CNN profile of two physicians in training, and their debt projection

Holy cow:

Young doctors in debt

CNNMoney.comChris and Meg Reis are on their way to long medical careers. Now it’s time to deal with $500,000 in student loans.

By George Mannes, Money Magazine senior writer

November 16 2007: 11:47 AM EST

(Money Magazine) — It’s Wednesday evening and Megan Reis can’t remember when she last saw her husband Chris. Small wonder. Since Sunday morning, Meg has worked more than 60 hours at Advocate Hope Children’s Hospital, the Chicago-area facility where she is training in pediatrics.

Chris, meanwhile, has put in a 24-hour day followed by a 12-hour one at the nearby Loyola University Medical Center, where he’s learning anesthesiology. Meg guesses she hasn’t seen him since Saturday.

Such are the lives of medical residents: med school graduates getting years of on-the-job training, putting in brutal hours for salaries that, on an hourly basis, work out to a little more than they could earn stocking the shelves at Costco.

It’s all supposed to pay off, of course. Once they become full-fledged doctors (attending physicians, in the trade), they’ll have six-figure incomes, more reasonable hours, a respected occupation and work that they love.

Chris and Meg live frugally, work hard and are making the kind of investments in their future that would make any parent proud. But they’re also on track to finish their medical training in the next few years with a staggering $700,000 in debt.

I have some debt, but thanks to the Navy (and all of you, thanks) it’s a whole, whole lot less.

Does anyone else think this is an excessive amount of debt, even given rising costs?  Seems like a lot more than I’m used to seeing quoted.


  1. Seems about right to me… I will be finishing up with ~240K in debt. Easy to do when tuition is ~38K per year.

  2. Just the ER doc says:

    I ended up with about $220,000 by the end of residency, but I had a wife who was a student, and I had one kid during med school and another at the beginning of residency.

  3. ScribeTurnedMSI says:

    At Texas Tech SOM the total “estimated yearly cost of living” runs around $31,000 for in-state tuition, and I think we’re one of the cheaper schools around the country. God bless state funding.

  4. Unfortunately the figure seems reasonable to me, maybe a little on the high side. When my wife and I got married we had approx $250,000 in student loans. Add the new $300,000 mortgage and you are in the same ball park. I don’t think most Americans have any clue.

  5. Say anyone want to trade their financial debt for my remaining military service commitment? We all pick our poison!

    Have fun!


  6. $700,000 does seem a bit high. However, when you look at their tuition costs, and then realize that this factors in their whole set of liabilities and assets, it’s not that out of line. $484,000 in student loans for 2 people, and $200,000 for a condo in Chicago doesn’t seem that out of line to me.

    Well, except for the $200,000 condo on $90,000 income a year for a couple under thirty years old.

  7. I will have 60k in debt by the time I am done with my MSW. Now that is much less than 250K. But social works have a low salary. Lower than teachers (who always complain about their pay).

    I think it really sucks because there is an image that drs make a ton of cash, and you don’t really. Lawyers may make about the same, but their tution is much much lower.

    Plus you get crappy pay during residency. Do they make you pay your student loan during residency????

  8. 700K is the combined debt number, which sounds totally on track to me. I know I’ll finish with around 250K easy, plus more monies for relocation back to US and 5th pathway year, I wouldn’t be surprised if I came close the 350K mark of these two individuals. The excruciating thing for us foreign school attendees is that our cost-of-living loans are not covered by any government guarantee; they are 100% private and therefore subject to both credit checks and the commercial interest rate of the time. It’s one thing to owe 300K in guaranteed student loans with a 6% cap or whatever; it’s another thing to have that much where 2/3 of it represents commercial loans that begin to approach credit card interest rates.

    And since FMGs are already stigmatized vis-a-vis matching in non-primary-care specialties, many pick IM/FP just to ensure a match, even though the future of those specialties, financially, is headed in the diametrically opposite direction. Something was wrong with us from the get-go to even go outside the US in the first place (thank you US admission committees–I appreciate your throwing the cinder block in the lifeboat). F it. I’ll deal.

