The ProspectiveDoctor Podcast

Podcast 69: Travis Hornsby on Medical School Finances

Travis Hornsby is our guest in this episode, the founder of Student Loan Planner. He is a former bond trader with Vanguard who has transitioned into a student loan advisor. He provides a great understanding of how to tackle financial issues as they relate to med school.

[1:05] How Travis got involved in this.

Travis wanted to work in the financial industry and got a job trading bonds. His girlfriend said that she had six figures in medical school loans, which caused him to dive deeper into the complexity of loans. Travis then discovered public service loan forgiveness (PSLF), which can substantially help med school graduates.

[6:54] Planning correctly.

There are nuances to student loans. Travis says that if the proper time isn’t taken to plan, these can be extremely costly.

[10:22] Average debt for a med school graduate.

The number that Travis sees is about $315,000. You could go to a school that is increasingly offering scholarships, but those are few and far between. Often, students choose specialties that pay more just so they can pay off their debt quicker. This is not quite acceptable reasoning for choosing a specialty.

[16:49] Why physicians are better off than people with an MBA or law degree.

Nobody needs an MBA to be a businessperson, so there is no barrier to entry. In law, there are not enough jobs. Additionally, there are rules in place that keep medicine a well-paying field.

[22:49] Looking beyond tuition numbers to make a decision.

If you want to be a private practice physician, prestige doesn’t matter. The patient doesn’t care where you went to school, they care that you’re a doctor. PSLF can help you repay debt regardless of which school you choose. However, it is possible that PSLF may not be offered by the time you graduate.

[28:22] Options for if PSLF is no longer offered.

Refinancing is a good option that can greatly reduce your interest rate. Travis discourages taking out private loans, but it some rare cases, it does make sense.

[31:06] Other financial advice for med school students.

Invest in taking care of your own physical and mental health. Those things will always be worth it. Do not stress about the amount you borrow; Travis has never had a physician client who has not been making less than two-to-three times the median household income in America.

Full Transcription

Welcome to the Prospective Doctor Podcast brought to you by MedSchoolCoach. Each week we cover topics related to the pre-med journey to medical school and beyond. From the MCAT to completing your application and from starting medical school to choosing a specialty. Our podcast will provide essential information for anyone contemplating a career in medicine.

Okay. Hey everybody. I am super excited to be joined by Travis Hornsby today. Travis is the founder of He is a former bond trader at Vanguard turned student loan advisor and I think he’s going to have some amazing advice for our audience. All of you med students and pre-meds who are thinking about going through the med school process. I’m sure a lot of you have on the top of your minds just how much this is going to cost you. What you are going to come out with in terms of loans, and Travis is going to be able to really give us some great understanding of how to tackle those issues and problems. So without further ado Travis welcome.

Really excited to be here, Sahil. Thanks for having me. No problem. Travis give me the audience a brief background but maybe you could dive a little bit deeper into how you got involved in this.

Yeah. So I thought I was gonna be an economics professor and then I just didn’t like abstract math as much as I thought I was going to. So basically I decided if I don’t like abstract stuff, I want to be in the real world and operating in finance. So I went and got a job working as a bond trader trading billions of dollars and municipal bonds for mostly very wealthy people and it was a good job but it wasn’t something that I was passionate about. I was in the Northeast and in Philadelphia, so you know you’ve got UPenn there and a lot of people there and training for various you know medical programs and I ended up meeting my now wife. When we were dating we kind of started to get more serious, had the money talk, and then she’s like “oh yeah,” I got six figures in medical school loans. I’m like oh okay well that’s probably easy, you know, you’re a physician you’re gonna pay it back no problem right. So I thought, okay we’ll just make a simple little spreadsheet model showing how much we’re gonna pay, if we pay this much it’s done in 10 years, if we pay this much is done in five. I thought It was gonna be really easy right, and then I found out about public service loan forgiveness and refinancing and taxable loan forgiveness and I found out that student loans are definitely not as complicated as medical school but at times it definitely seems like one of the most complicated things out there.

