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Upcoming Med Student with three kids a wife and lots of current debt

Home General/Welcome Upcoming Med Student with three kids a wife and lots of current debt

  • Avatar Saucy7 
    Participant
    Status: Student
    Posts: 14
    Joined: 11/02/2018

    Hi everyone. I’m a 28 year old pre med and have been accepted to a private MD program in my home state and will be attending there next fall. I am married with three young children ages 4, 2.5, and 8 months.

    I currently work as a healthcare professional and my wife is an educator our combined income is just shy of $100k currently. We own a home but have significant debt including credit cards, undergraduate loans, and small car loans. Our debt load is upwards of $100k combined not including the mortgage.

    We plan to sell the home as the school I will attend is in a different city and we expect, based on my own preliminary analysis and local comps, to walk away with a profit in the range of $35-$50k which will go towards the credit card debt and should eliminate that completely if all goes according to plan. Even if we still have some debt remaining we will finance that so its not such high interest. We plan to rent while in school and residency. My wife plans to work during and after my schooling and residency training and so we will have a small income (teacher salary) but that should help significantly over taking more loans.

    My question really regards opportunities to finance my education. The school i will be attending has an accelerated program that is 3 years and has a “guaranteed” residency program outside of the match in the same city as the school but only for general Internal or Family medicine. The last 2 years are tuition free and as stated before there is no fourth year. Basically I would only have to pay for one year of school at $43k tuition (not including fees etc) but then would go into a primary care specialty listed and the payback requires me to stay in my state for at least 3 years and work in general primary care before doing any fellowships etc.

    I am not sure what type of medicine I want to practice just yet but am very interested in this program for the shorter duration and financial consideration given my current life and family situation. However, I have spent significant time in the ED as a scribe and a technician prior to working in my current position in pathology as an assistant. I have considered going into Emergency Medicine but that would require the typical 4 full years of school leading me to upwards of $300k in debt from school and then the time to pay it all off.

    What recommendations would you have for me as I navigate the time prior to beginning school and making a specialty choice? I know that Family Medicine can do a fellowship in Emergency Medicine and practice in smaller hospitals so that may be an option down the road to take the scholarship but I want to make the most informed decision that sets my family and I up for success and not failure in our future.

     

    Thanks!

    #161819 Reply
    Dreamgiver Dreamgiver 
    Participant
    Status: Physician
    Posts: 812
    Joined: 03/09/2017

    Congrats for getting accepted! I think your game plan is on the right path, get rid of the house and of the CC debt quickly. Don’t know what car you drive, if it’s modest keep it, if it was a splurge get rid of it. Goal is not to take loans for living expenses if possible during med school. I would never pick a specialty so early, can you wait to make that decision? A couple of years of free schooling is not worth a lifetime of unhappiness. Also, be frugal but not so much that your wife will leave you. In the grand scheme of things a few grands a year more of loans now do not matter that much.

    #161860 Reply
    Avatar DCdoc 
    Participant
    Status: Physician
    Posts: 485
    Joined: 06/14/2016

    Seems like 150k saved in turuok and an extra year of attending salary (maybe another 150k post tax) so it’s $300k cheaper than the alternative.

    #161862 Reply
    Avatar Anne 
    Participant
    Status: Physician
    Posts: 1067
    Joined: 11/07/2017

    I wouldn’t commit to any specialty before you have even started. You could totally fall in love with a certain specialty your 3rd year and be stuck. If you fall in love with ortho for example (and can get into a good program) and can’t do it because you precommitted, that could end up being a poor financial decision , as well as a decision that will lead to a lifetime of regret. Besides, fourth year can give you so much exposure to things you might not see again if you choose your elective rotations well, and especially if you are going into primary care you want as broad exposure as possible throughout training.

    The only way I would consider choosing the combined option is if the school doesn’t have a good history of matching students in a variety of fields and most of its students enter primary care either way. Or if you have been dreaming of being a primary care doctor your whole life (even then i’d be cautious as I had plenty of classmates who entered school interested in PC and then realized they loved surgery, ob/gyn, psychiatry, or whatever else 3rd year)

    Take a long hard look at why you have credit card debt in the first place (was there some sort of catastrophe that explains it or does your family chronically spend more than you make) and evaluate whether you need to make some behavioral changes.

    #161871 Reply
    Avatar Tim 
    Participant
    Status: Accountant
    Posts: 2629
    Joined: 09/18/2018
    A couple of years of free schooling is not worth a lifetime of unhappiness.

    Click to expand…
    I would never pick a specialty so early, can you wait to make that decision?

    Click to expand…

    Almost any advice you will receive is NOT to become a doctor for the money.

    Almost any advice you will receive is NOT to chose the type of medical specialty for the money.

    Almost any advice is choose your specialty because that is the physician you want to be.

    The program is being consider because of ” shorter duration and financial consideration”, translation is “for the money”.

    The requirements may or may not have financial advantages or disadvantages, that is not the question. The question is should you do it for the money.

    NO. You are making a career change and congratulations are due. Get the training you want and desire, and figure out how to “live like a resident”. Keep in mind fellowships pay like residents as well. You will find a way to pay for it later, just not with training that is in a specialty you want to get out of and dislike.

