Student Loan Debt

Republished from the AMA-MSS

Available at: http://www.ama-assn.org/ama/pub/category/5349.html

The MSS Task Force on Medical Education Debt reviewed data that were compiled over the last 20 years from the Association of American Medical Colleges, the federal government, and other sources concerning the cost of medical education and the debt burden of medical students.

Key findings include: the average graduating medical student debt has been rising faster than the consumer price index (CPI) for the past 20 years, and tuition at public and private schools has been growing faster than the CPI over these same 20 years.

If left uncontrolled, these exorbitant amounts of debt may cause shifts in specialty choice, increase burnout and decrease the numbers of minorities in medicine.

Statistics:

  • $139,517 – According to the Association of American Medical Colleges, the average educational debt of indebted graduates of the class of 2007. The average debt of graduating medical students increased in 2007 by 6.9 percent over the previous year.
  • 75.5 percent of graduates have debt of at least $100,000
  • 87.6 percent of graduating medical students carry outstanding loans

Source: AAMC 2007 Graduation Questionnaire

Why medical education debt has increased

Medical education debt is driven by rising tuition. AAMC data show that median private medical school tuition and fees has increased by 50 percent (in real dollars) in the 20 years between 1984 and 2004. Median public medical school tuition and fees increased by 133 percent over the same time period. Other recent 20-year periods show similar trends. Figures 1 and 2 (PDF, 23KB) demonstrate an upward sloping curve juxtaposing the rising debt and tuition—both faster than inflation.

Tuition is just one source of increasing debt burdens. Some other causes include:

  • Interest accrued on loans over time significantly adds to the total cost of student debt
  • Students now entering medical school with more education debt from undergraduate education
  • Increasing numbers of “non-traditional” students who have children to support

Debt crisis harms both students and patients

The increase in debt not only burdens medical students, but can have effects on the entire health care system. Some of correlations found include:

Decrease in primary care physicians

  • Students with high debt are less likely to pursue family practice and primary care specialties and instead seek specialties with higher income or more leisure time

Decreased diversity of physician workforce

  • The cost of tuition can prevent students from low-income/minority and those with other financial responsibilities from attending medical school
  • Physician diversity is necessary to address the needs of heterogeneous, multicultural patient populations

Promoting unsafe physician behaviors

  • Residents with high debt are more likely to moonlight
    • Increases fatigue and may contribute to medical errors (see Figure 4 (PDF, 39KB)
  • Increasing debt leads to more cynicism and depression among residents (see Figure 5 (PDF, 41KB)

How can we reduce debt?

The MSS has come up with recommendations for legislative and administrative remedies to resolve the medical education debt crisis. These recommendations focus on controlling tuition, the principal component of education costs, but include a number of relatively simple administrative measures that could be taken immediately and at a low cost to individual medical schools.

Federal level

  • Reauthorization of the Higher Education Act
  • Securing adequate funding for Title VII health professions programs in the FY 2009 Labor, Health and Human Services, Education and Related Agencies appropriations bill and expanding and protecting the National Health Service Corps (NHSC) Loan Repayment Program
    • Read the AMA letter (PDF, 60KB) to the Chairman of the Senate Committee on Appropriations
  • Broadening the tax-exempt status of medical scholarships

State legislative options

  • Tuition caps
  • State tax deductions for loan interest
  • State service loan repayment programs

Reform individual medical school financial policies

  • Tuition caps
  • $50,000 private institutions
  • $30,000 public institutions
  • Change fee policy

Innovative strategies for reducing student loan needs

  • Increasing grants and scholarships
  • Collaborate graduate/undergraduate debt counseling
  • Collective buying to reduce student expenses

Republished from the AMA-MSS

Available at: http://www.ama-assn.org/ama/pub/category/5349.html

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40 Responses to “Student Loan Debt”

  1. Megan says:

    Interesting article. While the proposed MSS recommendations may offer some help to future medical students, there are thousands of us in the here and now suffering. Too bad for us?

    I do, however, disagree with the recommended tuition caps at private institutions. Public schools under direct government domain are one thing; private organizations should be exempt from extraneous government regulations.

