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Tuesday, February 1, 2011

Dealing With Burdening Loans

Evan asked this question...

My sister is currently in vet school and is very worried about paying off her student loans once she is finished.  The minimum payments appear to be close to $900/month, which a resident making $28,000/year would not be able to afford.  Do you have any advice for young veterinarians like my sister as they try to start their careers? 

Evan, this is a very common and very real problem that is changing how students live and practice after graduating. Currently in the US average starting salaries for a newly graduated vet are around $55,000-60,000.  The average student loan debt is around $80,000-100,000.  Veterinarians have the highest debt-to-income ration of any other medical profession.  That means that proportionally we go into more debt to get our education than any doctor, dentist, surgeon, or other professional.  Veterinary school really isn't horribly expensive; it's the very low comparative salaries we make that get us into trouble.

The situation is bad enough when you go straight into practice after graduation.  It's so much worse when you want to consider a residency like Evan's sister.  Since interns and residents get paid about 1/3 of what a practicing vet makes, the debt becomes untenable.  It's actually making advanced training difficult to acquire, purely because of finances.

The extreme debt is becoming a bit of a crisis in veterinary medicine here in America.  Starting salaries aren't keeping up with increasing tuition and other debt.  Eventually this reaches to the point where many younger vets can't purchase a practice because they don't have the financial resources or are too burdened by debt.  And because fewer veterinary practices are being purchased, retiring vets are having a hard time selling their clinics and leaving practice.

So what to aspiring vets do?  First, lower your expectations.  Unfortunately salaries aren't going to increase quickly, so you'll have to learn to live frugally.  You'd think that a doctor would be able to live very well, but that's not the case with new vets.  Second, get as much training as you can in personal and business finances.  Learn what it will take for you to be productive and profitable in practice, as this is the way to increase your personal salary.  By making sound financial decisions you can make your money go farther.  Third, you may have to re-think the decision to go straight into a residency program.  It may be better to work for several years and then go into a residency, simply to get yourself on more firm financial footing.  It's tempting to take out even more personal loans, but they you have to add them on top of what you already have, and this can mean that a specialist's salary is mostly going to repay the debt.

Evan, there isn't an easy answer for your sister.  Her situation is all too common, and nobody has come up with a good solution yet.  In my opinion it would be worthwhile for her to sit down with a professional financial adviser and take a hard look at her situation.  Good luck to her!

25 comments:

  1. Not trying to be alarming, but the average student loan debt for 2010 veterinary school graduates was close to $130K. One-third of graduates owed more than $150K. It's outrageous, especially considering a veterinarian's earning potential.

    The good news: your advice re: delaying residency due to the expense is erroneous. Completing a residency (NOT an internship) is the best way to enhance one's earning potential, and it's easiest to apply for residencies immediately following veterinary school.

    Read: Comparison of long-term financial implications for five veterinary career tracks;
    M. Gordon, J. Lloyd, D. Harris-Kober; Journal of the American Veterinary Medical Association; Aug 2010, Vol. 237, No. 4, Pages 369-375: 369-375.

    Specialty training is very worthwhile, financially speaking.

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  2. I graduated with less than average debt. I was lucky to have some scholarship money and eventually a spouce with a job. But when I was student, I lived like a student-drove a used and paid for car, shared a duplex, no cable, etc. I realize tuition has increased since I graduated but sometimes I wonder how frugal some of these students are living. I don't have gone to vet school if I was going to graduate withe $150,000 debt.

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  3. Evan's sister can look into income based repayment for her federal loans if she is serious about a residency. If you make < 80,000/yr, then you qualify, and your payments are adjusted based on your salary. The information is readily available at FAFSA.org.

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  4. Nicki, you said it yourself: scholarship money is a blessing, and tuition has increased astronomically since I graduated, while salaries have remained flat. This trend is likely to continue, thanks to aftershocks from the recession and anticipated future cuts in state support of veterinary schools.

    If I could go back in time, I'd have done a residency.

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  5. Outrider, I haven't read that article. But I remember when I was in vet school (admittedly 13-14 years ago) I did an externship with a surgical specialist. He said that his lifetime earnings wouldn't be much more than a general practitioner's because he had spent 5 years of additional training at a fraction of average salaries. If that's changed since the 1990s it would be really nice.

