Hacker News Reader

Comment by jseliger | Hacker News Reader

Also relevant: I wrote "Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school" (http://jseliger.wordpress.com/2012/10/20/why-you-should-beco...) based on watching the experience of my fiancée and her friends and peers.

EDIT: In the essay I describe why it can become so hard to leave medicine after one has invested more than a year or two in med school because of student loans; that may help explain the suicide issue: people who feel trapped may in turn feel like death is the only way out.

A surprisingly large number of doctors hit residency and realize they don't want to become doctors. In most professions that's not a tremendous problem, but in medicine the only way to pay back $100 – $250K in graduate student loans is by becoming a doctor.

View on HN

A similar phenomenon is at work with law students. Granted law school is shorter than an MD program at only 3 years -- but can still result in $150k of student loan debt.

This is true of almost all terminal degrees today. Higher education is such a corrupt industry, feeding those at the top of the pyramid by making promises to prospective students they are fully aware are unrealistic.

With Pay As You Earn a debtor won't pay more than 10% of AGI to federal student loans. Note that's AGI, not gross income, meaning you can contribute to retirement and not have it counted. Loans aren't as big of a constraint on career options as people make them out to be. Debtors are also willfully ignorant of these sorts of options and choose to instead destroy their lives paying debts that don't need to be paid.

To be clear, it's a huge problem, and we shouldn't have this sort of debt loads on those who want to educate themselves. It also weakens the broader economy and drives up professional services costs. But to say people are killing themselves because of student loans is a mistake.

While it is true that PAYE is capped at 10% of AGI, if you have an average medical school debt and are making a resident's salary, your payment will be less than your interest accrued each month. PAYE does nothing to cap your interest.

Further, implying that Doctors are willfully ignorant of loan financing options is...interesting. All Federal borrowers are required to complete exit loan counseling upon graduation from medical school. That counseling includes discussion of the various repayment options (Standard, Extended, ICR, IBR, PAYE, and forbearance).

Medicine is a very wide profession in itself, with lots of options for specialization in something that interests you somewhat. On top of that I am sure it is not too difficult to go into research that is only slightly related to medicine (I personally know a couple of people doing this).

Another explanation of the suicide rate: doctors have access to means and methods of completing suicide. They are also aware of techniques that make completed suicide more or less likely.

Reply on news.ycombinator.com