    I think the real deficit is in career counseling services at the undergraduate level. People as young as 21 years old are committing to a future financial burden they lack the capacity to understand, and are thus perfect targets for overeager lenders. Idealism and enthusiasm is important for those entering medicine, but it needs to be tempered with a large dose of reality.

  2. Z says:

    HAHA! I wish my debt would be $139,517. I’m about double that.

  3. J says:

    and this is why i went to a state school for undergrad. Med schools dont care where you go, they just expect you do well wherever you attend.

  4. D says:

    I think it is important to note that the average dept of 139k is for the 2007 class. From seeing my tuition bill, the dept of those graduating in 2012 will be >200k easy.

  5. Z says:

    Sorry J, but my parents didn’t set up a trust fund for me, my grandparents aren’t paying for my tuition, and I don’t have a spouse that makes $60,000/yr. There are plenty of people in my class with this situation, but I’m not one of them. I carry very little debt, but once you calculate in 4 years of med school plus the interest, it ends up pretty high. With a 6.9% average increase each year, that $139,000 for the class of 2007 will be just under $200 for my 2012 class.

  6. Seth says:

    I was wondering if anybody was able to get a loan to buy a house while they were in medical school. The reason I ask is because I start med school in the Fall and I want to get a house because my mortgage payment would be almost the same price as an apartment. I would specifically like to know about people who don’t have a spouse.

  7. J says:

    Well I actually pay for all my college by myself. My parents dont even cosign for my loans. I take them out by myself, so believe me ill have extensive debt as well. Im just saying that i chose to go to a college that is relatively inexpensive so that after med school my debt wont be astronomically high.

  8. Julie says:

    $139,517? I wish I was even double that……I had almost that much from undergrad and 1 masters degree before I even started med school. You can add in I have children and a husband too (He works full time) and you can chalk my debt up to almost $450,000 and I still need about another $75,000 to finish.

  9. Kel says:

    Try being $200,000+ in debt after VETERINARY school. At least most of the med school people are expecting decent salaries upon graduation. People always say veterinary medicine is one of those things you go into because you love it not because you want to be wealthy… well I’m not concerned about wealth but, the further I go the more I panic about the amount of debt incurred and lack of salary to pay it off… I’m thinking now that I may have made a very poor career choice regardless of how happy the work will make me.

  10. Jennifer says:

    how much do veterinarians make?

  11. Electrophile says:

    Jennifer, veterinary doctors typically average around 55-70K for small animal/food animal medicine when they get out and it stays right around there for a while unless you own your own practice…if you do private practice, that is. I’ve heard equine medicine tends to pay slightly less (which is surprising, as those animals are often highly valuable).

    If you do a residency, those pay about 25-30K for the internship and a residency I think is in the 30s or 40s (I think). The lowest paid board certified specialist averages around 90K (veterinary behaviorists) and the highest are veterinary nutritionists at 200K (because they typically work for industry, but not always). Even boarded surgeons only average something like 180K and IM is 150K.

    It’s not impossible to make pretty good money in veterinary medicine IF you have good business sense and IF you own your own practice, but no where near what physicians make. An associate doctor the equivalent of a family practice physician won’t make close to what they make.

    The sad fact is that vets have the highest ratio of debt to salary of the major professions with how much school we have to do. I’ll have about 125K, but only cause I went in state for undergrad, grad school for biology was free, and I went in state for vet med school.

  12. Luk says:

    Let’s hope for the best change in 4 years when I’ll be out of d-school.

  13. Andy says:

    While I can subjectively guess why tuition increases have outpaced inflation (i.e. greed), I can’t objectively figure it out. Someone care to enlighten me?

  14. MBA/MD says:

    Andy,
    It really does cost more to run a medical school than it used to. There are reduced government subsidies, increased medical knowledge to teach, and more accountability (insurance costs) than ever before. Of course, greed plays into the increasing cost but it is an ever-present problem that does not specifically explain the changing costs or be regulated away.

  15. RobDO says:

    I graduated in 2007 with over $220,000 (U.S.) in loan debt just from 4 years of medical school. 18 months later, including internship and 6 months into my 4 year residency, you can add $20,000 in interest on top of that 220K. Luckily I only had minimmal undergrad debt, but I also know residents who went to private undergrad universities for their B.S. or masters degree. Threy are close to or over 300K in debt.

