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  • #16
    "Non-profit schools can’t take a profit because they receive taxpayer dollars."

    Haha.  They most assuredly can take a profit.  No margin, no mission - the catholics will tell you that, and they have the largest non-profits out there.

    "There really should be a contractual connection between the tuition, the debt and the outcome."

    Yes x1000.  This is the exact problem with both healthcare and student loans.  Coincidentally, both industries have skyrocketing costs.  The lack of internalization of risk has driven bad behavior, particularly because big pockets Uncle Sam is there providing endless streams of funding.  The real joke is that now the US News and World Report ranks schools based on value.  If you look at their metrics for this ranking system you'll laugh.  This whole thing is so corrupt, and Uncle Sam is right in the middle making things worse.

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    • #17
      Find some basic scientific faculty, rent space in a strip mall or from an old college, use virtual anatomy lab, and you've got a medical school. They just farm out the last two years to other schools or to community docs who are unpaid by the school, and hopefully the COMLEX/USMLE prep programs and the clinical instruction (i.e. UpToDate) will help keep them afloat through the process, at least until their internship/GME can finish ironing them out.

      COCA will accredit more easily than LCME because they want more numbers, and kids just want to be doctors, and the government will give all the money a school wants...

      Yes, I'm concerned. I don't want my hard-earned DO degree from a public medical school to be devalued. I don't care so much for "X% of new grads are DOs" or hardcore osteopathic principles etc. I just want kids to get good solid fundamental medical educations and not be ridiculously gouged for them.

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      • #18
        If they're so confident in the value of their degrees, they need to be the ones doing the loans (or at least partially self funding the loans), not the federal government.  As Nassim Taleb outlines so well with so many problems, the schools have zero skin in the game.  They get guaranteed money from the government.

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        • #19




          Why not charge $100k/year?  You will still be able to fill a class.

          Why not enroll?  As long as you can match into a residency, there’s always PSLF.
          Click to expand...


          I see a not too distant future when the PSLF for physicians will not exist or there might be a ceiling like $200-250K, rising  with general inflation ( and not price tuition inflation)

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          • #20
            After seeing what my local non profit hospital does by hiring physicians and paying them at or above market wages and competing with us in PP, I see no reason why their physicians should get PSLF. They can very well pay the loans back fully without the tax payer having to shoulder it.

            It is not like they are in the rural areas serving the poor and downtrodden.

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            • #21


              I have answered surveys before where I suggested we do have some obligation to community and I remember being in the minority here.
              Click to expand...


              Add me to your minority.

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              • #22
                I agree with another poster. This is a major bubble and it's frankly criminal that students are allowed unlimited access to student loans but the government doesn't step in to limit the cost of schools.

                Lets say some student takes out a full 400k loans to attend this school. They enroll in a 3 year residency and a 2 year fellowship making on average 55k a year. They then take a government job making 180k a year. Lets say they do a repaye type program, they would be on the hook for about 100k in total and the government has essentially paid out the 500k that was forgiven. The school gets its money. The student gets to go to school. The government gets screwed. It's a Ponzi scheme and eventually everyone will pay. There would be a major class action lawsuit in the event that the PSLF program disappeared and I have a hard time believing it would be easily defensible.

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                • #23
                  I just graduated from one of the "original" DO schools--we usually have top 5 DO board scores/pass rates and good match lists--, and our tuition was very reasonable for a private institution. Lower, in fact, than a lot of private MD schools.  Most of the private MD schools are just as expensive. This isn't a DO/MD problem....it's a higher education problem all the way across the board.

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                  • #24
                    ^^^ ..."The government gets screwed."  Make that the taxpayers get screwed, i.e. you and me included.

                    Frankly, there are tons of high quality med schools with instruction in English in many parts of the world, incl Europe, where a med education can be had for far less money in a shorter amount of time.

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                    • #25




                      Frankly, there are tons of high quality med schools with instruction in English in many parts of the world, incl Europe, where a med education can be had for far less money in a shorter amount of time.
                      Click to expand...


                      Speaking as someone who just matched a few months ago--the current odds of matching at all, let alone into something competitive, are extremely low for people who would take this route.  It appears this was doable 10-15 years ago? But not today

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                      • #26
                        True, but what if it was from a well-known, eg, British school such as Cambridge, Oxford, Edinburgh, etc, esp if the student keeps ties to US med ctrs such as by doing research in the summer, etc?

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                        • #27




                          Find some basic scientific faculty, rent space in a strip mall or from an old college, use virtual anatomy lab, and you’ve got a medical school. They just farm out the last two years to other schools or to community docs who are unpaid by the school, and hopefully the COMLEX/USMLE prep programs and the clinical instruction (i.e. UpToDate) will help keep them afloat through the process, at least until their internship/GME can finish ironing them out.

                          COCA will accredit more easily than LCME because they want more numbers, and kids just want to be doctors, and the government will give all the money a school wants…

                          Yes, I’m concerned. I don’t want my hard-earned DO degree from a public medical school to be devalued. I don’t care so much for “X% of new grads are DOs” or hardcore osteopathic principles etc. I just want kids to get good solid fundamental medical educations and not be ridiculously gouged for them.
                          Click to expand...


                          I agree, I'm starting to feel like the old school live-trained NPs are feeling with the new online trained NPs coming out now. I don't want my DO degree from what I feel is one of the best osteopathic schools tarnished by these new assembly line schools. The AOA needs to step up and put an end to this before it gets out of hand, but unfortunately my 25 years of experience with the AOA tells me that the exact opposite is going to happen.

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                          • #28
                            Texas DO school charges same state tuition as the other allopathic schools (12-13k/yr for in state). But they’ve had university affiliation since the early 90s.

                            But I don’t agree with the new DO schools and the for profit models.

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                            • #29




                              Texas DO school charges same state tuition as the other allopathic schools (12-13k/yr for in state). But they’ve had university affiliation since the early 90s.

                              But I don’t agree with the new DO schools and the for profit models.
                              Click to expand...


                              I went to TCOM fwiw. It's had its troubles and identity crises, but great school imo. Still a proud alumnus.

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                              • #30
                                Don't get me wrong. There are numerous problems with the system.  But I'm not sure that it would be overpaying if one pays 80K/yr for 4 yrs to end up in a career that likely going to pay at least 200K/yr for as long as you want to do it.  I realize that the chances of landing the job are not 100%.  But if we plug any reasonable probability of success into the expected value calculation, it would still probably be the correct thing to do from purely a financial standpoint. At least I think so. I would be interested in hearing informed estimates of success.  My gestalt is that it's probably no lower than 70%, but I suppose I could be way off as people are making it sound like these schools are uniquely bad.  80K/yr for a regular allopathic med school should still be the correct move for just about anyone (from a purely financial standpoint).

                                It also really depends on what other career options are open to the individual.  Most individuals who could make a similar amount in other fields aren't really contemplating a 80K/yr DO school.

                                I think the problem is less the cost of the DO school and more the fiscal irresponsibility that occurs afterwards.  If you take on that much debt and you act correctly, you are not going to be living the "doctor lifestyle" for a long time. But if you'll live better than you would have if you didn't go to the 80k/yr school.

                                Once again, I'm not suggesting that schools should raise their tuitions.  There are plenty of other factors involved.  But if it is a strict cost benefit analysis, 80K/year is still not a terrible deal in an absolute sense (it is bad in a relative sense because cheaper options exist).

                                 

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