

Medical School at $278,000 Means Even Bernanke Son Has Debt - simonreed
http://www.bloomberg.com/news/2013-04-11/medical-school-at-278-000-means-even-bernanke-son-carries-debt.html

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Shenglong
I'm caught in an interesting trap where a third of my friends are set to
become doctors, a third investment bankers/consultants, and another third will
be going into tech. I'm also in Canada.

When our medical school friends explain their debt, my IB friends get really
excited and start cursing them for their _luck_. Here, apparently, in addition
to student loans that don't accrue interest until 6 months after graduation,
all medical students are apparently eligible for a $250,000 line of credit at
PRIME. Yes, you heard me--PRIME. At this point, my tech friends start to ask
why anyone would take debt.

Here in Canada, an emergency doctor would make about $250,000/year in Ontario
for working what works out (in shifts) to be about 25 hours per week, after he
has finished his residency. Assuming this is a similar situation in the
states, I don't see why this is so outrageous at all.

Oh, and Doctor shortage? _Really?_ It's medical schools that cap entrants, not
the price. Take a look at all the qualified students who are rejected each
year. I know a bunch.

~~~
eterpstra
The reason medical schools cap the number of entrants is the same reason they
raise tuition exponentially - it's expensive to run a medical school. It has
nothing to do with the number of applicants.

Also, 25 hours per week? My wife is a physician. Nobody at her hospital works
less than 60. Most work 80 or more. Surgeons are close to 100. For many full
time primary care physicians, it works out to about $10 / hour when first
starting out.

~~~
nmcfarl
But that $10/hr is gone once you are out of residency. And particularly for
the Surgeons - who are still working 100 hours - the real money starts. Med
Schools is a fine financial decision at this point in history. Lots of debt -
but lots of jobs, with good pay as well.

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davidf18
As a physician (with a BS EE/CS degree which is why I frequent HN), I tire of
this argument. If one reads the article carefully, they find that the father
Dr. Mark Moy attended excellent public medical school (and lower cost) Univ.
of Illinois in Chicago while his son is attending the very expensive (and
lower quality) Chicago Medical School (not to be confused with Univ of Chicago
School of Medicine).

Many graduating doctors get into big debt because they choose to attend
private undergraduate and private medical school. Instead of getting into such
huge debt, a fiscally responsible medical student should attend a lower cost,
quality public undergraduate school and a public medical school.

For example, in New York State, one could attend one of the SUNY schools or
the public part of Cornell (the Agriculture school for instance) undergrad and
then SUNY Downstate Medical School where they would get outstanding clinical
experience for the approx cost of private undergraduate tuition alone.

It seems odd that Berknanke's son would still be in debt if he had attended
both _public_ undergraduate and medical schools and does seem so fiscally
prudent on the part of the Fed Chairman and his son.

In addition, IIRC, you can have the military pay for full medical school if
you serve for four years as a doctor after you graduate if you are not good
enough to get into public medical school.

In summary, for most people who complain of medical school debt in this
country, it is really a sign of not being fiscally prudent on their part or of
those of their parents.

~~~
kbutler
"The median four-year cost to attend medical school -- which includes outlays
like living expenses and books -- for the class of 2013 is $278,455 at private
schools and $207,868 at public ones."

Whether the median is $278K (private) or $207K (public), that's a lot of debt
with which to start your residency before starting to practice.

I'd also dispute the "military...if you are not good enough" assertion.

~~~
mbreese
And that's not even considering the interest that accues _while_ you are in
residency.

Also, I'm fairly certain that the military (Army?) will pay for your medical
school costs, but you still have to go (and be admitted) to a normal medical
school.

~~~
djloche
There are two military options - you can have the military pay your medical
costs at a non-military (public/private) school, after which you owe the
military x years of service as a doctor in the military. The other option is
to go to the military medical school - you're paid standard officer salary to
go to school for the y years it takes, and then owe the military x more years
service as a doctor.

If you look at it as "getting paid to go to medical school" + "guaranteed
employment for x years following medical school" it looks like a pretty sweet
gig.

~~~
tsotha
I don't know how much value that "guarateed employment for x years following
medical school" is. From what I can tell there aren't a lot of doctors out
there hustling for a position.

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cjc1083
I'd say given the salary data, the fact that medicine is a stable and growing
field, and the amount of high level training required , these numbers are not
really crazy or out of line.