  16. A says:

    $139K! Thats it! I wish mine was that low. More like 139K X2!
    Just increase residency salaries.

  17. Gildas says:

    I guess I am not the only one in the “139K X2″ category.

  18. Gary says:

    Some tips:
    1. Only apply to your state school. Private schools charge way too much for really nothing much more in terms of education.
    2. Look for scholarships before even applying to medical school to see if you could get help.
    3. Live on a low budget. Live with other people and pay less in terms of fixed costs monthly. You don’t need a big apartment, a doorman, etc. Search for low cost housing. Don’t live “like a doctor.”
    4. If you already are in a career and it’s stable, don’t apply to medicine. Do not risk what you already have until you really experience medicine. Try following a resident on a service for 1 month. Then decide. Forget shadowing some guy in a clinic.

    Contact your federal representative and senator about undoing the fixed interest rate and allow for lower interest rates than can be consolidated. To add to that, make educational loan payments a real deduction on your income tax, meaning you shouldn’t owe anything ever as a resident.

  19. C says:

    I really don’t know why it costs $40,000 a year to go to medical school. For the first two years, I sat at home and read a freakin’ text book 24/7. It cost the school nearly $0! I paid $80,000 for the opportunity to go take a test every 3 months — talk about a rip off. I understand how the third year could cost the hospital money with insurance and the liability, but the spending is out of control. The answer isn’t more money; the answer is getting control of the wasteful costs of running the medical system.

  20. Ouch says:

    Ouch, I thought my 85k debt was a lot… But then again I finished med school in 2002…

  21. CNortorious says:

    its very helpful hearing how many people are way over that 139K…I really wasnt expecting that much debt but I guess that it happens very easily to get over that number. So can someone explain how much debt they have thus far and where it was allocated as far as food, car, housing, etc…

  22. D says:

    Yeah, these numbers, although perhaps accurate as averages, are not reflective of the “real” picture of financial debt. I myself will be graduating from medical school with probably $220k of debt, and that is with a small debt burden from undergrad (~$10k, which is small compared to many).

    Take the numbers presented here. ~75% over $100k. What that actually says is that if 25% of students do not rely loans like the other 75% do, then we probably have a picture that is split. 25% having very little debt burden 0-$50k, and 75% having closer to $180k. Even this is not accurate I feel in many cases, as most students will be taking out ~$160k for tuition and fees alone (even at a public institution), and that is before 4 years of living expenses.

    Fortunately for many (as I did) it is possible to work through undergrad without accumulating a ton of debt, however medical school is a different picture. It is a job within itself, and is not friendly to much more than a minimal (if any) part time job.

    I personally do not think that it will affect my specialty choice too much. As long as one ends up with a take home near or above $100k a year, paying back loans, buying a house and much needed new car are still completely possible. Most of America does with less than that. Figure it this way: 20k a year towards loans leaves you still around 80k. Not too bad. Perhaps not what you expected after a gazillion years of education, and dealing with the egos that subside in medical school, but still not bad. However, as alluded to by others, I think that many make the decision to enter medical school without a REAL picture of the financial quagmire that is to come, be it due to age, inexperience, etc. Sure, you may not be driving a benz, but smart ppl drive hondas anyways.

  23. D says:

    Sorry for the follow up…but I noticed the previous comment from CNotorious

    My debt will look like this…

    Tuition
    1st year- 29k
    2nd year – 29k
    3rd year – 38.5k
    4th year – 29k

    where are we? ~125k

    Academic expenses (books, internet (i split an internet bill with 3 others), computer, equipment (stethoscopes are not free like I thought they were in undergrad :) ), vaccinations, etc.)
    For 4 years =’s about 13k

    =138k

    Oh yeah…did we mention that you have to take AND PAY for Step 1 (~$495 for the exam, expect to spend another $200-$600 for books and question bank) as well as Step 2 ($1500, plus another $200-? for review materials), so that’s at least $2500

    =140.5k

    Then’s there’s the fact that unless you plan to be homeless during medical school you will need rent/food/utilities/clothing/car insurance/health insurance/etc. money….

