What To Do With $500K in Student Loans?

[Sergio Estavillo]

A nice benefit of REPAYE, in addition to the 50% interest subsidy on accrued interest, is accrued interest does not capitalize while in REPAYE.  So, while in residency:

1. Don't pay more that what's required.


2. Take advantage of any employer retirement match.  This will lower your AGI, which lowers your REPAYE payment.


3. If possible, save some monies in an interest bearing account for the purpose of paying down the accrued interest before exiting REPAYE.

While an attending:

1. Consider refinancing if rates remain competitive.


2. Pay down aggressively.

[StarTrekDoc]

MPMD wrote:

 

If I were in this scenario I would try to bust 20 shifts/mo or so for 2 years. I wouldn’t worry about the burnout factor that soon out of residency. You’re going to be coming off training where you probably worked around that or much worse (e.g. in ICU).

Just grind it.

I also think with $500k in loans you need to make a chart and hang it on your wall with clear rewards for yourself planned out, probably in $50k increments. Having just payed off my loans I can tell you that the amount of willpower required to take a $15k bonus check and basically sign it over to your loan company just to see the balance go from $200k to $185k is extreme and must be maintained with regular rewards.

Click to expand...

Remember this 'pups' are coming off 80 hr week restrictions --none of that crazy q3 call with post-call days finishing at 8pm --talk about PTSD.

 

@hightower - a lot of none W2 opportunities out there that's free of the burdens of corporate medicine; yet still impactful and in the chosen field.

@Re3iRtH - i would wager that being a physician is more humanitarian/life-universe changing than most profitable business or self travel venture would have.   I count myself lucky to have the ability to be a physician.

[The White Coat Investor]

StarTrekDoc wrote:

MPMD wrote:

 

If I were in this scenario I would try to bust 20 shifts/mo or so for 2 years. I wouldn’t worry about the burnout factor that soon out of residency. You’re going to be coming off training where you probably worked around that or much worse (e.g. in ICU).

Just grind it.

I also think with $500k in loans you need to make a chart and hang it on your wall with clear rewards for yourself planned out, probably in $50k increments. Having just payed off my loans I can tell you that the amount of willpower required to take a $15k bonus check and basically sign it over to your loan company just to see the balance go from $200k to $185k is extreme and must be maintained with regular rewards.

Click to expand…

Remember this ‘pups’ are coming off 80 hr week restrictions –none of that crazy q3 call with post-call days finishing at 8pm –talk about PTSD.

 

@hightower – a lot of none W2 opportunities out there that’s free of the burdens of corporate medicine; yet still impactful and in the chosen field.

@Re3iRtH – i would wager that being a physician is more humanitarian/life-universe changing than most profitable business or self travel venture would have.   I count myself lucky to have the ability to be a physician.

Click to expand...

Q3? You sissy. In my day we did Q2, and the only problem with that was that we missed half the good cases!

[StarTrekDoc]

That's just brutal.  My dad's recollection of his residency days were the same - Even making their own Gram stains.

[Re3iRtH]

I respecfully disagree. The reasoning is very simple.
As a physician, even in a full career you (at best) can truly impact or touch 'thousands' on lives (and realistically iatrogenically harm 10-15% of them).
With entrepreneurial/policy/media/humanitarian .. you have the potentially to touch 'millions' or 'tens of millions' of lives.

[Zaphod]

Re3iRtH wrote:

I respecfully disagree. The reasoning is very simple.
As a physician, even in a full career you (at best) can truly impact or touch ‘thousands’ on lives (and realistically iatrogenically harm 10-15% of them).
With entrepreneurial/policy/media/humanitarian .. you have the potentially to touch ‘millions’ or ‘tens of millions’ of lives.

Click to expand...

Absolutely agree. We also tend to overestimate our personal impact. Yes, a certain subspecialist in a place of dire need makes a big impact, but just another doc in the city is hardly noticed if they leave.

On the other end, it seems they vastly underestimate the scope of what could be in pursuits you have mentioned. They are huge. Too huge to pass up if you think that way.

