How risky is Med school student loan debt?

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Smorgasbord
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Re: How risky is Med school student loan debt?

Post by Smorgasbord » Sat Feb 03, 2018 12:43 pm

Helo80 wrote:
Thu Feb 01, 2018 8:11 pm
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.
I believe the people you are referring to are called "Veterinarians" :D

golfCaddy
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Re: How risky is Med school student loan debt?

Post by golfCaddy » Sat Feb 03, 2018 12:49 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
He seems to assume UPS drivers don't pay taxes. A UPS driver working a 40 hour week might be able to gross $60k/year, but there's no way they're going to have that as a net income.
Last edited by golfCaddy on Sat Feb 03, 2018 12:49 pm, edited 1 time in total.

scorcher31
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Re: How risky is Med school student loan debt?

Post by scorcher31 » Sat Feb 03, 2018 12:49 pm

EnjoyIt wrote:
Sat Feb 03, 2018 12:33 pm
ny_knicks wrote:
Fri Feb 02, 2018 7:34 pm

I would imagine that in most locations in the U.S. doctors are some of the most well compensated individuals. Different specialities pay more/less but on a whole it seems like an MD is a fairly safe bet to a very well paying/safe job irrespective of where you decide to live.
In most cases you are correct. The only outliers would be those with extremely high debt and a poor paying practice. I.e. Private undergrad with expensive med school. People like that can have $400k+ in debt making less than $200k/yr. That is a recipe for burnout and disaster.

I also unfortunately see so many doctors living in VHCOL areas living on credit/paycheck to paycheck.
I even think a 200k salary with 400k debt, even without a second spousal income, is very doable for a physician. They just have to keep with it, i.e. not become disabled/burn out of the field, live like a resident/student for a few years, and stay away from a VHCOL areas(NYC, Boston, certain areas in California).

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Re: How risky is Med school student loan debt?

Post by Herekittykitty » Sat Feb 03, 2018 1:00 pm

Nate79 wrote:
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.
But the graduation rate is not 100% and not everyone who graduates has a wonderful income.

In fact, not everyone graduates from medical school. Not everyone who graduates from medical school gets into a residency. Not everyone who gets into a residency graduates from residency. And you have to graduate from residency to get a job practicing medicine.
I don't know anything.

DrGoogle2017
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Re: How risky is Med school student loan debt?

Post by DrGoogle2017 » Sat Feb 03, 2018 1:11 pm

EnjoyIt wrote:
Sat Feb 03, 2018 12:33 pm
ny_knicks wrote:
Fri Feb 02, 2018 7:34 pm

I would imagine that in most locations in the U.S. doctors are some of the most well compensated individuals. Different specialities pay more/less but on a whole it seems like an MD is a fairly safe bet to a very well paying/safe job irrespective of where you decide to live.
In most cases you are correct. The only outliers would be those with extremely high debt and a poor paying practice. I.e. Private undergrad with expensive med school. People like that can have $400k+ in debt making less than $200k/yr. That is a recipe for burnout and disaster.

I also unfortunately see so many doctors living in VHCOL areas living on credit/paycheck to paycheck.
I believe my nephew is in this category, $400k debt, making somewhere between $250k-$300k, ER doctor. No undergraduate debt even, he got scholarship all 4 years and commuted from home. But his medical school training was in NewYork, a lot more medical schools there for California kids, but expensive, hence the huge debt.
But my nephew had no choice, after messed up his undergraduate years, where he majored in 3 subjects, hence his GPA was not very high, he was lucky to get accepted anywhere 2 years after graduation. I think it’s a fair trade off. Otherwise with his biology undergraduate major(and two other majors), he would be lucky to get a minimum wage job immediately after graduation.
Last edited by DrGoogle2017 on Sat Feb 03, 2018 5:46 pm, edited 6 times in total.

DrGoogle2017
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Re: How risky is Med school student loan debt?

Post by DrGoogle2017 » Sat Feb 03, 2018 1:13 pm

scorcher31 wrote:
Sat Feb 03, 2018 12:49 pm
EnjoyIt wrote:
Sat Feb 03, 2018 12:33 pm
ny_knicks wrote:
Fri Feb 02, 2018 7:34 pm

I would imagine that in most locations in the U.S. doctors are some of the most well compensated individuals. Different specialities pay more/less but on a whole it seems like an MD is a fairly safe bet to a very well paying/safe job irrespective of where you decide to live.
In most cases you are correct. The only outliers would be those with extremely high debt and a poor paying practice. I.e. Private undergrad with expensive med school. People like that can have $400k+ in debt making less than $200k/yr. That is a recipe for burnout and disaster.

I also unfortunately see so many doctors living in VHCOL areas living on credit/paycheck to paycheck.
I even think a 200k salary with 400k debt, even without a second spousal income, is very doable for a physician. They just have to keep with it, i.e. not become disabled/burn out of the field, live like a resident/student for a few years, and stay away from a VHCOL areas(NYC, Boston, certain areas in California).
Or live at home. My nephew is living with his parents to pay some of his loan.

EnjoyIt
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Re: How risky is Med school student loan debt?

Post by EnjoyIt » Sat Feb 03, 2018 1:16 pm

scorcher31 wrote:
Sat Feb 03, 2018 12:49 pm
EnjoyIt wrote:
Sat Feb 03, 2018 12:33 pm
ny_knicks wrote:
Fri Feb 02, 2018 7:34 pm

I would imagine that in most locations in the U.S. doctors are some of the most well compensated individuals. Different specialities pay more/less but on a whole it seems like an MD is a fairly safe bet to a very well paying/safe job irrespective of where you decide to live.
In most cases you are correct. The only outliers would be those with extremely high debt and a poor paying practice. I.e. Private undergrad with expensive med school. People like that can have $400k+ in debt making less than $200k/yr. That is a recipe for burnout and disaster.

I also unfortunately see so many doctors living in VHCOL areas living on credit/paycheck to paycheck.
I even think a 200k salary with 400k debt, even without a second spousal income, is very doable for a physician. They just have to keep with it, i.e. not become disabled/burn out of the field, live like a resident/student for a few years, and stay away from a VHCOL areas(NYC, Boston, certain areas in California).
Ok, let's do some math. $200k a year. Let's pull out 20% for retirement since we are good bogleheads. Now we have $160k. Unless we live in one of the few no state tax states we are looking at about 33% going to state, federal, social security, and Medicare tax. We are now down to 107K. School loans at 400k over 20 years at the standard 6.8% comes to 36K per year. Which means we have $71k a year to live off of for the next 20 years. Definitely doable, but this is not the lifestyle this physician thought they were getting into before applying to Med school.

EnjoyIt
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Re: How risky is Med school student loan debt?

Post by EnjoyIt » Sat Feb 03, 2018 1:18 pm

DrGoogle2017 wrote:
Sat Feb 03, 2018 1:13 pm
scorcher31 wrote:
Sat Feb 03, 2018 12:49 pm
EnjoyIt wrote:
Sat Feb 03, 2018 12:33 pm
ny_knicks wrote:
Fri Feb 02, 2018 7:34 pm

I would imagine that in most locations in the U.S. doctors are some of the most well compensated individuals. Different specialities pay more/less but on a whole it seems like an MD is a fairly safe bet to a very well paying/safe job irrespective of where you decide to live.
In most cases you are correct. The only outliers would be those with extremely high debt and a poor paying practice. I.e. Private undergrad with expensive med school. People like that can have $400k+ in debt making less than $200k/yr. That is a recipe for burnout and disaster.

