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Please help me with my med school decision, I am extremely confused financially

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  • Please help me with my med school decision, I am extremely confused financially

    Hey to whoever reads this, thanks for taking the time

    I am a 23 y/o current applicant who has been accepted to two amazing med schools this cycle that I am in between. I am extremely happy and grateful to have this opportunity in the first place, but my choice is one of the hardest that I've ever had to make and I am constantly flip flopping and I don't know what to do.

    I currently have narrowed my choices 2 MD schools: Perelman School of Medicine at the University of Pennsylvania and NYU-Long Island School of Medicine. Penn is Penn, and NYU-LI is a new school affiliated with NYU - they offer a 3-year MD and guarantee to rank you in specific programs at their Long island NY hospital geared towards primary care specialties (peds, IM, OBGYN, gen surg), and I am guaranteed a spot for residency at NYU-winthrop in Long Island in Internal Medicine - they will rank me, its up to me to rank them

    I am guaranteed a 20k/year scholarship at Penn. Their tuition is 67k/year, so this effectively makes my tuition 47k before living/travel expenses. According to my own analysis, I would be expecting to pay something along the lines of 300k in debt for tuition and living over 4 years. I have tried to negotiate and I their finaid has made it clear that they're not budging despite this offer. My father is willing to give me somewhere between 20-50k to help out. The rest will be direct unsubsidized loans/grad plus

    Tuition at NYULISOM is free - you're responsible for housing/board costs and stuff however but this seems trivial compared to the price of an MD these days. This school, while affiliated with the NYU health system, has only been open for 2 years - while you are guaranteed a spot at their long island hospital, they state that they will not hold you back from applying out if you want to match elsewhere, or even in a different specialty despite the fact that the schools' mission is actively based in primary care. Because this school has only been open for 2 years, I have no information on how well students can potentially match from there as there is no match list. There are some students there I have spoken to who are intending on matching into a specialty - I am not sure to say whether this is a large majority of them or not, but I've only spoke to 1-2.

    I have no idea what I exactly what to do. I'm pretty sure that I want to specialize, but I'm not sure I want to lock myself into IM - although I technically don't have to lock myself into IM if I go to NYULI and apply outside of their guaranteed match-rank to their hospital in IM - but this would a gamble in some shape or form depending on the competitiveness of the specialty. I think anesthesia is really cool. I think critical care is really cool. I think optho/derm looks cool. I have no idea what I truly like at this point. I think I would have a lot of trouble or shoot myself in the foot matching into competitive specialties/residencies from NYU-LI because its a new school with a unique mission, despite the weight that those first 3 letters inits name carry.

    At NYULI, I'll save a ton of money at the cost of potentially closing many doors for my career. At Penn, I have my foot in the door of any specialty I want if I do the work, any research if I do the work, dual degrees, connections, etc, at the cost of the price of a literal mortgage with no home. While I may regret it because I want the best possible opportunities for myself, I simply and absolutely cannot look at 250-280k of principal compounding over 8 +/- X years lightly at all especially if it delays the start of my 'post debt' life. That being said, what if I go to Penn and match into a higher paying highly competitive specialty, in which case financially it makes total sense vs. going to NYULI and matching into idk like IM and then specializing anyway.

    I realize my uncertainty about what I want my career in medicine to look like makes this hard to answer, but I'm just stupid little kid with a really big choice so I appreciate any input or advice anyone has. I'll try to answer questions if anyone has any. I have by April 30th to decide, and I'm asking as many qualified people as I know

    If you got through all of this, I really really appreciate you

  • #2
    despite being in academics this NYU-LI thing is new to me.
    you can enter the match as a 3rd year student?
    quick google search shows it is accredited. i'd be a little nervous applying to a school that was unable to produce a match list.
    also if you decide to do IM or any primary care specialty i wouldn't view the guaranteed match as being worth very much. most US allo students match just fine and the specialties you mention aside from surgery are not typically competitive.
    i don't know, it's a weird conundrum.

    my unpopular opinion would probably be to go to Penn, i'd rather be 300k in debt and have my spot in anesthesiology at brigham than be debt free but struggling to match outside of this unique system.

    don't overweight my answer, i really have no idea, i get nervous about things that close doors esp early. the one thing i would repeat is that i think the guaranteed match thing is worth almost nothing, if you got into Penn med i think you'll be able to get an IM spot on LI if that's your dream.


    • #3
      Congratulations on your acceptance. Unless you knew you wanted to do primary care I’d take a pass on the NYU one and fo with Penn. That sounds like a program that won’t have a lot of latitude in terms of clinical rotations and/or involve a shortened classroom cycle. Both make studying for boards, specifically Step 2 which will default to the new Step 1, more difficult. Without the rigor of diverse clinical rotations your Step 2 might suffer. Lack of clinical rotations or the ability to do so in specialties you’re interested in will limit your ability to get into a specialty residency. Even if you wanted to do primary care, you still have the same competition (Step 2) for spots outside that Long Island hospital. You might get sick and tired of being there after three years and want a change. Lots of reasons to choose Penn here. And if you needed any other reasons:

      Whiz with > NY slice
      Eagles > Giants > Jets


      • #4
        If you want to do something competitive and it leads to a long and fulfilling career, then Penn is your best bet. If you play your cards right financially (and the fact you are posting here bodes well), the $250-$280k of debt shouldn’t hold you back that much in the long run.