I was kind of very attracted by this complexity because personally my wife and I lost at least tens of thousands of dollars, if not a six figure amount because of some bad student loan advice that she received. Basically she consolidated some loans and maybe she shouldn’t have. Then she also had things set up on the wrong repayment plan, and then also her loan servicer screwed her over, and did not count her payments appropriately. When I started dating her she was going into her last year of fellowship. At that point she should have had about seven years worth of qualifying credit towards the 10 years that you have to pay based on your income in order for the ones to be forgiven tax free.

So for the meds the prospective med-students listening to this, public service loan forgiveness by the way is just a program where you work for a not for profit or government employer for 10 years, you pay payments that are based off of your taxable income while you’re employed at that kind of a place and over a cumulative 10 years worth of credit amount worth of payments. Then the rest of the balance that you owe is forgiven without any taxes.

It’s a wonderful program, and for physicians, it actually applies to the majority of the physician workforce, because most physicians these days, are increasingly being employed through health systems. Most of which are organized as not for profits. There’s a couple big exceptions like HCA you know in the Southeast is a for profit hospital chain. There are some exceptions, but the vast majority of these hospital systems are not for profits, and so most physicians actually end up qualifying for this If you are an employee pretty much anywhere. You don’t have to be some you know 150,000 a year primary care doctor working in some rural location. These are people that are even neurosurgeons in New York City they can qualify for this.

So that’s really interesting because I’m not sure a lot of pre-meds know that or would even understand that. Certainly when I was going through med school there were loan forgiveness programs if you worked in a community based program at the end of the day. But, I actually didn’t realize any of this that you’re talking about. That you could actually be part of an HCA and have that still work?

Well you could be a part of a 501c(3) and it works. So what is 501c(3)? You know any hospital in New York City basically qualifies. Right. So if you think about, it like say you’re working at Brigham and Women’s in Boston right. 501c(3). Certainly some of the top specialists there are making probably tons of money, so if you had a lot of student loan debt, you know pretend for a moment that you do a you know a program with a really long training period like neurosurgery or you know you could even say like urology with fellowships or like you know hand surgery one of these really higher income earning fields, then you could potentially get payments of zero to three hundred dollars a month because it’s based off of your income, your taxable income. While you’re a resident or a fellow that’s fairly low, so you can get those payments of that kind of level for the entire length of time that you’re in training, plus one year, because it’s based off of prior year adjusted gross income.

So you could, for example in the case of that, I love using the neurosurgeon example because it just shows how outrageously generous this program is, but, you could potentially get 200 to 300 dollars or 0 to 300 dollars payments for like eight years, eight or nine years, and then have that one year of attending level payments of like four thousand dollars a month and you can even get this capped actually too. You can even cap the payment if you know what you’re doing.

So you could legit pay like 50 grand total over 10 years on any sized loan balance it does not matter. So this would help somebody going to an end state medical school, this would go to help somebody even more if they’re going to a private medical school, and the terrible dirty secret today of the financing of a medical school education is under current student loan policy in America. For someone that’s going to work in a not for profit hospital full time and meet that 10 years worth of service requirement, there is absolutely zero incentive to not take out every dollar you can possibly take out in medical school and literally go put it in the bank or in the stock market which is absolutely terrifying to say, but that is the rules that we live under currently.

It’s already becoming obvious probably for those who are listening that getting some real sound financial advice is obviously a starting point of this because I don’t think most med students even realize that these options exist, right. It’s really like even pre-meds. We come in with this anticipation of OK, I have this new bill every single quarter of 60 grand for my tuition and board and whatever else is involved. I may have already graduated with 75 to 200 thousand dollars in debt from undergrad, and I’m just expecting to add on another two hundred thousand dollars after med school, and just kind of be paying that back over the course of the next 10, 15, 20, 30, 40 years. But, it doesn’t sound like that has to be the case if you plan correctly.