I also unfortunately see so many doctors living in VHCOL areas living on credit/paycheck to paycheck.
I even think a 200k salary with 400k debt, even without a second spousal income, is very doable for a physician. They just have to keep with it, i.e. not become disabled/burn out of the field, live like a resident/student for a few years, and stay away from a VHCOL areas(NYC, Boston, certain areas in California).
Or live at home. My nephew is living with his parents to pay some of his loan.
A financially sound option, but being 30 years old, a doctor, and still living with your parents is a pretty sad state of affairs. This scenario surely will land you zero dates.

DrGoogle2017
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Re: How risky is Med school student loan debt?

Post by DrGoogle2017 » Sat Feb 03, 2018 1:29 pm

EnjoyIt wrote:
Sat Feb 03, 2018 1:18 pm
DrGoogle2017 wrote:
Sat Feb 03, 2018 1:13 pm
scorcher31 wrote:
Sat Feb 03, 2018 12:49 pm
EnjoyIt wrote:
Sat Feb 03, 2018 12:33 pm
ny_knicks wrote:
Fri Feb 02, 2018 7:34 pm

I would imagine that in most locations in the U.S. doctors are some of the most well compensated individuals. Different specialities pay more/less but on a whole it seems like an MD is a fairly safe bet to a very well paying/safe job irrespective of where you decide to live.
In most cases you are correct. The only outliers would be those with extremely high debt and a poor paying practice. I.e. Private undergrad with expensive med school. People like that can have $400k+ in debt making less than $200k/yr. That is a recipe for burnout and disaster.

I also unfortunately see so many doctors living in VHCOL areas living on credit/paycheck to paycheck.
I even think a 200k salary with 400k debt, even without a second spousal income, is very doable for a physician. They just have to keep with it, i.e. not become disabled/burn out of the field, live like a resident/student for a few years, and stay away from a VHCOL areas(NYC, Boston, certain areas in California).
Or live at home. My nephew is living with his parents to pay some of his loan.
A financially sound option, but being 30 years old, a doctor, and still living with your parents is a pretty sad state of affairs. This scenario surely will land you zero dates.
Yes, that is definitely a worry, but he has no time to date even. He is working all the time to pay off his loan. But when he had plenty of time to date in New York(he was there nearly 8 years, IIRC), no long term relationship emerged from those time being alone either.

golfCaddy
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Re: How risky is Med school student loan debt?

Post by golfCaddy » Sat Feb 03, 2018 2:52 pm

EnjoyIt wrote:
Sat Feb 03, 2018 1:16 pm
Ok, let's do some math. $200k a year. Let's pull out 20% for retirement since we are good bogleheads. Now we have $160k. Unless we live in one of the few no state tax states we are looking at about 33% going to state, federal, social security, and Medicare tax. We are now down to 107K. School loans at 400k over 20 years at the standard 6.8% comes to 36K per year. Which means we have $71k a year to live off of for the next 20 years. Definitely doable, but this is not the lifestyle this physician thought they were getting into before applying to Med school.
Let's do the same math, but look at someone who did an MBA at an expensive school like CMU instead. They graduated with a $150k debt of tuition and 2-years living expenses. They get a job paying $100k, put 20k into a 401k, pay 28% in taxes, and pay $13740 a year in students loans, using the same 6.8% interest rate and 20-year term. That leaves them $44k/year to live on, or 38% below the doctor's $71k.

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Re: How risky is Med school student loan debt?

Post by arsenalfan » Sat Feb 03, 2018 3:15 pm

Not an answerable question IMHO since no good study exists, and you're left with anecdotes like the Portland med student that make for very compelling stories. AMA or ACGME should keep track of med student bankruptcy data out to 10 years - would be interesting.

I can add my anecdotal opinion: not that risky based on the cohort I know.

All the Med Students I know who weren't suited for clinical medicine found other high-compensated jobs in other fields, and made it work.

And even those who stayed in medicine, found out very quickly where you stand: the ones who didn't match in competitive fields like ophtho or derm, or did internal medicine residencies but didn't match to competitive fellowships like GI or Cardiology, found another job. They all landed on their feet financially.

It's like any other field: you take out loans to go to professional school, and you should know how much those loans cost. If you do well, you get the next-level job you want. If you don't, then you adapt and find another job. Obviously that is the idea, in practice some may not adapt as easily due to internal or external factors. I know one person who took 6 years to give up on their dream of being a specialist.

On a side note, I don't understand all the fuss about Med Student debt NOW. In the 1990s, tutitions ranged from $3-40k per year (State vs private). Then you could decide how high on the hog you wanted to live during those 4 years, and presto, that's your debt load. I chose a less costly school with $10k tuition over the $40k school. Paying your own way without aid, your debt could be anywhere from $80k - 400k at my school, depending on how much in loans you wanted for your housing/car/vacations/lifestyle.

scorcher31
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Re: How risky is Med school student loan debt?

Post by scorcher31 » Sat Feb 03, 2018 3:29 pm

EnjoyIt wrote:
Sat Feb 03, 2018 1:16 pm
scorcher31 wrote:
Sat Feb 03, 2018 12:49 pm
EnjoyIt wrote:
Sat Feb 03, 2018 12:33 pm
ny_knicks wrote:
Fri Feb 02, 2018 7:34 pm

I would imagine that in most locations in the U.S. doctors are some of the most well compensated individuals. Different specialities pay more/less but on a whole it seems like an MD is a fairly safe bet to a very well paying/safe job irrespective of where you decide to live.
In most cases you are correct. The only outliers would be those with extremely high debt and a poor paying practice. I.e. Private undergrad with expensive med school. People like that can have $400k+ in debt making less than $200k/yr. That is a recipe for burnout and disaster.

I also unfortunately see so many doctors living in VHCOL areas living on credit/paycheck to paycheck.
I even think a 200k salary with 400k debt, even without a second spousal income, is very doable for a physician. They just have to keep with it, i.e. not become disabled/burn out of the field, live like a resident/student for a few years, and stay away from a VHCOL areas(NYC, Boston, certain areas in California).
Ok, let's do some math. $200k a year. Let's pull out 20% for retirement since we are good bogleheads. Now we have $160k. Unless we live in one of the few no state tax states we are looking at about 33% going to state, federal, social security, and Medicare tax. We are now down to 107K. School loans at 400k over 20 years at the standard 6.8% comes to 36K per year. Which means we have $71k a year to live off of for the next 20 years. Definitely doable, but this is not the lifestyle this physician thought they were getting into before applying to Med school.
I guess it depends what you grew up with. Currently we live in a HCOL in NJ but not VHCOL. We only spent 66k last year including a 15 year mortgage and property taxes. To me we have everything we could want. Factor in a working spouse and that 71k might go up to 100k and presto pretty great lifestyle.

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Re: How risky is Med school student loan debt?

