2017년 7월 7일 금요일

The 20 most affordable U.S. medical schools

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Although being a doctor can be a rewarding profession, the cost of medical school can be a huge barrier for aspiring students. It can also lead to massive student debt – around $164,800 on average, according to a new Student Loan Hero study.

While six-figure debt might be the norm for medical students, if you apply to affordable medical schools, it can make a big difference in limiting your student loan debt. And that gives you a huge head start in repaying medical school debt.

To help medical school applicants find the least expensive medical schools, we surveyed 110 medical schools to find out where students are likely to incur the least amount of student debt.

 

HOW AFFORDABLE MEDICAL SCHOOLS LIMIT YOUR STUDENT LOAN DEBT

To identify the best medical schools for limiting student debt, Student Loan Hero looked at three factors: annual tuition costs, average indebtedness at graduation, and the percentage of borrowers receiving institutional aid. These are central considerations for any student figuring out how to pay for medical school.

Overall, medical students can expect the following when it comes to paying for their doctorate:

  • Annual tuition (in-state): $39,116
  • Average medical school debt: $164,776
  • Students receiving institutional aid: 52 percent

However, students attending one of the top 20 affordable medical schools fare better:

  • Annual tuition (in-state): $24,483
  • Average medical school debt: $122,545
  • Students receiving institutional aid: 71 percent

They pay approximately $14,600 less in medical school tuition each year and are much more likely to receive college-sponsored grants or scholarships. They also owe about 25 percent less ($42,231) at graduation than an average med student.

On the other end of the spectrum, students at the 20 least affordable medical schools fare much worse:

  • Annual tuition: $48,843
  • Average medical school debt: $224,566
  • Students receiving institutional aid: 30 percent

Students here receive scholarships and grants less than half as often students attending the 20 best medical schools.

Plus, average student loan debt tips the scales at $224,566. That's about $59,800 more in medical school debt than the total average — not to mention, about $102,000 more than the average among the 20 best medical schools.

When your choice in medical school can equate to an extra $100,000 in medical school debt, the weight of your decision is clear. Medical school costs and student debt are central factors in the equation of whether medical school is even worth it.

To point you in the right direction, we've highlighted 20 medical schools where it's easiest to minimize student debt.

1. EAST CAROLINA UNIVERSITY BRODY SCHOOL OF MEDICINE

  • Annual tuition: $18,159 (in-state)
  • Average medical school debt: $112,692
  • Students receiving institutional aid: 80 percent

The Brody School of Medicine at East Carolina University in Greenville, North Carolina, is one of just 10 medical schools surveyed where annual tuition falls under $20,000. Four in five students receive a scholarship or grant, and on average, graduate with about $52,100 less in medical school debt.

2. UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE

  • Annual tuition: $15,798 (in-state)
  • Average medical school debt: $126,783
  • Students receiving institutional aid: 87 percent

The University of New Mexico's School of Medicine in Albuquerque, New Mexico, has low tuition, with an even higher rate of institutional aid. With these factors keeping costs low, it's no surprise these graduates can limit student debt to about $38,000 less than the average.

3. BAYLOR COLLEGE OF MEDICINE

  • Annual tuition: $19,650 (in-state)
  • Average medical school debt: $99,882
  • Students receiving institutional aid: 60 percent

Baylor College of Medicine in Houston, Texas, has the third-lowest average student loan balances among the top 20. And it's one of just three medical schools where the average graduate leaves with under $100,000 in student debt.

4. TEXAS A&M COLLEGE OF MEDICINE

  • Annual tuition: $13,790 (in-state)
  • Average medical school debt: $128,797
  • Students receiving institutional aid: 78 percent

Texas A&M College of Medicine has the second-lowest tuition of any medical school on this list.

These low costs, along high rates of institutional aid, means it's relatively easy for graduates to minimize their medical school debt here.

5. MAYO CLINIC SCHOOL OF MEDICINE

  • Annual tuition: $49,900
  • Average medical school debt: $69,695
  • Students receiving institutional aid: 91 percent

The Mayo Clinic School of Medicine is a renowned medical school that matches its reputation with low student debt. Despite having the highest tuition rates of any of the top 20 medical schools, Mayo Clinic's scholarships and grants significantly offset these costs.

In fact, Mayo Clinic graduates have the lowest levels of any medical school debt in this survey, owing about $95,100 less than the study's average.

6. TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER SCHOOL OF MEDICINE

  • Annual tuition: $15,016 (in-state)
  • Average medical school debt: $129,454
  • Students receiving institutional aid: 72 percent

Texas Tech University Health Sciences Center School of Medicine has the fourth-lowest tuition of any medical school surveyed. This adds up to about $35,300 less medical school debt at graduation, on average.

7. UNIVERSITY OF CENTRAL FLORIDA COLLEGE OF MEDICINE

  • Annual tuition: $25,491 (in-state)
  • Average medical school debt: $138,728
  • Students receiving institutional aid: 100 percent

The University of Central Florida College of Medicine in Orlando, Florida, takes the top spot for institutional aid, with 100 percent of students receiving a scholarship or grant. Add this to already-low tuition, and students can easily avoid getting too deep into medical school debt.

8. DAVID GEFFEN SCHOOL OF MEDICINE AT UNIVERSITY OF CALIFORNIA-​LOS ANGELES (UCLA)

  • Annual tuition: $32,757 (in-state)
  • Average medical school debt: $117,590
  • Students receiving institutional aid: 91 percent

The David Geffen School of Medicine at UCLA has the third-highest rate of institutional aid among these top 20 medical schools (tied with the Mayo Clinic).

These scholarships and grants help alumni of this school avoid around $47,200 in medical school debt, on average.

9. UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER

  • Annual tuition: $18,493 (in-state)
  • Average medical school debt: $109,350
  • Students receiving institutional aid: 52 percent

Only about half of students at the University of Texas Southwestern Medical Center in Dallas, Texas, receive a scholarship or grant. But with medical tuition starting low, graduates still borrow close to $55,500 less than the average medical school debt found in our study.

10. UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER-SAN ANTONIO

  • Annual tuition: $14,500 (in-state)
  • Average medical school debt: $120,529
  • Students receiving institutional aid: 55 percent

This medical school has the third-lowest tuition in this study, saving students around $24,600 a year. These low costs and above-average institutional aid put the University of Texas Health Science Center in San Antonio, Texas, among the most affordable medical schools.

11. UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER

  • Annual tuition: $13,078 (in-state)
  • Average medical school debt: $150,258
  • Students receiving institutional aid: 75 percent

Students at the University of North Texas Health Science Center in Fort Worth, Texas have higher student loan balances among the top 20 most affordable medical schools. They save just around $14,500 on average compared to overall borrowing patterns.

However, this is the most affordable medical school in terms of tuition. Combine low tuition with higher rates of institutional aid, and you have a smart choice when it comes to minimizing student loan debt.

12. UNIVERSITY OF CALIFORNIA-SAN DIEGO (UCSD) SCHOOL OF MEDICINE

  • Annual tuition: $32,346 (in-state)
  • Average medical school debt: $98,750
  • Students receiving institutional aid: 61 percent

Graduates of the UCSD School of Medicine enter residency with the second-lowest levels of medical school debt, less than $100,000 on average. This is despite having one of the highest tuition costs of the top 20 affordable medical schools.

13. UNIVERSITY OF NEVADA, RENO SCHOOL OF MEDICINE

  • Annual tuition: $26,114 (in-state)
  • Average medical school debt: $135,788
  • Students receiving institutional aid: 84 percent

University of Nevada, Reno School of Medicine graduates have one of the higher average student loan balances among the top 20.

However, they still fall just about $29,000 below the average amount of debt. This school also offers low tuition and plenty of financial aid opportunities.

14. UNIVERSITY OF NORTH CAROLINA-CHAPEL HILL SCHOOL OF MEDICINE

  • Annual tuition: $24,837 (in-state)
  • Average medical school debt: $147,899
  • Students receiving institutional aid: 87 percent

Thanks to high rates of institutional aid and tuition that's about $14,300 less a year than our study's average, students at UNC School of Medicine have fewer costs to account for than the average medical student.

That means they ultimately have less to pay for and can take out a smaller amount of student loans, minimizing their overall debt.

15. THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

  • Annual tuition: $15,525 (in-state)
  • Average medical school debt: $117,381
  • Students receiving institutional aid: 30 percent

The University of Texas Health Science Center in Houston, Texas, has the lowest rate of institutional aid of any school in the top 20. In fact, it's more on par with the averages for the bottom 20.

Despite this, having the fifth-lowest tuition costs helps make up the difference at UTHealth. Medical school debt here is also about $47,400 below the overall average found in our study.