[q-school]

Zaphod wrote:

Re3iRtH wrote:

I respecfully disagree. The reasoning is very simple.
As a physician, even in a full career you (at best) can truly impact or touch ‘thousands’ on lives (and realistically iatrogenically harm 10-15% of them).
With entrepreneurial/policy/media/humanitarian .. you have the potentially to touch ‘millions’ or ‘tens of millions’ of lives.

Click to expand…

Absolutely agree. We also tend to overestimate our personal impact. Yes, a certain subspecialist in a place of dire need makes a big impact, but just another doc in the city is hardly noticed if they leave.

On the other end, it seems they vastly underestimate the scope of what could be in pursuits you have mentioned. They are huge. Too huge to pass up if you think that way.

Click to expand...

boo!  disagree with zaphod.  maybe in fancy California, but here in the sticks, if someone leaves or retires, it is definitely noticed.   by patients, by physicians, by many.  if anything, my experience has been that physicians underestimate their personal impact.  that may contribute to burnout.

there are plenty of people who are entrepreneurial/humanitarian/etc.  if you feel so moved, be like buffett and make a ton of money (outside of medicine), and then create your foundation.  it is hard for me to imagine, you couldn't do both and continuing to work, even part time as a physician, seems to offer a way to make reasonable money and gain instant credibility in a lot of endeavors.  and help a lot of people as well.

 

[Zaphod]

q-school wrote:

Zaphod wrote:

Re3iRtH wrote:

I respecfully disagree. The reasoning is very simple.
As a physician, even in a full career you (at best) can truly impact or touch ‘thousands’ on lives (and realistically iatrogenically harm 10-15% of them).
With entrepreneurial/policy/media/humanitarian .. you have the potentially to touch ‘millions’ or ‘tens of millions’ of lives.

Click to expand…

Absolutely agree. We also tend to overestimate our personal impact. Yes, a certain subspecialist in a place of dire need makes a big impact, but just another doc in the city is hardly noticed if they leave.

On the other end, it seems they vastly underestimate the scope of what could be in pursuits you have mentioned. They are huge. Too huge to pass up if you think that way.

Click to expand…

boo!  disagree with zaphod.  maybe in fancy California, but here in the sticks, if someone leaves or retires, it is definitely noticed.   by patients, by physicians, by many.  if anything, my experience has been that physicians underestimate their personal impact.  that may contribute to burnout.

there are plenty of people who are entrepreneurial/humanitarian/etc.  if you feel so moved, be like buffett and make a ton of money (outside of medicine), and then create your foundation.  it is hard for me to imagine, you couldn’t do both and continuing to work, even part time as a physician, seems to offer a way to make reasonable money and gain instant credibility in a lot of endeavors.  and help a lot of people as well.

 

Click to expand...

Uh, I already mentioned the caveat of the sticks, maybe shouldnt have said subspecialist. Even if noticed, does it create serious access issues on average?

Obviously we make A difference, just that if one feels entrepreneurial then they should get after it. Probability of success low, but could be very powerful. For example this site, WCI has impacted more lives than his medical career very likely, and it will continue to live on whether or not he keeps at it. I see the draw.

I dont think anyone should be really judging of anyone elses set up. If you want to make a difference as a doc, do it, if you want to FIRE then do so. People are allowed to judge and tell me what to do as soon as they start paying my bills and taking care of me in the way im accustomed.

[q-school]

Zaphod wrote:

q-school wrote:

Zaphod wrote:

Re3iRtH wrote:

I respecfully disagree. The reasoning is very simple.
As a physician, even in a full career you (at best) can truly impact or touch ‘thousands’ on lives (and realistically iatrogenically harm 10-15% of them).
With entrepreneurial/policy/media/humanitarian .. you have the potentially to touch ‘millions’ or ‘tens of millions’ of lives.

Click to expand…

Absolutely agree. We also tend to overestimate our personal impact. Yes, a certain subspecialist in a place of dire need makes a big impact, but just another doc in the city is hardly noticed if they leave.

On the other end, it seems they vastly underestimate the scope of what could be in pursuits you have mentioned. They are huge. Too huge to pass up if you think that way.