Post by goodenyou » Sat Feb 03, 2018 3:30 pm

golfCaddy wrote:
Sat Feb 03, 2018 2:52 pm
EnjoyIt wrote:
Sat Feb 03, 2018 1:16 pm
Ok, let's do some math. $200k a year. Let's pull out 20% for retirement since we are good bogleheads. Now we have $160k. Unless we live in one of the few no state tax states we are looking at about 33% going to state, federal, social security, and Medicare tax. We are now down to 107K. School loans at 400k over 20 years at the standard 6.8% comes to 36K per year. Which means we have $71k a year to live off of for the next 20 years. Definitely doable, but this is not the lifestyle this physician thought they were getting into before applying to Med school.
Let's do the same math, but look at someone who did an MBA at an expensive school like CMU instead. They graduated with a $150k debt of tuition and 2-years living expenses. They get a job paying $100k, put 20k into a 401k, pay 28% in taxes, and pay $13740 a year in students loans, using the same 6.8% interest rate and 20-year term. That leaves them $44k/year to live on, or 38% below the doctor's $71k.
They're stupid too
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Re: How risky is Med school student loan debt?

Post by rcjchicity » Sat Feb 03, 2018 3:39 pm

kenoryan wrote:
Thu Feb 01, 2018 10:47 pm
I misread that. I thought he was talking about physicians CLAIMING disability.
My former college roommate is a general surgeon and made a claim on her disability policy when she was hit with Guillain-Barré. She recovered after many months and is now able to practice again. So, now (anecdotally) you know of one. :)
Last edited by rcjchicity on Sat Feb 03, 2018 4:04 pm, edited 1 time in total.

scorcher31
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Re: How risky is Med school student loan debt?

Post by scorcher31 » Sat Feb 03, 2018 3:51 pm

In terms of dropping out or not matching into some residency somewhere, I would guess there isn't more than a handful of people per class over the course of 4 years. It's not that common, I think you can get statistics on that from the school when you apply. The biggest advise would be make sure you want to actually do it as its a big commitment. Make sure you shadow multiple people in multiple settings. Also school prices widely differ so apply broadly. Some will give you a great in state price if you jump through some hoops. I got out with 160k while many others my year were closer to 400k in other schools. If i only had one option for school and and I knew it was going to lead to 500k or 600k in debt, unless I was extremely confident I was going to be in a high paid speciality, I would just pick a different career.

EnjoyIt
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Re: How risky is Med school student loan debt?

Post by EnjoyIt » Sat Feb 03, 2018 6:10 pm

golfCaddy wrote:
Sat Feb 03, 2018 2:52 pm
EnjoyIt wrote:
Sat Feb 03, 2018 1:16 pm
Ok, let's do some math. $200k a year. Let's pull out 20% for retirement since we are good bogleheads. Now we have $160k. Unless we live in one of the few no state tax states we are looking at about 33% going to state, federal, social security, and Medicare tax. We are now down to 107K. School loans at 400k over 20 years at the standard 6.8% comes to 36K per year. Which means we have $71k a year to live off of for the next 20 years. Definitely doable, but this is not the lifestyle this physician thought they were getting into before applying to Med school.
Let's do the same math, but look at someone who did an MBA at an expensive school like CMU instead. They graduated with a $150k debt of tuition and 2-years living expenses. They get a job paying $100k, put 20k into a 401k, pay 28% in taxes, and pay $13740 a year in students loans, using the same 6.8% interest rate and 20-year term. That leaves them $44k/year to live on, or 38% below the doctor's $71k.
Touché. But, with an MBA that person has room to grow significantly past that 100k/yr job but a physicians salary is pretty stagnant. In many specialties the wages are decreasing or the workload is increasing forcing them to do more for the same wages. I am unaware of all the potential or hardships required to achieve in the business/corporate world.

DireWolf
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Re: How risky is Med school student loan debt?

Post by DireWolf » Sat Feb 03, 2018 6:28 pm

There's a lot of bad advice being given. Facts are facts... physician salaries are decreasing and will continue to decrease... there are many unstoppable policies in place that will facilitate this. Couple that with tuition inflation (much higher than general inflation) and regular inflation. Decreasing salaries along with increasing costs = a recipe for disaster.

uberdoc
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Re: How risky is Med school student loan debt?

Post by uberdoc » Sat Feb 03, 2018 7:41 pm

physician salaries are decreasing and will continue to decrease
Completely agree with this. Go to medicine only if you satisfy both of these criteria:
1. You are dedicated to it.
2. Medical school tuition is waived.

TheNightsToCome
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Re: How risky is Med school student loan debt?

Post by TheNightsToCome » Sat Feb 03, 2018 8:15 pm

scorcher31 wrote:
Sat Feb 03, 2018 3:29 pm
EnjoyIt wrote:
Sat Feb 03, 2018 1:16 pm
scorcher31 wrote:
Sat Feb 03, 2018 12:49 pm
EnjoyIt wrote:
Sat Feb 03, 2018 12:33 pm
ny_knicks wrote:
Fri Feb 02, 2018 7:34 pm

I would imagine that in most locations in the U.S. doctors are some of the most well compensated individuals. Different specialities pay more/less but on a whole it seems like an MD is a fairly safe bet to a very well paying/safe job irrespective of where you decide to live.
In most cases you are correct. The only outliers would be those with extremely high debt and a poor paying practice. I.e. Private undergrad with expensive med school. People like that can have $400k+ in debt making less than $200k/yr. That is a recipe for burnout and disaster.

I also unfortunately see so many doctors living in VHCOL areas living on credit/paycheck to paycheck.
I even think a 200k salary with 400k debt, even without a second spousal income, is very doable for a physician. They just have to keep with it, i.e. not become disabled/burn out of the field, live like a resident/student for a few years, and stay away from a VHCOL areas(NYC, Boston, certain areas in California).
Ok, let's do some math. $200k a year. Let's pull out 20% for retirement since we are good bogleheads. Now we have $160k. Unless we live in one of the few no state tax states we are looking at about 33% going to state, federal, social security, and Medicare tax. We are now down to 107K. School loans at 400k over 20 years at the standard 6.8% comes to 36K per year. Which means we have $71k a year to live off of for the next 20 years. Definitely doable, but this is not the lifestyle this physician thought they were getting into before applying to Med school.
I guess it depends what you grew up with. Currently we live in a HCOL in NJ but not VHCOL. We only spent 66k last year including a 15 year mortgage and property taxes. To me we have everything we could want. Factor in a working spouse and that 71k might go up to 100k and presto pretty great lifestyle.
"Which means we have $71k a year to live off of for the next 20 years. Definitely doable, but this is not the lifestyle this physician thought they were getting into before applying to Med school."

I never thought about money when I decided to pursue med school at 19 yo, and I had no idea what I would earn until I interviewed for residency positions. Someone told me then that I would earn $120,000 four years after graduation (this was 1985-86) and I was dumbfounded at the prospect of having so much money.

I earn a lot more than that now, but I still spend less than $71,000 per year -- with no debt payments for decades now. It doesn't take that much money to have a good life.

Nevertheless, I'm not living the lifestyle that I envisioned as a student. The career is so much more demanding and draining than anything I imagined.

I know of one student at my school who didn't graduate because he couldn't pass the exams. One other didn't match in ENT, but then he spent a year in the lab and matched the next year. These cases are fairly rare in my experience.

Burnout is not so rare. That's the greater risk. Still, most people capable of making it through med school and residency are capable of landing on their feet in another career. I've seen many examples of the latter.

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Re: How risky is Med school student loan debt?

