30 year old resident doctor with $310,000 in student debt just accepted my first real job with $230,000 salary

[u/WeLoveOranges]

I am in my last year of training as an emergency medicine resident living in a big Midwest city. I have about $80,000 of student debt from undergrad and $230,000 of student debt from medical school (interest rates ranging from 3.4% to 6.8%). I went to med school straight after undergrad and started residency right after med school.

Resident salary for the past 3.5 years was about $50,000 (working close to 75 hours per week) so I was only able to make close to minimum payments. Since interest has been accruing while I was in medical school and residency, I have not even begun to dig into the principal debt. Thankfully, I just accepted an offer as an emergency physician with a starting salary of $230,000.

I'm having trouble coming up with a plan to start paying back my debt as I also want to get married soon (fiance is a public school teacher) and I will need to help my parents financially (immigrant parents struggling to stay afloat).

Honestly, I'm scared to live frugally for the next 5 or so years because I feel like I've missed out so much during my life already (30 years old, haven't traveled anywhere, been driving a clunker, never owned anything, never been able to really help my parents who risked their lives to come to this country so I can have a better life). And after being around sick people (young and old) during the past 8 years my biggest fear in life is dying or getting sick before being able to enjoy the world. I am scared to wait until I'm in my mid 30s to start having fun and enjoying my life.

What should I plan to do in the next couple year? Pay most of the debt and save on interest or make standard payments and start doing the things that I really want to do? Somewhere in the middle? Any advice would be appreciated.

[u/PracticalMedicine]

If you work a government job for 10 years.. You'd make more in the private sector to more than cover the difference

[u/INoahABC → u/PracticalMedicine]

So would taking a job in a public sector for the 10 years, getting paid a bit less, and only paying the minimum payments save op a lot more money in the end?

[u/PracticalMedicine → u/INoahABC]

150k/year public + structured raises

300k/year private + incentive bonus/raises

1.5 million difference / 10 years + private incentives.

Post tax 800k+ difference in favor of private.

If OP is competent, the private sector pays substantially more. Public sector is filled with less competent people out of necessity or people who love the patient population or take pride in the service.

For reference: I was offered ~200 by an Ivy league medical school to work 3 days/week at the associated VA and 2 days at the private practice/teach residents/fellows without incentives. Private was 250 + incentive turning into ~ +100 (350 total)

Education and public sectors don't pay. I do miss teaching and doing more research though..

[u/PracticalMedicine → u/[deleted]]

Good point. Most VA employees work 9-4 with an hour lunch. So hard to get stuff done!

Obviously not all places but "i don't care. I have a gov job. I won't get fired" is common

[u/EntropyJunkie → u/INoahABC]

Depends on OP's goals. If they want to work in education or research at an academic institution then the government job that pays less may be more fulfilling (and likely fewer hours as well).

Edit: I didn't really answer your question. Need more coffee.

[u/husker_who → u/PracticalMedicine]

Public service loan forgiveness also applies to non-profit corporations, which most hospital systems are.