    I also hadn't seen the 2010 data, and it is indeed shocking to see it climb this high. Unfortunately salaries haven't risen this quickly.

    Great advice, everyone! I love getting comments like this as it helps everyone.

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  6. >>I haven't read that article.

    In a nutshell: I think that surgeon gave you bad advice. I doubt he took the time to sit down and run the numbers; most people don't. That's why I didn't pursue a residency, actually. I was paranoid about my student loans, even though they were average for my graduation year and I had no other (car loan, credit card, etc.) debt. I hate the feeling of being in debt.

    Basically, the JAVMA article compared salaries for associates, owners (buy-in immediate vs. after 10 years) and specialists (full-time vs. 3/4 time). The model assumed specialists would earn residents' salaries for three years.

    Lifetime earnings:
    Specialist $2.27M
    Owner (buy-in immediate) $2.12M
    Owner (buy-in @10 years) $1.74M
    Specialist 3/4 time $1.70M
    Associate $1.22M

    Sobering, especially considering almost no one buys into a practice immediately following graduation, and many veterinarians have no plans to own a practice.

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  7. What a sore subject. To be honest, to me there is absolutely no purpose in fretting about this right now. There's absolutely nothing I can do about my astronomical debt (I'm over the "average" amount after only 2 years of school). I was lucky to have a choice of schools to attend, but unfortunately was rejected from my in-state school, so I had no choice but to go with out-of-state tuition.

    If the government is serious about the "veterinary shortage" then they should be doing something about our debt-income ratio and helping people actually want to go into our field when the cost is barely tolerable.

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  8. Following up on my last comment, I failed to mention the government's several loan forgiveness programs. The sad part is that they barely make a dent in your total debt-load, very few veterinarians are funded, and most of us did not enter this profession (knowing the amount of debt we would accrue) to be severely underpaid and working in rural Montana (apologies to anyone from rural Montana :P).

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  9. >>most of us did not enter this profession (knowing the amount of debt we would accrue) to be severely underpaid and working in rural Montana>>

    Therein lies the rub, and the great lie of veterinary school: in reality, there is no general "veterinary shortage". We do need more food animal veterinarians (who now work more as consultants vs. practitioners... don't get me started), and, in certain rural areas, mixed practitioners.

    We do not need any more small animal veterinarians in the city or suburbs of NYC, Boston, San Francisco, Chicago, or (any desirable locale).

    We do not need any more equine veterinarians in Wellington or Southern Pines - especially not more who are "lameness" or, worse, "alternative" veterinarians who don't cover general ambulatory emergencies.

    We do need beef cattle veterinarians in Montana, and swine veterinarians in Arkansas, and poultry veterinarians in Nebraska. We also need lab animal veterinarians.

    Veterinary schools aren't producing what the market is currently demanding, partly because graduates tend to resemble faculty: practicing companion animal veterinarians. As a result, I don't fault the government in any way for reducing funding for veterinary schools, anymore than I'd criticize a lack of funding for graduate degrees in literature, or art history.

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  10. What about as the baby boomers enter retirement and try to sell their practices? How is a new graduate supposed to garner up additional hundreds of thousands of dollars in business loans to buy out a practice?

    Honestly, I was interested in lab animal medicine, but the percentage increase in salary I would expect isn't worth giving up my true passion in exotic animal medicine. If I'm spending 200+K on education, might as well do what I truly want to do.

    Also, why do various news sources keep coming up with statistics showing huge increases in the job potential for veterinarians? Our Dean actually spoke with us the other day and said the veterinary community is expecting small animal veterinary salaries and demand to increase as we recover from the recession, while food animal salaries will remain steady.

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  11. >>What about as the baby boomers enter retirement and try to sell their practices?>>

    Baby boomers are working longer because they can't AFFORD to retire. I know some who came out of retirement!

    >>How is a new graduate supposed to garner up additional hundreds of thousands of dollars in business loans to buy out a practice?>>

    Good question.

    BTW, I'd check out some of the student loan re-payment calculators. Start figuring it out now.

    >>I was interested in lab animal medicine, but the percentage increase in salary I would expect isn't worth giving up my true passion in exotic animal medicine. If I'm spending 200+K on education, might as well do what I truly want to do.>>

    I'd run those numbers again. Lab animal veterinarians have much higher earning potential vs. exotic animal.

