400k in student loans
Bear with me because there are a lot of unknowns and variables here.
Starting PGY1 at a T20 IM program with 400k in student loans. My fiancée is a soon to be 4th year medical student applying anesthesia with 250k in loans.
I am planning on going into Cardiology (most likely EP). With the trend towards more and more cardiac procedures being done in ASCs Id ideally like to either spend a few years building a patient base and setting up shop on my own with a few partners or joining a privately owned group. Obviously this is nearly a decade away and things change, but no matter what I’d like to never work academics or in a setting where I don’t have ownership of some kind. I know GI is probably a better bet for this but I simply can’t scope buttholes for a living and I love cardiology. I also know EP Is rolling out fast track programs at a lot of sites where I’d likely be competitive so training would (in a perfect world) be 7 years instead of 8 and my fiancée would (again in a perfect world) be an Anesthesiology attending well before then.
My question is do I PSLF and bite the bullet on working a non-profit for less money for a few more years post training instead of deferring my loans entirely and using that time to get on a partnership track where by the end of the 2-3 years I’d likely be in a much better position financially?
With interest my loans will be 650-700k total and PSLF would be a huge burden off my back but I’m factoring in the opportunity cost of being on a partnership track instead of wasting time at a job I wouldn’t want to stay at long term.
Cardio EP jobs are paying at least 750 from mentors I know and many clearing 7 figures in private practice. I’d assume non-profit jobs are Significantly shittier with less freedom and less pay (500-600?).
Any advice, please help me. This is quite literally a million dollar decision for me and I have no clue what to do.