Click to expand…

boo!  disagree with zaphod.  maybe in fancy California, but here in the sticks, if someone leaves or retires, it is definitely noticed.   by patients, by physicians, by many.  if anything, my experience has been that physicians underestimate their personal impact.  that may contribute to burnout.

there are plenty of people who are entrepreneurial/humanitarian/etc.  if you feel so moved, be like buffett and make a ton of money (outside of medicine), and then create your foundation.  it is hard for me to imagine, you couldn’t do both and continuing to work, even part time as a physician, seems to offer a way to make reasonable money and gain instant credibility in a lot of endeavors.  and help a lot of people as well.

 

Click to expand…

Uh, I already mentioned the caveat of the sticks, maybe shouldnt have said subspecialist. Even if noticed, does it create serious access issues on average?

Obviously we make A difference, just that if one feels entrepreneurial then they should get after it. Probability of success low, but could be very powerful. For example this site, WCI has impacted more lives than his medical career very likely, and it will continue to live on whether or not he keeps at it. I see the draw.

I dont think anyone should be really judging of anyone elses set up. If you want to make a difference as a doc, do it, if you want to FIRE then do so. People are allowed to judge and tell me what to do as soon as they start paying my bills and taking care of me in the way im accustomed.

Click to expand...

Let me apologize if it sounded judgmental.  it was not intended to be any different than our normal level of conversation.

 

 

[Zaphod]

q-school wrote:

Zaphod wrote:

q-school wrote:

Zaphod wrote:

Re3iRtH wrote:

I respecfully disagree. The reasoning is very simple.
As a physician, even in a full career you (at best) can truly impact or touch ‘thousands’ on lives (and realistically iatrogenically harm 10-15% of them).
With entrepreneurial/policy/media/humanitarian .. you have the potentially to touch ‘millions’ or ‘tens of millions’ of lives.

Click to expand…

Absolutely agree. We also tend to overestimate our personal impact. Yes, a certain subspecialist in a place of dire need makes a big impact, but just another doc in the city is hardly noticed if they leave.

On the other end, it seems they vastly underestimate the scope of what could be in pursuits you have mentioned. They are huge. Too huge to pass up if you think that way.

Click to expand…

boo!  disagree with zaphod.  maybe in fancy California, but here in the sticks, if someone leaves or retires, it is definitely noticed.   by patients, by physicians, by many.  if anything, my experience has been that physicians underestimate their personal impact.  that may contribute to burnout.

there are plenty of people who are entrepreneurial/humanitarian/etc.  if you feel so moved, be like buffett and make a ton of money (outside of medicine), and then create your foundation.  it is hard for me to imagine, you couldn’t do both and continuing to work, even part time as a physician, seems to offer a way to make reasonable money and gain instant credibility in a lot of endeavors.  and help a lot of people as well.

 

Click to expand…

Uh, I already mentioned the caveat of the sticks, maybe shouldnt have said subspecialist. Even if noticed, does it create serious access issues on average?

Obviously we make A difference, just that if one feels entrepreneurial then they should get after it. Probability of success low, but could be very powerful. For example this site, WCI has impacted more lives than his medical career very likely, and it will continue to live on whether or not he keeps at it. I see the draw.

I dont think anyone should be really judging of anyone elses set up. If you want to make a difference as a doc, do it, if you want to FIRE then do so. People are allowed to judge and tell me what to do as soon as they start paying my bills and taking care of me in the way im accustomed.

Click to expand…

Let me apologize if it sound judgmental.  it was not intended to be any different than our normal level of conversation.

 

 

Click to expand...

Oh no, sorry not specifically to you! I didnt think that at all, the topic just made me think of it.

I was just thinking as a general principle its a strange thing to just be very judgemental about another persons take on their life. Docs do a lot of good as drs, but if they decide not to it doesnt stop another from still being their best self. I sometimes slip from specific to universal ponderings in the same sentence, its very confusing. I've known about it for years, always confuses people at home, but cant seem to stop.