16. UNIVERSITY OF ALABAMA-BIRMINGHAM (UAB) SCHOOL OF MEDICINE

  • Annual tuition: $26,778 (in-state)
  • Average medical school debt: $108,690
  • Students receiving institutional aid: 44 percent

The UAB School of Medicine has low tuition and graduates leave with low medical school debt – approximately $56,100 less than the average debt found in our study.

Keep in mind that a first-year medical resident's typical salary stipend is $54,100, according to a 2016 AAMC survey of resident and fellow stipends. So even if this medical school offers aid to fewer students than most, going to UAB medical school can help graduates save on debt that's almost the equivalent of a year's worth of salary.

17. UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE

  • Annual tuition: $24,030 (in-state)
  • Average medical school debt: $121,668
  • Students receiving institutional aid: 49 percent

The University of Oklahoma College of Medicine has below-average tuition, saving students around $15,000 a year. Graduates of this school also save about $43,100 on total medical school debt.

18. UNIVERSITY OF CALIFORNIA-​SAN FRANCISCO (UCSF) SCHOOL OF MEDICINE

  • Annual tuition: $33,420
  • Average medical school debt: $139,457
  • Students receiving institutional aid: 82 percent

About four in five medical students at the UCSF School of Medicine get institutional aid to help cover costs. This probably helps them borrow about $25,300 less than an average medical student, despite paying tuition that's closer to average.

19. UNIVERSITY OF CALIFORNIA-​DAVIS SCHOOL OF MEDICINE

  • Annual tuition: $35,933
  • Average medical school debt: $153,419
  • Students receiving institutional aid: 95 percent

Almost every UC Davis School of Medicine student receives a scholarship or grant. This helps cover most students' medical school costs and keep tuition affordable. Although tuition may seem higher compared to the other 20 most affordable medical schools, it's still below our study's average.

These factors also help UC Davis graduates keep their medical student loans $11,400 below the average.

20. UNIVERSITY OF MICHIGAN MEDICAL SCHOOL

  • Annual tuition: $34,050
  • Average medical school debt: $124,091
  • Students receiving institutional aid: 56 percent

Rounding out our top 20 is the University of Michigan Medical School. This school gets closer to average on both its tuition and rates of institutional aid.

However, a typical University of Michigan student graduates with medical school debt that's 25 percent lower than the $164,800 average.

THE 50 MOST AFFORDABLE MEDICAL SCHOOLS

Curious to see how other affordable medical schools stack up?

Here's a list of the top 50 institutions we found to be the best options for minimizing six-figure medical school debt, based on our methodology listed below. See how your school compares in terms of average indebtedness each med school graduate walks away with.

Medical schoolAverage debt
1.East Carolina University (Brody)$112,692
2.University of New Mexico$126,783
3.Baylor College of Medicine$99,882
4.Texas A&M Health Science Center$128,797
5.Mayo Clinic School of Medicine$69,695
6.Texas Tech University Health Sciences Center$129,454
7.University of Central Florida$138,728
8.University of California—​Los Angeles (Geffen)$117,590
9.University of Texas Southwestern Medical Center$109,350
10.University of Texas Health Science Center—​San Antonio$120,529
11.University of North Texas Health Science Center$150,258
12.University of California—​San Diego$98,750
13.University of Nevada Reno$135,788
14.University of North Carolina—​Chapel Hill$147,899
15.University of Texas Health Science Center—​Houston$117,381
16.University of Alabama—​Birmingham$108,690
17.University of Oklahoma$121,668
18.University of California—​San Francisco$139,457
19.University of California—​Davis$153,418
20.University of Michigan—​Ann Arbor$124,091
21.University of Chicago (Pritzker)$119,830
22.Washington University in St. Louis$84,758
23.University of Kansas Medical Center$155,241
24.University of South Dakota (Sanford)$160,439
25.University of Arkansas for Medical Sciences$163,049
26.University of Florida$150,126
27.University of Missouri$153,398
28.University of Virginia$125,094
29.Ohio State University$168,656
30.Harvard University$101,478
31.University of Washington$153,494
32.University of Iowa (Carver)$146,207
33.University of Maryland$157,155
34.Wayne State University$160,859
35.Vanderbilt University$127,184
36.University of Hawaii—​Manoa (Burns)$160,000
37.University of Connecticut$148,575
38.Johns Hopkins University$113,684
39.Duke University$118,579
40.West Virginia University$154,798
41.Stanford University$122,611
42.University of South Florida$148,306
43.Florida State University$150,008
44.University of Wisconsin—​Madison$144,334
45.Columbia University$113,367
46.Marshall University (Edwards)$190,345
47.University of California—​Irvine$159,161
48.University of Massachusetts—​Worcester$138,479
49.University of Nebraska Medical Center$162,638
50.University of Utah$166,985

 

Methodology: Student Loan Hero ranked 110 medical schools in the U.S. for this study. Rankings were determined by three factors:

1) Level of indebtedness for medical school graduates

2) Annual in-state tuition to attend the medical school full-time

3) Percentage of students receiving institutional aid in the form of scholarships or grants.