  9. I have been very fortunate. My husband and I leapfrogged our educations. We have so far 2 B.S.’s, 1 M.D., and 1 J.D. and a cumulative total of 19K in educational debt (whick is now paid off). OK, we ate a lot of beans, did not go out much, lived in some less than desirable locations, and certainly did not have many toys. I don’t know how some of my classmates are doing it with their large debts. On the other hand, some of my classmates had all of their expenses covered by their parents. We were not so fortunate there, and we paid every single penny for our education by ourselves.

    We aren’t done yet. We are both in school part time to earn B.A.’s while working full time. We tell “the kids” at college that your education is the best investment you can ever make. So no matter what the cost, it would seem a good investment as long as you can earn enough to pay it off.

    LadyK73-Residents have their loan repayment deferred during residency, and most educational loans do not charge interest in that period.

  10. I think I’ll end up with 120k-140k. That was with a tuition scholarship for my first year (saved 12k I think). This is a state school with a relatively low cost of attendance.

  11. It does seem high, but is that the price for doing what you’re “called” to do? I was an elementary school teacher, before my children were born, I taught in a Private school and a Public, and was thankful for every penny. Teaching was a joy (and a pain sometimes), but I’d never have traded it in for more money doing something else.

  12. I’m forced to ask what were they thinking? Two residents with a combined income of under $100K and they BUY a place with a $200K mortgage? That’s not educational debt.

    I managed to get through medical and law school without anywhere near that kind of educational debt. I just don’t understand.

    Young physicians teeter on the brink of financial disaster. The cold reality is that compensation will decrease in the future. It’s just not a good business anymore. It must be a calling.

  13. medstudent says:

    I heard somewhere that there is an attempt to change the policy so that residents can no longer defer loan payments. Does anybody know more about this?

  14. idiots. what kind of bullsh!t story is that-i thought i would have a better chance of getting residency in chicago from osteopathic medical school than from the university of illinois?

  15. This topic prompted me to do a little research. Bush signed the College Cost Reduction and Access Act in September which is changing everything. Under this new law, residents are no longer allowed to defer payments on their educational loans while in residency. The new repayment plan does not start until July 2009. Between now and then, residents are falling into an uncomfortable period where no plan is in effect, and they may have to make large payments on the loan or go into forbearance (no payments but interest accrues). This means a resident with $130 K in debt would be making payments during residency of a little less than $1900 a month this next year. On a resident’s salary, that would just suck.

    Thank you very much Bush. I am sure that he has many good friends in financial institutions who will profit handsomely from this.

  16. It is indeed sad that young doctors come out of school with that much debt. Perhaps some financial counselling during training years may help some.

  17. Maybe there will be an increase of residents filing for bankruptcy..I knew an EM resident who did this and then married and relied on her husband for their credit.

  18. “Thank you very much Bush.”

    Why is everything always someone elses fault? Why does the taxpayer have to subsidize ANY form of student loan? Why do we have to feel sorry for people that make bad financial choices. Why do we have to feel sorry for anyone who can’t afford medical school, or can’t get into a U.S. medical school (Enrico). Just maybe medical school is out of reach for some people. Just because I want a nice house, nice car, expensive education does not mean that I can have it.

    Just because a person is smart enough to get into medical school does not mean they are smart with money.

  19. Why is everything always someone elses fault? Why does the taxpayer have to subsidize ANY form of student loan? Why do we have to feel sorry for people that make bad financial choices. Why do we have to feel sorry for anyone who can’t afford medical school, or can’t get into a U.S. medical school (Enrico). Just maybe medical school is out of reach for some people. Just because I want a nice house, nice car, expensive education does not mean that I can have it.

    Just because a person is smart enough to get into medical school does not mean they are smart with money.