Yeah it doesn’t. In reality if you do go to private practice, then don’t get me wrong like please, please, please you know take out the minimum you possibly can because you probably will need to pay it back. What’s also kind of interesting is you know a lot of times people are like, “well should I go work for a not for profit for like a few years to hit the 10, you know after I’m an attending,” and the answer is usually it does not make sense. You really want to think of it as you would never do this for the loan forgiveness only. That doesn’t really make that much sense in most cases. You really only want to do this if your plan is to be an academic medicine anyway, or to be a not for profit medicine anyway, and my wife’s a physician. She got a couple of job offers when she finished schooling, one of them was a very traditional academic medicine job offer which is what she took, but another one paid her more like she was going to be private practice but it just so happened to be at a not for profit hospital.

There’s all these like nuances where a lot of times people think they’re going to be in private practice, but then they just happen to work for some community hospital that’s 501c(3) not for profit and then they end up qualifying for this. Then, there’s actually additional loan forgiveness options beyond just PSLF. There’s also the ability to have it forgiven over 20 years instead of 10 years if you’re in the private sector. This is for literally everybody on the planet has this option. The catch is if you’re if you’re a private practice physician, you’re paying a percentage of your income on an income based plan when you graduate. If you are at a hospital as an employee, you do the 10 years for a given tax rate, but if you’re in the private sector as a private practice doc, then you could pay for 20 years and you have to pay income taxes on the forgiven balance.

So what that means is that really only helps somebody who’s a primary care doctor with a private school level of debt. Otherwise you just end up paying the full debt off, and you might as well have just refinanced to a lower rate and pay it off. But, there’s nuances here that people who don’t think about this all the time would miss, and when you miss it it’s extremely costly.

Yeah. Oh I can imagine. I mean it’s it’s obviously super nuanced. From the sounds of it and even from somebody who helps people get into med school everyday all day like we do at MedSchoolCoach, it’s oftentimes these are things we don’t necessarily deal with or want to put a lot of emphasis on because there are professionals like yourself who I think can really just have a much better understanding of everything that’s going on.

What is the average debt for a medical school graduate these days? Travis, I mean you work with a lot of physicians, what do you see?

That is a wonderful question so our current number for several hundred physicians that we’ve helped personally is about three hundred and fifteen thousand so that’s the average right. If you think about that average having a very large kind of a two humped distribution right, it’s not a normal distribution, you either go to a private medical school or at a state school and it’s 400 or 450 grand or you go in state and it ends up being like 200- 250. So that’s kind of the breakdown. You’ve got a lot of the D.O. schools too that are mostly private that have, in general, much higher costs than the allopathic in-state schools. That might be like 300 probably if you’re looking at D.O. minimum. Then, probably minimum 200 for the in state as an M.D.. Or if you’re doing private out of state significantly more than that, and obviously you can go to some of these schools that are increasingly offering a lot of scholarships and things like that, but that’s a very small slice of the total application pie that gets one of those zero tuition scholarships at NYU or something like that.

Sure. Yeah. And obviously the NYU example that you just brought up is a great one. For those you guys that don’t know NYU last year got a sizable donation I believe from an alumnus, that allowed them essentially to a erase med school debt for their classes for forever is what they say which is to say they going to pay tuition for all of their med students obviously NYU already is super competitive school, became perhaps the most competitive school in the country once they once they said that and had that going. But really, a med student perspective I mean this is a true struggle. People go in and they they anticipate and they have all this debt and people do choose specialties based on it. Right. I mean they choose higher paying specialties because they need to go and repay three hundred fifteen thousand dollars on debt on average over the course of their lifetime.

Yeah. I would say that that’s actually not the case that they need to repay it, and that’s where the big information like logic gap is missing, because it doesn’t make any intuitive sense. When you think about it your debt is either debt where you have to pay it back like in the case of you being a private practice doc that’s going to make so much money you just want to get rid of it. Alternatively it’s a tax, and it’s a tax because it’s a percentage of your income for either 10 or 20 years. That’s exactly what a tax is. There’s groups out there like ours that help people minimize that hit. So it’s like a tax where you’re trying to pay as little as you legally can versus as much as you possibly can. Right. So you know then you realize that you don’t actually have to go into these high paying specialties. We’ve actually written an article maybe a little bit unfairly about NYU, and to be honest like I kind of savaged the way that they designed that program, because it’s very very poorly designed for what their stated aims are, because they wanted to create more primary care doctors, increase diversity according to the stated aims right, and you know have more people choose specialties that are going to help people, when in reality, the person who benefits the most from that gift is actually a private practice orthopedic surgeon that needs to pay back their debt in full, not a primary care doctor that’s going to go work for a not for profit hospital that would benefit from PSLF and potentially only pay 50 grand of a three hundred grand total balance. What is really fascinating from the way they did this, they shrunk the size of their med school so that they could afford this program so they can make this announcement so they reduce the number of doctors they’re graduating every year.

