Essentially no one pays for medical school outright. They take out loans. Those loans aren’t credit based. People aren’t priced out of being doctors.
You do the math: over a 10 year repayment period with compound interest, their education cost them MILLIONS and they'll be well into their 40s before they start saving a dime for retirement. The cost and scarcity of medical education is extremely punitive to doctors and prices out many would-be great physicians. Many I know who have gone through this ended up regretting it due to the enormous financial burden they are saddled with for many years after becoming an attending.
Maybe folks believe these professions should be reserved to those who inherit great amounts of generational wealth.
The average debt is a little over $200k. Only 30% of graduates have over $300k in debt and they are considered high debt graduates.
Family Medicine salaries are above $200k in every state in the nation for full time doctors.
None of the doctors I know come from families with generational wealth.
Here is the nationwide average for resident salaries by year and its higher in higher cost of living areas.
Program year 1—$68,166.
Program year 2—$70,499.
Program year 3—$73,301.
Program year 4—$77,593.
Program year 5—$81,807.
Program year 6—$84,744.
Program year 7—$89,187.
Program year 8—$94,215.
Your entire picture is inaccurate.
The resident salaries that you listed are an average taken across all specialties. Family Medicine is the lowest paid specialty with 2026 PGY-1 salaries at $58,500 (representing an increase of over 15% since 2021) [2] That is simply not enough to pay the cost of living in a state like Massachusetts where the median household income is more than double that [3] and the average rent in Boston metro is almost $40,000 annually [4]. Not only can you not afford to pay down your student loan debt, you are extremely likely to accrue additional consumer debt on things like credits cards or vehicles.
My main point is that training to become a doctor carries so much financial risk that it selects against folks from poor socioeconomic backgrounds that would otherwise make great physicians. In 2018 the AAMC published a study showing that 51% of medical school matriculants were from families in the top quintile for family income [5] and if I were a betting man, I'd guess that proportion has only increased.
1. https://www.kff.org/state-health-policy-data/state-indicator...
2. https://www.inspiraadvantage.com/blog/how-much-do-medical-re...
3. https://fred.stlouisfed.org/series/MEHOINUSMAA672N
4. https://www.zillow.com/rental-manager/market-trends/boston-m...
Sure. But that’s not what you said. You said you had many fiends that graduated med school with $500k-$750k in debt. I think you were lying or your definition of many was highly exaggerated.
> That is simply not enough to pay the cost of living in a state like Massachusetts
$58k is the national average. Not the average in a high cost of living area like Massachusetts.
> My main point is that training to become a doctor carries so much financial risk that it selects against folks from poor socioeconomic backgrounds that would otherwise make great physicians.
There is almost zero financial risk.
Eventual graduation rate is 96%. Eventual match rate is around 99%.
Are there doctors that could have make more money going into finance sure. Are there doctors who are financially ruined, not meaningfully.
>In 2018 the AAMC published a study showing that 51% of medical school matriculants were from families in the top quintile for family income
1. Doctors kids are more likely to become doctors.
2. High income is correlated with intelligence and intelligence is partially heritable.
3. Kids from high income families are more likely to have extended family and friends who are editors who encourage them to become doctors.
4. Med school requires college and college and children from income families are much more likely to have college degrees.
5. Medical school entrance is competitive and high income kids are much more likely to go to better colleges.
6. High income kids are much more likely to have higher grades in college because they don’t have to work.
7. High income kids are much more likely to go to better high schools which impacts what college they get into and how well they do there.
The list goes on and on. The cost of medical school is so far down that list.
https://www.reddit.com/r/whitecoatinvestor/comments/1jayeai/...
Residency match rates for American graduates from American MD or DO programs are more like 93%. Also worth considering that thousands of Americans go abroad for medical school due to limited seats in the US. For American IMGs the match rate is only 70%. If you dig into things a little bit further, it’s actually worse than that because the figures do not include applicants who did not submit a rank list because they did not receive any interviews.
I agree that the vast majority are able to match into a residency program, but I certainly would not consider that “almost zero financial risk”
https://www.nrmp.org/about/news/2026/03/nrmp-releases-result...
I think it’s more likely you’re just exaggerating. How many is many? If you personally know more than 5 doctors with $500k-$750k in debt after med school I’ll eat my hat.
That reddit link only had 7 actual doctors who claimed to have graduated with more than $500k in debt. In a post about high debt with 200+ comments in a subreddit for doctors.
And the OP mentioned in the comments that he was borrowing enough to pay for his “expensive” med school and to support himself, his stay at home wife, and their baby in an expensive area.
> Residency match rates for American graduates from American MD or DO programs are more like 93%
That’s only after primary march. Match rate after SOAP is 98%. Roughly half of the unmatched 2% get marched in the next max cycle which is where I got 99%. Of the remaining 1% most of those want to eventually place somewhere.
>For American IMGs
Yeah don’t go to a factory medical school in the Caribbean. It’s a bad idea.
It’s definitely almost 0 financial risk. The only real risk is that you just hate being a a doctor. But even in that case med school unlocks tons of opportunities outside of clinical practice.
The chance of you ending up suffering financial hardship is too small to consider in your decision making.
The real out of your control risks would be severe disability that prevents you from finishing med school or working (before you can afford disability insurance). But in the case it really doesn’t matter whether you owe $50k from undergrad or $250k from med school. You’re not paying either one back and you can actually bankrupt out of student loan debt in those cases.
The average med school debt is half that and only 30% of borrowers end up owning $300k or more.
Fewer than 1% of us med school graduates never find a slot. And that includes people who start families, move into industry etc and voluntarily leave.
The bottleneck is residency slots not med school slots.
Right, because they are paying for it out of pocket
Also the bottleneck is residency slots, so even if this is the case, it wouldn’t change anything.