    There's no reason you couldn't become boarded in lab animal medicine, work a 1/2 or 3/4 time schedule, AND work as a part-time exotics veterinarian. Think about it.

    >>why do various news sources keep coming up with statistics showing huge increases in the job potential for veterinarians?>>

    Because it's a feel-good story, and because until 2007, we thought it was true.

    >>Our Dean actually spoke with us the other day and said the veterinary community is expecting small animal veterinary salaries and demand to increase as we recover from the recession, while food animal salaries will remain steady.>>

    Food animal salaries will probably remain steady, for a number of reasons specific to food animal practice. I won't be surprised if small animal salaries drop. Look at some of the veterinary publications (Veterinary Economics, DVM Magazine, Veterinary Practice News, JAVMA). All have recently been discussing the "new" economic reality: clients have cut back on spending, and this may be permanent.

    Keep in mind your dean is selling you a product: your education.

    I'd advise you to sit down and figure out how to get where you want to be five years from now. Without a careful financial plan, you will not get there. I sure wouldn't trust the dean, who doesn't have a crystal ball. I'm guessing he or she was telling everyone veterinary medicine was recession-proof a few years ago... like every other dean in North America. Wrong.

    Be glad you're still in school.

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  12. You bring up good points. I just don't see any way around my current situation; I try to take out as few loans as possible, do not live beyond my means, and recently applied for in-state residency. Maybe I can hire you to assist with my finances? Haha.

    Honestly, if you were in my position (or the original poster's) right now, what would you be doing to prepare yourself?

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  13. I have to agree with Outrider's assessment of lab animal vets' salaries. When I was in school I considered lab animal medicine, and was president of the first student chapter of ACLAM (American College of Lab Animal Medicine). I wrote an article for Intervet Magazine (a student-published magazine given out in US vet schools...I'm not sure if it's still published) on careers in lab animal medicine. Vets in this field have far higher starting salaries and earning potential than any other aspect of veterinary industry. Or at least they did when I researched it in 1996 or so.

    I'm not sure about working as a part-time lab animal vet, though. When you're in this aspect of medicine you're usually working for a college, pharmaceutical company, or research facility and they usually ask for a full-time commitment.

    Veterinary schools aren't really in the business of "producing" a certain kind of vet. They provide the education and the means, and then students determine which fields they want to pursue. A college can't force a student to follow one aspect or another. So it's not really the fault of the vet schools because they aren't graduating more veterinarians in certain areas. It's the changing demographics of who is applying to these schools that is making the difference. With more and more students from urban and suburban backgrounds and fewer from rural backgrounds, their interests are naturally going to gravitate more towards what they grew up around. As a suburbanite myself, I couldn't imagine life on a farm, and have no interest in that area.

    Honestly, I don't know that anyone can really predict what the future will hold. Like outrider said, just a few years ago veterinary medicine was considered "recession-proof". When I graduated in 1997 there was worry that we were graduating too many vets and there would be a glut on the market. Within a few years the pendulum had swung and we suddenly had a general shortage. Now we're back to worrying about oversupply. At the same time our clients are becoming more demanding about the level of care and quality of medicine being performed, which has the potential to support more vets by seeing fewer pets but doing more with each one. Again, I don't know that anyone can accurately predict it, because over the last 15 years any given prediction has been pretty short-lived (except the crisis in large animal medicine).

    My advice? Follow your passions and interests in the field. Almost every vet is going to find a job at some point, but having flexibility with your work hours and ability to relocate greatly increase these chances. And you may have to make sacrifices in your lifestyle or salary in order to keep a steady job. I'd also recommend doing a lot of self-education on personal finances and talk to a professional financial planner to help you with structuring your life after graduation.

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  14. Thanks for the advice, Chris! And sorry to semi-hijack the original post. We did get some good conversation going about one of the hot topics in veterinary medicine, so hopefully this thread helps others.

    I'll have to do some soul-searching and discussion with my significant other about where to go from here, since I've flip-flopped about doing an internship +/- residency quite a few times now...

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  15. I'm a second year vet student and I just want to say that at Cornell the cost of out-of-state tuition alone is $40,000 a year. That applies to roughly half my class (including me). Most of my classmates live very frugally-- some have even taken to hunting deer as a source of meat for the winter. For the holidays, I gave two of my favorite classmates warm socks (bought on sale-- 3 pair for $3) and they were ecstatic.