They did that so obviously they would increase the competitiveness of this applicant pool, so that’s going to increase the average MCAT scores and those kind of things, and we know that when you get that big focus on things like U.S. News and World Reports uses to rank the number one medical school, that can often decrease diversity not increase it, because you’re so focused on stats. And then the last kind of point there is they started designing this program in I think 2007- 2008 when PSLF got passed, and they basically did not take into account the fact that so many of their students would qualify for tax free loan forgiveness anyway. So they could have instead doubled the size of their medical school, created a program that was basically a grant for everybody going into primary care. If that was the stated aim right or to increase scholarships for underrepresented students, but instead they designed a program that is totally designed to try to rank number one on the U.S. News medical school rankings. If those are the stated goals of their program then they’ve designed it extremely poorly.

That’s so interesting. I mean that’s fascinating and I completely understand what you’re saying. I mean particularly from the from the aspect of hey you know a lot of these people who maybe were going into primary care could have gotten their loans forgiven anyway through programs like the PSFL and others. That’s fascinating because the lay press picks it up as “hey you know NYU is giving free tuition we’re going to get more primary care docs,” but it sounds like that may not be the case.

Well yeah also let’s be real, so you know a group like yours helps somebody get into NYU. Maybe that’s the several hundred thousand dollar benefit that’s worth paying a ton of money for if you’re able to help them do that right, and so if that kind of super competitive applicant gets it into NYU and they get like a you know what is the USMLE scores it helped place residents right. So if they the most competitive applicant pool in the nation and all those people are scoring off the charts in USLME, is that group going to disproportionately go into primary care, or are they going to choose orthopedic surgery where they can make 600 grand versus two hundred even more. Right? So it’s just laughable to me that they think that they can even say to do it with a straight face like it makes sense when you say like “Oh people choose specialties because of debt,” But I don’t think that’s true at all. I think they choose the specialties because orthopedic surgery can make six hundred thousand, and the primary care people are only making two hundred.

They’re choosing it because of the salary differential. That makes sense. The good news is that even the person that’s doing primary care is actually significantly better off than a lot of other professions because we have a really wide window that we are able to see because we advise basically any professional school grad with six figures of debt and physicians are still much better off than most places.

Really. So why is it that physicians are better off than somebody getting an MBA for a law degree or something along those lines.

That’s a great question. So here’s a couple of reasons. So number one is that nobody needs an MBA to be a business person. You can be a successful business person without an MBA. That’s no barrier to entry. You’re paying tons of money for something that may or may not have actual value in the workplace. So that’s the reason for the MBA. For the law folks, the number of legal jobs just isn’t there because you’re either making a big law salary where you’re working 80 hours a week, or you’re working some family law job make an eighty thousand so there’s not really, and I would argue that the work environment is not nearly as appealing for a big law person that’s working so many hours. I’ll give you another really good example, this applies really well for medicine versus other health care specialties, the pharmacy for example right. So pharmacists used to really attractive field to go into. Is that fair? When you’re trying to decide to go to medical school that was a popular option?

Yeah. I mean certainly I think is still a popular option at least among some people.

So here’s the dirty laundry that they won’t tell you from the schools because they’re trying desperately to get everybody to sign up. For pharmacy school the acceptance rate about 10 or 15 years ago was about 35 percent. So a fairly selective there was about 40 schools and pharmacists made pretty solid money. Today, there are three times the number of people being accepted because there’s one hundred and thirty schools instead of 40.