Post by TheNightsToCome » Sat Feb 03, 2018 8:23 pm

uberdoc wrote:
Sat Feb 03, 2018 7:41 pm
physician salaries are decreasing and will continue to decrease
Completely agree with this. Go to medicine only if you satisfy both of these criteria:
1. You are dedicated to it.
2. Medical school tuition is waived.
One of my younger brothers considered med school and asked for my advice. I told him to pursue it only if he couldn't imagine being happy doing anything else.

Just about every other career involves a shorter training period, less educational debt, and fewer demands on your personal life and health.

If you are sharp enough and determined enough to get through med school and residency, but it's money that you want, then go for Big Law or investment banking. If you don't care about the biggest paycheck you can choose from dozens of careers that provide professional satisfaction and a good living while still allowing for a life.

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Re: How risky is Med school student loan debt?

Post by goodenyou » Sat Feb 03, 2018 8:27 pm

rcjchicity wrote:
Sat Feb 03, 2018 3:39 pm
kenoryan wrote:
Thu Feb 01, 2018 10:47 pm
I misread that. I thought he was talking about physicians CLAIMING disability.
My former college roommate is a general surgeon and made a claim on her disability policy when she was hit with Guillain-Barré. She recovered after many months and is now able to practice again. So, now (anecdotally) you know of one. :)
One of my Partners in our practice also got Guillain-Barré. Never could "fully" operate again. His shaking was so bad that he could hardly operate under a microscope. It was awful. Lesson learned to all of us in our practice: You Better Have Disability Insurance.
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Re: How risky is Med school student loan debt?

Post by bubbadog » Sat Feb 03, 2018 10:26 pm

The prospect of the government, through the Public Student Loan Forgiveness Program, paying off the loans for physicians may minimize the risk greatly.

I have a son who intends to start medical school in about 1.5 years. I am in a position to provide significant assistance with his expenses but I am not sure if this is the smart thing to do from a purely financial standpoint. He would have to make 10 years of very minimal payments and the balance could be completely forgiven. This could amount to hundreds of thousands of dollars forgiven!

Would it be smarter to let him accumulate the debt and wait and see if the loans are forgiven? I could always help him with his loans later. I find it hard to believe such a generous program exists and wonder if it really is a viable program long term.

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Re: How risky is Med school student loan debt?

Post by golfCaddy » Sat Feb 03, 2018 10:26 pm

EnjoyIt wrote:
Sat Feb 03, 2018 6:10 pm
Touché. But, with an MBA that person has room to grow significantly past that 100k/yr job but a physicians salary is pretty stagnant.
Even if the MBA got a 50% raise to $150k, he would only be breaking even with the physician in terms of livable income. Unless the MBA gets a job in some highly compensated finance field or management consulting at one of the big three, his salary is likely to hit a ceiling eventually.

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Re: How risky is Med school student loan debt?

Post by Shikoku » Sat Feb 03, 2018 11:02 pm

bubbadog wrote:
Sat Feb 03, 2018 10:26 pm
The prospect of the government, through the Public Student Loan Forgiveness Program, paying off the loans for physicians may minimize the risk greatly.

I have a son who intends to start medical school in about 1.5 years. I am in a position to provide significant assistance with his expenses but I am not sure if this is the smart thing to do from a purely financial standpoint. He would have to make 10 years of very minimal payments and the balance could be completely forgiven. This could amount to hundreds of thousands of dollars forgiven!

Would it be smarter to let him accumulate the debt and wait and see if the loans are forgiven? I could always help him with his loans later. I find it hard to believe such a generous program exists and wonder if it really is a viable program long term.
I think there are at least two considerations: a) Possible status/availability of the PSLF program in future, and b) whether your son would be interested in working at a PSLF-eligible institutions which might limit career choices.
"I don't worry too much about pointing fingers at the past. I operate on the theory that every saint has a past, every sinner has a future." -- Warren Buffett

ny_knicks
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Re: How risky is Med school student loan debt?

Post by ny_knicks » Sat Feb 03, 2018 11:09 pm

golfCaddy wrote:
Sat Feb 03, 2018 10:26 pm
EnjoyIt wrote:
Sat Feb 03, 2018 6:10 pm
Touché. But, with an MBA that person has room to grow significantly past that 100k/yr job but a physicians salary is pretty stagnant.
Even if the MBA got a 50% raise to $150k, he would only be breaking even with the physician in terms of livable income. Unless the MBA gets a job in some highly compensated finance field or management consulting at one of the big three, his salary is likely to hit a ceiling eventually.
Very true. Average first year compensation for MBAs out of top schools approaches $150k ($25k sign-on and $125k salary). At top schools 50% or more go into consulting, IB or tech. Consulting and IB pay a lot but both are a grind in their own way and are extremely competitive up/out. While the exit opportunities from both of these are good, there is a significant pay cut that comes with leaving. Some might make it/stick it out for a career but a lot will be doing something very different 5 years out of school.

As someone w/ an MBA, I'd rather be the physician with the stagnant $250k for 40 years and job security than worrying every 3 years in consulting/finance if I am going to make the next rung on the ladder. And if you want to talk about quality of life, nothing like being on the road every week or working 80-100+ hours a week.

What I am gathering from this thread is: don't get an MD, JD or MBA lol it is all a crap shoot.

Just go into tech right out of undergrad.

Allixi
Posts: 162
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Re: How risky is Med school student loan debt?

Post by Allixi » Sat Feb 03, 2018 11:13 pm

As others have said, as long as a medical student matches in to a categorical residency and completes it, things will be generally OK.

You can't always control your level of debt. Med school is getting more competitive all the time. Maybe you're only accepted to one or two schools that costs 60K a year for out of state students, + 4 years of living expenses, + compounded interest on the unsubsidized portion, +several thousand dollars of travel expenses during interviews. 220K is the average amount; if you have to raise a family during this time, could be much more.

What's awful is how high the stakes are involved with the match itself, which is a giant smoke-and-mirrors kabuki dance that takes the better part of 2 years. Imagine you've completed a dozen job interviews, where all the employers seem to like you. But instead of just accepting any offers, you have to go through a giant lottery/crapshoot and hope you got something. Those who don't match (6% of US grads per WCI's post) are in for a world of pain. I know from first hand experience.

Those who mentioned the "scramble" probably aren't aware, but it's been replaced by the "SOAP", which is a second mini-match for those who don't match. These spots are generally for preliminary residency - a one-year gig during which you have to reapply for the match, with even worse odds than before, because you now have the stigma of having failed the first time. There will be no phony-baloney interpersonal questions ("tell me about a time you demonstrated leadership") the second time around. Programs will simply ask, "why didn't you match the first time?", and like the article about Robert Chu pointed out, there is no way to get constructive feedback to give a good answer for this.

The financial ramifications are dire, but they're distant compared to the emotional devastation of failing at something you've spent the last 4 years and countless hours working towards. There is no way for me to adequately convey this, and I wouldn't wish it on any one.

Shikoku
Posts: 270
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Location: USA

Re: How risky is Med school student loan debt?

