with $200,000 in student debt.

帶著20萬的學生債。

But did you know that over a quarter of medical school graduates have no loans at all?

但你知道嗎，超過四分之一的醫學院畢業生根本沒有貸款。

This is the real cost of medical school.

這就是醫學院的真實成本。

Dr. Jubbal, MedSchoolInsiders.com.

朱波醫生，醫派內參網。

Data from this video comes from the official 2020 AAMC Medical School Graduation Questionnaire

本視頻中的數據來自2020年AAMC醫學院官方的畢業調查問卷

and the AAMC's reports on Economic Diversity.

和美國亞美尼亞商會關於經濟多樣性的報告，

Links in the description.

說明中的鏈接。

Here's a trend that will surprise you — the percentage of newly minted doctors graduating

有一個趨勢會讓你感到驚訝--新進醫生的畢業比例。

with medical school student debt is dropping.

隨著醫學院學生債務的下降。

In 2014, 82.6% of students had medical school loans, trending down to 70.8% of students

2014年，82.6%的學生有醫學院的貸款，趨勢是下降到70.8%的學生

in 2020.

在2020年。

In terms of the debt distribution, approximately 50% of students graduate with debt between

從債務分佈來看，約有50%的學生畢業時的債務在

$100,000 and $300,000.

10萬美元和30萬美元。

Approximately 12% graduate with $300,000 or more, 12% with less than $100,000, and 25%

約有12%的畢業生擁有30萬美元以上的資金，12%的畢業生擁有10萬美元以下的資金，25%的畢業生擁有30萬美元以上的資金。

with no debt at all.

在沒有任何債務的情況下。

The median debt for those who need to take out loans is going up, meaning the average

需要貸款的人的債務中位數正在上升，這意味著平均。

medical student taking out loans is in more debt than the average from just a few years

貸款的醫學生比幾年前的平均水平還多了不少債務

ago.

前。

But the fraction of students graduating with any debt at all is decreasing.

但畢業時有任何債務的學生比例正在減少。

In the 1980's, rates hovered around 90%, in 2014 it was 82.6%, and in 2020 we're at 72.3%.

上世紀80年代，利率在90%左右徘徊，2014年是82.6%，2020年我們是72.3%。

So what does this mean?

那麼這意味著什麼呢？

There doesn't seem to be a simple and clear cut explanation.

似乎沒有一個簡單明瞭的解釋。

This decreasing trend cannot simply be explained by a few medical schools offering free tuition,

這種減少的趨勢不能簡單地用少數醫學院提供免費學費來解釋。

namely NYU, Columbia, and Kaiser.

即紐約大學、哥倫比亞大學和凱撒大學。

Nor is it likely that this can be accounted for by masses of medical students going to

這也不可能用大量醫學生去解釋。

service contracts, such as the military, to cover their medical tuition.

服務合同，如軍隊，以支付他們的醫療費用。

One possibility is that scholarships are increasing in number and in value, which is part of the

一種可能是，獎學金的數量和價值都在增加，這是它的一部分。

equation, but I don't think this accounts for the whole story.

等式，但我不認為這說明了整個故事。

The number of medical students receiving free money in the form of scholarships, stipends,

以獎學金、助學金形式獲得免費資金的醫學生人數。

or grants has slightly increased from 61% to 63% from 2014 to 2020.

或贈款從2014年到2020年從61%略微增加到63%。

But the median scholarship amount has remained around $20,000 to $25,000.

但獎學金金額的中位數一直維持在2萬至2.5萬美元左右。

Or perhaps it's because more students from affluent families have parents who are footing

也可能是因為更多來自富裕家庭的學生有父母的支持。

the bill.

該法案。

For some time now, more than half of matriculating medical students have parents who are in the

一段時間以來，半數以上的預科醫學生的父母在。

top quintile of income.

收入最高的五分之一。

Explaining that finding could be a separate video in and of itself, but what's important

解釋這個發現本身可以是一個單獨的視頻，但重要的是什麼？

to focus on here is the trend, which seems pretty stable.

這裡要關注的是趨勢，這似乎很穩定。

In the last decade, there doesn't seem to be a shift to explain the larger number of

在過去的十年裡，似乎並沒有轉變為解釋更多的。

students graduating without debt.

