How much should I weigh possible debt in this decision?

Pre-Med & Medical School Multiple Degree Programs
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I got a lot of help on my other threads, so I am hoping you can help me again. However, I don’t want to name specific schools. As a reminder, I’ve got $400K put aside for college. My parents say it’s possible they could pay more, but that’s how much I can count on, plus any interest it earns.

I got into a bunch of schools, and one combined degree program, and have narrowed down my options to 2 schools. I know both schools pretty well, have been on campus a lot for both.

School A: This is the combined degree program. It’s also a school I love. I feel really at home here. It would be top choice for me even without the combined degree program. But it would cost me about $140K undergrad, and about $320K for medical school. So, it would possibly mean taking on some debt.

School B: This is objectively also a good school, very similar in reputation etc. . . to school A, but I don’t love it. It’s OK. I would be fine there. Maybe I’d fall in love. I also worry that I wouldn’t get into medical school, or that I’d require multiple gap years to get into medical school. However, I have a full ride here, so it’s likely that if I got into medical school, I could graduate with zero debt.

In my particular financial situation, is $140K worth it for a guaranteed admission, and a school I love?

I’ll also add that I got into some reach schools, but am not considering them because I got no merit aid.

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That’s a tough one. I do wish you liked School B more, were more confident about thriving there, and so on, because then it would make it easier to just take the cost savings. With what you described, well, I think it is very personal what monetary value you assign to the the relative pros of School A.

If it helps, if you already have $400K, with the higher med school costs being backloaded, returns on that $400K might help close the $60K funding gap a bit. Similarly you have some time to work and save, possibly including a gap year.

If the total difference is $140K, that’s still a lot. But maybe there is less actual debt coming out of the School A path than the raw numbers suggest.

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This is a tough one. This might be a bit tougher without knowing the names of the two schools, although it can also be tough when you are the one who is deciding what to do with your life.

At some level we all do the best we can when faced with these choices, even though we cannot know how it will come out in the end.

I have noticed in your other threads that you were interested in medical school a year ago. I am also guessing that by “combined degree program” that you are talking about a BS/MD program. The fact that you even got accepted to this suggests to me that you have a significant amount of medical shadowing experience. All of this suggests that there may a pretty good chance that you will stick with medical school as a goal.

I will note that the majority of students who start medical school thinking “premed” end up doing something else. However, starting off in a BS/MD program does not preclude this.

$140k undergrad is not that bad for a bachelor’s degree. This plus $320k for medical school, plus inflation, minus $400k that you have available might leave you with $100,000 or a bit less in debt. This is a lot of debt, but is significantly lower than average for someone getting an MD. It will take you a while to pay this off, but if we assume that you get through medical school you should be able to pay this off more quickly than is average for all MDs.

Getting an MD with no debt is quite a luxury.

I may worry about this less than most people would. One issue might just be that the people I know well (including my immediate family and a sibling) all got into the graduate program that made sense for us, including some highly ranked programs. For several of us this did seem like some luck was involved (three of us only had one acceptance, but to very good programs that really were the right one for each of us). My understanding is that BS/MD programs do require maintaining some minimum GPA, so it is not really guaranteed (if I am understanding this correctly). Thus I am inclined to think that if you are meant to get to medical school and become an MD or DO then you are likely to get there either way. I am wondering whether I should be more worried about this (or at least worried on your behalf). I do recall one daughter having a good friend who was premed with very good grades who was having trouble getting accepted to any MD program (first time through this friend had no acceptances), so I think that this might be a valid issue.

Gap years before getting into medical school, or into any graduate program, are relatively common.

I could go either way on this. You might want to make a list of pros and cons both ways, think about this a bit, then take a few days off and not think about it at all. Then go with your gut.

Frankly both choices to me look better than average for a high school senior who is thinking “premed”. It sounds like you have earned these two very good opportunities.

And I think that you are very wise to avoid the more expensive alternatives that you have already ruled out.

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As I understand it, the particular program at School A I got accepted into, requires a minimum GPA, and a certain number of hours of shadowing, clinical and service experiences. But at School B, if you want to apply to medical school you need a committee recommendation, and you won’t get that without a good GPA, shadowing, clinical and service experiences, and even then I could still not get into medical school.

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I think there are lot of things that could impact the level of debt in both directions at both schools. I could earn money during undergrad summers and school year. I could get something like a Residential Assistant position and reduce my housing costs. I could get a partial scholarship, or a job that comes with loan repayment. I could also see tuition increases outpacing interest. Or I could have a medical issue or something that would require an extra year, or make working during undergrad impossible.

If I go to School B, I could end up at a medical school that costs a more or a lot less than School A’s.

What I need is a crystal ball.

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I think you are right School A would likely at least marginally increase your chances of ending up at some medical school. I am not sure how much, let alone what monetary value to put on that. But I agree that is a good assumption, that there is at least some increase.

Aside from the cost aspect, another potential downside to choosing a BS/MD program is it might lead you to a college you like less if you end up changing plans. In this case, though, it sounds like it is really just the cost that might be an issue.

