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I paid off my med school loans today. I went to Penn State and graduated with $280k in debt, just from med school. My tuition doubled between my first and second year, which coincided with Penn State merging with Geisinger. There’s no way to fight that. 1/
Upon graduation, I spent the next 5 years in two residencies— peds and preventive medicine. My salary was ~$40k in peds and $20k in prev med. Meanwhile, interest accumulated for 5 years. Others with the same education and drive are earning 2-6x as me, in other fields for 9 years.
When I finished prev med, I took a risk and became an entrepreneur and put my loan into forbearance during this period. And then the 2008 crash happened and my forbearance ran out and my loan was stuck in a 10 year loan. This was a $5k monthly payment. Banks were not refinancing.
For about 18 months, I was stuck paying $5k a month, until Obama signed a law mandating that banks refinance student loans 
https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙏" title="Folded hands" aria-label="Emoji: Folded hands">. I jumped on that and now I had a 30 year loan at $900 per month. I was 35 so it’d be paid off when I turned 65. But much more doable.
Again, my colleagues are making now 3x-10x more than me. Remember, I was an entrepreneur who didn’t take the guaranteed doctor salary. I was hustling trying to change healthcare for the better. Zero regrets. But, again, a massive financial sacrifice.
So instead of saving and buying a house and other wealth accumulating things like traditional docs and my friends in other industries, I wasn’t able to participate in that. I’m def self-aware enough to know my life is nowhere near as challenging as most of America.
When I talk with young folks who want to go to med school, I discuss this financial sacrifice you make for the first 10 years post college. It’s not just the cost of med school, it’s the low salary for 7+ years and a loss of a few cyclings of doubling your savings.
Again, doctors have it exceptionally great compared to most of the US. It’s just the finances of going into medicine vs other industries must be considered. As time marches on, it‘s clear that a life of medicine is a calling, and increasingly rare a wise financial decision.
I have no regrets and absolutely love what I do. @crossoverhealth is a dream come true. I wouldn’t be able to do what I do without all those sacrifices. But now I’m playing catch up for the next few decades. It’s not bad, but the finances of a life of medicine deserves attention.
And finally, my grandfather Winston went through 8th grade. He ended up working at McDonnell Douglas and built the spacecraft Gemini. He set a policy where parents pay undergraduate tuition for all children in our family. I am eternally grateful to my loving and amazing parents.
I went to Wash U in St. Louis (~$150k). Many med students are graduating with both undergrad and med school loans. It’s even harder for them. Grateful to all of you out there making the sacrifice, especially in these times. Y’all are awesome.
And thank you to @ramit for the inspiration and education and to @nickgray for the introduction. Financial health is intimately tied to physical and mental health. You’re doing god’s work and I appreciate everything you’ve taught me. They don’t teach you that stuff in med school.
There’s another thread someday about the financial sacrifices of innovating and entrepreneurship in healthcare, but for now, you can watch my TedX talk from a 100 years ago: https://youtu.be/l5GcEiLGSRQ ">https://youtu.be/l5GcEiLGS...
And finally, if you’re a doc, how much education debt did you have upon graduating from med school? Would love these responses to spread wide and far.
