Reddit Response: Doctors in Debt

I woke up angry about medical school tuition deregulation.

On my Reddit IAmA, we talked about medical student debt.

sync303given that the average ontario doctor grosses $300K+ per annum i don’t think $120K of school debt is out of line with earning potential.

there are many medical professions, like physiotherapist, pharmacist, nurse that all require an investment of probably $40K-$60K dollars for earning potential that will never, ever reach anywhere near $300K/yr.

so, again i don’t think $120K investment is bad considering the ROI.


All enumerated quotes from

  1. “Medical students must complete three years of undergraduate university education before entering medical school. As a result, many start their medical education with debt loads of $21,000 – $40,000.”
  2. “According for the National Physicians Survey conducted in 2010, the amount of debt that students incurred during medical school was from $100,000 -$160,000.”
  3. “Graduating medical students must work as residents for two to seven years before becoming full-fledged physicians — first-year residents in Ontario earn $51,065.”
  4. “The cost to service a $100,000 debt is approximately $14,000/year – which works out to half of their take home pay.”

Me: Even if the average physician grosses $300K, in Ontario, you’re pretty much immediately giving up 50% to taxes even before you eat, put a roof over your head, pay thousands of dollars in malpractice and other fees, and (the real kicker) pay your staff and buy equipment.

By deregulating medical school tuition, the “ROI” has gotten to the point that even banks are limiting their loans and Moneywise magazine calculated that you’d be better off becoming a plumber.

They started deregulating tuition when I was a student. I made up a sign that said, Poor students=poor medical care.

You’re taking our best, brightest, most altruistic students and turning them into enslaved paupers.


Me in real time: I don’t think anyone’s reading my IAmA anymore. Why would they, when Jerry Seinfeld and YouPorn are coming down the pike. But I’m still mad.

Does anyone even know that medical school now costs the average Canadian over $20,000 in tuition alone? Check here  and here. $56K for those tasty international students. Meanwhile, they’re cutting our pay. And part-time doctors like me make bupkes. I will never make 300K.

I’ve decided to reprint my letter to the Ontario premier, which I had included in my collection, Fifty Shades of Grey’s Anatomy. Please note that since I wrote this letter, they have raised med school tuition again *and* reduced my pay.

My husband suggested I cut this one. “It’s not entertaining.” Gosh, I thought pay cuts and indentured medical students were funnier than a frontal lobotomy without anaesthetic. Back me up here.

Protest: A Letter to the Premier of Ontario

Dear Dalton McGuinty:

I’m an emergency room doctor. I work literally 24 hours a day, seven days a week. I take care of patients who are drunk, who are withdrawing from OxyContin, who spit on police officers and bite nurses. I take care of patients who have no health insurance and no family doctor.

The Ontario Medical Association offered you a pay freeze. Now you want to cut my pay.

I went to school for 25 years and I have paid the price, both financially and in grey hairs.

When I got into medical school, my med school tuition doubled to $4000 and then $8000. When I realized that I’d spend $10,000 just on tuition and textbooks in one year, not including food or rent, I started to hyperventilate.

I was lucky because now it’s $17,371 per year. Ontario medical students’ debt load is so high that the banks are starting to worry that the students won’t be able to repay it once they graduate. CIBC (a Canadian bank) is capping their loans at $100,000-$130,000.

In residency, I worked all hours of the day and night, including call up to every second night, in Quebec, where I paid $700 tuition every year for the privilege. When I decided to do an extra year of emergency medicine training, not only did I have to pay that tuition plus sacrifice earning significant income, but then the College charged me $1500 to take the emergency licensing exam.

In order to practice in Ontario, I pay $1500 a year to register with the College of Physicians and surgeons. I pay up to $2000 a year to the Ontario Medical Association as a full-time physician. I pay up to $1000 to the College of Family Physicians. I pay malpractice insurance every month, some of which is subsidized, and I pay thousands of dollars in courses every year to make sure that my knowledge is up to date.

Newsflash: I do not make $326,000 a year. In recent years, I’m lucky if I gross [redacted]. And, as I have explained, I have sacrificed most of my life to my education and make considerable financial outlay every single year. And with the cuts to inpatient beds and the constant pressure to reduce imaging and other investigations, my job has gotten harder, not easier.

I am not a fat cat that you need to target to score political points with the public. I am the doctor who makes the decisions overseeing the care of the grandmother with cancer or the child in a car accident.

Doctors are not nurses or pharmacists and cannot be replaced by either one, no matter how appealing that may look on a spreadsheet. We each have our own role.

I am not telling this story because I want you to feel sorry for me. I am telling you that my profession works harder and has made more sacrifices than just about any one I know. We deserve to be treated with respect and paid fairly.



Melissa Yuan-Innes, MD, CCFP-EM

This is the most downer essay in the book. The rest are about medicine and, er, the naughty bits.

This is the most downer essay in the book. The rest are about medicine and, er, the naughty bits. And if you hate me for writing this blog and including this link, well, you probably hated me anyway. Cheers.