When Your Debts Affect Your Dates

by guest-blogger David Z. Presser, MD, MPH for Insider Medical Admissions

A recent article in the NY Times highlights how individual debt taken on as a student has the power to adversely affect one's subsequent relationships. You can link to the article here.

You are feeling less anxious and more comfortable with the whole medical school applications game. The interviews keep rolling in. Finally, you start to receive acceptance letters from multiple schools. Suddenly you find yourself in the enviable position of having a choice between a reputable state school, where tuition is relatively low, and a reputable private school, where you will go deeply into debt. You visit the private school and see stars: the buildings are made of marble, the admissions officials wear designer suits, and the alumni network, everyone assures you, will give you a leg up in residency applications. Should financial considerations play into your decision? Should you ignore finances and follow your heart, assuming that as a future physician you'll comfortably be able to pay off any educational debt?

These are important questions. Let's look at a few numbers, accessed online on 9/7/10:

Average (2008) loan debt of a Georgetown Medical Student on graduation: $167,000

Average (2007) loan debt of a UCLA Medical Student on graduation: $98,677

Note that each of these numbers do not include debts accrued from undergraduate education. What you owe from college, you owe in addition to this.

Now let's add a touch of romance to the mix. You fall madly in love with another med student, who took out loans to attend a private undergraduate university (s/he owes $100k for that) and you both went to private medical schools ($150k each). Let's give you a pass and say your parents generously paid for all of your undergraduate education, so you personally only assumed debt for your medical education. The wedding after graduation is followed by the shocking realization that you collectively owe $400k. This does not account for the fact that your residency salaries are insufficient to let you pay off significant debt.

Were you both planning on a career in primary care? Think again - your earning potential would adversely affect your ability to pay off your loans. Compare the following starting salaries based on a 2009 American Medical Group Ass'n Survey:

Family Medicine $144,990

Urology $300,000

Anesthesiology $325,000

Internal Medicine $146,251


What if one of you has a high interest loan on a credit card because of poor financial discipline in the years before you met? What if one of you is a saver and the other is a spender? What if the medical student you marry is a U.S. citizen International Medical Graduate (IMG), where only 47.3% obtain a residency position through the match? If your partner cannot get a residency position, there is a real possibility that $250k in loans may not realistically be paid back. Despite the promise of a comfortable life as a two-physician household, your joint credit ratings may never permit you to get a home loan.

These are sobering possibilities that need to be realistically appraised early on. The debts you assume in your youth will have far-reaching consequences. So consider your choice of medical school carefully, because your debts will ultimately affect your dates.