[q-school]

Zaphod wrote:

q-school wrote:

Zaphod wrote:

q-school wrote:

Zaphod wrote:

Re3iRtH wrote:

I respecfully disagree. The reasoning is very simple.
As a physician, even in a full career you (at best) can truly impact or touch ‘thousands’ on lives (and realistically iatrogenically harm 10-15% of them).
With entrepreneurial/policy/media/humanitarian .. you have the potentially to touch ‘millions’ or ‘tens of millions’ of lives.

Click to expand…

Absolutely agree. We also tend to overestimate our personal impact. Yes, a certain subspecialist in a place of dire need makes a big impact, but just another doc in the city is hardly noticed if they leave.

On the other end, it seems they vastly underestimate the scope of what could be in pursuits you have mentioned. They are huge. Too huge to pass up if you think that way.

Click to expand…

boo!  disagree with zaphod.  maybe in fancy California, but here in the sticks, if someone leaves or retires, it is definitely noticed.   by patients, by physicians, by many.  if anything, my experience has been that physicians underestimate their personal impact.  that may contribute to burnout.

there are plenty of people who are entrepreneurial/humanitarian/etc.  if you feel so moved, be like buffett and make a ton of money (outside of medicine), and then create your foundation.  it is hard for me to imagine, you couldn’t do both and continuing to work, even part time as a physician, seems to offer a way to make reasonable money and gain instant credibility in a lot of endeavors.  and help a lot of people as well.

 

Click to expand…

Uh, I already mentioned the caveat of the sticks, maybe shouldnt have said subspecialist. Even if noticed, does it create serious access issues on average?

Obviously we make A difference, just that if one feels entrepreneurial then they should get after it. Probability of success low, but could be very powerful. For example this site, WCI has impacted more lives than his medical career very likely, and it will continue to live on whether or not he keeps at it. I see the draw.

I dont think anyone should be really judging of anyone elses set up. If you want to make a difference as a doc, do it, if you want to FIRE then do so. People are allowed to judge and tell me what to do as soon as they start paying my bills and taking care of me in the way im accustomed.

Click to expand…

Let me apologize if it sound judgmental.  it was not intended to be any different than our normal level of conversation.

 

 

Click to expand…

Oh no, sorry not specifically to you! I didnt think that at all, the topic just made me think of it.

I was just thinking as a general principle its a strange thing to just be very judgemental about another persons take on their life. Docs do a lot of good as drs, but if they decide not to it doesnt stop another from still being their best self. I sometimes slip from specific to universal ponderings in the same sentence, its very confusing. I’ve known about it for years, always confuses people at home, but cant seem to stop.

Click to expand...

me too.  I can't help it if people cannot follow my genius. 

I agree that we should not be judgmental.  I am constantly amazed at the wealth of knowledge on various topics displayed here and on other boards.

I guess another way to look at it, I am saddened by (my sense that it is) inefficient use of time/money by very smart and talented people to go to medical school, train, and then work a short time and then go into business or law or consulting.   Having said that, we always talk about fixed cost fallacy, and maybe I shouldn't look at things the way I do.

 

 

[Zaphod]

q-school wrote:

Zaphod wrote:

q-school wrote:

Zaphod wrote:

q-school wrote:

Zaphod wrote:

Re3iRtH wrote:

I respecfully disagree. The reasoning is very simple.
As a physician, even in a full career you (at best) can truly impact or touch ‘thousands’ on lives (and realistically iatrogenically harm 10-15% of them).
With entrepreneurial/policy/media/humanitarian .. you have the potentially to touch ‘millions’ or ‘tens of millions’ of lives.

Click to expand…

Absolutely agree. We also tend to overestimate our personal impact. Yes, a certain subspecialist in a place of dire need makes a big impact, but just another doc in the city is hardly noticed if they leave.

On the other end, it seems they vastly underestimate the scope of what could be in pursuits you have mentioned. They are huge. Too huge to pass up if you think that way.