    My school gives about 16k for med 1 and med 2, and 19k for med 3 and med 4.

    That is not a lot, but it is fair. WORD TO THE WISE, if you are coming from the real world (as I did between undergrad and med school) and are used to making 35k+ a year, you have some serious adjustments to make.

    Ok, so living expenses adds up to ~70k for 4 years (and this is not in an expensive city)…

    Lets do some math….

    140.5k + 70k = 210k (here is where you add in any undergrad debt; in my case ~10k)

    Leaving me at $220,000 of debt when I get out of school.

    My picture may be a little extreme. My expected family contribution based on my parents’ info, which most medical schools make you provide if you expect to take out federal loans, was 0 if you need an idea of my background, so your case may differ. But I do think it is important for people to be WELL INFORMED, and make a decision about med school knowing that it is very likely you will come out of med school with well above the average of debt.

  24. K says:

    D,

    This is the math that scares me. I finish school with $260k in principal. Finish adding the interest from med school and 3 years of residency and that looks like $400k. Now, say you’re in a low income specialty, (most likely after 3 year residency) starting a $120k a year. Doesn’t sound horrible right? Now minus about 35-40k in taxes a year. That leaves you with about 85k. Still not terrible. Now take out the 40k a year that you’ll pay for 20 years to pay off your debt. Leaves you with about 45k left. Still livable. Now just hope you’re not paying insurance because that could kill anymore. That makes things tough to live on. Especially if you’re practicing in a city.

  25. Tiffany says:

    Does any one else feel let down by this whole system?

    For those of you trying to figure out your interst your Federal Loans use simple daily: Princpal * interest / days in a year (365.25) that’s the amount of interest you accrue a day. So if you are lucky enough to have 139k in Stafford loans at 6.8% you guys are looking at paying $25.88 A DAY IN INTEREST. (Don’t bother calling your lenders.. you can thank the government for this) If you were unlucky enough to get a private loan from some one like Sallie Mae…rest assured they are capping your interest every quater…costing you more and more money…

    The students that graduated in 07 also have a huge advanatage over you new med students. Their stafford loans were based off the T-bill not the new fixed 6.8% Stafford. This changed in July of 06. Those students were able to consol. while in school and lock in a lower rate. Not you guys! Oh .. and rest assured the government is now taking away your EHD option 6. Which is what most of you are hoping is going to get you through your Residency…. Good Luck! The government doesn’t want to pay your sub interest because they think your 45k a year in residency is too much. They will now be offering you an income senstive plan. Which will include your spouses income, and yes you would have to make payments. If you guys really can’t make your payments keep in mind if you have Federal Loans you can use upto 42 months of forbearence….

  26. John says:

    Hello. I happened on this site randomly and thought I would offer what advice I have.

    I graduated in 2000 and did a med/peds residency. I initially worked as a hospitalist, then in primary care (each for a year), and now I’m back working as a hospitalist.

    I just reviewed my accounts and it looks like I graduated with $141,716 in debt. However, due to the fact that the loan interest capitalized when I was in residency, my final debt amount was $171,512.

    I haven’t kept up with the new rules, so some of this may be slightly arcane, but may apply to some readers. There were options to pay only the interest while in residency. I wish I had done this, as the capitalized interest royally sucks. If you can, try to pay down some of the interest while in residency.

    I seem to recall in medical school talk about student loan interest being deductible. It is IF you make <$70,000 if single or <$145,000 if married (and phase-out begins at $115,000). Now, tell me, what physician makes less than that? Very few.

    My advice:
    1. Live frugally during medical school. Find a (relatively, haha) inexpensive school where the board pass rates and residency matches are adequate. Residency location matters more than medical school. Develop hobbies that are cheap, study, workout, have friends over, don’t eat out a lot, take your lunch (and supper), have roommates, live at home if you can, work jobs summers when you can, get cheap furniture from Goodwill, etc, don’t buy much ’stuff’, and on and on.

