Hoss, as a current undergraduate who has done a lot of research and is looking at medical school, I just felt inclined to call out some misleading things in your posting.

First, the average medical school debt is 159K. Obviously there are outliers - some with none, your bud with 500K (I'd say 80K for pilot career is extreme as well), but 159 is the average.

Second, there is no medical school that charges 100K per year for tuition (yet, at least.) Granted, many of these rates are still nasty. Factor in living expenses and it's expensive as hell. Here are the figures for you:

https://services.aamc.org/tsfreports..._of_study=2012

The most critical thing for those looking at medicine these days is to aim for your state school or the USUHS (military medical school - there are a few other military programs as well). Obviously the tricky thing is to get in to one of those very few select schools, but it's still financially a good prospect if you can get in to one of those. The Canadian medical schools have their **** together too and those are options as well, though they are hard to get into as an American. It's out-of state or private medical schools where you will incur massive (200K +) debt. If I can get into my state school or a Canadian medical school, especially one of those where I have relatives, I can keep the debt-load in the five figure range.

Just to point out as well, there is still excellent job security. However, I am all with you that there are really no secure paths these days. I think it's pathetic that medical students have become burdened with debt and that it's a really alarming indication in the country. Your friend with 500K is basically handcuffed to the job now and is going to have that hanging over him forever. Soon enough medicine will consist of basically the super rich who can afford to get into it, and the heavily indebted who are screwed, with a few military.

I'm not a kool-aid drinker. I acknowledge many positive aspects to the career, especially if you can keep the debt load down, but I still find the new trends in medicine to be VERY alarming. If I cannot get into my state school/military/Canadian medical school, I will have to go to my backup career. I cannot afford to go to any other schools and medicine is not worth it for 200K + loans.

Didn't mean to insult you or anything, but just wanted to make sure others didn't think it was quite at that doom and gloom point yet. There are still ways to make a good career out of it, but they are becoming more elusive every year. Accounting, engineering, and computer science are probably the most ideal careers right now for the average student.

EDIT: Re-read it and just wanted to add that professional school loans are unsubsidized at 6.8% and for some up to 7.9%. That's how a lot of med students taking full loans to go to pricey school are getting whammed to the 350/400 point, because the interest accrues starting immediately. Is that what's happening to your friend? 250K at 6.8% would already lead to ~325K, 300K at 6.8% -> 390K at graduation, 350K -> 455K at graduation. Then at residency it's not like you can really even handle the interest on those. It's nasty.