    I certainly hope that you want doctors in the future because the way things are going now, it won’t be long before people who will make very good doctors will not go into medicine because there is absolutely no way to make it financially. Then you will be left with the system of medicine that the United States had before the turn of the 20th century. Remember cures like mercury baths? How about bloodletting? It takes a special breed to do this job. Everyone wants to cure people. The crackpots at your local herbal cures and remedies store have an herb or a spice or a tea that will cure just about anything that’s wrong with you. That’s providing that they can diagnose exactly what’s wrong with you and they have a thoroughly double-blind tested herb to give you. If you want to go back to that system, the feel free to let things slide the way they are going. There’s a lot more money that way too. Big corporations can market all kinds of cool cures that you will have absolute confidence in because you saw it on a Super Bowl ad. It’s great for everyone. Except the people who really need the cures.

    We’re not stupid. We see the writing on the wall. I’m actually pretty good with money. I just happen to like medicine a lot. And so I am paying in excess of $45,000 per year to go to a wonderful school where I will learn how to manipulate anatomy, diagnose disease, sift through research dats, prescribe drugs, and provide care, all so that when the day rolls around when you have cancer, I will either find it, treat it, or develop the novel drug that puts it into remission. That kind of training costs money. Too much money nowadays. The tipping point is not far away when the financial incentives far outweigh the joy of doing what you love to do. Who can truly love what they are doing when they are up to their eyeballs in debt with no way to repay it?

    [belatedly fixed bad HTML- GruntDoc]

  20. Sorry about that, I tried to do a blockquote and it put the whole thing in bold. I don’t mean to sound like I’m yelling. Need a “view comment” and “edit comment” section.

  21. Flightfire,

    BTW, I am a doc, have been for 15 years. Dirt poor family. Paid my way with jobs, military service, and Heal loans, which at the time were 11%, and lived in a 250$/month ghetto apartment.

    I really don’t follow your logic that if we don’t make medical education more affordable that it will bring us back to 19th century medicine. Herbs and snakeoil have always been around and always will be. If we come to a completely socialized system where government pays for tuition then we will be rewarded with “punch the clock” type of job “to repay the man” with even more byzantine beauracracy than we have now (hard to imagine). When I was repaying my military scholarship I “punched the clock” for 2 of the 4 years because I was under the charge of incompetent pencil heads. I am thankful that there is still a shred of the free market out there that allows me to practice excellent medicine and be compensated accordingly. However, that is rapidly diminishing and will certainly be gone for you because we will by then all sold our soul to suck on the big government teat because we felt like we could not make it by ourself.

    Health care is nice, but not a right, nor is free tuition, nor is a 200k condo.

    If you expect help from taxpayers then you (medicine) become more subject the byzantine be

  22. yes, healthcare is not a right. We should let people rot and die. Insurance ran out? Rot and die. Lost your job? Rot and die. Main provider in the family died? Rot and die. Unforseen accident? Rot and die. I know, I know, the beauracracy, ‘the man’.

  23. Goatwhacker says:

    I’m going to second Jerry on this. When people complain about taxpayers not subsidizing their loans enough it’s hard for me to drum up much sympathy.

    The implication that wanting people to pay back loans quicker will lead to 19th century medicine is ridiculous. I know when I was a student and resident I felt sorry for myself a lot, looks like things haven’t changed.

  24. jerry-i agree with you in principle that medical students and residents currently are crying a bit too loudly. i do think, however, that deferring loan repayment and interest through residency is not an unreasonable request. even if they have to forbear, the interest service on what now is 250k loans would cause those loans to grow to (even more) ridiculous levels. residency salaries are a established by a cartel system. if we could free the salaries so that programs would have to compete with each other then i would think we may not need to defer the repayments.

    the thing is that the world is tougher for everyone. college grads may have 40k in debt when they finish undergrad. there is no guarantee that they will be able to pay those loans back either. we probably as a society should really consider how we spend our educational dollars. maybe we need to make sure affordable college is readily available for the general population before worrying about our medical school debt.

    in the interests of transparency my wife and i have over 250k in educational loans at 8+%. we don’t have the biggest house or the fanciest cars, but we are comfortable several years out or training. of course we are on the thirty year payment plan for educational loans and our loan payment is bigger than our mortgage. we could pay it off faster but we are putting the money into our kids college funds and retirement instead. if we time it right we may die before paying back the educational loans but after paying for the kids educations. :)

    to the medical students and residents-although it is hard to imagine, i am not preoccupied with the loan amount or my income. when i was in training i spent a lot more time worrying about it. you just learn to accept the loan payment as part of the budget. if anything i would take less money to be at home more with family. i think you guys will be the same, although certainly ymmv.

    people will always scream the sky is falling. keep the faith.