Then, the acceptance rate for pharmacy schools about 88 percent which means that if you have a pulse, you can get into pharmacy school now. So what that has done is it has actually pushed down you know earnings significantly and people are really struggling to get to get jobs and so why did this happen? In the medical world the lobbying for like you know the American Medical Association and those kind of groups is way better than it is for other professions. They are really smart about capping the number of people entering the profession. Even at conferences such as my wife’s conference, there’s a specialist conference they just had this big meeting about how do we constrain the other number of fellowship spots so we don’t create too many peoples that drives down our earnings so there’s a whole lot of very sophisticated thinking behind that.

And also there’s a simple fact that Medicare funds residencies in America. That puts a cap on the number of residency slots that are available. It’s a hundred thousand and then some of the for profit hospitals augment that a little bit, but the hospitals are so used to this free money that they want to not pay for residency spots themselves.

Because of that you have this artificial cap of a hundred thousand that exists for physicians that doesn’t exist for any of these other programs. Because of that it prevents you can’t really be a physician without going to a residency. That prevents all these sketchy schools from opening up like in some of the other professions and charging people that barely had 2.1 GPAs charging them three hundred fifty thousand dollars to become a quote unquote doctor. Like that’s the practice and a lot of these other professions right now and for the medical world it’s still highly competitive. That’s why groups like yours exist because it’s so hard to get into medical school right. So you know that’s the big differentiator, the supply is still constrained. So even though it costs a lot of money, I would say that the MD/DO degree is probably still one of the only ones that’s still has a decent R.O.I. that’s worth borrowing for although I would not do it for for monetary reasons compared to other things.

Yeah that I mean it makes tremendous amount of sense. The last thing you said I think makes the most sense which is that nobody should do and enter the profession of medicine for monetary reasons because the reality is you’re in for a rude awakening if you do. Partly because of all this debt and partly because of other factors that are certainly driving down salaries and all the other headaches that you have in medicine. But, you do it because you really like medicine and then you kind of deal with all the side effects from it. You’re never going you’re never gonna be a physician who starves. That’s just not the case. You’re gonna make a really nice decent living, but there are a bunch of other factors and you could certainly make money in other professions easier than you can in medicine.

Yeah, like you said there’s opportunity cost right? like you’re 8 to 12 years that you’re doing residencies, Medical School, and fellowships, like you could be earning so much money doing something else such as engineering or not taking out all that debt. I mean financially it probably doesn’t make sense to be a physician compared to using your really smart brain. I got into medical school doing something else. But that said, if you’re comparing medicine to any other quote unquote “stable occupations” medicine’s really in my opinion somewhat unrivaled right now.

The only kind of exception might be that can make an argument for physician assistants and nurse practitioners from a lifestyle standpoint, because they also can get PSLF working for a hospital, they can really work a lot more flexible hours, they’re able to not necessarily have as much stress as being the ultimate decision maker and the person who’s at their core responsible for the patient care they can make that life or death decision. I mean that you know some people might listen to that and think that’s unfair, but you know what I’m basically trying to say. I think that there’s some lower stress fields out there in healthcare that still have pretty good R.O.I. You might train for a lot fewer years, might be a little bit easier to have a family with some of these other professions, but in terms of the financial aspect of things, I mean becoming a fellowship trained specialist and working for a not for profit hospital and realizing that you have a lot of bargaining power to design the lifestyle that you want is something that I think that is an extremely attractive path, still even with the ridiculous cost of med school partly because these forgiveness programs mean that the sticker price after you analyze it, is not really the true sticker price, it’s what you pay over the 10 to 20 years which in many cases is a fraction of what the cost was.

I want to hit on that point because I just feel like so many people don’t understand that as the point right, and so let’s say you’re a pre-med student choosing between medical schools and you have your option of let’s say you’re a North Carolina resident you have a fabulous school like UNC in front of you, but you also got into Yale as well. You look at the tuition bills, what should a student really be understanding about the tuition numbers because that’s sometimes all you have to go on. It says well tuition at UNC is twenty thousand per semester tuition at Yale is seventy thousand or sixty thousand per semester, I’m making up numbers here, but that’s sort of what the student sees. I mean what do you advise a student to really look at within those numbers or beyond those numbers to make a decision?

