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Is medicine worth the money?

3 min read

The right question is not “Do doctors earn a lot?” It is whether your likely debt, training path, and career fit justify the years and risk ahead.

THE IDEA

Medicine can be financially rewarding, but the return arrives after application costs, four years of school, and several lower-paid training years. Among indebted 2025 graduates, AAMC reported $223,130 mean education debt and a $215,000 median; 28% owed at least $300,000. The 2025 national average PGY-1 stipend was $68,166.

Calculate the debt-to-income ratioProjected education debt at graduation ÷ expected first-year attending gross income = debt-to-income ratio. Use an actual offer when available; otherwise label every income input as an estimate. There is no universal pass/fail cutoff—record the maximum ratio and monthly payment you are willing to accept before choosing a school.
1.06×$223,130 debt ÷ $210,040 pediatrician median wage
0.53×$223,130 debt ÷ $420,860 radiologist median wage

Those two illustrations use the AAMC mean debt and May 2025 BLS national occupational medians; they are not starting-salary quotes. Your worksheet should run at least four combinations: lower-cost school/lower-paid specialty, lower-cost school/higher-paid specialty, higher-cost school/lower-paid specialty, and higher-cost school/higher-paid specialty.

Price the downsideUse the highest plausible debt balance, private-loan share, longest training path, and a specialty change.
Price the base caseUse each school’s net cost, realistic borrowing, residency pay, and the employment setting you are actually considering.
Count opportunity costInclude years of foregone full-time earnings and the delay before attending-level saving begins.
Test forgiveness separatelyModel the required-payment path and qualifying employment instead of subtracting assumed forgiveness upfront.

A credible ROI worksheet separates federal debt from private debt, tests whether PSLF or another service program is realistic, and avoids assuming that a preferred specialty, salary, or forgiveness outcome is guaranteed. Keep meaning, fit, workload, and burnout risk beside—not hidden behind—the spreadsheet.

Your next steps

  1. Calculate debt-to-income for each school and specialty scenario.
  2. Model training years, monthly payments, and forgiveness separately.
  3. Write down your own ratio, payment, and lifestyle thresholds before choosing.

Check your understanding

Select each question to reveal the answer.

✓ $223,130.
✓ 28%.
✓ Projected education debt at graduation divided by expected first-year attending gross income.
✓ Higher debt, more private borrowing, longer training, and a less favorable career outcome.

Planning questions

  1. For each school/specialty combination, what is your projected debt, expected first-year gross income, calculated ratio, and monthly loan payment?
  2. What maximum ratio and payment would you accept, and how would realistic forgiveness change—not replace—that decision?

Sources