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- No. I did not opt to pursue the 10-year forgiveness plan for
primary care providers working for a non-profit. I did not want
to limit myself after graduation from residency. If I want to
work for a physician's group or a for-profit institution, I want
to be able to without feeling like I must work for a non-profit
in order to qualify for debt forgiveness through government
programs. I think I will be able to pay off my debt without
having to work somewhere I may not truly want to work. My
goal is to avoid physician burnout.
- Yes, I took a job offering a competitive signing bonus, as well
as retention hours.
- Yes, I will be more inclined to go to a place which provides
money towards loans if it is more than I could put up myself (if
they do not take it out of my salary).
- Yes, I am trying to practice under a public service organization
to qualify for the loan forgiveness program under the federal
government.
6. Has student debt affected any major life decisions such as
marriage, purchasing your first home, starting a family?
- Yes. I am married, but we relied a lot on my husband's parents
for help financing our wedding. We do not have money for
the down payment on a home. We also know it would be
financially straining to try to start a family right now as well.
Plans are on hold for a house and family at least until I have
graduated from residency and start earning an attending
physician's salary.
- Somewhat - we are waiting to have children for other reasons
as well.
- No. (no explanation given)
7. Have you experienced anxiety or depression over your
student debt?
- Yes. More in medical school than in residency. Medical school
was not easy for me. I had anxiety over keeping up my grades,
but the amount of debt I was accruing also added to my
anxiety. I felt trapped, that if I were to fail I would have no
way to pay back any of the loans I was amassing. The amount
of pressure and anxiety I felt that stemmed from this was
unhealthy and I probably should have seen a therapist. Now
that I graduated and made it to residency, some of this anxiety
has diminished.
- Yes, but it is needed to become a doctor.
- No. (no explanation given)
8. Knowing what you know now about the cost of a medical
education, what advice would you give to an aspiring pre-med
student?
- I would not tell them not to pursue their dreams, but I would
not sugar coat my experience. I would encourage them to try
to find as many scholarships to help them as possible. There
are not too many that are substantial, however, aside from
the military. If they had help, it could take away some of the
anxiety and pressure around their fear of failure. Pre-med
students are already smart and motivated. It is a shame many of
them will suffer anxiety over keeping up with their coursework
as well as anxiety over fear of failure leading to financial crisis.

Selected Figures from the AAMC Medical Student
Education: Debt, Costs, and Loan Repayment Fact Card
(October 2016)
Class of 2016
Pct. with education debt
Mean (indebted only)
Median (indebted only)

Public
78%
$180,610
$180,000

Private
73%
$203,201
$200,000

Total education debt of:
$100,000 or more
$200,000 or more
$300,000 or more

83%
43%
9%

82%
55%
20%

Planning to enter loan forgiveness/repayment program: 44%
Cost for first year of medical school, in-state, 2016-2017:
Median Tuition and Fees:
$36,453
$57,472
Median Cost of Attendance: $59,026
$80,753
Median 4-year C.O.A.:

$240,351

$314,203

Interest rates for federal Graduate/Professional loans
disbursed 7/1/2016 - 6/30/2017:
Direct Unsubsidized: 5.31% Direct PLUS: 6.31%
(Rates change annually)*
2016 First Post-MD year median stipend: $53,580
*Editor's note: Graduate/professional students may borrow a
maximum of $20,500/year through the Direct Unsubsidized program.
When need exceeds this limit, they may apply for the more expensive
Direct PLUS loans. Loan fees are deducted from both types of loans
at the time of disbursement, and interest charges begin to accrue
immediately. Students may also resort to private loans, which
generally charge higher interest rates than federal loans.
For a graduating student whose $180,00 loan total is composed of
the maximum through the Direct Unsubsidized program ($82,000)
plus remainder through the Direct PLUS program, repaying their loans
with a flat monthly payment over 10 years would mean payments
totaling $24,480 the first year. Flat monthly payments spread over
20 years would total $15,720 over the first year. Obviously, neither of
these scenarios would be possible on a stipend of $53,580/year. For
repayment of federal loans, as student debt has ballooned, a variety
of options designed to make monthly payments more manageable
have become available.

continued on next page
SPRING 2017

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