What You Need to Know Before Starting Residency

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After a long, difficult year of going through the match process, you’ve finally made it and will be starting residency soon. But the journey is far from over. While matching is a major success, residency comes with its own challenges.

Here are three things you need to do to prepare for residency.

 

1 | Personal Finance

Don’t let the stereotype that doctors are clueless with money apply to you. If you can get into medical school, you can certainly understand and take control of your finances.

Residency marks a significant change in your career. You are no longer a student paying for your education. You are now a resident who is earning money. And while doctors are known for making good money, this isn’t the case in residency. The average salary for a new resident is $52,000.

How you decide to handle your finances now will set the course of your financial future.

Student Loans

As a medical student, you’ve probably picked up your fair share of student loans. While most people will tell you to pay these loans off as soon as possible, your plan should depend on the kinds of loans you have.

For private student loans, you can refinance these loans to lower the interest rates and have lower monthly payments. For federal loans, there are a variety of programs you can utilize.

Certain school loans will also have deferment so that you’re not accruing any interest while in medical school and even residency. This is an extremely good deal, and while this is not financial advice and is for informational purposes only, I would personally pay these types of loans as slowly as possible—inflation is chopping away at them without me having to pay a cent.

When I was first learning about finance, I got really really into it. I read half a dozen finance books. I read WCI religiously. I actually emailed Jim Dahle from WCI about my student loan situation and he essentially said “Kevin, I help pediatricians with 300k in loans. As a future plastic surgeon with 30k in loans, why are you wasting my time?”

For those wondering, I only had $30,000 in loans between college and medical school during residency because I earned the only merit-based scholarship that UCSD was offering that year, which covered all of my tuition and most of my living expenses.

Loans are offered on a need-basis, so if you’re in greater financial need, you’ll be offered school and government loans prior to needing to dip into private loans. They offered me very favorable school loans that I could choose to take if I wanted to max out the budget.

So, let’s say tuition was roughly $35,000 per year, and living expenses were another $25,000 or so. I actually didn’t feel like I needed the full budget they allocated, but the terms were so favorable for the school loan—interest was deferred for both medical school and residency—that it made complete sense for me to take all of the loans they offered.

This is where financial optimization gets more nuanced.

Disability Insurance

Start looking into other financial priorities than your loans, for example, disability insurance.

Why invest in disability insurance? You’ve already invested tons of time and money into becoming a physician with a high earning potential. If something were to happen to you and prevent you from being able to practice, for example a surgeon who experiences a hand injury, disability insurance will replace some level of your income into the future.

I stopped doing any work on my car in residency because I realized if I damaged my fingers or hand in any way, I would not be able to be a plastic surgeon. I figured it was worth it to pay someone else to do my oil changes and brake fluid flush.

I actually tried getting disability insurance while in residency, but was denied and not even offered any sort of plan because I’m on biologic medication for my inflammatory bowel disease.

Medicine is a physically taxing career and can take a toll on your health.

As a healthy, young resident, you can get disability insurance at a significantly cheaper price compared to an older attending.

Residency Relocation Costs

Your finances can also include fees needed to relocate if you’ve matched in another city. Make sure you have enough time to properly research how much it will cost to move and how much you’ll be paying for your new place.

Ask your co-residents for help. After all, they went through the same process just one year earlier, and they know the area better than you. Ask your program coordinators as well. Some programs offer moving stipends that can help cover hotel costs until you settle in.

Other Financial Priorities

I remember reading about retirement savings prior to starting residency and thinking: “Who cares? I don’t need to save money for when I’m 65. I’m 25 and I want to save money for a trip or a new computer or a car or something!”

The key thing here is to still take advantage of retirement accounts because you save a significant portion. Getting into the habit of saving money and understanding how to invest and save money in a protected Roth IRA (individual retirement account) are things you should definitely consider as well.

Do your own research and talk to financial experts before making any serious decisions.

For more research, check out my video on student loans, and also check out Dr. James Dahle’s book White Coat Investor to help you understand how to get the most out of your salary.

 

2 | Studying

Do not waste your last precious months studying and preparing for your intern year. If you worked hard in medical school, as most people do, studying isn’t worth your time and effort at this point.

Intern year is such an intense learning experience that the few hours of studying here or there you’ll do in the months leading up to July 1st will be close to meaningless.

That said, there are certain things worth brushing up on, but this will be based on your own strengths, weaknesses, and specialty.

While your seniors are available to support and teach you, you don’t want to be the overly needy intern either. What you brush up on will depend on your specialty and your weaknesses.

As an internal medicine intern, you could refresh your knowledge of EKGs and fluid management. As a surgical intern, you can take some time to practice suturing techniques, particularly if you don’t feel well-versed in your OR skills.

The key is not to spend too much time preparing. In the last couple weeks leading up to residency, a couple hours here or there will suffice.

Remember, intern year is an intense learning experience, but you’re starting a stepwise training process. You don’t go straight into leading your own surgeries. You are slowly given more responsibility based on your ability.

Some programs also offer a boot camp during their orientation period to help prepare incoming residents for intern year. If you’re more study-oriented and are willing to dedicate more time to studying before residency, you can take these few months as an opportunity to study for Step 3. Most residents take it some time during their intern year.

For many specialties, your score doesn’t really matter. The most important thing is passing.

Only study before residency if you feel it will ease your nerves or if you feel particularly strong about wanting to. A better way to spend your time is learning from other residents and attendings. This will help shift your perspective now that you’re no longer a medical student.

Overall, enjoy your freedom before residency because you’re not going to have an extended period of free time and flexibility for the next few years.

 

3 | Self-Care

The past four years of medical school have been physically, mentally, and emotionally draining, especially with match season and all the stress that comes with it so fresh.

You’ll only have a few months to enjoy your time before your life changes for the next few years during your training.

In residency, you’ll be working long hours and won’t have much free time to see your loved ones or to do the things you enjoy. Also, most residency programs only have two to three weeks of vacation during intern year, and requesting that time off is also less straightforward than in other professions.

The best thing you can do to take care of yourself is to take these months to recharge.

Take time to see your friends and family and do the things you love. I recommend traveling and doing something fun, something to recharge the soul. I found credit card hacking to be quite helpful here in making travel feasible.

For some, this may also be a good time to dial in certain habits you want to maintain during residency that may not come naturally.

Residency will take up too much time to effectively develop new habits, and if your habits aren’t well developed, you’ll resort to skipping habits or taking shortcuts to save yourself precious time.

Developing new healthy habits takes time and dedication, and with an empty schedule before residency, you can build those habits so that they’re more resilient when you start intern year.

To learn more about developing strong, healthy habits, check out our summary of James Clear’s book Atomic Habits or order the book and read it yourself.

Congratulations to all who are graduating from medical school and starting residency. I wish you the best in this final leg of your medical training journey.

For tips to make the most of your intern year, read 5 Biggest Surprises of Intern Year. For more on how to succeed in residency and beyond, check out our Insiders Scoop series, which interviews practicing doctors about their career choices, the doctor journey, and the future of the medical industry.

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