty (emergency medicine) and didn't want to settle for anything else. He had to sit out a year (got a gig doing volunteer research), then successfully matched the following year. He's doing fine.

A more common scenario: someone that starts med school and quits before graduating. That, or someone who flunks out of med school. The VAST majority of folks in this camp will have left within the first two years of med school (the "basic sciences" years, devoted exclusively to constant studying/testing and likely the most difficult time of their life). I know a few of those in this camp, and they basically had to service their med school loans while navigating a different career. While they don't accumulate as much school loans (since they didn't finish 4 years), its still a lot and I can't imagine how much of a pain in the rear it would be.

The outliers such as:

Those scenarios, fortunately, are rare. The closest I've seen to this is a mediocre-ish med student aiming for a super competitive specialty, and not willing to compromise... before realizing (by not matching/scrambling) it just isn't going to happen and they settle for a less competitive specialty.

I suppose my primary messages to future prospective med students:
1. Make absolutely sure you want to be a doctor before applying/starting med school.
2. If you get accepted to med school (congratulations!), then don't take your foot off the gas once you start. From day one, aim to excel and never look back.
100% disagree on medschool being the most difficult time. Residency is the most difficult time in life. Sure studying was nerve wracking but being an intern in the middle of the night and figuring out whether to intubate someone or not was my hardest moment. Having life and death in my hands changed me for good and probably for the worse-depression anxiety high stress. Granted Im in IM and I know a lot of er docs go through this and are fine as are surgeons but its not an easy job and it is highly stressful. I see it in the er residents and the ccu attendings just as much. It takes a certain person.

I can categorically say that all of my colleagues have felt this sense of stress and dread. I certainly didnt experience it in med school. If I was told before med school this is what would happen and at the end of the road was a 6 figure salary I would have said no thank you. Or I would have worked extra hard to be a derm ;)

Med school is a joke compared to hospital medicine and no doubt surgery (entirely in its own world)

jayk238
Posts: 390
Joined: Tue Jan 31, 2017 1:02 pm

Re: How risky is Med school student loan debt?

Post by jayk238 » Thu Feb 01, 2018 10:16 pm

staythecourse wrote:
Thu Feb 01, 2018 8:58 pm
goodenyou wrote:
Thu Feb 01, 2018 2:02 pm
The stakes are very high at the numbers now. Upward of $85k per year to attend medical school. Remember, you have to borrow ALL living expenses for 4 years since school is year round for most of the 4 years. What many do not realize is that you may not be able to choose your specialty. If you want a high paying specialty you better first like it and second be at the top of your class. Not easy. Primary care is being savaged by PAs and NPs that “practice” right out school. No need to be well trained with a Residency where you are paid a fraction of a nurse and your loans get to compound the interest. I know because my wife is NP Dermatology Certified and can make nearly what a Pediatrician can make. There is a push for NP to get “Doctorates” so they can have it all by being called “Doctor” too .
Interesting as a physician married to one and from a family of ones (both dads, uncles, and sisters) I dare to say I would rather my kids be PA's or sub specialty NP. The difference in pay is not as extreme as it used to be and likely to narrow in the next 10-20 years outside of the highest paying sub specialty fields in medicine on an after tax basis. The work hours are a lot better. You are a true rank and file employees in corporate medicine where you do work on from x to y time. Love how employed docs are not even compensated for call or phone calls on off time (other docs, coordinating care, and talking to families). Also, a lot less years before making money AND a lot less debt. Throw in the fact you have A LOT less mental stress and medical liability since you are not the final one calling the shots.

This is likely to be taken sexist, but if my daughter wants to be in medicine I think I prefer that route over being an MD if there is a good chance she wants a family life (husband, kids, etc...). Going through ALL that to do part time or not work is a total waste of time on a financial sense.

Good luck.
Thats a harsh assessment but in many ways true.

Post Reply