Post by Shikoku » Sat Feb 03, 2018 11:29 pm

ny_knicks wrote:
Sat Feb 03, 2018 11:09 pm
golfCaddy wrote:
Sat Feb 03, 2018 10:26 pm
EnjoyIt wrote:
Sat Feb 03, 2018 6:10 pm
Touché. But, with an MBA that person has room to grow significantly past that 100k/yr job but a physicians salary is pretty stagnant.
Even if the MBA got a 50% raise to $150k, he would only be breaking even with the physician in terms of livable income. Unless the MBA gets a job in some highly compensated finance field or management consulting at one of the big three, his salary is likely to hit a ceiling eventually.
Very true. Average first year compensation for MBAs out of top schools approaches $150k ($25k sign-on and $125k salary). At top schools 50% or more go into consulting, IB or tech. Consulting and IB pay a lot but both are a grind in their own way and are extremely competitive up/out. While the exit opportunities from both of these are good, there is a significant pay cut that comes with leaving. Some might make it/stick it out for a career but a lot will be doing something very different 5 years out of school.

As someone w/ an MBA, I'd rather be the physician with the stagnant $250k for 40 years and job security than worrying every 3 years in consulting/finance if I am going to make the next rung on the ladder. And if you want to talk about quality of life, nothing like being on the road every week or working 80-100+ hours a week.

What I am gathering from this thread is: don't get an MD, JD or MBA lol it is all a crap shoot.

Just go into tech right out of undergrad.
Image
"I don't worry too much about pointing fingers at the past. I operate on the theory that every saint has a past, every sinner has a future." -- Warren Buffett

am
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Re: How risky is Med school student loan debt?

Post by am » Sat Feb 03, 2018 11:32 pm

DireWolf wrote:
Sat Feb 03, 2018 6:28 pm
There's a lot of bad advice being given. Facts are facts... physician salaries are decreasing and will continue to decrease... there are many unstoppable policies in place that will facilitate this. Couple that with tuition inflation (much higher than general inflation) and regular inflation. Decreasing salaries along with increasing costs = a recipe for disaster.
Specialized MD here in mid career. Although demanding and stressful, rewarding in many ways. Trend towards consolidation, employment, and corporate culture. My salary has stagnated and now going up. If you specialize and go somewhere where your needed, you’ll have no problem paying off even 500k+ debt. People making much less take this out as mortgage all the time. I appreciate it more given the alternatives... Ability to work in many places, make a great living, retire early if your careful, but all this comes with constant stress. But are there any careers that pay top 1-2% that arent?

TheNightsToCome
Posts: 356
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Re: How risky is Med school student loan debt?

Post by TheNightsToCome » Sun Feb 04, 2018 12:42 am

ny_knicks wrote:
Sat Feb 03, 2018 11:09 pm
golfCaddy wrote:
Sat Feb 03, 2018 10:26 pm
EnjoyIt wrote:
Sat Feb 03, 2018 6:10 pm
Touché. But, with an MBA that person has room to grow significantly past that 100k/yr job but a physicians salary is pretty stagnant.
Even if the MBA got a 50% raise to $150k, he would only be breaking even with the physician in terms of livable income. Unless the MBA gets a job in some highly compensated finance field or management consulting at one of the big three, his salary is likely to hit a ceiling eventually.
Very true. Average first year compensation for MBAs out of top schools approaches $150k ($25k sign-on and $125k salary). At top schools 50% or more go into consulting, IB or tech. Consulting and IB pay a lot but both are a grind in their own way and are extremely competitive up/out. While the exit opportunities from both of these are good, there is a significant pay cut that comes with leaving. Some might make it/stick it out for a career but a lot will be doing something very different 5 years out of school.

As someone w/ an MBA, I'd rather be the physician with the stagnant $250k for 40 years and job security than worrying every 3 years in consulting/finance if I am going to make the next rung on the ladder. And if you want to talk about quality of life, nothing like being on the road every week or working 80-100+ hours a week.

What I am gathering from this thread is: don't get an MD, JD or MBA lol it is all a crap shoot.

Just go into tech right out of undergrad.
"As someone w/ an MBA, I'd rather be the physician with the stagnant $250k for 40 years and job security than worrying every 3 years in consulting/finance if I am going to make the next rung on the ladder. And if you want to talk about quality of life, nothing like being on the road every week or working 80-100+ hours a week."

The Big Law, Big Consulting, or investment banking lifestyle (i.e., hours, stress level, etc.) is probably comparable (in a bad way) to that of surgical and internal medicine sub-specialties. Big Law and IB offer a shorter runway and better payoff. I looked at healthcare consulting, but the constant travel was a non-starter for me.

"What I am gathering from this thread is: don't get an MD, JD or MBA lol it is all a crap shoot."

Burnout is common in all four career paths (medicine, Big Law, Big 3 consulting, or investment banking), but financial risk is low. If you want one of these careers, the degrees are still a good investment.

Helo80
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Re: How risky is Med school student loan debt?

Post by Helo80 » Sun Feb 04, 2018 9:31 am

Smorgasbord wrote:
Sat Feb 03, 2018 12:43 pm
Helo80 wrote:
Thu Feb 01, 2018 8:11 pm
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.
I believe the people you are referring to are called "Veterinarians" :D


LOL... you win. Never considered vets.

afan
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Re: How risky is Med school student loan debt?

Post by afan » Sun Feb 04, 2018 11:55 am

It is NOT true that physician incomes are going down. Like most highly paid professionals, physicians have seen their incomes go up consistently over the years. As is clear from this thread the range of financial outcomes makes the prospects for a college student unpredictable. Yes, there is a tiny fraction of people who complete med school but cannot practice. But that is really a tiny fraction.

They tend to have bigger problems than even very weak academic performance in med school. There are training programs that would be happy with the academic ability of any American graduate of any American med school. The doors start closing when programs decide that their are psychological or professionalism problems. Then they are scared to take someone who could be a serious liability. They are not necessarily correct about someone who graduated, eventually, with some black marks on their records. There can be a lot of reading between the lines. There can be mistakes in these inferences.

The safest thing for a graduating med student is to be conservative in applying. Include some backup programs. Include more backup programs than your advisors recommend. If you want a high demand specialty and your record says you have an excellent chance of matching then apply to a LOT of programs, go to a LOT of interviews and have backup plan with some applications to less competitive fields.

If you are one of those students with a marginal record then apply to a lot of those programs that usually do not fill. A lot of them. In the middle of nowhere. If you were suspended for conduct, have a conviction on your record or lost time in med school to psychological problems then review the situation with your advisors and cover the waterfront with applications.

A successful residency can compensate for a great deal of weakness coming out of med school.

People who graduate and don't match usually pursued bad strategies rather than were doomed from the start.
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

EnjoyIt
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Re: How risky is Med school student loan debt?

Post by EnjoyIt » Sun Feb 04, 2018 12:11 pm

Without a doubt after finishing a residency I think working in medicine is probably one of the most secure professions available. No market downturn or econonomic crisis will ever diminish people getting sick and requiring care.

DireWolf
Posts: 335
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Re: How risky is Med school student loan debt?

Post by DireWolf » Sun Feb 04, 2018 4:56 pm

afan wrote:
Sun Feb 04, 2018 11:55 am
It is NOT true that physician incomes are going down. Like most highly paid professionals, physicians have seen their incomes go up consistently over the years.
It absolutely IS true. Your dishonesty is reckless.

Pawpatrol
Posts: 21
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Re: How risky is Med school student loan debt?

Post by Pawpatrol » Sun Feb 04, 2018 4:59 pm

I guess i am in the minority of this board but while medical training costs have soared relative to compensation the overall perks of the profession are tremendous.

