valuemd (Admin)
One of the questions we receive from prospective and current TMSU students is about the real cost of attendance, not the sanitized figure that appears in an enrollment brochure, but the total out-of-pocket reality when you add up everything from the day you start basic sciences to the day you submit your residency applications. We are creating this thread to get honest, community-sourced numbers on the table so that future students can plan more accurately.
The sticker price of tuition is only one part of the picture. Students routinely underestimate the cumulative cost of flights between their home country and the island during breaks, housing and utilities on and off campus, food, transportation, Step 1 and Step 2 CK prep materials and exam fees, clinical rotation travel and housing (often in multiple US cities), USMLE registration fees, the ECFMG application and certification fees, ERAS application fees which scale with every program you apply to, NRMP registration, interview travel, and the often-overlooked costs of failed attempts, leaves of absence, or extended timelines.
We are asking graduates, current students, and anyone with relevant experience to share honest breakdowns of what they spent, ideally with approximate numbers attached. This is not the place for school marketing or vague reassurances. We want real figures. Numbers that might shock prospective students are exactly what this thread is for, because informed students make better decisions about debt, timelines, and expectations. Please keep the discussion factual, specific, and respectful.
BrandonLane (Aspiring student)
I graduated last year and matched into family medicine so I can give you a pretty complete picture. I kept a spreadsheet the whole time so my numbers are close to accurate.
Tuition (basic sciences, 5 semesters) - $92,000
On-campus housing + utilities - $18,400
Flights home and back (Nigeria, 8 trips) - $14,200
Food, toiletries, miscellaneous on island - $9,500
Step 1 prep (UWorld, Amboss, First Aid, tutoring) - $3,800
USMLE Step 1 and Step 2 CK fees - $2,100
Clinical year housing (4 different cities) - $22,000
Clinical year travel and transportation - $6,300
ECFMG certification and ERAS fees - $3,200
NRMP registration - $85
Residency interview travel (12 interviews) - $7,800
Total estimate - $179,000
And I want to be clear that this does not include interest on my loans, which has already added close to $18,000 since I started. The real number is closer to $200,000 for me personally. I came from Nigeria so the flights were expensive. Someone from the US or Canada would probably spend les s on travel.
LillianStone (Aspiring student)
This is the thread I wish existed before I started. Currently in MS3 doing rotations and already at around $130,000 spent without finishing clinical year. A few things I didn't anticipate at all that I want to flag for incoming students.
First, ERAS fees are brutal and nobody warns you about them ahead of time. If you apply broadly, which most IMGs kind of have to, you can easily spend $1,500 to $2,000 just on ERAS application fees depending on how many programs you apply to. Second, the clinical rotation housing situation is really variable and some of the approved housing options are genuinely expensive. I've paid anywhere from $800 to $1,900 per month depending on the city I was rotating in. Third, if you have any leaves of absence for any reason including health, family emergencies, or failed steps, the cost resets in ugly ways. My roommate took one semester off and it added roughly $12,000 to their total when you factor in extended housing and lost time.
Ethan89 (Alumni)
Reading this is genuinely making me rethink some things. I had budgeted around $160,000 in loans thinking that would cover it. Based on what people are posting it sounds like I was being optimistic. Is the $180,000 to $200,000 range pretty typical or were those cases on the higher end?
BrandonLane (Aspiring student)
Honestly based on the people I graduated with, $160,000 to $200,000 is pretty common for the full cost before interest. If you come from far away, took any extra semesters, or applied widely for residency you are more likely to hit the higher end. If you have family in the US you can stay with during rotations or if you are from somewhere close to the island, you might come in lower. But budgeting $160,000 as your ceiling is risky. I would plan for $180,000 minimum and treat anything under that as a good surprise rather than the expectation.
LillianStone (Aspiring student)
Agreed with BrandonLane (Aspiring student) . Also remember that the loan interest does not pause during school unless you have specific deferment terms. For a lot of private loans it is accruing the whole time. By the time you match and start residency you could be looking at another $15,000 to $25,000 on top of what you borrowed depending on your rate and how long it takes you to match. Factor that in when you are calculating the real number.
Charlotte14 (Student)
I graduated TMSU two years ago. I want to add something that I haven't seen mentioned yet which is the cost of Step prep if you do not pass on the first try. I did not pass Step 1 on my first attempt and had to postpone my clinical start by about five months. That added up fast.
Extended housing on the island for those extra months, another round of Qbank subscriptions, a dedicated tutor, and then the exam fee again came to about $9,000 extra that I had not planned for at all. And that does not count the emotional toll which does not show up in a spreadsheet but is very real. I say this not to scare people but because Step prep costs are something people seriously underestimate. Budgeting just the one exam fee is not realistic for a lot of students. Plan for the possibility of a second attempt.
Charlotte14 (Student)
Charlotte here, started in the fall semester. Already feeling the pinch and I am only a few months in. I wanted to ask about the on-campus versus off-campus housing decision because I have heard mixed things. Right now I am on campus which is more expensive per month but I thought it would be simpler. Is moving off campus actually worth it financially or does it create other headaches that eat up the savings?