[http://www.profilesdatabase.com/resources/2011-2012-physicia...](http://www.profilesdatabase.com/resources/2011-2012-physician-
salary-survey)

After six years of practicing, even a non specialized doctor will be at 200K
with the lowest starting salaries around 140K. That is a fantastic amount of
money when you consider that it is the lower end of the pay scale for doctors
and that it will be a completely secure position in which you can work until
death or retirement.

250K is a small price to entry into 8Million+ lifetime earnings.

Being highly successful in most fields is equated with 150K and beyond salary
point, which comes with increased competition and no job security as you move
up the ladder...I don't see this as being a bad deal at all, even for those
totally self/debt funding.

~~~
nilkn
Indeed, the salaries in medicine can be so absurdly high that $250k of debt is
truly not as much as it sounds.

If a dermatologist _starts_ at $234k, then you could easily pay back
$100k/year and still have a very comfortable chunk of change left over. And
that's ignoring salary increases. In a few years, you'll be debt free making
$350k. And you could see numbers of that magnitude even in cheaper rural areas
where you'll live like a king.

And I completely agree with you on job security as well. Once you start
practicing, you're pretty much made for life.

------
dr_
And to add to this we are heading into an era of what appears to be declining
reimbursements. If not declining, then there certainly have not been increases
commensurate with increases in the cost of training. Students are always told
there will be a shortage of primary care physicians. I was told the same in
the mid 90's as a student. Just because there's a shortage, however, it does
not mean that "increased" demand has resulted in increase reimbursements for
primary care physicians. Instead, the trend has been the growth of nurse
practicioners and physicians assistants assuming greater responsibilities for
care, at a much lower cost.

So if you are medical student now, my advice would to practice, of course,
whatever specialty makes you happy, but don't fall for the shortage of primary
care providers schtick - if that's the reason you choose primary care, you
will be disappointed.

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rayiner
Bernanke is a career academic. What would make you think he's particularly
wealthy?

~~~
antidaily
My thought too. _Even Ben Bernanke_. His salary is 180k. Good but not enough
to spend 50k a year on med school most likely.

~~~
Gravityloss
That's something like 1.6 years salary (assuming 6 years of med school)? Seems
quite cheap, compared to something like an apartment...

~~~
rayiner
Med school is 4 years at around $65,000 per year (post tax obviously).
$180,000 per year post tax is $105,000. So that's 60% of his after-tax income
for four years.

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forgottenpaswrd
But Bernanke can print money for him and for his friends.

You can't.

------
mindslight
Of course - you've got to be a True Believer to get that kind of leadership
position, and he would have of course taught that to his son. These people
actually believe that having any non-monthly expense able to be financed is a
good thing, as it is then more "affordable", where affordable means not
requiring any sort of planning or saving for the future. Of course this really
just causes prices to shoot up, with positive feedback if the good can serve
as collateral, which exacerbates the problem causing more people to finance.
Essentially they are working to erode the utility of money itself, and revert
us back to a social reputation based system where your stature in life depends
on your creditworthiness and obedience to your job (stability required to make
all those continuing monthly payments).

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frozenport
Maybe, but they also have a stable guarantee of income. They certainly don't
live in poverty and fear.

~~~
mbreese
You'd be surprised how many doctors struggle to get by while paying their
debts off. Starting doctors don't get paid very much (considering their debt
load).

It's even worse when you factor in their opportunity losses by spending 4
years more in school and 3-5 years more in residency (where you don't get paid
much). And if you add in a specialized fellowship? That's 3-4 more years. It's
7-13 years before you actually get to start making real money. And if you're a
GP, you're still only making a fraction of what you could be making elsewhere.

~~~
haldujai
I disagree, many physician jobs offer loan repayment (of up to $200k) while
offering salaries in the upper 300-400s (for many specialties). Surgeons can
easily make seven figures depending on what they are doing.

You also have to factor in the job security, the fact that transitions to
other roles does not entail a pay cut (as in law or finance) and the potential
to be your own boss (run your own practice).

Doctors who make little money (the reason the average is so low) is because
they choose to work less hours and spend time with family and friends. It's
not as bleak as you think.

~~~
nilkn
> Surgeons can easily make seven figures depending on what they are doing.

That seems like quite an exaggeration to me. Surgeons are highly paid, but in
the grand scheme of things very few of them make $1m+/year. And the ones who
do so generally do not do so easily. Neurosurgeons and orthopedic surgeons are
generally the highest paid of all doctors, but both rarely crack seven
figures, and they work horrendous hours in many cases. And becoming a
neurosurgeon is simply beyond the ability of most medical students anyway.

Perhaps if you set up a plastic surgery shop in Beverly Hills and hired other
doctors under you.