  25. erdoc_in_tx says:

    I have to say that I have seen a lot of people I’ve been acquainted with during medical school and residency make very foolish decisions with their money. This contributes to those outrageous loan amounts. A few people eluded to this in previous posts as well. A few examples from people I know:
    -trips to Europe during medical school on loan money
    -buying a $70,000 car prior to receiving a single paycheck out of residency, even when this person’s credit card debt is excessive
    -4,000 square foot home prior to residency graduation

    I could go on and on and on but I won’t. To each his own, some people are willing to take on the extra expenses and debt to enjoy themselves during the training process. Life is short after all. But for those who are complaining about debt, they’d better take a long look at their expenses and ask themselves if they are living within their means along the way. We get very little exposure to financial planning in our training process (if any at all) and a lot of people make some huge blunders. This may ultimately lead some to work more hours or more years than they want to later in their careers……

    Something to think about. A lot.

  26. Frank Drackman says:

    WOW, I went to a state medical school in the mid 80’s, couldn’t afford the outrageous $6,000 tuition so signed up for the Navy scholarship. Did borrow $10,000 in student loans to buy a motorcycle and some other toys, couldn’t beat the interest rate and being able to defer repayment while in the Military, of course the year in Cuba sort of sucked.

  27. Goatwhacker says:

    I’ve seen this article referenced a couple of other places so read it again. Two things stick out. One is that this couple bought a 200K condo despite already being 450K in debt. The “staggering” 700K figure includes that debt. It would be less staggering if they lived in a crappy apartment like I did (and probably many of us did) in residency. Actually between the two they are making 88K per year and probably could rent a fairly nice place and accumulate no additional debt.

    The other is that the male doc passed up entering the state medical school to attend a private one at an extra 20K per year. This is certainly his choice but as a choice he has to deal with the results – increased debt. This is not to diminish the real problems medical school debts cause, but this is not a particularly sympathetic couple.

  28. I think they made a good decision to buy. 200K for a home in Chicago is pretty unheard of, and they will get it all back when they sell in 5 years. Why waste the money and put it into rent? Also, if you read it carefully, they did not finish school with 250K each…this was with interest accumulation. This is reasonable considering the cost of living in Chicago.

  29. roger pedactor says:

    I don’t think these two are looking for your sympathy or panhandling. Just letting everyone know what type of dedication it takes to become a physician.
    The payment on there 200K condo is probably about the same as paying rent for the 3-4 years they will have the place. They are not complaining, just passing along the facts.

  30. yellowmutant says:

    This does strike me as excessive debt….I am a fairly recent grad from med school who went in without a nickel to my name, but went to my state’s flagship medical school rather than a private one out-of-state, graduated with about $80K in debt, moonlighted a bit during residency, and had disposed of all debts after my first year in practice (in a competitive subspecialty). I remember meeting a D.O. intern during my training who was $250K in debt, planning to go into family practice, and I have to say he struck me as being a bad money manager.

    I wonder if there are differences among M.D.s and D.O.s in this situation, and between graduates of top and mid-tier medical schools….

  31. Goatwhacker says:

    I was thinking about this article the other day, wondering how these two turned out and if they are now underwater on their condo in the housing crash. I maintain that if you’re already in a lot of debt then do not take on more debt. If you’re a poor resident it’s not the time to be a real estate speculator, just accept a few more years of renting.

  32. All these stories are not just in medicine, and are a reflection of just how screwed up our whole economy really is.
    If you think of all the years we spend getting educated to become physicians, taking out loans to pay for overpriced medical education, and then add in the cost of delaying income, adding interest to the lost income…you will see the loss of income and the delay in saving for retirment this far outweights the ‘golden image’ of making it all worthwhile. High incomes are now gone for most specialties, overhead is soaring, and the need for cash flow creates many unethical situations for doctors in general.