How comfortable is residency pay?

[JamaicanHerb]

I know the first thing you are thinking is, "Well it depends where you live." Ok forget about the difference between big cities and small cities/rural.

The average range I've seen on the trail is mid-low 50s with benefits. How comfortable are residents feeling with these pay and benefits/stipends?

Do you feel strapped for cash after spending 1500ish (about what i plan to spend on housing) and few hundred a month for a car?

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[Tenk]

It is fine because you will be working all the time and won't have time to spend money anyways.

 

[Ismet]

I live quite comfortably, but I live in a relatively cheaper area and also take full advantage of the meal stipend we're given at the hospital. I put plenty into savings and I'm not hurting for money to do things I want to do, but granted I don't do extravagant things like super expensive meals or expensive trips.

I spend ~$1000/month for rent and utilities, which is roughly 1/3 of my take-home pay for the month. You'll also eventually be factoring in loan repayment.

 

[neusu]

Yes, you will feel strapped for cash. No, you won't have much time to notice it. No, there is nothing you can do to change the situation.

 

[cbrons]

I know the first thing you are thinking is, "Well it depends where you live." Ok forget about the difference between big cities and small cities/rural.

The average range I've seen on the trail is mid-low 50s with benefits. How comfortable are residents feeling with these pay and benefits/stipends?

Do you feel strapped for cash after spending 1500ish (about what i plan to spend on housing) and few hundred a month for a car?

How good are the benefits though. Heard from one chief resident that she couldnt even afford the university's health insurance for her husband and son.

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[Ismet]

How good are the benefits though. Heard from one chief resident that she couldnt even afford the university's health insurance for her husband and son.

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Will vary by institution. The insurance through my residency institution is quite good and isn't expensive, I think between health, vision, and dental I pay maybe $80 per pay period. I do have a high deductible but I'm healthy and preventive visits are 100% covered, excellent dental and vision coverage so I can actually go to the eye doctor now and not pay OOP for once. I'm also single and non-smoker so that makes it cheaper as well. Family plans are more expensive.

 

[SurfingDoctor]

GME pays about what the median household income is in the US. By that metric, residents live "well". However, residents also have to usually deal with excessive educational debt. Now, if you went to a state school or went the MD/PhD route and have limited debt it is not an issue, but if you didn't... well you just have to be very conscious of what you spend. You may be able to justify deferment for your loans if you are lucky, or forbearance if you are less lucky to put off paying some of that debt. There is also the Income Based Repayment which is a new thing that income adjusts your payments. It is not unlivable (because every resident does it), but you're not going to be living the life of luxury. It will never be that residents or fellows make a poor salary, they just have more educational expenses (and thus the latter is what needs to be addressed, not the former).

 

[takeurmeds02]

GME pays about what the median household income is in the US. By that metric, residents live "well". However, residents also have to usually deal with excessive educational debt. Now, if you went to a state school or went the MD/PhD route and have limited debt it is not an issue, but if you didn't... well you just have to be very conscious of what you spend. You may be able to justify deferment for your loans if you are lucky, or forbearance if you are less lucky to put off paying some of that debt. There is also the Income Based Repayment which is a new thing that income adjusts your payments. It is not unlivable (because every resident does it), but you're not going to be living the life of luxury. It will never be that residents or fellows make a poor salary, they just have more educational expenses (and thus the latter is what needs to be addressed, not the former).

Honestly, I'm just tired of being medstudent-dirt poor...and it's only my first year. *sigh*

 

[witzelsucht]

im in a suburban-ish program. i get by with a wife who doesn't work and has some medical problems which require some out of pocket spending. its tight but doable. if i werent married id be eating takeout every night and taking rando 3 day vacations like my dumb facebook friends. ugh. i have to get rid of facebook

 

[cowme]

It's comfortable.

If you live in San Francisco or New York it won't be.

If you have kids and a stay at home wife it will be tight

If you are an idiot with money and drive a BMW or rent a penthouse apartment, it will be tight.

Otherwise, just learn to budget and find ways to pay off loans and save/invest.

 

[mimelim]

Was fine until we started family planning.

 

[mvenus929]

I live comfortably and am able to pay off small amounts of one of my loans. You just have to budget well. Give yourself some extra spending money compared to Med school, and build a budget.

 

[Moose A Moose]

Federal loans allow continued deferment during residency. On top of that, you can qualify for IBR.

I don't think the ship could get much tighter than it is now- I depend on Uncle Sam to get by, and it's no where near 'residency salary'. I'm gonna feel like I'm living high on the hog.

 

[timetraveling]

The way I think about it, my mom makes around that. I never struggled for anything. Things will be fine.

 

[Stagg737]

The way I think about it, my mom makes around that. I never struggled for anything. Things will be fine.

