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> salaries need to offset the insane burden of training A cycle here is that student loans rise with expected earnings and banks are fairly open ended about it
by ska 3y ago
> salaries need to offset the insane burden of training
A cycle here is that student loans rise with expected earnings and banks are fairly open ended about it, institutions happy to justify the use of the cash.
Salaries wouldn't need to be nearly as high if you didn't walk out of residency with 200k+ [medical school ] debt at a point that is effectively mid-career. As a society we'd probably be better off if the both the median salary and median debt was much lower. I've also seen the "guarantee" of a high salary later lead many young doctors and med students to be foolish with money, as "eh, what's a little more debt" is easy to fall into.
It's also part of the driver to overspecialization, more available GP's and fewer people reliant on emergency visits would obviously improve the system, but the economics and QOL for a general practice keep getting harder.
Residency bottleneck and the high barrier for foreign trained mid-career people are the two other areas for potentially major impact.
- HPsquared 3y agoThe question is, does it really cost 200k to train each doctor? Surely the main input is the student's own time and effort, which isn't even included.
- ska 3y agoI wasn't wording things clearly. The 200k is just the median residual debt from medical school alone. People don't tend to pay it off much during residency years though, since residency pay is relatively low (50-70k). Lots of them acquire extra personal debt during residency. Doctors aren't typically considered "trained" until after residency.
- SkyPuncher 3y agoMy wife had $210k in debt from medical school. It's basically impossible to pay it off durning residency, so it just balloons. All in, at the end of my wife's training, we would have been $1M ahead if she had simply worked a normal career. That's huge in your 20's and 30's when your trying to establish a house/family/etc.
- jltsiren 3y agoIt probably costs more than that. As a baseline, university education in Finland costs about €10k/year on the average. Medical education is more expensive than the average, probably between €15k and €20k a year. Universities in the US are generally better funded than those in Finland, which allows them to provide more personal attention to the students. And university salaries are higher in the US than in Finland. Overall, I would estimate something like $20k/year for the undergraduate degree and $30k to $40k/year for the medical school, for a total of $200k to $240k. And that's just for the education, not including costs of living as a student.
- HEmanZ 3y agoSounds great, but my wife’s state-funded public medical school cost $85k/yr usd before cost of living. There are a handful of state medical schools near the $40k/r, but they are on the much cheaper end
- jltsiren 3y agoI was estimating the costs of providing the education, not the prices of getting it. (The latter would be €0/year in Finland.) If a university can charge more, it can usually find a way to spend the extra money.