1) i can throw a dart at the US map and likely get a high paying job in the time it would take to get a state license and credentialed. This is the most undervalued perk.

2) assuming you have long term disability coverage you have pretty incredible job security. Another undervalued perk.

3) at the end of the day even if you had a crappy day I can reflect and realize I made a positive impact in people’s lives. This is invaluable compensation to me.

4) you get to experience the realities of the human condition which allow you to be more connected to that reality. Also, you become a great asset to yout family in helping them navigate the health care system.

People just finishing def have it worse every year with more debt but it is pretty low risk money to borrow.
Last edited by Pawpatrol on Sun Feb 04, 2018 5:34 pm, edited 1 time in total.

afan
Posts: 3925
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Re: How risky is Med school student loan debt?

Post by afan » Sun Feb 04, 2018 5:19 pm

DireWolf wrote:
Sun Feb 04, 2018 4:56 pm
afan wrote:
Sun Feb 04, 2018 11:55 am
It is NOT true that physician incomes are going down. Like most highly paid professionals, physicians have seen their incomes go up consistently over the years.
It absolutely IS true. Your dishonesty is reckless.
Wow.

Try facts instead of insults Or at least in addition to the insults.
Or cite your source.

https://www.medscape.com/slideshow/comp ... ew-6008547

Slide 3

"Physician incomes have steadily increased over the past 7 years"
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

TheNightsToCome
Posts: 356
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Re: How risky is Med school student loan debt?

Post by TheNightsToCome » Sun Feb 04, 2018 5:20 pm

DireWolf wrote:
Sun Feb 04, 2018 4:56 pm
afan wrote:
Sun Feb 04, 2018 11:55 am
It is NOT true that physician incomes are going down. Like most highly paid professionals, physicians have seen their incomes go up consistently over the years.
It absolutely IS true. Your dishonesty is reckless.
Total nominal income has risen substantially for most of us over the last 10 and 20 years; just check longer-term trends in MGMA data. Real compensation per work hour has probably declined, more so for some specialties than others, but real wages have also been stagnant in the broader economy for a long time.

TheNightsToCome
Posts: 356
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Re: How risky is Med school student loan debt?

Post by TheNightsToCome » Sun Feb 04, 2018 5:29 pm

Pawpatrol wrote:
Sun Feb 04, 2018 4:59 pm
I guess i am in the minority of this board but while medical training costs have soared relative to compensation the overall perks of the profession are tremendous.

1) i can throw a dart at the US map and likely get a high paying job in the time it would take to get a state license and credentialed. This is the most undervalued perk.

2) assuming you have long term disability coverage you have pretty incredible job security. Another undervalued perk.

3) at the end of the day even if you had a crappy day I can reflect and realize you made a positive impact in people’s lives. This is invaluable compensation to me.

4) you get to experience the realities of the human condition which both allow you to be more connected to that reality. Also, you become a great asset to yout family in helping them navigate the health care system.

People just finishing def have it worse every year with more debt but it is pretty low risk money to borrow.
I agree on all points.

I diagnosed one brother with acute appendicitis and another with cholecystitis. Both had surgery the same day. I also managed to (probably) save my own life when I suffered a critical illness but was misdiagnosed.

hightower
Posts: 512
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Re: How risky is Med school student loan debt?

Post by hightower » Sun Feb 04, 2018 5:47 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?
I think right now it's still a pretty solid career to "invest" in, but could change significantly in the near future. Physician wages have never been higher, especially if you're a sub-specialist and physicians are still in high demand. However, I think we are heading for a time in which it could be risky. One thing I worry about is the number of DO schools being opened all over the country. If these schools are flooding the market with new grads who are 250k+ in debt and not guaranteeing them residency spots, there could be lot's of unemployable docs out there who would have been better off doing something else. Another thing that worries me is the rise in popularity of NPs/PAs in primary care, urgent care, etc. Mid-level providers are doing essentially the same work for 1/2 the price. This combined with rising corporate interests in medicine could mean that fewer docs are actually needed in primary care fields and lower wages for the surviving doctors. That could make taking on mounds of student loan debt more risky as well.

hightower
Posts: 512
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Re: How risky is Med school student loan debt?

Post by hightower » Sun Feb 04, 2018 6:13 pm

sawhorse wrote:
Fri Feb 02, 2018 12:47 am
If you want to avoid debt in medical school, some combined MD/PhD programs waive tuition and even provide a stipend. Doing a PhD definitely isn't for everyone, and it adds years of schooling. But it can allow you to graduate with much less debt, possibly debt free.
MD/PhD programs are incredibly difficult to get into. Way harder to get into than most medical schools. I had a friend in college who was number 1 in our class, never got below an A in every class except one his entire 4 years, scored near perfect on the MCATs, took all of the hardest classes our school offered and he was still turned down for admission to MD/PhD programs. He ended up going to a PhD program instead, which was probably the right choice for someone as intelligent as him.

hightower
Posts: 512
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Re: How risky is Med school student loan debt?

Post by hightower » Sun Feb 04, 2018 6:23 pm

Allixi wrote:
Sat Feb 03, 2018 11:13 pm
As others have said, as long as a medical student matches in to a categorical residency and completes it, things will be generally OK.
You need to add to this: "AND passes specialty board certification exam." Very few hospitals and physician groups will consider non-board certified physicians these days, even if you've made it through a residency program. The ABMS is really all that matters anymore. If you're not board certified, you're not employable.

afan
Posts: 3925
Joined: Sun Jul 25, 2010 4:01 pm

Re: How risky is Med school student loan debt?

Post by afan » Sun Feb 04, 2018 7:30 pm

The need for board certification varies with field and where you want to work. New fields and broader general work will see non certified docs getting jobs. Particularly if they look in underserved areas that are desparate to get any physicians they can.

So far, medicine has not gone the way of law where there are lots of people who graduated law school but cannot find work as lawyers. Physicians are also highly likely to pass their qualifying exams, while many law school grads cannot pass the bar exam. This leads to law having both highly compensated people getting rich and a great excess of people with degrees but unable to find jobs.

So far there are still enough jobs, nationally, for everyone who can make it through training. Maybe not in the places where a lot of people want to live. Maybe not practicing high priced specialties. But the unemployment rate among doctors is very low.
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

sawhorse
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Re: How risky is Med school student loan debt?

Post by sawhorse » Sun Feb 04, 2018 9:07 pm

hightower wrote:
Sun Feb 04, 2018 6:13 pm
sawhorse wrote:
Fri Feb 02, 2018 12:47 am
If you want to avoid debt in medical school, some combined MD/PhD programs waive tuition and even provide a stipend. Doing a PhD definitely isn't for everyone, and it adds years of schooling. But it can allow you to graduate with much less debt, possibly debt free.
MD/PhD programs are incredibly difficult to get into. Way harder to get into than most medical schools. I had a friend in college who was number 1 in our class, never got below an A in every class except one his entire 4 years, scored near perfect on the MCATs, took all of the hardest classes our school offered and he was still turned down for admission to MD/PhD programs. He ended up going to a PhD program instead, which was probably the right choice for someone as intelligent as him.
And as a result will probably never in his career make as much as an early career physician if he remains in life sciences research. A Nobel prize winner in chemistry, whose findings are hugely important to modern medicine, makes $218k as a biochemistry professor at UNC. A 7th year post doc cancer researcher (14 years out of undergrad) at a leading cancer research center makes $54k with terrible job security.

