Haskell Bruce S, Keefe Thomas J
J Am Dent Assoc. 2022 May;153(5):429-439. doi: 10.1016/j.adaj.2021.10.003. Epub 2022 Feb 3.
When attracting talent to dentistry, graduates need educational costs justified by future financial outcomes. The authors provide insights into how career choices (employee versus practice owner) and student loan repayment plans (principal-based versus income-driven) can be made to work.
Five loan repayment and career choice combinations were assessed using spreadsheets (Microsoft Excel) to rationally model monthly budgets and financial decisions during a projected 40-year work life.
Even with high levels of student loan debt ($292,169 average for new graduates), it is still possible, but increasingly difficult, to achieve desirable career, lifestyle, and financial outcomes. Outcomes are highly sensitive to rates of investment returns and inflation. On the basis of the 5 scenarios of projections of debt and income levels to 2060, assuming reasonable levels of investment return and stable inflation, career and repayment choices can make a difference of more than $5 million in lifetime earnings and more than $3 million in retirement savings (2020 dollars).
The new reality of high educational debt requires graduates to budget and plan before beginning their careers. Use of loan servicers, consultants, brokers, attorneys, certified public accountants, and financial advisors is needed. Working for a dental service organization is a valid option for developing dental and practice management skills. Owning a practice is still a viable career path.
Dental graduates should choose a student loan repayment that minimizes the size of monthly payments, balance budgets, practice frugality, obtain a practice purchase loan at lowest rates, and heed financial advisors.
在吸引人才投身牙科领域时，毕业生需要教育成本能由未来的经济回报来证明其合理性。作者深入探讨了如何做出职业选择（雇员还是开业医生）以及学生贷款偿还计划（基于本金还是基于收入）才能发挥作用。
使用电子表格（微软Excel）评估了五种贷款偿还和职业选择组合，以便在预计40年的工作生涯中合理模拟每月预算和财务决策。
即便学生贷款债务水平很高（新毕业生平均为292,169美元），实现理想的职业、生活方式和财务成果仍是有可能的，但难度越来越大。这些成果对投资回报率和通货膨胀率高度敏感。根据到2060年债务和收入水平预测的5种情景，假设投资回报率合理且通货膨胀稳定，职业和偿还选择在终身收入方面可造成超过500万美元的差异，在退休储蓄方面（按2020年美元计算）可造成超过300万美元的差异。
高教育债务的新现实要求毕业生在开始职业生涯前进行预算和规划。需要借助贷款服务商、顾问、经纪人、律师、注册会计师和财务顾问。为牙科服务组织工作是培养牙科和业务管理技能的一个有效选择。开办诊所仍是一条可行的职业道路。
牙科毕业生应选择能使每月还款额最小化的学生贷款偿还方式，平衡预算，厉行节约，以最低利率获得诊所购置贷款，并听取财务顾问的意见。
