How involved are you as medical residents in the financial end of the treatment you provide? Do your administrators walk around reminding you not to do procedure x or stop ordering test y because of the way it affects your department's bottom line? Do your patients ever ask you "how much will this cost?" and how do you handle that? I assume your priority is to get an education, not worry about your department's financial health. Background: I am currently doing my second residency as a dentist. Both hospitals where I have been are private and have well known private med schools attached, although they are in different parts of the country. At both places, the admin always walks around grumbling about our budget and funds almost to the point where it interferes with our education. It doesn't always affect patient health since teeth can always be extracted for cheap, it costs more to save them. But it does affect the tecnology we use and the procedures we learn that are used commonly in private practice but we get almost no experience with during residency. I understand departments need money to operate, but we are in residency to get an education. Since many dental procedures are not automatically covered by insurance, we as residents often discuss financial aspects with our patients who want to pay out of pocket for uncovered procedures. We know how much our department charges for procedures and can readily discuss financial options with patients because if a patient agrees and pays, we get the educational experience of doing that procedure. Part of our scut work is ordering supplies from vendors so we know how much it costs to stock and run our clinic on some level. I did spend some time on the inpatient floors and did rotations in internal medicine and anesthesia at my first residency. I don't recall any resident, staff member, or attending ever mention the word money, especially when they were seeing patients.