Medical students could do with an infusion

I have a lot of friends in medical school. Personally, I think that it sounds hard. Not deeply unpleasant all of the time, but certainly hard. Medical school also isn't free. Tuition is somewhere around $50,000, with a bit more on top for living expenses. Let's say $60,000 per year.

Now, despite a lot of articles talking about how doctors are going to be commoditized, disrupted, or completely eliminated over the course of the next century, the facts on the ground are that doctors are still the highest paid professionals in the US. For context, that's more than CEOs. There are plenty of other factors to consider here: lost wages, long hours, low pay during residency and fellowships, but salary is a good measure for compensation. And eventually, after a generous 20 years of post-secondary education, doctors can pretty easily clear $170,000 (the average salary of a primary care physician).

And yet, despite these facts, medical students feel poor. Constrained on time, many medical students ignore basic consumption smoothing principles and artificially constrain their purchasing power. What I find even more interesting, though, is that they could choose to finance a more expensive lifestyle with very little trouble. Simply taking out an additional $20,000 of annual debt would enable them to join gyms, take taxis, buy better food, and quite frankly, enjoy what little free time they have. Amortized with their lifetime earnings, it's a no-brainer. And yet many medical students don't take on this additional debt.

Economically, this is crazy. In exchange for increasing their debt burden from $240,000 to $320,000, med students could essentially spend as profligately as they could imagine throughout medical school. Given an 80 hour work week and 8 hours of sleep per night, this is the equivalent of ~$12/hour of additional spending money, an amount that could reasonably be exchanged for high-utility activities like eating dinner with friends or going to movies.

In terms of lifetime earnings, having 30% more debt would have a marginal impact on overall lifestyle (assuming 30 years of work before retiring as a doctor, it's still less than $3,000/year, or ~2% of a primary care physician's annual income).

In general, I think a lot of this is rooted in a deeply moral approach to debt; we accept student debt as an acceptable expense, and tend to consider it in terms of an investment, while taking on debt to travel or eat fancy food is seen as deeply irresponsible. For many people, this is probably good - taking on debt to improve short-term happiness generally comes at the cost of long-term indebtedness. But for doctors, and many other people in school, it's probably worth it. And as doctors begin to approach more of medicine through the lens of quality-adjusted life-years more seriously, its acolytes could stand to apply the same logic to their own lives.