Smart Money MD

College admission letters officially came out a few weeks ago, and there were many happy parents as well as some disappointed ones.  One of my colleagues’ daughters received her acceptance letter to Harvard. He had kept me in the loop during the application process and her daughter had already been accepted into Stanford and Berkeley, both with full tuition scholarships. I congratulated him and we had no further discussion about it.

Implicitly we both knew that she was going to Harvard even though there were two full scholarship offers at great schools.  I guess you know where I stand in terms of private vs public education…
There is no end to the debates about private and public schools.  The contention has always been that private schools confer no guaranteed return on investment despite having a higher price tag than publicly funded schools.  We’ve all seen private grade schools that are great, and probably an equal number that are lousy.  I recall that in childhood many of the doctors’ kids all enrolled in a private school only to find that the public city schools offered better advanced classes. I attended public schools that were considered some of the worst in the entire country up until college, and managed to develop a relatively good career.  It all depends on where you live and options are around.
The money bloggers are relatively vocal in their opposition of private education, from secondary school all the way into college.  The doctor money bloggers in general seem to favor the public school route, but their rationale also involves saving oneself from unnecessary expenses.  There is nothing wrong with that viewpoint, especially when these very same money bloggers have hard evidence from their own experiences that they carved out a financially successful lifestyle without the huge price tags.  I would venture to assume that the physician bloggers who developed successful professional careers without shelling out the big bucks would also argue that private education confers zero advantages.  There is a saying in medical school “P = MD”—if you can make it through, an “M.D” is an “M.D” whether you got it in the Caribbean or Dublin.

The evolution of medical school tuition costs
We’ve seen quite a few changes in the medical school world over the past year and a half.  We’ve seen that New York University’s medical school is waiving tuition for all of its students.  Likewise, Columbia University has also has a program that covers all need-based aid.  Most recently, Washington University in St. Louis also announced that it will cover the cost of tuition for its entering medical school class.
That’s three private universities using their endowment to eliminate tuition cost out of the picture.  
For those of you who aren’t familiar, these three medical schools are highly competitive.  I remember that there was a time that WashU gave its first year students a t-shirt with the student’s MCAT score on it.  Many aspiring doctors would strongly consider finding a means to fund their tuition at these schools if they were accepted.  

Free private education for all?
How would your opinion of private education change if it were all free? This is an interesting thought exercise, as many private schools survive solely on the premise that they offer a higher quality of education. Most non-parochial primary and secondary schools have certain testing requirements for entrance, whereas non-magnet public schools simply require you to live within a certain vicinity.

Residency and fellowship
Doctors have to train beyond medical school in order to enter the profession.  It’s pretty clear cut that a top tier residency will likely offer a stronger peer group and potentially a higher quality of training.  Many of these training programs are tied public universities (at least one in most states), but a large number are also tied to private universities with affiliated hospitals.  Most medical students aren’t really going to care whether they train at a private or public hospital.

One reason for this? Residents are paid during their training, so you might as well go to the best program you can get accepted into as long as it works with the rest of the family.
Interestingly, many dentists I know who enter residency (dentists are not required to train after dental school) still opt for the private route, with the hope that they will get “better” training.  Their rationale? Dentists have to pay for their residency.

Professional school, colleges, and primary school
If money weren’t a factor then choice of all other schooling will likely distill down to two factors: (1) quality of education and (2) convenience.  Gee, that sounds like the same criteria that most people look at to try to justify the cost of private education.  Many of my colleagues consider that paying for a child’s four-year education will only sent them back four years of retirement.  We all know that this translates to more than that due to investment growth, but I still see perfectly rational people make choices that perhaps are a little bit irrational.  That is the beauty of human nature!

By the way, tuition alone at Harvard for the upcoming school year runs upward of $46,000.  Early retirement anyone?