‘I’m Finally A Doctor, But The Debt Is Killing Me’

“Dr. Kelso: Dr. Dorian, do you not realize that you’re nothing but a large pair of scrubs to me? For God’s sake, the only reason I carry this chart around is so I can pretend to remember your damn names!”

In our society, we tend to put doctors on a pedestal. First of all, they help heal people, which is pretty incredible. Second, they went to school for about a decade to be able to diagnose that weird rash on our arm so we commend them for just being able to withstand that much time. But we can’t help but wonder that with the average debt for medical school grads being about $150,o00 when they get out and they haven’t even begun their residency yet (which pays about $50,000 per year), is it worth it?

One recent study by the American Association of Medical Colleges shows that more than 86% of med-school graduates have debt; the average 2010 debt for newly graduated docs was $158,000. In fact, the AAMC reports that the cost of private medical schools rose 165% — while public med-school costs soared 312% — over the past 20 years. Figures from the American Medical Association show that these costs far outpace the rate of inflation. “It is frightening to realize that I am a quarter of a million dollars in debt after paying for my medical-school education. With this much debt, I feel like I will be paying off my loans for the rest of my life,” said Dr. Sharel Ongchin who has been studying eyeballs for nearly 12 years. She is currently doing her residency, which pays her $50,000 annually, in Seattle. She told The Seattle Times all of her extra money goes to paying off her debt. Heck Izzie on Grey’s Anatomy had to strip her way through medical school to pay for it.

Older doctors often are wary to encourage young people to go into the profession because of the debt they could incur. Healthcare and the way physicians are paid has changed a lot in the last 30 years.  A physician blogger named Skeptical Scalpel wrote that a friend of his son’s was considering being a surgeon (he was in his late-20s) and wanted his advice on whether he should do it or not. He wrote:

“Suppressing the urge to tell him not to even consider becoming a doctor, I tried to help him think it through. He is looking at about 10 years of hard work including taking a year of post-graduate pre-med science courses, four years of medical school and five years of surgical residency training before his dream becomes reality. Here are the issues.He is still paying off his college tuition loans. He will have to pay tuition for his post-grad year. Medical school tuition alone will cost at least $40,000 per year [private] or $20,000/$40,000 per year [public, resident/non-resident]. Fees, health insurance, books, housing, food etc are not included. According to the AMA, the average debt facing graduating medical students in 2009 was $156,000. Here is a Wall Street Journal story about the worst case scenario for medical school tuition debt, a whopping $550,000 tab run up by a family practitioner.

He will not be able to earn much money during his five years of residency training. The average salary for a surgical resident is about $56,000 per year, which will force him to defer paying the principal on his loans while the interest keeps on accruing. By the time my young friend is ready to start his residency [2015], I fully expect the current allowable work hours to be significantly lower than the current 80 hours per week. This may lead to a lengthening of the duration of surgical training to six or seven years.

At best he will be 40 years old when he is ready to start practice. No doubt Medicare reimbursement for physicians will be reduced as this was barely averted for 2011 by a last-minute compromise band-aid bill passed by Congress. The insurance companies will surely follow with decreases of their own. God only knows what will happen to malpractice insurance premiums, the cost of running an office and other practice expenses. One thing for sure is that decreases are unlikely. “Private practice” may not even exist by 2020. Every doctor may be salaried as regulated by the government.

So do you want to invest ten years of your life to become the 21st century’s version of an indentured servant who runs up a debt so big that it can never be repaid for the privilege of working 60-80 hours per week for the rest of your life? If that sounds like a good deal to you, then go for it.”

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    • Lastango

      Excellent piece — very informative! I’d like to add to the mentioned reasons to respect doctors: they’ve applied themselves during their whole lives, and made good use of their intellect. That’s how they got the opportunity to go to med school in the first place. They have a strong work ethic that carries over into their practice. They’ve learned a lot, and they use it to help the rest of us. In my experience, there are far more good, caring doctors than bad ones.

    • Lastango

      Excellent piece — very informative! I’d like to add to the mentioned reasons to respect doctors: they’ve applied themselves during their whole lives, and made good use of their intellect. That’s how they got the opportunity to go to med school in the first place. They have a strong work ethic that carries over into their practice. They’ve learned a lot, and they use it to help the rest of us. In my experience, there are far more good, caring doctors than bad ones.

    • Kailey

      Another important consequence is that many of my medical school classmates can’t see themselves becoming primary care physicians (the category for which need is currently urgent and will only climb) because they can’t see a way out of debt at those salaries. To be clear, these aren’t people trying to be rich–just trying not to spend their entire lives in significant debt.

    • Kailey

      Another important consequence is that many of my medical school classmates can’t see themselves becoming primary care physicians (the category for which need is currently urgent and will only climb) because they can’t see a way out of debt at those salaries. To be clear, these aren’t people trying to be rich–just trying not to spend their entire lives in significant debt.

    • RM

      Their income to debt ratio is the same as mine, as a teacher.

    • RM

      Their income to debt ratio is the same as mine, as a teacher.

    • Amanda

      Try spending eight years on your education and $150,000 of debt, but only make $60,000 a year. Yep, that’s what it is like for veterinarians.

      • Lastango

        Vet’s in clinical practice may have it even worse than doctors, due to the floor space they need and the cost of equipping their offices.

    • Amanda

      Try spending eight years on your education and $150,000 of debt, but only make $60,000 a year. Yep, that’s what it is like for veterinarians.

      • Lastango

        Vet’s in clinical practice may have it even worse than doctors, due to the floor space they need and the cost of equipping their offices.