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I don’t understand this. If I end up changing plans, and not needing that money for medical school, then I will be glad to be at School A. I might wish I picked one of the reach schools, but I won’t wish I picked School B.

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Don’t we all!

So I guess my point is you have one hard piece of information: $140K versus $0 for undergrad. If you didn’t already have $400K saved, this would be a different conversation, as then I would think you needed to seriously consider whether medical school would be affordable at all, not least because of the new loan limits. But with the $400K saved, those limits don’t seem likely to become an issue, so really it is the pure cost difference.

And you then have to decide if the pros of College A are worth another $140K. Not necessarily an easy choice in this sort of context.

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Sorry, the logic of my post might have been a little obscure. That sentence was supposed to be describing a “potential” downside that people in general might consider. The next sentence, however (“In this case, though, it sounds like it is really just the cost that might be an issue”), was meant to acknowledge that this potential issue for people in general is not an actual issue for you specifically, since you prefer School A to School B anyway.

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Sounds like School A passes the “broken leg test”. Go there :slight_smile: Plus, the 400,000, with any luck, will generate interest income, and your total debt could therefore be less than $140,000.

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THis is a touch one, but you clearly like your first choice better, with guaranteed med school admission. Is not having to take the MCAT and stressing over that worth it? Maybe so!!

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We could all use this.

One thing that occurs to me: Most students who take the more traditional route of first getting a bachelor’s degree and then applying to medical schools end up with at least one gap year, and often two or three gap years. During those gap years they may be working a low paying job.

Suppose you go with the combined BS/MD program. My understanding is that this avoids the gap year. You get to medical school a year or two earlier. This means that you get your MD a year or two earlier. You become a resident. Residency does not pay all that well. However, you start your residency a year or two earlier, which means that you complete your residency a year or two earlier, and end up with a full MD salary a year or two earlier.

This could go quite far towards offsetting $100,000 in debt.

To me this suggests that going to the university that you like best might be worth the $140,000 in undergraduate education cost and the “hopefully less than $100,000” in total debt.

However, I would only say this because you also say that you love the school, and that it is a very good university. I am also only saying this because the anticipated debt is still significantly less than average for a newly minted MD.

And of course this is your choice, you get to live with the consequences, and I do not actually know which schools you are thinking about.

And if you end up changing plans, the money that you saved by attending “relatively reasonably priced school A” would help quite a bit if you for example needed some other form of graduate school. Master’s degrees are usually not funded but are short (one or two years) and therefore cost less in total than medical school. PhD’s in STEM fields are typically fully funded, but having a small contribution from parents or a college fund can help turn a “dirt poor marathon” into a “live reasonably marathon”, which starts to look like an interesting multi-year job where if your research works out they hand you a doctorate at the end of it.

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That’s a really good point. Being in a position now to watch my S24 (and some of his friends and acquaintances) go through being a premed, I have a new appreciation for the constant stress involved. Even if you are doing well in classes, there is always something else you are supposed to be doing, arranging to do, or so on. And no one is ever quite sure if anything is enough.

Of course that is not unique to premeds, it feels like many “recruiting timelines” are very accelerated these days. But point being if you at least got that down to knowing if you successfully do A, B, and C, then you can go to medical school, that could be the sort of stress reliever that could filter through a lot of your college experience.

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Also a very good point. I totally agree this alone is not enough to be decisive, but if you combine that with all the other stated pros of School A, it is looking more and more like a reasonable choice to me.

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What is the broken leg test?

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I think it means “if you play a sport and you break your leg and can’t play, will you still be happy at that school?”

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I would like to offer an opinion, but cannot as I can’t find the US News ranking for either school.

On a more serious level, School A because it is for a combined degree program (assuming BS/BA and med school ?).

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Broken leg test for you…for school A…if you decide NOT to become a physician, will this still be a college where you have other options you might want to pursue?

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“Suppose you go with the combined BS/MD program. My understanding is that this avoids the gap year. You get to medical school a year or two earlier. This means that you get your MD a year or two earlier. You become a resident. Residency does not pay all that well. However, you start your residency a year or two earlier, which means that you complete your residency a year or two earlier, and end up with a full MD salary a year or two earlier.”

This gets a “maybe, check your math”.

This depends on the specialty, the residency, a fair amount of luck, etc. I know a young man who did three fellowships after residency. It was required for the specialty he was interested in. One fellowship was “convenient” (in a city where he had friends, he shared an apartment, kept his costs very low). The other two were not- and one was in a high cost city and as a fellow, he did not qualify for the housing reserved for med students. So I wouldn’t count on a combined BS/MD saving you time ‘til you are earning a physicians salary. Interested in a plain vanilla primary care specialty? Yes. Interested in a high tech type of surgery specialty- no. You have years of training after med school and then residency.

The financial realities are NOT like what you see on TV!

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Oh yes, if something happened where I couldn’t pursue a medical degree, School A has other things.

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