Feels Bad Man

[bugsterizer83]

Trying to do my rank list. I want to rank two of my programs higher, but both of them have disgustingly high health insurance costs for covering spouse + kids. Have to move a couple programs I don't like as much with probably worse training higher on my list because they are affordable in terms of insurance.

FeelsBadMan

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[KVBane]

Im just a med student so I dont have alot of knowledge on the subject, but shouldnt you rank the programs you want higher. I know cost is an important factor, but a residency is kind of important for your life, and choosing a worse residency to save a little money may not be the smartest decision in the long term. Plus you can always moonlight or something to earn a bit more cash.

 

[Wordead]

This seems like a really intelligent way to rank programs.

 

[bugsterizer83]

This seems like a really intelligent way to rank programs.

Sarcasm?

 

[bugsterizer83]

Im just a med student so I dont have alot of knowledge on the subject, but shouldnt you rank the programs you want higher. I know cost is an important factor, but a residency is kind of important for your life, and choosing a worse residency to save a little money may not be the smartest decision in the long term. Plus you can always moonlight or something to earn a bit more cash.

Its not really a little money actually. It'd be like 400-500$ per month.

I would love to moonlight to help make up the difference but not sure how realistic this is in residency in general. Some places you can't do it until you are a 3rd year. Other places don't allow it all. Still at every program you can't do it during 1st year.

Obviously I created thread as a passive-aggressive way to be convinced otherwise.

 

[wholeheartedly]

Its not really a little money actually. It'd be like 400-500$ per month.

I would love to moonlight to help make up the difference but not sure how realistic this is in residency in general. Some places you can't do it until you are a 3rd year. Other places don't allow it all. Still at every program you can't do it during 1st year.

Obviously I created thread as a passive-aggressive way to be convinced otherwise.

will your wife work at all, maybe she'd get better insurance through her own job for her and the kid? some of my coworkers spouses did that

It does seem a bit odd that the difference is that bad. sorry you're in that situation.

 

[Psai]

That's cause of all the wasteful labs and scans we do on the old people that infest hospitals

 

[chromuffin]

Its not really a little money actually. It'd be like 400-500$ per month.

I would love to moonlight to help make up the difference but not sure how realistic this is in residency in general. Some places you can't do it until you are a 3rd year. Other places don't allow it all. Still at every program you can't do it during 1st year.

Obviously I created thread as a passive-aggressive way to be convinced otherwise.

Could you not look into the moonlighting opportunities at the programs you are interested in? Although I would assume you knew this based on the knowledge of the insurance plans. I'm surprised the costs are that different.

 

[quickfeet]

Could you not look into the moonlighting opportunities at the programs you are interested in? Although I would assume you knew this based on the knowledge of the insurance plans. I'm surprised the costs are that different.

The thing is its hard to get real info on moonlighting at most interviews (For IM at least). It seemed the residents are rather quiet about it, even if they are doing it. I had to contact one residents at a place I interviewed at a month or so after the interview, and he revealed to me what moonlighting he did and how much $ he makes for each opportunity and how the P.D. views it. The guy actually said that some peeps in his program do it under the table.

Even funnier was the IV I had at another program where the associate PD basically said (without me asking directly) that the residents moonlight under the table all the time. He said this with a chuckle.

At another interview, I was expressly told by the program director that they offer internal moonlighting opportunities, how often they are offered, how much they pay etc.

 

[Cara Delevingne]

In ten years, will you miss the $6000/year (maybe $30k total) from residency health insurance costs? In med school, would you have preferred to go to a worse school if tuition was $6k cheaper?

IMO these numbers are quite small when you look at the big picture, at least in my experience - I expect to take out ~$300k throughout med school, and the extra $6k/year expense of a better residency will be of little importance.

You should go where you'd be happiest, however, and if saving that money makes you happier, then so be it.

 

[wholeheartedly]

In ten years, will you miss the $6000/year (maybe $30k total) from residency health insurance costs? In med school, would you have preferred to go to a worse school if tuition was $6k cheaper?

IMO these numbers are quite small when you look at the big picture, at least in my experience - I expect to take out ~$300k throughout med school, and the extra $6k/year expense of a better residency will be of little importance.

You should go where you'd be happiest, however, and if saving that money makes you happier, then so be it.

the problem is you don't get to wait 10 years to pay for rent, food, etc. in residency. In med school you can take out loans and pay that back over time. That's a good chunk of change on a residents salary. I make more than a resident and an extra $500 / month would make things pretty tight for me on top of my other expenses and student loan payments etc.

 

[caffeinemia]

getting -500/month right now would piss me off. Valid consideration when those $500 go towards feeding your kid or making sure he/she can see a doctor. At the end of the day, will the training be sufficient to get a job? Honestly, no one said having a family didn't come with sacrifices, but yeah, def feels bad.

 

[raiderette]

Have you done an overall budget for each city? Are there housing choices that can help make up the cost of healthcare?

 

[tantacles]

I think you have to think about expenses when you choose your residency program. This decision is not easy. I will say that I purposely ranked programs with good moonlighting opportunities high than those that had none.