    2. Pay what you can during residency. Salaries will not increase much, because the higher education lobby is larger than the student physician lobby. A large part of the money comes from Medicare, and that’s about to take a huge hit from the Baby Boomers. We’ll see how Obama changes things, but he, like most lawyers, likely has no love for physicians. Note that his stimulus plan rebate stops at $150,000, which is the usual lower limit of physician salaries. Health care reform will be for the middle class, not for the “rich doctors”. I wish some of those people could have seen my debt when I was practicing primary care. Now that IS a field that I could foresee improving financially in the future.

    3. Limit the times where you are on financial hardship. When it IS necessary, try to pay the interest.

    4. Go into a field that you love and change your lifestyle if you have to. I wanted to do a little bit of everything, so I went into med/peds. I tried primary care, but the time commitment was too high and the compensation too low. Now I’m a hospitalist. I work 7 days in a row (12-hour shift), see 15-20 patients each day, and then I have 7 days off. My base salary is over $200,000. I did a few extra shifts last year and ended up grossing almost $260,000. My wife, who is a lawyer, doesn’t have to work now, because I make what we made together when I was working in primary care (although I know several primary care groups in town where guys are making over $300,000. They have some partnership & ancillary services in their building). On my weeks off, I’m doing large projects all around our little 4 acre farm, and I can spend a lot of time with my wife. We’ve gone on 3 cruises in the last year (one was CME paid for by the hospital. My part, anyway. How sweet is that?) The point is, you can find something eventually that pays you what you think you’re worth.

    5. Lobby together as a group to get loans consolidated at the end of residency into one, single number that charges minimal interest. Get the message out there that medical schools, hospitals, and federal payor systems are taking gross advantage of you at a point where you have no other options to reach your intended goal. I think loan assistance would balance with the bad part of a brutal internship at the end of medical school.

    6. Student loan payments do not take away an overwhelming portion of our income each month. After tax income was something like $12-$14,000 or so last year (with maximizing 403(b), and some 457). My part of our student loans was $1,000 per month. So, even though the loans are annoying, they really are just another bill. If you limit your house size & other expenses, loans aren’t a big hassle. We currently live in a 1,600 sf brick ranch on a farm, less than 30 minutes from work. We paid $265,000. Just because you’re approved for $600,000 doesn’t mean you should use it all. Most physicians change jobs 2 or 3 times when they get out before they settle on where they want to live. If you’re not sure you are going to be in an area for at least 3 years (and with the current housing market, maybe 5), you should seriously entertain leasing a place. Then, if you have to pick up & go, you will not have to sell the house. We moved to NC from Michigan, & we had to pay the MI mortgage for a year before we sold it. Thankfully, we leased here with an option to buy, then didn’t buy it. Moving was a breeze.

    I’ll bet, wherever you are, there are physicians just like I am, who want to tell you what they’ve done right & wrong, to help you avoid as many mistakes as possible. Find one you trust, or several, and pick their brains like a vulture. It’s probably the best advice I can give.

    P.S. Watch those first employment contracts, especially with smaller groups. Even though you are intelligent, the wording in the contract was designed by lawyers working for the employer, and it is never favorable for you, even if it appears to be neutral. Once you start the job, you find out the truth. That happened to me twice. The first job was production, and I didn’t get paid for 5 months b/c of insurance problems (but they ‘graciously’ gave me $5,000 in no-interest loans each of the last 3 months after 2 other physicians & I bitched enough). The second job, they basically just took my money. I produced enough to get a bonus, but then they made an excuse about paying my malpractice. I would definitely initially limit contracts to 1 year.

    P.P.S. Claims-made insurance sucks. You should work tail coverage into the contract. Read about it. You’ll be amazed. The system is broken in so many ways. If the government tries to clamp down, physicians are going to bail left & right.

  27. Rob says:

    If debt is a MAJOR concern…..go into a specialty like anesthesiology….Say you have 350K debt after residency. You will START off bringing in 200K per year AFTER TAXES! If you consolidate at 7%, which is high, you need to pay 130K for only 3 years and you are DEBT FREE!! All while living on 70K AFTER TAXES a year!!! In all honesty there is no need to worry!! If you don’t like anesthesiology choose something else in the same ball park in salary that you do like. LET”S BE REAL NOW. The average salary in the USA is only around 30K. YOU DO THE MATH

  28. Caboose says:

    I’m buying a lottery ticket. Budgeting will save me a few grand if I quit buying coffee and whatnot. There’s absolutely no time for a job without sacrificing the quality of my education. After wasting a lot of time and moral on highly competitive scholarships, I vote for a quick stop at 7-11.