WallStreetPhysician
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Contact:

Re: How risky is Med school student loan debt?

Post by WallStreetPhysician » Mon Feb 05, 2018 6:28 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?
Depends on where you go to medical school. If you go to a U.S. MD school, essentially zero, presuming you don't choose to quit during residency or have some other issue that prevents you from going to residency or completing residency.

-WSP

EDIT: essentially zero is probably too extreme, but it is very low. If you are accepted to a U.S. M.D. school, you should not choose not to go because of concerns of not graduating and not being able to pay off your debt.
Last edited by WallStreetPhysician on Mon Feb 05, 2018 12:03 pm, edited 1 time in total.

Allixi
Posts: 162
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Re: How risky is Med school student loan debt?

Post by Allixi » Mon Feb 05, 2018 9:51 am

WallStreetPhysician wrote:
Mon Feb 05, 2018 6:28 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?
Depends on where you go to medical school. If you go to a U.S. MD school, essentially zero, presuming you don't choose to quit during residency or have some other issue that prevents you from going to residency or completing residency.

-WSP
6% of each graduating class every year, who don't match at all, is NOT essentially zero. That number is going to go up too, since med schools increased class sizes, but residency spots haven't. This was meant to get more people into primary care and family medicine, which are becoming less appealing for reasons already stated. While it may work, it leads to a lot of heartbreak for unmatched students who had unrealistic expectations and/or were inadequately counseled by the schools. Many of those students do find a categorical residency eventually, but there is no blueprint or systematic method to this, and almost no assistance from the schools themselves.

Once you get into a categorical residency, then that number (of residents who don't finish) is probably much smaller, but I'm not aware that anyone tracks it.

EnjoyIt
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Re: How risky is Med school student loan debt?

Post by EnjoyIt » Mon Feb 05, 2018 10:32 am

afan wrote:
Sun Feb 04, 2018 5:19 pm
DireWolf wrote:
Sun Feb 04, 2018 4:56 pm
afan wrote:
Sun Feb 04, 2018 11:55 am
It is NOT true that physician incomes are going down. Like most highly paid professionals, physicians have seen their incomes go up consistently over the years.
It absolutely IS true. Your dishonesty is reckless.
Wow.

Try facts instead of insults Or at least in addition to the insults.
Or cite your source.

https://www.medscape.com/slideshow/comp ... ew-6008547

Slide 3

"Physician incomes have steadily increased over the past 7 years"
I don't know how accurate this survey is, but many specialist will say that reimbursement for the same procedure or code has gone down. I know Emergency Medicine, wages have gone up over the years faster than inflation. I also see that CMS is cutting physician reimbursement so that growth will be less than historical inflation. Lastly, due to regulatory changes the same job takes more time. So you might be paid slightly more for a billing code, the same code takes longer to complete and therefor the hourly reimbursement becomes lower.

I see in Emergency Medicine we need to employ scribes to help do our work because the documentation has become too cumbersome and time consuming. That scribe comes out of our reimbursement. Despite that we still spend time after every shift finalizing the scribe's notes.

So yes, our pay has gone up over the last 7 years, but so has the hours worked and so has the stress. Don't get me wrong, I'm not complaining just stating fact that just looking at yearly compensation may not give the full picture. As WCI mentioned, this feels like the golden age of medicine for ED docs.

WallStreetPhysician
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Contact:

Re: How risky is Med school student loan debt?

Post by WallStreetPhysician » Mon Feb 05, 2018 11:58 am

Allixi wrote:
Mon Feb 05, 2018 9:51 am
WallStreetPhysician wrote:
Mon Feb 05, 2018 6:28 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?
Depends on where you go to medical school. If you go to a U.S. MD school, essentially zero, presuming you don't choose to quit during residency or have some other issue that prevents you from going to residency or completing residency.

-WSP
6% of each graduating class every year, who don't match at all, is NOT essentially zero. That number is going to go up too, since med schools increased class sizes, but residency spots haven't. This was meant to get more people into primary care and family medicine, which are becoming less appealing for reasons already stated. While it may work, it leads to a lot of heartbreak for unmatched students who had unrealistic expectations and/or were inadequately counseled by the schools. Many of those students do find a categorical residency eventually, but there is no blueprint or systematic method to this, and almost no assistance from the schools themselves.

Once you get into a categorical residency, then that number (of residents who don't finish) is probably much smaller, but I'm not aware that anyone tracks it.
These unmatched people often went for competitive specialties and chose to do a research year to boost their application, or they may have signed up for a preliminary year. If you are willing to match into any specialty (e.g. FM/IM), then the number is significantly less than 6%. Many people also choose not to go into clinical medicine (e.g. some go into consulting or finance).

Yes, these FM/IM jobs may not be what they signed up for when they started medical school, but the question was whether they would be able to pay back their loans.

Agree that this number could go up with time with more medical schools, but the risk at this time is low.

CppCoder
Posts: 846
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Re: How risky is Med school student loan debt?

Post by CppCoder » Mon Feb 05, 2018 9:29 pm

sawhorse wrote:
Sun Feb 04, 2018 9:07 pm
hightower wrote:
Sun Feb 04, 2018 6:13 pm
sawhorse wrote:
Fri Feb 02, 2018 12:47 am
If you want to avoid debt in medical school, some combined MD/PhD programs waive tuition and even provide a stipend. Doing a PhD definitely isn't for everyone, and it adds years of schooling. But it can allow you to graduate with much less debt, possibly debt free.
MD/PhD programs are incredibly difficult to get into. Way harder to get into than most medical schools. I had a friend in college who was number 1 in our class, never got below an A in every class except one his entire 4 years, scored near perfect on the MCATs, took all of the hardest classes our school offered and he was still turned down for admission to MD/PhD programs. He ended up going to a PhD program instead, which was probably the right choice for someone as intelligent as him.
And as a result will probably never in his career make as much as an early career physician if he remains in life sciences research. A Nobel prize winner in chemistry, whose findings are hugely important to modern medicine, makes $218k as a biochemistry professor at UNC. A 7th year post doc cancer researcher (14 years out of undergrad) at a leading cancer research center makes $54k with terrible job security.
Yes, but that chemistry professor's listed salary is a nine month, tenured salary at a state school. Salaries at, say, Harvard would be higher, and professors can earn a lot consulting. After tenure, the life is pretty flexible, and really, only as stressful as you make it.

I know many Ph.D.s at megacorp where I work in technical jobs that make in excess of $200k, some make in excess of $300k, and some in excess of $400k. I suspect the salaries go up from there for select individuals, but I'm low enough on the management ladder not to see their salaries. Most jobs at megacorp research lab are 40 hrs/week...some like what they do and work more. Some seem stressed, but it's simply because people tend to stress over silly deadlines that, in the grand scheme of things, are pretty meaningless. It's nothing like the real life and death stress of medicine and nothing like the hours of investment banking.

sawhorse
Posts: 3148
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Re: How risky is Med school student loan debt?