 

[235009]

You really have to factor in the actual salary and taxes at each program as well as cost of living. You can also put your student loans in deferment if you can't afford to pay them off. Can your wife and kids instead be covered by Medicaid? I fear that making this decision solely based on health insurance costs doesn't take into account the bigger picture.


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[cbrons]

Can your wife and kids instead be covered by Medicaid?

Now this to me is just simply unacceptable and unforgivable of the residency program and system in general that an actual M.D. cannot afford ****ing health insurance for his kids.

 

[Pepe18]

.

 

[Crayola227]

also ran across programs that made it clear if you were caught doing a goddamn thing that wasn't above board kosher i's and t's on moonlighting your ass was grass, meaning you were done with training at that program and immediately fired

life being what it is I think it's silly for a resident to budget based off anything but base salary

policies change people die

OP - I didn't pay attention to the numbers ITT for you.
I know that as a single person in need of good health insurance benefits, I had to think about what you're thinking about.

 

[235009]

life being what it is I think it's silly for a resident to budget based off anything but base salary

Agree with this, especially when you're a resident. I know I certainly went into residency with thoughts of moonlighting but never ended up doing it. Time is very limited and there's a pretty significant financial barrier to getting licensed (especially if you're not going to be moving on to fellowship in a different state). Definitely only budget based on your resident salary.


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[futuremdforme]

Can't you sign up for an obamacare plan or shop around for something cheaper?

Or just take a couple thousand in loans out now that you could use to help get a head start on the costs....it's not the most financially smart thing to do, but the extra debt may be worth being in the program/location you want?

In the current economic climate, I would be hesitant to recommend long-term choices based on Obamacare.

To the OP, sorry you are in this position. I know other people who have had to make major career decisions based on family insurance. It is insane for organizations to lose out on top talent for this reason.

 

[Señor S]

I fear that making this decision solely based on health insurance costs doesn't take into account the bigger picture.

Kids are the "bigger picture."

 

[cbrons]

you were done with training at that program and immediately fired

Are you in IM?

 

[sazerac]

It is insane for organizations to lose out on top talent for this reason.

If an organization wants top talent doctors, they gotta pay in salary and/or benefits.

 

[Crayola227]

If an organization wants top talent doctors, they gotta pay in salary and/or benefits.

lol totally not how residency works

they have a total monopoly over the slaver's market

they have what you want - training, for which you need or your quarter million dollar degree is almost not worth the paper it's printed on

ACGME sets rules on the salaries for this reason, there's some ups/downs for COL, that's really it

the way that residencies "compete" for better residents is more to do with what name branding/fellowship placement they can give you, trying to offer good training, little perks like money for conferences, etc

they really only do that because sure, they don't want **** residents
at the end of the day though the most important to them is to fill their slots

 

[PL198]

If an organization wants top talent doctors, they gotta pay in salary and/or benefits.

Tell that to the NE

 

[sazerac]

lol totally not how residency works

they have a total monopoly over the slaver's market

they have what you want - training, for which you need or your quarter million dollar degree is almost not worth the paper it's printed on

ACGME sets rules on the salaries for this reason, there's some ups/downs for COL, that's really it

the way that residencies "compete" for better residents is more to do with what name branding/fellowship placement they can give you, trying to offer good training, little perks like money for conferences, etc

they really only do that because sure, they don't want **** residents
at the end of the day though the most important to them is to fill their slots

That's why I mentioned the benefits. Does the ACGME limit the benefits distributed to residents as well?

I interviewed at some programs where the health insurance for residents was so good it was better than what the attendings were getting. The attendings were jealous.

 

[Redpancreas]

Could you not look into the moonlighting opportunities at the programs you are interested in? Although I would assume you knew this based on the knowledge of the insurance plans. I'm surprised the costs are that different.

I don't think we should hyperfocus on moonlighting. Looking at it if you're at a 5 yr. residency that's 30K. You'll be earning quite a lot more after no matter what you're doing and where you train is a very important decision.


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[cbrons]

I don't think we should hyperfocus on moonlighting. Looking at it if you're at a 5 yr. residency that's 30K. You'll be earning quite a lot more after no matter what you're doing and where you train is a very important decision.


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You can make a lot more than that

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[futuremdforme]

I don't think we should hyperfocus on moonlighting. Looking at it if you're at a 5 yr. residency that's 30K. You'll be earning quite a lot more after no matter what you're doing and where you train is a very important decision.


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If he's in residency with a spouse and a kid, he doesn't have time to moonlight!

 

[quickfeet]

also ran across programs that made it clear if you were caught doing a goddamn thing that wasn't above board kosher i's and t's on moonlighting your ass was grass, meaning you were done with training at that program and immediately fired

life being what it is I think it's silly for a resident to budget based off anything but base salary

policies change people die

OP - I didn't pay attention to the numbers ITT for you.
I know that as a single person in need of good health insurance benefits, I had to think about what you're thinking about.

Are you a resident in internal medicine? Or what specialty are you in?

 

[mistafab]

That sounds sad OP.

I know you are looking after your family. It is true indeed that medicine calls for a lot of sacrifices. I can't imagine being a dad/mom and going through this near-decade of my life.