It's pretty simply really... there are ways to avoid racking up this much debt. Student loans shouldn't be a way to support one's lifestyle. It's called living on what you need, and not what you want. Then, after your schooling is over, rather than trying to live like most tenured ortho's do, you live like you work at Walmart until you're in a place where you can start enjoying luxuries because you've properly managed your finances.

I know Mike and his family well, really good people. But this is just poor decision making and a poor job of managing finances. I know several dentists and ortho's who have a fraction of the debt that he does. Shoot, I know a few that are in their mid-30's that are practicing now with zero student loan debt.

It all comes down to humility and thinking long term. Both are lacking in this situation and it's epidemic among college grads today.