    I did get into my state school, and perhaps foolishly turned it down. I know there are many people in my class who turned down their state schools for the opportunity to come to Cornell, not sure how many would do it again. I had a pretty good idea of what I was taking on financially but it is still sobering. According to statistics, I will be earning about the same amount as a new vet in small animal GP as I did working as a licensed emergency veterinary technician at a large hospital in a major metropolitan area! Four years of grueling school, added stress and responsibility, and virtually no pay increase if I go right into GP= outrageous.

    I'm interested in clinical pathology, and I'm told clinical pathologists generally make about $80,000 to start. Even that seems abysmally low to me after 8+ years of training!

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  16. >>Veterinary schools aren't really in the business of "producing" a certain kind of vet.>>

    Maybe not intentionally. It's true, however, that most faculty members are companion animal veterinarians. That's the warm, fuzzy image of veterinary medicine to which most veterinary students can relate and which veterinary schools sell in their promotional materials (I'm looking at my alumni rag as we speak). Most veterinary students become practicing companion animal veterinarians; they're attracted to the traditional image of practice, and there certainly is subliminal pressure to conform. Companion animal veterinarians also hold the majority of faculty positions; if veterinary schools suddenly produced fewer small animal veterinarians, that group of faculty members would be trimmed.

    Think about it: if veterinarians specializing in food animal medicine made up the majority of faculty members, at least half (if not more) of required coursework focused on food animal medicine, and the NAVLE subject matter were at least half food animal medicine, might we see a very different group of graduates?

    When you aren't interested in companion animal medicine, it's more difficult to find faculty mentors who are like-minded. As a result, students who may not have considered non-traditional career paths (lab animal, food animal, public health, regulatory, pathology, etc.) tend to go the traditional route of practice. It's easier, and it's appealing.

    Vogue Vet: Basic advice from me...

    1. If you have credit card debt, start paying it off right now. If you don't, good for you, and NEVER use credit cards to "get by" for a semester or two, though you may be tempted.

    2. There are on-line student loan payment calculators. Check them out, not to make yourself crazy, but to keep yourself honest.

    3. If you haven't already, make a budget. Stick to it.

    And look into lab animal medicine. It *IS* possible to work part-time for a biotech or pharmaceutical company, especially if you've worked in the field for a few years, which you'll no doubt want to do immediately upon finishing training.

    Hermit Thrush: I'd talk to some clinical pathologists at your school, and visit the ACVP website. Last time I checked, starting salaries for boarded clinical pathologists were in the $120-150K range.

    I spent veterinary school trying to find a veterinarian who did what I wanted to do, and unfortunately did not succeed. Honestly, I didn't know where to look! I initially chose the path of least resistance and HATED it within six months. Next I tried second best, which is what I've been doing for almost ten years. We'll see what happens next.

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  17. I was an in-state student at a state university so my tuition costs were nowhere near $40,000 a year. I don't remember looking much at the cost of tuition when I applied but I'm not sure I would have done it for $40,000 a year. I also think I got an excellent education at said state school. Now that it's said and done it's hard to say for sure but I find my loans annoying now so I can't imagine how they would affect my lifestyle at that cost.

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  18. I would disagree that most veterinary faculty are companion animal oriented. My second semester of anatomy was strictly large animal, so the course was equally split between large and small animal. In my senior year my required large animal clinics were about the same as the small animal ones. In my epidemiology course the instructors had most of their experience with large animals. I also had to take a lot of large animal and poultry courses as a requirement, knowing that I would never enter those fields of medicine. When I was in school the only reason why I ended up with more small animal than large animal training was due to the electives and track that I chose to take in my junior and senior years. There was equally as much opportunity for me to pursue a large animal career. In fact, one professor that influenced my outlook on client service was an equine vet.

    In my experience most vets already know what aspect of medicine they want to practice BEFORE entering vet school. In my own education the only classmate I had who changed their mind went from small animal to equine based on her experience in vet school. I knew that I didn't want to do large animal going in, and most of my classmates had similar experiences. The choices are made by the students, and if they wish to pursue something other than companion animal medicine I have never ever seen anyone try to talk them out of it. So I do disagree that veterinary schools are influencing vets out of large animal medicine.