I'm guessing your mom also didn't have $200k+ in debt to pay off while she was raising you. Not exactly the same situation (though doable either way).

im in a suburban-ish program. i get by with a wife who doesn't work and has some medical problems which require some out of pocket spending. its tight but doable. if i werent married id be eating takeout every night and taking rando 3 day vacations like my dumb facebook friends. ugh. i have to get rid of facebook

Was fine until we started family planning.

To the people with families going through residency, how much are you budgeting towards your family? Do you moonlight to help the budget, and if yes how much do you moonlight and how much extra do you pull in? I'm married and am wondering since we will likely be starting a family around first year of residency, so I'm curious as to how those that have done/are doing it make it work if your spouse isn't working.

 

[cowme]

Federal loans allow continued deferment during residency. On top of that, you can qualify for IBR.

if you defer, be sure to at least pay off the yearly interest. It's a tax benefit, and will help with credit scores,which will be huge when you refinance as an attending. Otherwise, your loans are going to spiral out of control.

Also, If your residency offers a 401k match, make sure you put enough away to get the full match. It's free money.

 

[Ismet]

Federal loans allow continued deferment during residency. On top of that, you can qualify for IBR.

I don't think the ship could get much tighter than it is now- I depend on Uncle Sam to get by, and it's no where near 'residency salary'. I'm gonna feel like I'm living high on the hog.

You really should make payments. With IBR you get loan forgiveness after 20-25 years of payments. You may be able to pay it all off sooner depending on your debt load and your salary as an attending, but might as well start chipping away at it instead of deferring and letting it sit there accruing interest and getting even more massive for 3+ years. Unless you're living in NYC or San Fran, or trying to support a whole family on a resident salary, you should be able to afford a payment that's 10% of your income.

 

[saveourpens]

I'm sure you and me will be fine and comfortable making the "median household income". Working for what amounts to about $15 /hour is another story.

 

[witzelsucht]

To the people with families going through residency, how much are you budgeting towards your family? Do you moonlight to help the budget, and if yes how much do you moonlight and how much extra do you pull in? I'm married and am wondering since we will likely be starting a family around first year of residency, so I'm curious as to how those that have done/are doing it make it work if your spouse isn't working.

I don't moonlight. There's a few people in my program who have either fetuses or babies, and they all seem to have some combo of family money or relatively high income spouse (attorney, pharmD, etc). I don;t see how a one-resident income + stay at home wife + baby would work unless you were in a truly rural program with $600 apartments. Maybe if you can get on WIC or have super subsidized childcare at work but I imagine residnecy income is too high.

 

[SansaStarkMD]

Anymore residents with a family care to chime in?

 

[Bancrofti]

if you defer, be sure to at least pay off the yearly interest. It's a tax benefit, and will help with credit scores,which will be huge when you refinance as an attending. Otherwise, your loans are going to spiral out of control.

Also, If your residency offers a 401k match, make sure you put enough away to get the full match. It's free money.

So... say we went to a private college and then an expensive med school and will have well over 300k in debt.
Would income based repayment be the way to go? If I was to do interest only on my loans, it looks like I'd probably end up paying my whole net salary in loans, so obviously that wouldn't really be feasible. So it would be IRB or defer completely?

 

[Promethean]

It depends on what you are used to. $1500 a month is twice my mortgage on a 3 story house in an acceptable working-class neighborhood 6 blocks from the hospital that I used to work at. My car is paid off. I can live really well what you plan to spend for rent. Residency pay is going to be amazing for me.

Residents are basically paid the median household income. If you live modestly, you will have more than you need. If you try to live larger than your income, it isn't going to be enough.

 

[Promethean]

I don't moonlight. There's a few people in my program who have either fetuses or babies, and they all seem to have some combo of family money or relatively high income spouse (attorney, pharmD, etc). I don;t see how a one-resident income + stay at home wife + baby would work unless you were in a truly rural program with $600 apartments. Maybe if you can get on WIC or have super subsidized childcare at work but I imagine residnecy income is too high.

A stay at home spouse means no child care bills. It means no need for an expensive work wardrobe, or high transportation costs, or lots of fast food meals. Stay at home spouses can do much to stretch income by controlling expenses, if they are so inclined.

A great many families live on under $50k with both parents working, and don't get WIC or other benefits. Especially since it is a time-bound period in your life, which you can expect to be followed by considerably higher income, it isn't as if you'd be expecting your family to live as merely middle class forever.

 

[Postictal Raiden]

How much do health insurance premiums cost for a resident + spouse + children?

 

[AlteredScale]

Was fine until we started family planning.

Well damn. That's when I was planning to start that.