So I mean in that case I would say this, if you want to be a private practice physician prestige matters like zero. The patient that you’re going to work on does not care one hill of beans whether or not you went to Yale or UNC for med school, they care like your doctor right. Your doctor so and so, you’ve got a good reputation, you do this many of the procedures per year. So if you want to make money and that’s your main goal honestly like I mean if you’re interested in making a lot of money as a physician, I would go to UNC because that’s going to give you the opportunity to easily refinance those loans and pay them down at no time at all. Alternatively if you want to go into academic medicine and be known as a researcher and get into the very best residency and fellowship programs, then I would go to Yale because they have a higher ranking, they have more resources for research, and you probably will get maybe a marginally better placement coming out of Yale. Then, if you’re going to go into academic medicine you’re going for PSLF anyway. So the amount that you borrow is actually not going to be very important If you do go the PSLF route.

So I think it really comes down to career decisions and then I would also heavily look at the placements for med school. So look at the placements for where the med school folks are getting matched into residencies. If you want to match in like a very competitive residency, like do the programs have the same track record of matching people. My guess is that UNC and Yale probably are somewhat similar or at least I think that they’re probably both pretty solid programs with good good outcomes for people. If you compare Yale to UNC or to like you know one of the DO schools where it’s all primary care or a lot of primary care like yeah, if you want to be an orthopedics you probably shouldn’t go to that place. It would make sense to borrow way way more to go to the place thats got the better placement rate.

But even with the borrow more if you end up in academics or a non for profit group, and as you mention so many groups are nonprofit nowadays even if they seem like they’re for profit or their physicians are paid like they’re for profit, so many of the groups fall under that category. It sounds like it doesn’t really matter at the end of the day if you’re gonna go this route, like, the PSLF would take care of being able to minimize the amount you pay back.

Yeah I mean the only catch is this. PSLF is a thing that is going to be right now it’s solid it’s in the promissory notes. Any of the repeal proposals have said that everybody’s grandfathered in while you’re currently in a program that you already borrowed for. So there’s been a lot of efforts to repeal PSLF because it’s not very popular for the general average voter who’s making fifty thousand dollars a year to pay for the medical school education of a six figure income earner tax free.

That is that is not a popular thing and it’s not really happening in big numbers yet for this reason. The first medical school grads that really got access to direct loans without having to do anything special was approximately like 2008 to 2010 timeframe, really mostly 2010. If you take 2010 to four years later 2014 add 10 years to that, the first big wave of physicians getting PSLF is going to happen in 2024, and it’s going to be kind of an exponential curve because of the way the program got designed initially. So a lot of the people that have looked at this program from Google search, will find you know things like ninety nine percent rejection rates for PSLF.

That’s because the program was designed very poorly for that first cohort of people that entered it. So the key thing that your audience needs to care about is that this program could go away, and that has a huge impact about the financing decisions and what path you’re going to take, and what med school you’re going to accept. What I would just warn people about is that you need to look at the promissory note when you’re going to medical school and right now everybody that’s you know signing up in the fall of 2019 is fine. There’s not a lot of people that get into the off season and winter, but you know those people are fine.

Anybody that’s going to med school in the fall of 2020 is very likely fine. What I would be concerned about is if you’re going to med school in the fall of 2021 and beyond, there is a lot of uncertainty regarding whether this program will be killed and if it is killed it’s going to be killed for people who are not yet enrolled. So that’s a really important point and that’s one thing to think about when you’re trying to weigh different acceptances is, what is the likelihood that PSLF is going to exist for the full duration of your attendance there. That’s one reason why it’s kind of important to be monitoring this stuff because you want to make sure that you make that decision with all of the information and if you don’t, than you could easily go to higher cost school and then not be eligible for PSLF because it was repealed and you weren’t reading Google.

So let’s say PSLF was repealed. Hypothetically in two years and whatever legislation comes down the line. What other options are there for students to pay down their loans or pay back their loans in a more sensible way?