    #161876 Reply
    Liked by RosieQ, Dreamgiver
    Drop it into MD Drop it into MD 
    Participant
    Status: Physician
    Posts: 440
    Joined: 09/20/2018

    Medical school is pretty crammed full of information as it is.  So it if was shortened that means something is being left out.  I am not sure I would want only 75% of the education that I received.    True you learn a ton in residency but you need that foundation and experience that you get in med school.

    #161880 Reply
    Liked by RocDoc, Firefly, Anne, Tim
    Avatar Saucy7 
    Participant
    Status: Student
    Posts: 14
    Joined: 11/02/2018
    Splash Refinancing Bonus

    Thanks for all the great replies and advice. I work with a privately owned pathology practice and my attendings have given me generally the same advice as to NOT go simply for the money and not to pigeon hole myself so early. For the program I described I would have to apply by end of first year so before rotations begin. Like I said before I’m not sure what I want to go into just yet but have had diverse experiences in my career so far from hospital ED to private pod labs and now hospital path. The CC debt is a combination of things including making ends meet as I did night school to get into Med school but there are behaviors we need to change ala the Dave Ramsey methods etc. I’m excited to begin the process and just want to ensure I don’t wind up bankrupt etc. thanks!

    #161881 Reply
    ENT Doc ENT Doc 
    Participant
    Status: Physician
    Posts: 3355
    Joined: 01/14/2017

    Thanks for all the great replies and advice. I work with a privately owned pathology practice and my attendings have given me generally the same advice as to NOT go simply for the money and not to pigeon hole myself so early. For the program I described I would have to apply by end of first year so before rotations begin. Like I said before I’m not sure what I want to go into just yet but have had diverse experiences in my career so far from hospital ED to private pod labs and now hospital path. The CC debt is a combination of things including making ends meet as I did night school to get into Med school but there are behaviors we need to change ala the Dave Ramsey methods etc. I’m excited to begin the process and just want to ensure I don’t wind up bankrupt etc. thanks!

    Click to expand…

    It sounds like you have time to make the decision on the accelerated program.  I’d force yourself to spend time in the ED and shadowing other specialties you might be interested in during that first year.  It’ll be hard with a family, but work your tail off.  You were clearly good enough to get in and compete with all the others there (congratulations BTW).  So don’t limit your options by not attacking the classes with all your might from day one.  Good luck.

    #161886 Reply
    Avatar treesrock 
    Participant
    Status: Physician
    Posts: 319
    Joined: 08/14/2017

    Am I the only one surprised to hear a med-school is willing to shave an entire year off the curriculum to get you into primary care?  How is this even possible?

    #161888 Reply
    Avatar ZZZ 
    Participant
    Status: Spouse
    Posts: 566
    Joined: 06/18/2018

    ‘Medical school is pretty crammed full of information as it is’…really? Did you really learn anything that you otherwise wouldn’t have your 4th year that has impacted your career?

    As per an earlier thread, midlevels are practicing independently in many locales with far less training. A future FP would benefit more from saving 50k on a year of tuition, the opportunity cost of a year of their life, and less time for interest to accumulate then they’ll get out of doing some electives and hitting the interview trail their 4th year. The more options, the better. It’s not for everybody (I’d never do that), but it undoubtedly makes sense for some.

    #161889 Reply
    Avatar ZZZ 
    Participant
    Status: Spouse
    Posts: 566
    Joined: 06/18/2018

    ‘Am I the only one surprised to hear a med-school is willing to shave an entire year off the curriculum to get you into primary care’

    Yep, consider yourself uninformed. Some schools have been doing this for at least a decade. You may also be shocked to learn that 10’s of thousands of patients are seen weekly by midlevels with even less training. Things evolve. Not always for the better, but that’s reality.

    #161890 Reply
    Liked by jz
    fatlittlepig fatlittlepig 
    Participant
    Status: Physician
    Posts: 948
    Joined: 01/26/2017

    Am I the only one surprised to hear a med-school is willing to shave an entire year off the curriculum to get you into primary care?  How is this even possible?

    Click to expand…

    Medical school is too long and full of useless crap.

    Fatlittlepig would go for the program and “drop” out of the program if you didn’t want to do primary care.

    #161892 Reply
    Avatar Golfing Doc 
    Participant
    Status: Physician
    Posts: 66
    Joined: 01/16/2017

    What happens if you change your mind and don’t want to do primary care? Do you have to do a 4th year of medical school?

    #161894 Reply
    Avatar Saucy7 
    Participant
    Status: Student
    Posts: 14
    Joined: 11/02/2018

    From my understanding (I’m meeting with financial aid and the director of the program next week to get definitive answers) you can switch back to the regular program at any point if you change your mind. I’m not sure how the money works though as in I don’t know if I would take loans for the three years saying I did the program then they would discharge them once I enter residency or if I would have to scramble finances together and pay up if I decided to switch to regular 4 year track.

    #161895 Reply
    Avatar kstarm 
    Participant
    Status: Physician
    Posts: 5
    Joined: 11/02/2018

    What is the plan for child care if your wife is working? If she is making a small teacher’s salary as you mentioned I wonder what the numbers look like if having to pay for child care vs her staying at home (assuming she would be up for that).

    #161891 Reply

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