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[NickNaylor]

Depends on where you're going to be. In some places (e.g., California), even though the resident salaries might be nominally higher than in other areas, the COL is so insanely high that you will be living relatively poorly.

I live in Texas, which has a pretty low COL. I'm also married to a woman that makes more than me, which is a nice plus. We were able to buy a ~$210k house this past year and still live comfortably while paying off student loans and our usual costs of surviving. Sure, we're not living a life of luxury, but it's certainly a life of comfort. There would be no way that we would be able to afford that standard of living if we were living in a high COL area - e.g., California, New England, any large metro area, etc..

You will not be starving as a resident. However, you can be more or less comfortable depending on your specific financial situation and the COL of the area that you move to.

 

[surfguy84]

im in a suburban-ish program. i get by with a wife who doesn't work and has some medical problems which require some out of pocket spending. its tight but doable. if i werent married id be eating takeout every night and taking rando 3 day vacations like my dumb facebook friends. ugh. i have to get rid of facebook

or your wife.

I kid. but seriously, Facebook is the absolute worst...I was just reading something about this the other day.

 

[Perrotfish]

The average range I've seen on the trail is mid-low 50s with benefits. How comfortable are residents feeling with these pay and benefits/stipends?

Medicare, or Medicaid for Pediatrics residents, directly reimburses residencies for up to about 50K of a Resident's salary, in addition to paying a 'tuition' of up to 70k/year per resident. The tuition they pay varies with the institution, but the amount they will reimburse up to does not vary that much. So everyone in residency, whether in downtown New York or Rural Iowa, makes about 50K/year. The 'benifits', beyond health insurance, usually are no more than a few hundred dollars/year of free food

Since the salary doesn't vary, all that will change is your expenses. So how it feels depends 100% on what housing costs in your area. If you live in NY/DC/Silicon valley you are going to feel quite poor in your 2500/month single bedroom apartment. If you live in a less popular mid sized city you will feel alright in your 1,500/month 1 bedroom apartment. If you do an FM residency in the sticks you are going to feel pretty wealthy in your $800/month 3 bedroom house.

 

[Zedor]

Medicare, or Medicaid for Pediatrics residents, directly reimburses residencies for up to about 50K of a Resident's salary, in addition to paying a 'tuition' of up to 70k/year per resident. The tuition they pay varies with the institution, but the amount they will reimburse up to does not vary that much. So everyone in residency, whether in downtown New York or Rural Iowa, makes about 50K/year. The 'benifits', beyond health insurance, usually are no more than a few hundred dollars/year of free food

Since the salary doesn't vary, all that will change is your expenses. So how it feels depends 100% on what housing costs in your area. If you live in NY/DC/Silicon valley you are going to feel quite poor in your 2500/month single bedroom apartment. If you live in a less popular mid sized city you will feel alright in your 1,500/month 1 bedroom apartment. If you do an FM residency in the sticks you are going to feel pretty wealthy in your $800/month 3 bedroom house.

This bolded is not true.

Par example, North Shore LIJ:

Program level Base salary
PGY-1: $67,000
PGY-2: $69,000
PGY-3: $71,000
PGY-4: $72,500
PGY-5 $74,000
PGY-6: $75,500
PGY-7: $77,000
PGY-8: $78,500

Source: https://www.northwell.edu/research-and-education/graduate-medical-education/benefits-compensation

 

[the argus]

To the people with families going through residency, how much are you budgeting towards your family? Do you moonlight to help the budget, and if yes how much do you moonlight and how much extra do you pull in? I'm married and am wondering since we will likely be starting a family around first year of residency, so I'm curious as to how those that have done/are doing it make it work if your spouse isn't working.

How much do health insurance premiums cost for a resident + spouse + children?

I'm a PGY2 in a relatively expensive state at a program with strong benefits.

My wife was working until we had a kid and since then we've been solely living off my paycheck. It's definitely doable and we have all the normal expenses (home, car, student loans for both of us, etc), although now we are basically breaking even most months.

I pay ~$200/month pretax for medical/dental for everyone. Most of that is for medical for the wife and kid, a small amount is for dental which is not covered in my base benefits. My entire medical is basically covered as part of my benefits.

People have different philosophies on this, but my opinion is that residency is not the time to worry about saving money (with the exception being if your program offers matched funds to a retirement account, which my program doesn't). The pay increase once you become an attending is so substantial that any amount put away during residency is almost inconsequential compared to your attending earnings. It's realistic to put away ~$100K/year for a few years if you're willing to continue a frugal lifestyle after residency, whereas putting away even $30-40K total during residency would be pretty difficult for most people.

 

[eefen]

How much do health insurance premiums cost for a resident + spouse + children?