We have refinancing links on our site such as, got a bunch of the best cash-back bonuses and lowest interest rates for refinancing, so the government’s going give you a loan at like six to seven percent. With all these income based and forgiveness options available. But, we know that physicians are better credit risks than 6-7 percent right. So when you graduate, you can refinance that loan to like 3 to 5 percent basically. That’s the best option for somebody who has a bunch of medical school loans that’s trying to pay them down to zero as just whenever you’re able to, and you’re in a good financial situation, and you just sell your loan to a private lender that wants to give you a better interest rate because you’re a physician. That’s a that’s a great decision. If you are in the private sector, you don’t qualify for any debt forgiveness stuff, you make a lot of money, you’re going to pay it down to less than five years. It’s a no brainer to not refinance that. The other kind of caveat is if you are a thousand percent sure that you’re taken over mom or dad’s like private practice, then you know there is a potentially an argument to take out some private loans for medical school.

That is a that is a very limited set of cases where that makes sense because again a lot of people are not aware that you know they might not end up taking that role they might take a not for profit role and not realize it. So I’d really like to discourage people from taking out private loans. But, it can make sense for probably like 5 percent of medical school folks, like a pretty small number of people. You do that you basically get like five to six percent interest rates with no origination fees in a lot of cases instead of seven percent rates with 4 percent upfront fees for borrowing.

So you know so like we have a list,, that has some private lenders, but I like to discourage people against using those unless they’re 100 percent sure that they’re going to be doing a private practice, paying it down. They just want to minimize the interest build up while they’re in school right.

Yeah fascinating. So let’s take a step back for a sec because a lot of pre-meds and med students they are solely focused on a couple of things right. It’s number one doing well in the MCAT, doing well in classes, and getting into med school. Then once they get to med school, obviously getting through med school with all the material, and the only financial thing that they’re ever thinking about through this whole process is the debt that they’re going to accumulate. What other pieces of financial advice do you have for pre-med or med student or even a resident as they you know obviously the resident is now starting to make money, what else can they do, and this is not it shouldn’t even be involved with loans, but just in general what can they do with their money? Maybe like two or three pieces of advice from somebody who deals with physicians in this situation all the time that you can give them that hopefully will allow them to better utilize their money.

I mean so I would just say make sure that you invest in taking care of yourself from a mental and health mental and physical health standpoint. As an example of this you know, my wife when she was in residency got worked a ridiculous number of hours, probably hours that we’re not legal probably even at times, and there was this culture of kind of scaring you into not talking about how many hours people were working. I would say like you know if you need to invest in things like, having healthy food made for you, or you know counseling sessions or like psychology sessions that deal with the stress and anxiety. Those things are are worth it, like going to a personal trainer, as much as that sounds silly, the main thing that you should worry about in residency is limiting your housing costs and your car costs. So in terms of like things that you need to spend your mental energy on, I don’t want anybody caring how much they go to Chipotle and whether or not there’s guac on the brita bowl.

That literally has no impact on your final net-worth and what you’re going to be, and how stable you’re going to be financially. What happens a lot in residency as people you know eat poorly, they don’t sleep well, you know they don’t they don’t invest in themselves and getting help when they need help. Then they just put themselves in a situation where there’s so much stress, they just feel so depressed, their relationships might suffer if they don’t invest in marriage counseling when they need it. I guess my financial advice for you while you’re in training is do not stress or even med school, do not stress about the amount you borrow as a physician I promise you you will be OK. I’ve never had a physician client who has not been set up at least two or three times better than the median household in America. I’ve got a lot of physicians that probably would’ve been better off being a computer engineer. OK. But that’s not the thing you should worry about. Again, we’re choosing the medical path because that’s the one you’re more passionate about. You feel like you’re a call to it.

So take care of yourself. Keep your relationships on the top of mind instead of on the back-burner, and then just self care. I can’t stress that enough, there’s been so many really highly publicized incidents where people have been struggling with mental health issues, and obviously physicians have a much higher suicide rate than the average. So I just want to kind of break that stigma and just tell you that the financial stuff really does not matter. I think people love comparing themselves to their other really smart friends and that’s not what you should be comparing yourself to. You should just be focusing on getting through med school, being happy, and standing up for yourself when you have a dictatorial person that’s pushing you around, and not treating you well.

