The Cost Of Medicine

As I look at the HSDN forum I see so many bright eyed idealistic premeds. How many of you have thought about the costs associated with medicine. Some are easy to quantify monetarily direct costs are 4 years of foregone income after college. That works out to $200,000. There are the additional costs of medical school an instate schools will be 20,000 per year, OOS or private will easily be 40,000 per year. Living costs are 15,000 per year for bare bones in a low cost area, higher cost areas like New York can easily top 25,000. The average medical student graduates with $150,000 of debt from med school on top of whatever costs you have from undergraduate assuming average debt from undergrad that's an additional $20-40,000 with the interest clock running. In addition you will be paid horribly for the 3 to 7 plus years of residency and fellowship. This is merely the economic cost. There are huge intangible costs to attending medical school or any other professional school. In college you will study harder than most to maintain the 3.45 average for Osteopathic or 3.65 for allopathic medical school. While your best friends party, you will study. You will do research and ECs that may be tangential to medicine merely because they are expected not out of any abiding love or desire to do them. You will be forced to take a proscribed set of courses. Once all of this is done you sit for the MCAT, a difficult exam requiring months worth of preparation, a low score may mean 3 years of hard work were all for nought. After all this you apply you have a 50:50 shot of getting accepted anywhere. If accepted you will complete 2 years of basic sciences, you will study all day and night. You then sit for the COMLEX or USMLE which will help determine what caliber of specialty you will match into. Then come clinicals, long days and pimping questions characterize this time. You then do the match and find out what you will spend the next 3-7 years doing in residency. Residency involves long days and nights, lack of sleep and horrible pay. If you do a fellowship you will be paid even worse during this. 11 to 15 years after your high school diploma you will finally practice. Starting pay is not wonderful PCPs may start as low as 75K specialists in the mid 200s. You will have had to delay marriage and starting a family most likely. Pay in real terms is falling. Medicare continues to cut pay in both real and relative terms. PCPs are making 150K 20 years out of medical school, not bad, however with your exceptional debt load and taxes you won't see most of it. Preexisting relationships will be strained throughout medical school and many will fail.

The point of this is not to dissuade you from going for your MD or DO, but to give pause. Contemplate how committed you are. From a financial perspective avoid as much undergrad debt as possible and eschew expensive private med schools for cheaper state schools. If you will be graduating with 300K in debt you will be forced into choosing the best paying specialty. Medical school costs have really been hiked up when my father went to med school in the mid 70s the cost was 20k or in todays dollars $80,000 and this was at one of the most expensive private schools in the US. Today it is 172K for four years not including the additional 25 or 30K in living costs a year. With the coming changes and continued cutting of reimbursement consider this. Also consider the cost emotionally being a physician is disruptive, you will get called and paged at all hours. Think about this carefully. Medicine is no longer accesible to the poor and is quickly outstripping the ability for the middle class to pay for. Even if you take out loans they will cost you 2200 a month assuming 10 years at 6% interest. However this is artificially low. You will most likely be forced to defer payment through residency and the interest will continue to roll on.