All data was sourced from the U.S. News & World Report rankings of the Best Medical Schools.

2017년 7월 5일 수요일

한밤중 가슴 통증…알고 보니 위산역류 때문 

차민영 내과 전문의가 위산역류로 응급실을 찾았던 여성에게 주의 사항을 설명해 주고 있다.
차민영 내과 전문의가 위산역류로 응급실을 찾았던 여성에게 주의 사항을 설명해 주고 있다.
식도와 연결된 괄약근 느슨해져 
위산이 거꾸로 올라오기 때문

누워있을 때 증세 더욱 심해
자다가 위산으로 식도 경련

협심증과 같이 갑갑하면서 통증
물 마시면 증세 호전될 수 있어


60대 초반의 여성은 최근 자다가 식은땀이 흐르면서 가슴이 조여왔다. 점점 숨쉬기가 힘들면서 가슴이 누르듯 아파와서 다급히 병원 응급실로 갔다. 하루를 병원에 입원하면서 심장에 관한 검사를 받았는데 결과는 '네거티브(이상 없음)'였다. 병원의 미국인 심장전문의는 'GERD'가 의심스러우니 내과 전문의에게 가서 위내시경을 받아보라고 했다. 차민영 내과전문의는 "GERD는 우리가 흔히 말하는 위산역류증으로 증세가 협심증이나 심근경색증과 거의 같아서 의사들도 자세한 검사를 하기 전까지는 판단 내리기 힘들 정도"라고 설명한다. 자세히 들어 보았다.

-왜 위산이 식도로 역류될 때 가슴이 갑갑하면서 통증이 생기나.

"위산은 상당히 강한 산성이다. 유일하게 위(stomach)에 머물 때에만 안전하다. 위산이 위에서 빠져나와 식도로 올라오면 강한 산성으로 인해 식도의 근육이 경련을 일으키는데 이 때 증세가 가슴이 갑갑하게 압박되면서 조여오고 타는 듯한 느낌으로 아프기까지 한다. 이런 증세가 심장의 협심증과 거의 같다. 또 위산이 식도에 오래 닿아있으면 식도 벽을 상하게 하여 염증도 생기게 된다."

-식도에 염증이 있을 때에도 위와 같은 증세가 나타나나.

"그렇지는 않다. 식도에 염증이 생겨도 잘 느끼지 못한다. 그래서 위내시경을 받지 않으면 식도에 염증이 생겼는지 모른다. 식도 염증이 있을 경우 대부분 위산역류를 갖고 있다."

-협심증과 위산역류증세를 구분할 수 있는 방법은 없나.

"30년 넘는 내과의사 생활을 통해 밤(주로 새벽 1시~2시)에 숨이 막혀 죽을 것 같다는 응급전화를 너무도 많이 받았다. 증세를 들어 보면 위와 같다. 식은 땀이 온몸에 흐르면서 가슴이 타는 듯 숨도 쉬지 못하겠다고 한다. 이럴 때 '겁내지 마시고 상온의 물을 한잔 마시라'고 한다. 그러면 2/3 정도는 좀 나아진 것 같다고 답한다. 그 다음에 집에 있는 소화제(오메플라조넥시움잔탁덱실란트 등)를 먹으라고 하는데 이때는 알약보다는 물약으로 된 것(민톡스 말란타 등)이 빨리 반응이 오기 때문에 더 좋다. 그러면 훨씬 더 좋아졌다고 한다.

만일 이렇게 약을 먹은 후에도 계속 가슴 갑갑하고 조여오면 그 때는 즉시 응급실로 가거나 911을 부르라고 한다. 위산역류가 아니라 심장에 문제가 의심되기 때문이다. 그러나 물 한잔과 소화제로 진정된 사람들도 아침에 반드시 의사를 찾아가 심전도 검사를 해보라고 한다. 50세 이후의 경우 위산역류와 협심증을 동시에 갖고 있을 수 있기 때문이다. 실제로 그런 사람들이 많다."

-위산역류증세는 낮에 활동할 때는 발생하지 않나.