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  19. Chris, it's not surprising you were influenced by an equine clinician, because equine IS companion animal. The one notable exception is racetrack practice, which most equine veterinarians don't do; I'm not typical. Veterinary schools are currently producing a surplus of equine veterinarians. The market is saturated, unless the veterinarian wants rural, ambulatory practice, and that's a hard life. I know.

    I took the same core courses you did (epidemiology, anatomy, etc.) but found it all to be majority small animal. Epidemiology was taught by a veterinarian who had practiced both large and small animal at different points in his career. True, anatomy was split 50/50 large vs. small, BUT there's a lot more similarity between a cat and a dog vs. a horse and a ruminant (poultry was crammed into the large animal unit, too). Honestly, in retrospect, I felt like I was drowning in small animal, especially when I studied for boards (equine was only about 10%, IIRC). You probably weren't as sensitive to this, for obvious reasons.

    Sure, fourth year allowed for electives (we didn't track at my school), but I had a much harder time filling my schedule than did my small animal classmates. Equine anesthesiology, ophthalmology, dermatology, cardiology, even radiology? Forget it.

    I did NOT say veterinary schools discourage students from entering large animal practice. I DO think they (unintentionally) discourage students from pursuing NON-practice careers.

    I am honestly concerned that recent graduates will enter a market where associate salaries in private practice will not be sufficient for them to pay off student loan debt. When I look at the industry (yes, it's a business) of producing veterinary students, I see some real similarities to the housing bubble of a few years ago: overpriced, overvalued, and ultimately unsustainable. Furthermore, I see schools doing a rotten job of preparing students for careers that are less "warm and fuzzy", even though these careers offer better, or more stable, income and many students are at least interested... at least if I, VogueVet and Hermit Thrush are typical.

    A veterinary degree is supposedly valuable for its flexibility; veterinarians are well-trained for work in many venues, not just private practice. At this time, however, veterinary schools are doing a poor job of making students aware of their options. It's too easy to say, go practice for a few years, then decide. That's a trap.

    Here's a thought: look at medical school. Many students arrive thinking, I'll be a pediatrician, or a neurosurgeon, then change their minds and become radiologists or cardiologists. Medical school is set up to challenge students to find a specialty where they'll be content for the next 30-40 years. Perhaps veterinarians are victims of our generalist natures.

    In the meantime, I tell students: get your finances in order, for real. Keep an open mind, and investigate anything that interests you, even if it's not typical companion animal practice. Have a plan. Don't let your heart completely overpower your intelligent, rational brain.

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  20. We can debate horses being "companion animals", as they are typically seen by "large animal" vets and equine training is included in "large animal" courses. However, that's probably semantics and we probably don't need to get into it to that degree.

    I still disagree that a veterinary education is skewed towards private practice in small animals. I never felt that and haven't seen that in any of the recent graduates I've mentored. When I was in school there was incredible flexibility, and my degree could open me up to so many possibilities. Any limits in my education and career were due to MY choices, not the faculty or courses.

    Outrider, I seem to have the opposite experience than you did: I felt that there was WAY too much large animal and poultry medicine for my interests! I hated those courses, as it seemed to be far too much information on subjects that I knew I would never use once I graduated. I would have liked fewer courses in equine/farm/poultry and more in pet/exotic medicine. So maybe the perception of our education comes from us being more aware of the courses we DIDN'T want.

    I still firmly contend that the trends in where and how new graduates practice is mostly due to the students' choices. If someone has the desire and interest, they can get a strong education in almost any aspect of veterinary medicine while in school. But personal preferences will strongly influence that. I strongly looked into lab animal medicine and could have pursued that with my training. However I decided that the "herd health" aspect of that career was more unappealing than the higher salary was appealing, and chose not to go in that direction. I can't stand the idea of sitting at a microscope for most of the day, so I didn't want to go into pathology. I never grew up around large animals, and that field held no appeal to me. I've also known several vets who started in large animal and went into small animal due to lifestyle and career choices. Again, these are all due to the student's choices. The opportunities are there if someone wants them. I looked into several specialty options (lab animal, cardiology, surgery) that I could have pursued, but eventually decided on general practice. The opportunities are there just as much as in human medicine, and I feel that those options are well known by vet students.