學生畢業時沒有債務；

I'm not quite sure what to make of the data.

我不太清楚該如何看待這些數據。

What do you think?

你覺得呢？

Let us know with a comment below.

請在下面留言告訴我們。

Another interesting finding is that 2/3 of matriculating medical students have no loans

另一個有趣的發現是，2/3的預科醫學生沒有貸款。

from their college premed years, which is surprising to say the least.

從他們的大學預科開始，這至少可以說是令人驚訝的。

On a national level, 70% of college graduates take on student loans with a median of $29,000,

從全國範圍來看，70%的大學畢業生承擔了學生貸款，中位數為2.9萬美元。

yet only 33% of first year medical students have any student debt, similarly with a median

然而，只有33%的第一年醫學生有任何學生債務，類似於中位數的學生債務。

of $28,000.

28 000美元。

This is likely due to two main factors.

這可能是由於兩大因素造成的。

First, the socioeconomic status of entering medical students is skewed towards more privileged

首先，入學醫學生的社會經濟地位向較為優越的人群傾斜。

backgrounds, therefore more medical students have parents who footed their college bills.

背景，是以，更多的醫學生的父母為他們支付大學費用。

And second, those who were successful in getting into medical school were very strong students,

其次，成功考上醫學院的都是非常優秀的學生。

and were therefore more likely to secure merit based grants and scholarships, thus reducing

是以，更有可能獲得基於成績的助學金和獎學金，從而減少了對學生的影響。

their loan burden.

他們的貸款負擔。

So what does this all mean?

那麼這一切意味著什麼呢？

The number of graduating medical students without any student debt is increasing.

沒有任何學生債務的畢業醫學生數量正在增加。

Maybe you're rejoicing and giving your friends high fives right about now.

也許你現在就在歡欣鼓舞，和朋友們擊掌。

Not so fast.

沒那麼快

It's important for premeds and medical students alike to keep this data in perspective and

醫學預科生和醫學生都要把這些數據看得清清楚楚，並且

understand the nuances of what it tells us.

明白它告訴我們的細微差別。

First, yes, it's great that close to 30% of freshly minted doctors have no med school

首先，是的，接近三成的應屆醫生沒有讀過醫科大學，這很好啊

debt.

債務。

That's a substantial improvement from just a few years ago, and that's something to celebrate.

與幾年前相比，這是一個實質性的進步，這是值得慶祝的事情。

But understand that the median medical school debt has been increasing, meaning if you're

但要明白，醫學院的債務中位數一直在增加，也就是說，如果你是。

not one of the lucky 30% to graduate without any debt, your total loan burden is likely

如果你不是幸運的30%的畢業生，你的總貸款負擔可能是

going up — more specifically, up from $180,000 in 2017 to $200,000 in 2020.

要漲--更具體地說，從2017年的18萬美元漲到2020年的20萬美元。

Considering median debt amounts have been steadily rising for the last several years,

考慮到過去幾年債務金額中位數一直在穩步上升。

it's not unreasonable to expect that trend to continue, meaning if you're graduating

這種趨勢繼續下去也不是沒有道理的，也就是說，如果你在畢業的時候

medical school in 2022 or 2025, the median student debt will likely be higher than $200,000.

在2022年或2025年的醫學院，學生債務的中位數可能會高於20萬美元。

Second, understand that when we talk about the median, that doesn't mean you'll necessarily

第二，要明白，當我們說到中位數的時候，並不是說你一定會

graduate with that amount.

畢業生的金額。

You could be in substantially more or substantially less debt.

你的債務可能會大幅增加或大幅減少。

In 2020, 11% of graduating medical students had between $300,000 and $400,000 in medical

2020年，11%的畢業醫學生的醫療費用在30萬到40萬之間。

school debt, nearly 3% had between $400,000 and $500,000, and about 1% had more than half

學校債務，近3%的人有40萬至50萬的債務，約1%的人有一半以上的債務。

a million dollars in debt.

一百萬美元的債務。

Third, understand the math that goes behind student loans and paying them off.

第三，瞭解助學貸款和還款背後的數學知識。

Too often I hear students saying $300k in loans is no big deal, I'll pay that off in

我經常聽到學生說，30萬的貸款沒什麼大不了的，我會把這些錢還清的。

one year as an orthopedic surgeon!