Post by sawhorse » Mon Feb 05, 2018 10:39 pm

CppCoder wrote:
Mon Feb 05, 2018 9:29 pm
sawhorse wrote:
Sun Feb 04, 2018 9:07 pm
hightower wrote:
Sun Feb 04, 2018 6:13 pm
sawhorse wrote:
Fri Feb 02, 2018 12:47 am
If you want to avoid debt in medical school, some combined MD/PhD programs waive tuition and even provide a stipend. Doing a PhD definitely isn't for everyone, and it adds years of schooling. But it can allow you to graduate with much less debt, possibly debt free.
MD/PhD programs are incredibly difficult to get into. Way harder to get into than most medical schools. I had a friend in college who was number 1 in our class, never got below an A in every class except one his entire 4 years, scored near perfect on the MCATs, took all of the hardest classes our school offered and he was still turned down for admission to MD/PhD programs. He ended up going to a PhD program instead, which was probably the right choice for someone as intelligent as him.
And as a result will probably never in his career make as much as an early career physician if he remains in life sciences research. A Nobel prize winner in chemistry, whose findings are hugely important to modern medicine, makes $218k as a biochemistry professor at UNC. A 7th year post doc cancer researcher (14 years out of undergrad) at a leading cancer research center makes $54k with terrible job security.
Yes, but that chemistry professor's listed salary is a nine month, tenured salary at a state school. Salaries at, say, Harvard would be higher, and professors can earn a lot consulting. After tenure, the life is pretty flexible, and really, only as stressful as you make it.

I know many Ph.D.s at megacorp where I work in technical jobs that make in excess of $200k, some make in excess of $300k, and some in excess of $400k. I suspect the salaries go up from there for select individuals, but I'm low enough on the management ladder not to see their salaries. Most jobs at megacorp research lab are 40 hrs/week...some like what they do and work more. Some seem stressed, but it's simply because people tend to stress over silly deadlines that, in the grand scheme of things, are pretty meaningless. It's nothing like the real life and death stress of medicine and nothing like the hours of investment banking.
What sort of jobs are paying $400k for biochemistry research? My husband earns $130k a year in a very high cost of living area. It took him years to find this job. He did 3 post docs at very prestigious institutions and never earned more than $44k and never knew if he would have a job the next year.

Academic jobs at private schools like Harvard might pay a bit more than $100k for an associate professor position. That's what a friend who was a Rhodes Scholar is currently getting at an elite private university in a high cost of living area, $101k last year. None of the academic biochemists I know make much if anything from consulting. There are more opportunities for consulting for physicians than academic biochemists.

The salary I quoted was for a Nobel Prize winner. Think about that again: a Nobel Prize winner. My point is that biochemistry researchers are as intellectually gifted and hard working as physicians and took mostly the same classes in college. Without their research work so much of modern medicine would not exist. Oncologists for example rely on the research being conducted by biochemistry researchers who, 7 years after their PhD, make $54k at one of the nation's leading cancer centers with little job security.

One major advantage the biochemistry researchers have, however, is little to no student debt. If you start a biochemistry PhD and don't finish, it's not financially devastating as if you start medical school and don't finish school and residency.

CppCoder
Posts: 846
Joined: Sat Jan 23, 2016 9:16 pm

Re: How risky is Med school student loan debt?

Post by CppCoder » Tue Feb 06, 2018 9:42 am

sawhorse wrote:
Mon Feb 05, 2018 10:39 pm
What sort of jobs are paying $400k for biochemistry research? My husband earns $130k a year in a very high cost of living area. It took him years to find this job. He did 3 post docs at very prestigious institutions and never earned more than $44k and never knew if he would have a job the next year.
Fair enough, I don't know any biochemists. When I attended grad school, bio was hot and became oversaturated. I presume it's largely a supply and demand issue for that field. I can assure you there are $400k/yr industrial research jobs for geologists, geophysicists, geochemists, mathematicians, and engineers of all flavors. These are for senior-ish positions...starting Ph.D. salaries would be more like $120k-$140k, but this is after attending a program that pays a stipend to attend; no postdoc necessary. There should be no graduate school debt. I was just offering an alternative graduate level degree that could pay similarly to a medical degree without incurring any of the debt of medical school.

afan
Posts: 3925
Joined: Sun Jul 25, 2010 4:01 pm

Re: How risky is Med school student loan debt?

Post by afan » Tue Feb 06, 2018 12:54 pm

CppCoder wrote:
Tue Feb 06, 2018 9:42 am
sawhorse wrote:
Mon Feb 05, 2018 10:39 pm
What sort of jobs are paying $400k for biochemistry research? My husband earns $130k a year in a very high cost of living area. It took him years to find this job. He did 3 post docs at very prestigious institutions and never earned more than $44k and never knew if he would have a job the next year.
Fair enough, I don't know any biochemists. When I attended grad school, bio was hot and became oversaturated. I presume it's largely a supply and demand issue for that field. I can assure you there are $400k/yr industrial research jobs for geologists, geophysicists, geochemists, mathematicians, and engineers of all flavors. These are for senior-ish positions...starting Ph.D. salaries would be more like $120k-$140k, but this is after attending a program that pays a stipend to attend; no postdoc necessary. There should be no graduate school debt. I was just offering an alternative graduate level degree that could pay similarly to a medical degree without incurring any of the debt of medical school.
Those salaries are for engineers in fields like petroleum and computing. The market for life sciences PhD's is entirely different. As sawhorse points out, the biomedical PhD graduates head into at least 2 post docs while the MD grads are doing residencies. Six years of post doc would be typical, with plenty of people doing more. That post doc position pays poorly and by definition is a training job with no chance of it being long term.

As the post doc time wears out the biomedical PhDs then search for jobs. The competition for tenure track positions at major research universities is brutal. They will get hundreds of applications for an advertised job. The lucky person who gets that job is by no means secure. They then have to get funded, another competitive game that most lose. If they can get and stay well funded over their first 6-10 years, depending on the university, then and only then are they eligible for tenure.

Many such grads take jobs in medical schools that do the same work, with less teaching, but no chance of tenure, ever. They spend the rest of their careers trying to get and keep enough funding to pay their salaries.

Being a truly tenured professor at a major research university, particularly one of the elite privates, is a great job. You get to spend your time reading, researching and writing about what you likely believe to be the most interesting questions in the world. You get prestige, quite a good salary, essentially perfect job security, stimulating colleagues and usually an exciting place to live. The ability to do consulting depends on your field. In many fields it is simply not possible. You could write a textbook and if it hits big you might get some money. But that is very time consuming.

Although it is a 9 month salary, a researcher cannot just close down the lab and take the summer off. They may not have to show up to teach classes, but they have to keep the research operation running all year long.

Income- varies WIDELY by field. Professors in higher income fields can earn a lot more than, say, an English professor. Stars recruited in with big packages or who get retention bonuses can earn far more than the mean, even for their fields.

Recent numbers from Harvard- which is usually the highest paying university- Professors mean $230k, associate professors $135k. People who make it to associate professor typically move on to become professors and spend most of their careers as full professors.
Salary at less wealthy universities can be much lower.

But ending up tenured at a top private university is so unlikely that it is not a realistic plan for any undergrad trying to decide between medicine and scientific research. Medicine is much more secure. People drop out of PhD programs all the time. Those who finish often cannot get tenure track faculty jobs at all, let alone at a rich private university. Those who get such jobs often do not get tenured and have to leave.

People who get admitted to medical school can reasonably count on finishing, getting a residency, completing training and practicing for the rest of their careers. None of that applies to people entering PhD programs in biomedicine.
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