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  21. [Apparently there's a character limit on comments and I exceeded it. ;)]

    Now I do completely agree that we are a crisis point where starting salaries aren't keeping up with debt load. But that's not a simple problem or one that is due to the direction of faculty influence. Yes, tuition is high and increasing faster than inflation. However, there are a lot of costs in running a college, and the tuition crisis isn't limited to vet school. With government funds to colleges dwindling, more and more ends up being carried by the students.

    The other aspect to this is starting salaries. Veterinary salaries are far lower than they should be for our education and skill level. But those salaries are dependent on what revenue is brought in by practices, and that's dependent on what clients can and will pay for services. We can't increase salaries without charging more, and the market will only bear so much, especially at this time. In inequity between debt load and salaries is complex, and can't be firmly laid at the feet of the colleges.

    I'll also strongly agree with Outrider's final statements: "get your finances in order, for real. Keep an open mind, and investigate anything that interests you, even if it's not typical companion animal practice. Have a plan." Too many students go into school not truly realizing the burdensome debt they will have, and thinking that they'll figure it out later. That's a pathway to trouble.

    Here's another hint to anyone not yet in school. If you can't get into an in-state school and are looking at going out-of-state for tens of thousands of dollars more, I'd recommend waiting. Yes, I know that it's hard to wait, and you may have to apply for several years before being accepted. But I feel that the huge savings in tuition and the reduced financial burden are worth that.

    Now how weird is it that through all of the controversial subjects we've had over the years, this particular post has gotten the most comments. :)

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  22. Chris, most of the equine veterinarians I know do not see other large animals, other than the occasional pet goat, sheep, or llama. We're equine veterinarians, not large animal veterinarians, and our patients are companion animals. I wouldn't know what to do with a herd of dairy cattle.

    Re: large (food) animal veterinarians entering then leaving the field - yes, that's EXACTLY what happens. The AVMA just published a study of rural veterinarians a year or two ago. We don't have problems attracting veterinarians to rural, large animal practice but many don't stay there for more than a few years. Some become small animal veterinarians, but I'd guess it's a mismatch for those veterinarians who actually like herd health.

    As to salaries not being adequate: I think veterinary schools are most certainly guilty of not being realistic with students. Sure, it costs a lot to run a school, and it's also true that in private practice, clients can only afford to pay so much. I think we're currently undergoing a price correction, actually. That's not what veterinary schools are telling students; they're continuing to say "don't settle for less than you're worth!" and "don't discount your services!", all the while graduating a glut of small animal veterinarians. Out in the real world, this is a formula for disaster. I've seen a couple of small animal veterinary practices go through bankruptcy these past few years, just in my area, caused by huge loans + too many veterinarians per population + poor economy.

    There is a retired veterinarian in my town who graduated from a veterinary school that no longer exists. That may be where one or two schools may be headed in the next 10-20 years. It's happened before. At the moment, though, a lot of people running veterinary schools are hoping the party isn't really over.

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  23. Wow, some great conversation here! I think people should pursue their dreams, but I understand it is sometimes difficult from a financial standpoint. I am a first year vet student and I pay in-state tuition, but I got really lucky because I am a dependent of a Veteran and the state waves almost all my tuition for veterinary school. I am hoping it will continue, considering the financial situation of my state, I am worried, but for now, I have my tuition waved in addition to scholarships I have received. A lot of people might hate me right about now for having no debt from undergrad or vet school, but I worked my butt off to get scholarships to make my way through undergrad before finding out my senior year that I qualified for the Veteran's fee waiver. I plan to try to donate what I would have paid in tuition back to my veterinary school in scholarship form in addition to volunteering my time at spay and neuter clinics and in needy countries around the world. I feel almost guilty my tuition is waved especially since I am surrounded by class mates with accumulating debt loads.

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  24. This is somewhat back to the original question about the residency, but I know that in other health professions at least you can defer your loan payments during a residency. Granted they still aquire interest, but you then have the option to pursue you residency passion without worrying about having enough money to live.

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  25. She should not wait until she gets her first pay check to pay her student loan. There are many ways that she can do now to start pay her debt. Why not try garage sales or do some crafty arts or pieces like accessories that she can sell online? Or why not work part-time? In way she can start paying her student loan. And there are also merchant cash advance that can help her with her allowance if she would have hard time with her budget.

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