當了一年的骨科醫生!

Not quite.

不完全是

That $300,000 is going to be compounding around 6-7% per year during your residency training.

這30萬元在住院醫師培訓期間，每年的複利約為6-7%。

So while you'll be making minimum payments, the principal will actually be increasing

所以，當你要支付最低的還款額時，本金其實是在增加的。

during that time.

在此期間，。

Even as an orthopedic surgeon pulling in $500,000, you have to pay taxes, meaning you'll take

即使是一個骨科醫生，收入50萬，你也要交稅，也就是說你要拿著...

home between $289,000 and $335,000, depending on your state income tax situation.

家28.9萬到33.5萬之間，這取決於你的國家所得稅情況。

And out of that amount, you'll need to pay your mortgage, utilities, health insurance,

而在這筆錢中，你需要支付房貸、水電、醫療保險。

your kid's daycare, car payments, car insurance, food, travel, Netflix, that new iPhone you

你的孩子的託兒所，汽車付款，汽車保險，食品，旅遊，Netflix，你的新iPhone。

gotta have, a new sim racing rig with VR headset, and of course save for retirement.

得有，新的模擬賽車裝備與VR頭顯，當然也要為退休後的生活儲蓄。

And that's before making a dent in your loans.

而這還沒有在貸款上做文章。

Suddenly that $300k doesn't seem like such an insignificant amount, particularly when

突然間，這30萬似乎並不是一個微不足道的數字，特別是當... ...

you add the reality of the compounding effect working against you with your student loan

你加上現實的複利效應 對你的學生貸款不利的工作

interest rates.

利率。

And while there are many aspiring orthopedic surgeons, many are unable to match because

而有志於做骨科醫生的人很多，但很多人都無法匹配，因為

it's one of the top 5 most competitive specialties.

是競爭最激烈的五大專業之一。

If you end up going into sports medicine, internal medicine, emergency medicine, anesthesiology,

如果你最終進入運動醫學、內科、急診科、麻醉科。

or something else, you'll likely be making substantially less than the average orthopod,

或其他東西，你很可能會比一般的整形外科醫生賺得少很多。

meaning it'll take much longer to pay off your loans.

意味著需要更長的時間來償還貸款。

While the default path in the United States is to attend an allopathic medical school,

雖然美國默認的途徑是就讀於對立的醫學院。

we cannot exclude the alternate paths from the financial analysis, namely osteopathic

我們不能從財務分析中排除其他路徑，即整骨療法。

and Caribbean medical schools.

和加勒比地區的醫學院。

The American Association of Colleges of Osteopathic Medicine publishes similar data in their annual

美國整骨醫學學院協會在其年度的《美國整骨醫學》雜誌上公佈了類似的數據。

survey, showing similar trends.

調查，顯示出類似的趨勢。

In recent years, the median osteopathic medical school debt has been increasing, from $256,000

近年來，骨科醫學院的債務中位數一直在增加，從25.6萬元

to $265,000.

至265,000美元。

But similar to allopathic medical schools, the percentage that are in debt has been decreasing,

但與全科醫學院類似，負債的比例一直在下降。

from 85% in 2017 to 83% most recently.

從2017年的85%到最近的83%。

Caribbean medical schools don't have a central organization publishing this data, so it's

加勒比地區的醫學院沒有一箇中央組織來發布這些數據，所以它是

more difficult to pin down an exact number.

更難確定一個準確的數字。

It's widely accepted, however, that students graduating from Caribbean medical schools

然而，人們普遍認為，從加勒比醫科學校畢業的學生

have a greater student loan burden than those from US allopathic or osteopathic medical

比來自美國對立療法或整骨療法的學生有更大的學生貸款負擔。

schools.

學校：

This isn't a surprise, considering these schools generally have substantially more costly tuition

考慮到這些學校的學費一般都比較昂貴，這並不奇怪。

and fees.

和費用。

Depending on the article and school you're looking at, a 40-50% increase in the median

根據你所看的文章和學校，中位數增加40-50%。

student loan burden for Caribbean grads, compared to US allopathic graduates, is not out of

加勒比海地區畢業生的學生貸款負擔，與美國的全科畢業生相比，並不是不可能的。

the ordinary.