It depends on the program. Some of the programs I've interviewed at cover literally everything or almost everything (medical +/- dental and vision for you and dependents), many are shared (which can range from anything to $500/mo for a family).

People have different philosophies on this, but my opinion is that residency is not the time to worry about saving money (with the exception being if your program offers matched funds to a retirement account, which my program doesn't). The pay increase once you become an attending is so substantial that any amount put away during residency is almost inconsequential compared to your attending earnings. It's realistic to put away ~$100K/year for a few years if you're willing to continue a frugal lifestyle after residency, whereas putting away even $30-40K total during residency would be pretty difficult for most people.

Practically speaking, I agree with you. One thing to consider is saving at least a nominal amount each month to develop the habit of putting something away. It is easy to keep delaying things (I'll start saving once I'm done with X - residency, fellowship, paying of loans, then paying off mortgage/car/etc.) and realize you are now 40 and have very little in the way of retirement savings. Starting with at least a nominal amount each month makes it easier to continue and expand that habit once your income increases.

That's fairly theoretical, though. Once you add things like a stay at home spouse + kids into the mix, I know how things can change and it really does become more about just trying to break even.

Another thing to consider if you have dependents, as I think someone mentioned, is where to decide to do residency. Obviously this is likely not going to be the primary consideration, but doing residency in a city like New York or San Francisco may be less of a good idea if money is tight as it is, whereas completing residency in a state with no income tax and lucrative moonlighting opportunities and a low COL might dramatically change the day-to-day standard of life for your family.

 

[psychMDhopefully]

im in a suburban-ish program. i get by with a wife who doesn't work and has some medical problems which require some out of pocket spending. its tight but doable. if i werent married id be eating takeout every night and taking rando 3 day vacations like my dumb facebook friends. ugh. i have to get rid of facebook

Tell your wife to get a job, that should fix things.

 

[mvenus929]

Tell your wife to get a job, that should fix things.

Where I live, childcare for two children is essentially equivalent to a resident's salary. If the other spouse isn't going to make at least that, it's not financially worth it to go to work.

 

[MackandBlues]

So those thinking of family planning - make sure you research childcare costs such as daycare in your future area into your budget. A two month old baby in day care is going to cost $1000 a month (Houston) initially then it will gradually decrease as the baby gets older.

 

[mimelim]

I'm guessing your mom also didn't have $200k+ in debt to pay off while she was raising you. Not exactly the same situation (though doable either way).





To the people with families going through residency, how much are you budgeting towards your family? Do you moonlight to help the budget, and if yes how much do you moonlight and how much extra do you pull in? I'm married and am wondering since we will likely be starting a family around first year of residency, so I'm curious as to how those that have done/are doing it make it work if your spouse isn't working.

Anymore residents with a family care to chime in?

I do consulting work that pays about the same as moonlighting, but is obviously a lot more flexible. I have not moonlighted, primarily because I have essentially another well paying job. I enjoy the other work and since it is directly tied to what I do in medicine, it is something that I would have done a little of even if they didn't pay me. However, if we weren't saving for family, I probably wouldn't be doing it. As many people have found, despite our best laid plans, unexpected family emergencies and medical expenses ate away quickly at the little we were saving from my resident salary. I make in the ballpark of an extra $1500/month.

Tell your wife to get a job, that should fix things.

I obviously don't know you, but just a word to the wise. There are a lot of reasons why people don't work. Medical reasons, especially psychological ones are a very real burden on many families out there. Given your user name, I will simply say, I would be very careful about how you say such things and how you judge other's home situations.

 

[Donald Juan]

I find my resident salary quite comfortable. I've had many jobs before college and med school, and I make more money now than I ever did before, and a decent bit more than when I was living off of loans throughout college and med school. Yes, I have the debt, but with the repaye options, I currently pay $0. Next year, my payments will go up to about $60/mo, and the year after that they will be about $260/mo. But, by that time I will make about $5000 more per year, and they will keep halfing my interest (which is nearly $20 grand/year).

 

[tco]

If you're single and avoid one of the really expensive cities, you'll be fine. It's up to you if you want to do IBR and draw out the pain/cost of repaying loans. I definitely did. My logic was, "What if something happens to me when I'm 35?" I wanted to live life - buy stupid things and take trips - rather than the responsible thing. I still pay more than is required per income based repayment, and I still save for retirement, but I go out on days off, I make trips, and I bought a new car. Plus, I live in a nice apartment.

I also had less debt than most when starting (90k), so I'll have less compound interest when I eventually do pay off the loans completely.

 

[Wordead]

I live in a mid-size city and as a PGY1 I put away ~17K in savings. This year should be about the same because even though I'm paying more in IBR I got a fairly sizeable raise.

I would say I spend pretty lavishly when I go out though I do not have any children or a spouse to support.