"낮에도 증세가 나타나는데 상태에 따라 못 느낄 뿐이다. 위와 이어진 식도 부위에 있는 괄약근이 나이들면서 다른 근육과 마찬가지로 힘이 빠져 느슨해져 완전히 닫혀 있지 못하고 항상 약간 벌려있기 때문에 위산이 마치 종이에 물이 스며들어 퍼져가듯이 식도 위로 계속 조금씩 역류하고 있기 때문이다. '가슴이 항상 갑갑하고 뭔가 속이 개운치가 않아 피곤하다'고 느끼는 사람들이 여기에 속한다. 그러다가 과식 혹은 기름기 너무 단 초콜릿 그리고 카페인이 강한 커피를 먹으면 위산이 더 많이 분비되기 때문에 위산이 역류되어 속쓰림을 느낄 수 있다. 무엇보다 업무나 화나는 일이 생겼을 때는 더욱 가슴이 갑갑함을 경험하는데 위산 분비를 가장 많이 자극하는 요인이 바로 스트레스다. 과다한 업무를 피하는 것도 위산역류 증세를 진정시키는 방법의 하나라 하겠다."

-위산역류로 복통은 동반되지 않나.

"한 환자의 경우 배(명치 부위)가 하루 종일 아파서 회사에서 소화제를 먹었는데도 점점 통증이 심해졌다며 온몸에 식은땀을 흘리면서 저녁에 찾아왔다. 잘못 먹었는지 배탈이 심하게 난 모양이라며 그가 움켜 잡은 명치 부위를 본 순간 위가 아닌 협심증을 의심하게 되었다. 혈압을 재어보니 높아(160/100) 곧바로 심전도 검사를 했는데 예감이 맞았다. 즉시 응급실로 보냈고 심장수술로 위급한 순간을 모면할 수 있었다. 위산역류로 복통증세는 거의 없다. 혈압이 높고 당뇨가 있으면서 복통이 심하게 지속될 때에는 내과가 아닌 심장과로 가서 협심증인지 확인하는 것이 매우 중요하다."

-위산역류를 갖고 있는지 자가진단하는 방법은 없나.

"음식을 먹은 후 몸을 좀 많이 움직였더니 가슴 부위가 답답할 경우 위산역류가 원인일 가능성이 있다. 낮에 이유없이 하품을 많이 하는데 이 때 물을 마시면 좀 나아진다는 사람 아침에 일어났을 때 목이 칼칼하면서 아프고 목소리가 쉬는 사람 항상 가슴이 개운치 않고 뭔가 걸려있는 듯 답답한 사람 스트레스를 받을 때 가슴부위가 갑갑해오면서 속쓰림을 느끼는 사람은 위산역류를 의심해 보는 것이 안전하다."

-어떻게 해야하나.

"위내시경을 받아 보아야 한다. 본인의 상태에 따라서 의사가 처방해주는 위장약을 의사의 지시대로 잘 복용한다. 동시에 위산 분비를 자극하는 음식물은 피하면서 위산 분비를 적게 하는 식습관을 갖는 것이 중요하다."

-피해야 할 음식은 어떤 것이 있나.

"먼저 피해야 할 3가지가 스트레스 술 담배이다.그 다음 식습관으로는 야채와 과일을 자주 먹되 한번에 너무 많이 먹지 않는다. 과식은 위산분비를 자극하기 때문. 기름기 짠 것 매운 것 그리고 카페인을 되도록 멀리 할 것. 정 커피를 마시고 싶으면 한잔 정도 반드시 음식과 함께 마시는 것이 중요하다. 어떤 환자는 꿀이 위산역류에 좋다는 말을 듣고(?) 매일 아침 빈속에 꿀을 한 스푼씩 하고 낮에도 수시로 먹었다. 당분(설탕)은 위산을 더 많이 나오게 한다. 차(티)도 대부분 카페인이 있기 때문에 성분을 확인할 것."

-어드바이스가 있다면.

"미국에 매년 300만명 이상의 위산역류 환자들이 발생할 만큼 흔한 소화기 질환이다. 안 먹고 살 수 없기 때문에 약 복용도 중요하지만 위산 분비를 자극하는 음식이 어떤 것인지 알아서 개인에 맞는 식습관을 갖는 것이 중요하다. 자주 물을 마시고 음식은 소량을 자주 먹을 것. 위산역류가 있는 사람은 2년에 한번 정도는 위내시경을 받아 상태를 항상 점검해 나가는 것이 안전하다."

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