普通的。

That means close to $300,000.

這意味著接近30萬元。

In terms of stratifying the financial cost of allopathic medical schools, osteopathic

在對全科醫學院的財務費用進行分層方面，骨科的

medical schools, and Caribbean medical schools, US MD schools generally have the best financial

醫學院，以及加勒比海地區的醫學院，美國的醫學博士學校一般都有最好的財力。

outlook, followed by DO schools, with Caribbean medical schools trailing.

前景，其次是DO學校，加勒比地區的醫學院校緊隨其後。

We've already discussed on this channel why the finances even for US MD graduates is not

我們已經在這個頻道上討論過，為什麼美國MD畢業生的財務也不

a clear cut win.

明顯的勝利。

But what's concerning here isn't just that DO and Caribbean grads have more debt, but

但這裡令人擔憂的不僅僅是DO和加勒比海地區的畢業生有更多的債務，而是

also the fact that greater proportions of these graduates end up in primary care and

此外，這些畢業生中有更大比例的人最終從事初級保健工作，而且，他們的收入也很高。

other specialties with lower average compensation.

其他專業的平均報酬較低。

And while DO graduates have a similar residency match rate to their US MD counterparts, understand

而雖然DO畢業生的住院醫師匹配率與美國MD同行相近，但要知道

that a significant proportion of Caribbean medical school graduates fail to secure a

注意到加勒比地區醫學院的畢業生中有相當一部分人無法獲得醫療服務；

residency seat.

居住席位。

And without residency, they cannot practice as a board certified physician, meaning they

而如果沒有住院醫師資格，他們就不能作為董事會認證的醫生執業，這意味著他們

won't necessarily be making six figures per year.

不一定會年薪六位數。

And unfortunately, those student loans don't disappear, even if you file bankruptcy.

而不幸的是，即使你申請破產，這些學生貸款也不會消失。

Imagine being in $300,000 in debt with no residency position, and no easy way to pay

試想一下，在沒有住院醫師職位的情況下，欠下30萬元的債務，也沒有輕鬆的方法來支付。

off your loans.

貸款。

I don't say this to scare you or discourage you, but to be realistic with you.

我說這些不是嚇唬你，也不是讓你氣餒，而是實事求是地告訴你。

That's what we're about at Med School Insiders.

這就是我們醫學院內部人士的工作。

I care more about your success than your feelings, and if the numbers are making you uncomfortable,

比起你的感受，我更在乎你的成功，如果數字讓你不舒服。

I prefer you getting comfortable with reality now rather than when you're in six figures

我更希望你現在就能適應現實 而不是等你有了六位數的時候

of debt and unable to do anything about it.

負債累累卻無能為力。

While your personal situation is going to vary and I cannot speak for every student

雖然你的個人情況會有所不同，我不能代表每一個學生髮言。

watching this video, I'll provide you with some general guidelines.

看了這個視頻，我將為你提供一些一般的指導。

First, make sure you truly want to go into medicine, and you understand that it's not

首先，要確定你真的想去學醫，而且你要明白這不是

nearly as financially lucrative as pop culture has led you to believe.

幾乎像流行文化引導你相信的那樣經濟上有利可圖。

Second, try to attend a US MD school with favorable financial aid and scholarship packages

其次，儘量選擇經濟援助和獎學金待遇優惠的美國MD學校就讀。

over DO or Caribbean options.

而非DO或加勒比選擇。

And third, be as competitive of a student as you can be, not only because US MD schools

第三，要儘可能成為一個有競爭力的學生，不僅因為美國MD學校

are more competitive than DO and Caribbean schools, but because if you're in a position

是比DO和加勒比海的學校更有競爭力，但因為如果你在一個位置上

where multiple medical schools want you, you're in a position of power to leverage more favorable

在多所醫學院想要你的地方，你就有能力利用更多的有利條件。

financial aid packages.

財政援助計劃；

If you want to know more, check out my video about how I got my medical school tuition

如果你想知道更多，請看我的視頻，我是如何得到我的醫學院學費。

paid for through merit based scholarship, or my video about medical school prestige.

通過擇優獎學金支付，或我的視頻關於醫學院的威望。

Much love, and I'll see you guys there.

很愛你們，我們在那裡見。