        If it turns out you’re not that good of a med student anyway (unlikely since you got into Penn), find out medicine isn’t as enchanting or enjoyable as you expected, or something else in life happens, then you won’t get as good of a return on your Penn investment.

        Really, it’s impossible to know. I think if you’ve done enough self-examination before applying to med school in the first place, you’re not taking on a crazy debt load. If it were me, I’d probably make a decision from a place of optimism. The worst “likely” scenario if you go to Penn IMO is you can’t get into a good fellowship/specialty and then you just either pay the debt off slowly or get it forgiven in 10 years.
        I sometimes have trouble reading private messages on the forum. I can also be contacted at [email protected]


        • #5
          Is there any overlap between NYULISOM and the main NYU med in terms of rotations? NYU med has skyrocketed through the rankings to #2 and I imagine that any free medschool will gain a good reputation for having highly competitive students in short order.


          • #6
            Also, if you matched outside of NYULI, or outside of the specialties listed, do you have to pay back any of that free education?
            And as much as I like Pats and Tony Lukes, I cant eat them every day. A slice of real NYC pizza however...


            • #7
              Food for thought: if you're already considering this conundrum and reading financial forums before going to med school you'll be financially successful no matter where you go. That would lead me to choose the school based on other factors (location, rank, etc), without considering the cost (within reason, 300k for an MD doesn't disturb me that greatly)


              • #8
                Take a breath. You are going to be fine no matter where you go. How do I know? Because you have the initiative and intelligence it takes to be an amazing provider. You've got this!

                How do you make this decision? Go where you think you'll be happiest.


                • #9

                  I'm going to go against the grain here. A free MD is a free MD. That 200k difference could easily be 250-275k difference by the end of residency. You can match any specialty from any US MD school, the hurdle to entry may just be slightly higher, or maybe you match at a slightly less prestigious program. That prestige may feel warm and fuzzy, but the 5k/month of post-tax cold hard cash in your pocket you/ll be saving from not paying those loans (if you're trying to pay them off in a reaosnable time frame) feels a heck of a lot better.

                  Medicine is all about what have you done for me lately. Once you're in med school, no one cares where you went to undergrad. Once you're in residency, no one cares where you went to med school. And so on.

                  To quote Steve Miller: Take the Money and Run.
                  Last edited by TheTodd; 04-22-2021, 03:59 PM.


                  • #10
                    Penn, hands down, no questions asked. You *always* want to set yourself up to have as many choices as possible. Penn will do that for you. 300k in med school debt will be paid off fairly quickly post residency even if you go into peds or something.


                    • #11
                      Totally agree with those who say Penn and not to close any doors too early. You will never be the Chairman of Neurosurgery at Harvard from the NYU-LI program, but you may be from Penn.


                      • #12
                        Originally posted by VagabondMD View Post
                        Totally agree with those who say Penn and not to close any doors too early. You will never be the Chairman of Neurosurgery at Harvard from the NYU-LI program, but you may be from Penn.
                        You are closing off a lot of doors with 300k in debt as well. Maybe you end up hating medicine and want to walk away? Hard to do that with 300k in debt. Maybe you're one of the 5% or so that drop out during med school for unforseen reasons? You'll be glad to not have that extra debt. Maybe you want to retire at 45? A lot easier to do that without debt weighing you down during your early career years.

                        In fact, you may be opening doors to academia, because maybe with the debt you feel you need a higher income level to maintain the lifestyle you want, pushing you towards a private job when you'd rather be 50% research at Harvard for 1/3 the salary?

                        You may or may not benefit significantly from having Penn on your diploma. You will benefit from having 200-300k less debt.


                        • #13
                          You had me at free... unless there is some financial penalty for not going into primary care I'd take this free education. You can work hard, excel, and prove yourself wherever you go, so why not save a ton of money in the process?


                          • #14
                            Neither option is wrong. But I would choose Penn. Because it sounds like that is your first choice and the only reason you wouldn’t choose it is the money.

                            You may end up doing exactly what you want to do either way. In truth, where you go will likely influence what you want to I think a lot of decisions on specialty choice are influenced by who you end up working with on your med school rotations. But let’s say you have your heart set on a certain specialty at a certain location for residency. And let’s say you don’t get that. If you don’t get it coming from Penn, you’ll know you did everything you could to get it and it just wasn’t meant to be. If you don’t get it coming from NYULI, I think you will always feel like maybe it would have been different if you had gone to Penn. That might sound like a minor issue, but regret can be an extremely powerful thing. Given your lifetime earning potential, 200-300k is a small price to pay for regret minimization. Also 3 years for med school, while the right financial decision in that it gets you to earning an income one year sooner, will leave out a lot of potential electives and also I think it probably leaves out some room for fun. Med school was hard but I also had a lot of fun, I think squashing 4 years into 3 would make it less fun. I always hear people say that they gave up their 20s for medicine. I don’t feel that way and I would encourage anyone to make sure they enjoy their 20s, even going to medical school. Not to mention a lot of people struggle with making a decision on specialty by the beginning of 4th year, I can’t imagine having to make that decision with even less time.

                            The fact that you are thinking about these things makes it very likely that you will be FI by your 40s. You will have plenty of money someday either way. So I would go with the path that gives you the most enjoyment, diverse experience, and opportunity along the way. That path could actually be NYULI, who knows. But I would choose Penn.


                            • #15
                              This decision is not as momentous as it feels. Why? You will do great with either choice. So take some of the weight off your shoulders and go with the one that feels happiest.