Student Loan Forgiveness is Set to Expire: This is Going to be Painful for Many!

UNCjigga said:

My sister got $300K+ in med school debt wiped out. Pretty big deal, as we don’t come from money and her public hospital salary doesn’t go that far in California.

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Thanks Biden for fixing the public service loan forgiveness program, first passed under Bush Jr, and it's fucked up implementation by Trump.

Thanks the fixed regulations, my wife may look towards those programs as she starts her residency next year.

Some medical fields are understaffed, which is incredible considering their high salary. Until you dig deeper and see the insane mountain of debt one has to accumulate in order to enter the medical fields.

They need to just make medical school free, with a requirement that graduates work in publicly funded hospitals for 10 years, or whatever makes it economical as part of their residency. These hospitals would be located in strategic areas to provide free or low cost health care to those most in need.

akugami said:

Some medical fields are understaffed, which is incredible considering their high salary. Until you dig deeper and see the insane mountain of debt one has to accumulate in order to enter the medical fields.

They need to just make medical school free, with a requirement that graduates work in publicly funded hospitals for 10 years, or whatever makes it economical as part of their residency. These hospitals would be located in strategic areas to provide free or low cost health care to those most in need.

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Part of the understaffing just comes from the nature of the training: low pay during residency (which is the true bottleneck to more doctors, given that the number of slots is largely controlled by Medicare funding), and excessively long training (some specialties need a long residency, and then a fellowship, or require 1-2 "research" years, which tack on time to training). This leads to a leaky pipeline where people either decide to not further specialize or just leave clinical medicine altogether. If anything, compensation for some specialties might be what keeps people away more than costs of schooling.

The loans are a lot (schooling is like $67k/year, not including any ancillary living costs), but with loan forgiveness programs targeted towards physicians working in underserved communities and others for working in public/non-profit institutions, I don't think doctors necessarily need more loan forgiveness options, given that an attending physician, even on the lowest side, will make $200k. I think a combination of capping interest, and covering inter payments during residency (a period where a physician makes like $60-$80k/yr) might be a better approach though. Plus, any place offering residencies are getting a huge bargain when it comes to doctors (so the public is already benefiting here; just maybe not when it comes to medical billing). A resident's total compensation is low and they can be forced to work crazy hours, and the hospital can bill as if they are a full-fledged attending. And if the hospital goes bankrupt, they can auction off the residency slots for millions of dollars a piece to other hospitals.

@Brainonska511

Part of the "leaky pipeline" is the financial barrier to entry, which would be solved with what is essentially free education. The payoff for the government is in a longer residency. This gives cheaper medical staff for a set duration, which hopefully is used to help serve more needy locales. The payoff for the trainee is, they don't acquire that huge mountain of debt. The payoff for society, is more medical staff.

Now, obviously it has to be fleshed out more, and I don't even know if it's a feasible plan, but that's where politicians and those in a position of knowledge comes in. It's literally their job to look into these types of things. It's these types of social programs that our politicians should be looking at when thinking about how best to serve the public interest.

akugami said:

@Brainonska511

Part of the "leaky pipeline" is the financial barrier to entry, which would be solved with what is essentially free education. The payoff for the government is in a longer residency. This gives cheaper medical staff for a set duration, which hopefully is used to help serve more needy locales. The payoff for the trainee is, they don't acquire that huge mountain of debt. The payoff for society, is more medical staff.

Now, obviously it has to be fleshed out more, and I don't even know if it's a feasible plan, but that's where politicians and those in a position of knowledge comes in. It's literally their job to look into these types of things. It's these types of social programs that our politicians should be looking at when thinking about how best to serve the public interest.

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I think the longer residency is already a substantial hurdle. The training required for some specialties is already 6-8 years between residency and fellowships, on top of the 4 years of medical school and 4 years of college. So you have that period of long hours, low pay - and your reward, especially for pediatric specialties, is an attending position that pays less than a regular pediatrician. Factor in doctors' ages, and it is especially grueling if you didn't start med school directly out of college, or even as you're in your late 20s, chugging through this gauntlet. Even without a student loan to repay, that situation would still suck and push people out.

The point of residency is also not to provide cheap labor for hospitals: it's to train new physicians. Perpetuating a cycle of underpaying labor by making that process arbitrarily longer doesn't seem like a winning move.

Yeah my wife is a Pharmacist and is making close to what non-specialty MD's are getting...and she was able to start working after 1 year of Residency when she was 25...a much smaller amount of debt, doesn't have call, and mal practice is a fraction of MD cost.

If you actually want to make bank as an MD you need to be in a specialty, preferably doing some sort of procedures.