After a challenging journey through medical school and the match process, you’ve finally made it—you’re about to start residency. Residency comes with its own unique challenges, so here are three key areas to focus on as you prepare: personal finance, studying, and self-care.
1 | Set Yourself Up for Financial Success in Residency
The Financially Illiterate Doctor Stereotype
First, don’t be part of the stereotype that doctors are clueless when it comes to money.
You have all the excuses in the world to be bad with money. You spent so much time studying and working to become a doctor that you didn’t have the time to learn about finances, or maybe your excuse for the day is that financial literacy should be taught in grade school.
You could compellingly argue those things, or you could take responsibility, own up to the situation, and educate yourself on finances, which I promise are stupidly simple. If you can get into medical school, or if you can just pass the MCAT, you can certainly nail down finances!
Residency marks a significant change in your career, transitioning from a student who is paying for their education to a resident who is earning money. While doctors are known for making good money, that isn’t the case in residency, and the average salary for a new resident is 52k.
You’re not going to be balling out, but how you decide to handle your finances will set the course of your financial future.
Here’s the hard part about finances: there are few blacks and whites, it’s a lot of gray area and nuance, but the nuance isn’t that difficult to understand.
Student Loans
Take loans for instance. As a medical student, you’ve probably picked up your fair share of student loans, and most would tell you to pay them off as soon as possible. In reality, your plan will 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, you have a variety of programs you can use. Certain school loans will also have deferment, such that you’re not accruing any interest while in medical school, and some even while you’re in residency. That’s a crazy 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 since inflation is chopping away at them without me having to pay a cent.
I tend to get really passionate about certain hobbies or topics at a time, and when I was first learning about finance, I got really really into it. I read half a dozen finance books, read White Coat Investor religiously, etc. I actually emailed Jim Dahle from White Coat Investor about my student loan situation, and he essentially said “Kevin, I help pediatricians with $300,000 in loans. As a future plastic surgeon with $30,000 in loans, why are you wasting my time?”
For those wondering, I had $30,000 in loans between college and medical school during residency because I earned the one 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.
Let’s say tuition was $35,000 per year, and living expenses were another $25,000 or so. I don’t think these are the exact numbers, but just rough estimates. I actually didn’t feel like I needed the full budget that they allocated, but the terms were incredibly favorable for the school loan, as interest was deferred for both medical school and residency. Therefore, it made complete sense for me to take out all the loans I could that they offered. This is where the nuance comes in when it comes to financial optimization.
Disability Insurance
Other than your loans, start looking into other financial priorities. One of these should be disability insurance.
The point is that you’ve invested so much time and money into becoming a physician having a high earning potential. If something were to happen to you such that you couldn’t practice, let’s say a surgeon who experiences a hand injury, disability insurance will replace some level of your income in the future.
In residency, I stopped doing any work on my car because I realized if I damaged my fingers or hand in any way, I was going to be SOL. I figured it would be worth it to just pay someone else to do my oil changes and brake fluid flush.
By the way, 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).
Spending and Saving
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 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 are things you should definitely consider as well.
Just a disclaimer, this is not financial advice. You should do your own research and talk to financial experts before making any serious decisions. For more research, you can check out our guide to student loans, and you can also check out Dr. James Dahle’s book White Coat Investor to help you understand how to get the most out of your salary.
Your finances can also include fees needed to relocate if you’ve matched somewhere else. 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 since they recently went through the same process 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.
2 | Study Smart: Dos and Don’ts to Prepare for Residency
A lot of people will tell you that you shouldn’t waste your last precious months studying and preparing for the intern year, and I’m one of those people.
If you worked hard in medical school, as most people do, there’s little that’s 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 that you’ll do the months leading up to July 1st will be close to meaningless.
Others say that certain things are worth brushing up on, and I will say there is some validity here based on your own strengths, weaknesses, and what you’re going into. Sure, your seniors are available to support you and teach you, but 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 that you shouldn’t spend too much time preparing. Even then, I feel that in the last couple of weeks leading up to residency, a couple of hours here or there will suffice.
Remember, your intern year is an intense learning experience, but you’re starting a stepwise training process. You don’t go straight to leading your own surgeries. You are slowly given more responsibility based on your ability. Some programs offer a boot camp during their orientation period as well to help prepare incoming residents for the 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 take it some time during their intern year.
For many specialties, your score doesn’t really matter, and the most important thing is passing. I did 1/3 of the UWorld questions and ended up with around a 240 on Step 3, which made me feel like I over-studied and wasted time studying that didn’t actually provide me any benefit. Obviously, I quit residency, but even if I stayed, my Step 3 score would be close to meaningless for any fellowship opportunities after plastic surgery residency.
Overall, I’d say 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. Only prepare if you feel it will ease your nerves, or if you feel particularly strongly about wanting to. If you are on the fence or simply don’t want to, I think you’ll be better off not doing any prep.
3 | Balance Work and Wellness Before Residency
The past four years of medical school have been physically, mentally, and emotionally draining, especially with match season and all its stress still 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 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 that you want to maintain during residency that might not already be natural.
While we can sometimes try to radically change our lives and habits whenever we start a new phase in our lives, residency takes up too much time of our day to effectively develop new habits, and if your habits aren’t well-developed, you’ll resort to skipping certain 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 in a way that will be more resilient when you start intern year.
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.