Click to expand…

boo!  disagree with zaphod.  maybe in fancy California, but here in the sticks, if someone leaves or retires, it is definitely noticed.   by patients, by physicians, by many.  if anything, my experience has been that physicians underestimate their personal impact.  that may contribute to burnout.

there are plenty of people who are entrepreneurial/humanitarian/etc.  if you feel so moved, be like buffett and make a ton of money (outside of medicine), and then create your foundation.  it is hard for me to imagine, you couldn’t do both and continuing to work, even part time as a physician, seems to offer a way to make reasonable money and gain instant credibility in a lot of endeavors.  and help a lot of people as well.

 

Click to expand…

Uh, I already mentioned the caveat of the sticks, maybe shouldnt have said subspecialist. Even if noticed, does it create serious access issues on average?

Obviously we make A difference, just that if one feels entrepreneurial then they should get after it. Probability of success low, but could be very powerful. For example this site, WCI has impacted more lives than his medical career very likely, and it will continue to live on whether or not he keeps at it. I see the draw.

I dont think anyone should be really judging of anyone elses set up. If you want to make a difference as a doc, do it, if you want to FIRE then do so. People are allowed to judge and tell me what to do as soon as they start paying my bills and taking care of me in the way im accustomed.

Click to expand…

Let me apologize if it sound judgmental.  it was not intended to be any different than our normal level of conversation.

 

 

Click to expand…

Oh no, sorry not specifically to you! I didnt think that at all, the topic just made me think of it.

I was just thinking as a general principle its a strange thing to just be very judgemental about another persons take on their life. Docs do a lot of good as drs, but if they decide not to it doesnt stop another from still being their best self. I sometimes slip from specific to universal ponderings in the same sentence, its very confusing. I’ve known about it for years, always confuses people at home, but cant seem to stop.

Click to expand…

me too.  I can’t help it if people cannot follow my genius. 

I agree that we should not be judgmental.  I am constantly amazed at the wealth of knowledge on various topics displayed here and on other boards.

I guess another way to look at it, I am saddened by (my sense that it is) inefficient use of time/money by very smart and talented people to go to medical school, train, and then work a short time and then go into business or law or consulting.   Having said that, we always talk about fixed cost fallacy, and maybe I shouldn’t look at things the way I do.

 

 

Click to expand...

I dont think its wrong to think about those things of course, its important. Obviously everyone cant do it and it would be a tragedy, but for a small constant number not terrible.

Always think looking at the underlying idea and not the person its attached to is a good starting point. The ones I was thinking about were those directly getting after a particular person. I myself am unsure how I feel about it, except Im pretty sure I dont know the right answer.

[Re3iRtH]

Probablity of success might be low, by one will never know unless they try.

Personally, if I earn $400k/yr. I have zero problem taking a $50K or $0 job for a few years if it means I can expand my thinking or make a difference in a completely different way. Money is a last consideration for me. My theory is, physicians are above average intelligence and will probably do well and not starve in a multitude of other pursuits outside medicine.

Perhaps comfort, and family expectation that you will continue to earn a certain salary in perpetuity are hindrances. imo

Great discussion guys. Cheers!

[q-school]

Re3iRtH wrote:

Probablity of success might be low, by one will never know unless they try.

Personally, if I earn $400k/yr. I have zero problem taking a $50K or $0 job for a few years if it means I can expand my thinking or make a difference in a completely different way. Money is a last consideration for me. My theory is, physicians are above average intelligence and will probably do well and not starve in a multitude of other pursuits outside medicine.

Perhaps comfort, and family expectation that you will continue to earn a certain salary in perpetuity are hindrances. imo

Great discussion guys. Cheers!

Click to expand...

some have been successful in other opportunities, some have gone broke.

being good at medicine may not have strong correlation to being good in other fields.   agree would not starve, but don't know if would have been equally happy continuing medicine at different pace for few more years either.

as you say, never know until you try.

 

[StarTrekDoc]

There's something to say about "Nothing Ventured, never Gained' -- so true.

As q-school notes like all brokerages would disclaim -- past performance doesn't necessarily reflect nor guarantee future gains.

I would disagree on the notion that we as physicians have a small societal footprint.