Loan Repayment: Worth the hype?


Medical school saddled me with an enormous amount of debt.  I wanted to stay in California close to family to study medicine and decided to do my training at Loma Linda University.  I am grateful for my time there and feel I received an excellent education.  I would highly recommend it to anyone pursuing a medical career.  That being said, it is a private medical school and with it comes a premium price tag.  I escaped undergraduate school without any debt but medical school was fully financed leaving me a six figure debt anchor.

Through residency I received a paycheck but decided to defer my loans until I was making a better income.  This allowed my loans to compile much more interest and when I graduated residency I was looking down the barrel of about $225,000 I owed.  A local community clinic had offered me a position and with it came the added bonus of loan repayment since it was a “Federally Qualified Health Center.”  

I spoke to the CEO and other doctors and they all stated the repayment plan was very attractive.  The government would pay $60,000 for the first 2 years and then $20,000 each year after for as long as you stayed with the clinic.  I was guaranteed that everyone from this particular clinic had received the repayment and they had never been rejected.   I agreed to a 2 year commitment with reassessment at the end to see if I would continue.

My troubles started early.  I started my position on August 1.  I quickly learned that the loan repayment application cycle ended on July 31.  Are you serious?!  I would have to wait until the application cycle opened again which wasn’t for a few months.  When this came around I was ready.  Everything was in order on my end but something had changed on the payment program’s end.  

The amount to be repaid had been decreased to $40,000 for the first 2 years.  No sweat, I thought, this is still a sizable dent in my debt and anything would be helpful.  The only downside would be extending my commitment another few months.  I submitted my application and waited.  And waited.  And waited.  Something was up.  I had talked to the other doctors who had applied in previous years and they stated that they had heard back with a decision in a few weeks.  It had now been a few months.

I decided to call the government program myself and see what was up.  I soon learned the reason.  Not only had the amount been changed, the way the applicants were prioritized had also changed.  In previous years it was first come, first serve.  Now it had changed to place those at a clinic in an area of higher need first.  This was calculated based on a HPSA score.  The higher the score, the more the need.  Ours was apparently low.  So low in fact that the repayment program ran out of money before they even got to my application.  I did not get the repayment.

I later learned there was a state based program.  I did my research and found that this one was not based on the HPSA score and I would actually have a chance.  Only one problem: While I was waiting to figure out why I didn’t receive the federal repayment the application deadline had passed.  I gave up.  I decided I would complete my 2 year commitment and then move on.  That landed me where I am right now.  I have continued my loan payments on my own and will complete them on my own.

I’m not writing this to be political or as an attack on that clinic.  While this sounds like a very clear “bait and switch” I am sure that the clinic had no knowledge of this.  I just wanted to parlay my experiences to allow you to again see behind the curtain, but on the financial side.  Yes, I do harbor some bitterness about this.  But it portrays an important point.  Most people think of doctor’s and quickly make the assumption that we’re rich and have it well off.  While I am not hurting financially, I am not rich by any means.  Just a few months ago was when my net worth first crossed into the positive.  

Most doctors do not get into the profession for the money.  It is an attractive incentive, but it doesn’t drive our decision.  We wanted to help people.  At our deepest core, this is what drives our daily medical activities, not a paycheck.  This is what makes us wake up at 3 AM to go into the hospital to deliver a baby.  This is what makes us drive to a patient’s house to check on them.  This is what makes us work 60 hour weeks.  We care for you and we want you to be healthy.