  29. Jayme says:

    I’m not completely in same boat. I went to Chiropractic School. I’m in Debt 200,000. + a little more(for those of you who know after interst over the life of the loan is $400,000). I’ve been out for 2 years opened my own office after turing down several jobs for $20-25,000 a year. What’s the poverty level? I’m still on deferment for some of my loans but not all. I make $550.00 a month that’s all that’s left after paying for my building, 1 business loan (still paying only interest on one). I do all work myself at my office. I scrimp by and pray I will make it. As for any of you who walk out of school with that much debt, at least you can get a job that will pay you good money, with benefits. I so picked the wrong profession. Wish i could go back in time.

  30. Ignorant says:

    If high debt is causing a shortage of primary care physicians, assuming primary care physicians make less money, then maybe primary care physicians should get paid more. Can someone work on figuring out how to make that happen?

  31. Cambo21 says:

    Take a military scholarship, get your school completely paid for with a 30,000+ salary while in med or dental school and only owe 3 or 4 years active duty at somewhere between 60-80k while in. I know its not over 100k but that is what you will be making when you get out after four years with no debt. This is a much better deal I think for dental school, but still worth it for medical school. plus good clinical experience while you are in (patients, ie soldiers, don’t refuse treatment, its all paid for by the military for them). But obviously the military is not for everyone.

  32. steve says:

    The laws in this country have to change in regards to student loans. The biggest disservice we are doing is letting interest accrue on any loans during residencey. My monthly loan amount is 1300 per month for the next 30 years. It would be half that if interest wasnt tacking on at 700 bucks per month during my five year residency. THat means my loan increased by about 35K just for sitting in residency. Un believable. Not to mention my interest rate is much higher than my mortgage on my house. unbelievable. student loans is the biggest sham that is being perpetrated. anyway the lenders are reaping what they sowed. **** them i should have been a garbage man

  33. marie says:

    are we going to see serior citizens paying student loans????
    My son aquired a student loan when he was 18. He wasn’t able to finish the classes due to the fact that he just could not do the work (it was a trade school). He paid the payments for a while working minimum wage jobs. Had a son to support, you know the story. He made payments when he could. Then his dad got sick (stroke)and he had to help support us. Shortly before his father died, he got a call that he was in danger of having his wages garnished. They told his he had to make paymeents of $476.00 a month for a year before they would consider reducing the payment. He had heart problems & was in the hospital 5 or 6 times in one year & wound up having surgery. He missed a month of work & 1 payment. Now he’s told he has to make payments for a year from the month he missed before they will consider lowering the payment. Last year (2008) he made just under $30,000.00 and paid $8239.00 in student loan interest. So, somebody tell me how is he ever to get anything paid towards the principal paying that kind of interest on his salary. That’s almost 33%. And he can’t even take all of it off his income tax return. He has 2 children & is doomed to a life of poverty because of one mistake. Trying something he couldn’t handle. In this country you can swindle people out of hundreds of thousands of dollars, start businesses & fail, charge thousands up on thousands of dollars on credit cards, then file bank ruptuptcy. But the student loans will be with you to your grave. That’s the only “sin” thats unforgivable. I’m not saying that he shouldn’t pay, just let him live while he repays it. This I’m sure will be taken out of his old age social security well into his 70’s at this rate. Just like a lot of people in their 30s & 40s. Here’s a thought, let them serve 6 months to 1 year in a posh federal prison & then forgive the debt. Isn’t that what the goverment does to white collar criminals that take millions & don’t pay it back? Welcome to the new crisis for the eldery……student loans.

  34. Eric says:

    This avg of 130K for med student is very very underestimation. I know at least dozen and many more residents with excess of 400K . I remember talking to banking instution regarding residency loan they said its very common for graduating residents with 400K + debt. 100K is nothing in Med graduates. and there is no guarantee that you will finish to pay off that debt. 100K is for undergraduate education.