That’s fantastic advice. Taking care of yourself is just so important, something that we always forget. I can’t even say sometimes, I say we always forget that in medicine, when you’re working 80 hour weeks on average right, 80 hours is just the average, sometimes you’re working 36, 48, even more hours than that in a row you haven’t slept, you go to the hospital cafeteria and all they have is you know fried chicken wings or something like that.

That’s the only food that you can have. It’s what 1 am. It just it leads to bad situations, and on top of that you if you’re starting to think about the debt, not not investing, in yourself and not investing in healthy habits, and making you the best person you can, they can really lead to issues down the line. You know Travis I mean this has all been fantastic advice. Now you guys have a program called the pre-debt student loan plan. Right? do you want to talk a little bit about that because I think a lot of the a lot of our listeners may be interested in something like that and could really help them navigate the process.

Yea, so I mean so the the simple truth is we mostly help people after they graduate because that’s when you can optimize everything super well and save people a lot of money and reduce the stress because that’s when you get the bill in the mail that says you have to make a payment which is when usually people freak out. But a lot of the people that we worked with said you know what, it would be so helpful if you had some sort of service before I even borrowed that could tell me not to have my parents take out a second mortgage to cover half of medical school when it could have been forgiven. Or make sure that I am making this smart decision about is PSLF on my promissory note or not. Should I consider private loans for medical school or not.

So we decided to create a consult specifically for that. So the link for that is You can also find this on our site in the menu under the “hire us” part of the menu. So right now it’s about three hundred bucks. Thinking about raising that price to four hundred bucks, but it’s gonna be affordable for people who are making a six figure decision, and if that’s a stress point for you then I think it would be very helpful for you invest in that.

Or alternatively just read the stuff. We have a student loan planner podcast that you can find by typing in student input planner in any place you listen to podcasts. So if you want the free stuff like we have the free stuff, but if you want the paid stuff that’s customized to your situation we have that available.

Yeah I mean I think this is great. I mean I always tell my students listen, you’re about to invest in an education that costs you six figures easily. Take a little bit time and make sure that number one, your doing the right thing. Number two, you’re hiring us to help you through that process and make sure that you’re taking the right steps to actually get into school. Then, I think this is a great add on the third thing which is, hey you’re about to embark on this process, figure out how are you going to pay for it, how it’s going to work, and I think just taking a little bit of time and honestly a tiny investment into a program like yours could really help students make the most of their next 10, 15 years and set them up for success. I mean you guys have heard just how much you can be set up for success versus how many bad decisions you could potentially make if you don’t have the right counselor on your side or the right coach on your side in this case. So I would highly encourage students to actually check that out.

I wish I had something like that what I was going through med school. I think it could have been tremendously helpful and I know a bunch of my classmates would say the same. Then certainly once you graduate. For sure. That’s definitely necessary because it sounds like there’s so many nuances to this that somebody like yourself understands that you can’t always just get by Googling and reading, and I think that a lot of other financial planners who are not focused on this won’t necessarily understand it.

Yeah I mean like a lot of people say that they know something, but it’s kind of like the physician that does one case a month of some complex procedure. It’s like they’re just not going to know nearly as much as somebody that does 100. So you know we we do probably do 100-150 plans a month. We see more in a month than most planners probably see in 10 years. I mean it’s just basically if it makes sense, great make the investment if not you know it’s fine. Like we have enough. We have enough clients we’re happy helping people however you want to be helped.

Awesome. Well Travis I really thank you for your time and your expertise. I know I’m sure a lot of students will have more questions and Travis is at, so you can check him out there. Obviously on we also have a ton of tools and a lot of articles that revolve around paying for school and choosing school along with obviously getting in and how to how to be a doctor and all those kind of things that we talk about all the time, but I think is a great resource for you guys out there. So Travis thanks so much for joining us, I think our audience really appreciated this insight.

Thanks Sahil.

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