  35. Karen says:

    Marie, contact the Clarke Howard show: http://clarkhoward.com/ . Click the “Consumer Action Link” – it might be the door in to asking the questions you’ve asked on this forum. Best wishes, Karen

  36. NP says:

    Well, I just couldnt resist posting on here to give some hope.

    I am an anesthesiologist working in private practice. 1st yr out of residency. Making 300K. what a relief? I can finally start paying back my student loans. I had 136K in loans that capitalized to 170k at the end of residency. My monthly student loan payments are 900/month. I get 15.5K for my 401K. Free health, dental, etc. Malpractice insurance is paid for by the group. After taxes, I end up with roughly 60%. It feels great to make extra payments towards my student loan payments. I also bought a new car, got some expensive dental work done. And now I have some extra cash to play around in the stock market. I plan to pay off my loans slowly over 10 yrs (4% interest rate). In the meantime, I am accumulating real wealth so that I can live comfortably later.

    Moral of this story: Don’t let financial issues ruin your nights. Be an anesthesiologist.

  37. J says:

    I went to an inexpensive state (5tht cheapest in nation at the time) med school and took military money (which covered tuition even when it increased by 15% every year). My debt was less than 16K upon exiting med school. I owe 3 years of military service with pay about 100k a year. I have no debt now, 1 year out from residency. I think more should think about military service, IF you have certain specialties. Gen surgeon, ER, internists, etc. will get deployed. If you can live with that for 3-4 years to have much less debt, THEN it is a good choice. You also will serve your country and the people protecting our freedoms. If you are a doctor in the US, then it is YOUR country. Otherwise, you will need to choose certain specialties that will pay well enough to live comfortably and reduce your debt.

  38. Peter O’Lalor and I just wrote a comprehensive bill for student loan debt relief and we want everyone to obtain it (cedresq@gmail.com), share it with others in the U.S. and ask legislators to support it. We need to work together and advocate for its passage. It asks for consumer protection, bankruptcy relief, a fixed 10-year term on student loans or discharged, a low fixed rate of interest, constitutional protections, etc. It is great. Student loan creditors are making huge profits every year. We need to work together. I am 53, a divorced parent of 3 teens. My home in California just went into foreclosure because mortgage co refused to work with me – negative equity in home – my employer never did the loan forgiveness plan as promised and the student loan creditors are garnishing wages. My children and I are temporarily separated because of financial crisis. My debt is allegedly now at $160,000 and increasing as we speak. It went up $60,000 in 2 years and I’ve been out of law school for 18 years. There is so much corruption. Please get the bill and share it. Thank you!

  39. Kay Em says:

    Any student loan over 50K – might has well be considered an unsecured mortgage.
    Anyone who has/had a mtg. knows that the total payout can triple the original cost in 3 decades of amortization with even a reasonable interest rate.
    What also needs to happen is to prohibit the transfer or sale of student loans without the consent of the borrower. Make all these lenders accountable for the servicing of their own loans.
    I know what I got myself into but I never signed on to double billing – by a lender who claimed to have purchased one of my loans from the original lender.
    Mind you I had a good chunk of loans – none ever defaulted – so it was no surprise that my original lender had no record of selling any of my loans. I got stuck paying my legit loans as well as paying a single 10k note to the claim lender – which went to 18K by the time they threatened to garnich wages – never mind I am always on time paying my student loan and had a letter from my legit lender! – So I paid the crooks! As long as we give these student lenders free reign to do as they please, they will continue to fleece the borrowers as well as the tax-paying public.

  40. Frank Bauer says:

    I think that we need to move past just dealing with these large numbers as monolithic figures. I am writing a series of columns breaking down medical school debt into different parts. I aim to move beyond griping to real education. I invite you to read, share, and comment.

    http://garbageplatemd.blogspot.com/2009/07/anatomy-of-debt-part-i.html

    http://garbageplatemd.blogspot.com/2009/07/anatomy-of-debt-part-ii.html

    http://garbageplatemd.blogspot.com/2009/07/my-idyllic-home.html

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