How do you manage to live with what you get?

[WhyMD]

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I am finishing 2nd year now and seriously thinking of changing to dental or something else due to my family's financial situation. My last push was when I read the article regarding the pending regulation that would prevent loan deferment during residency which would bring down the monthly spending money to mere $1300 or so. I just can't live with that having a dependent. And 3-4yrs of that appear too much misery.

Before I make my final decision, I want to know how you current residents are surviving with the money you bring home. My family is poor and unable to help.
Your honest sharing will be appreciated.

 

[zinjanthropus]

If the deferment option does not continue past 2009 (indications are that it likely WILL), then there will be an income sensitive 15% repayment on federal loans or a minimum of about $350. Thus, no matter what, you will still see more than $1300/month. Net income will likely be between $3100 - $3700 per month.

 

[Winged Scapula]

Agree with the above.

And as a word of advice, do not tell anyone you are helping your family out with your student loans. This is a violation of your loan agreement which states that the loans are only to be used for YOUR educational expenses.

 

[WhyMD]

Thank you for the caution.

Monthly spending money of $3100-3700 sounds much more hopeful than $1300. Certainly livable. That's a quote I got from a resident who expect that with about $200k loans we will have to pay around $1800/month if that regulation pass.

I thought all residents get the same pay but it seems there are about $600 differences depending on years and specialty?

 

[Winged Scapula]

Thank you for the caution.

Monthly spending money of $3100-3700 sounds much more hopeful than $1300. Certainly livable. That's a quote I got from a resident who expect that with about $200k loans we will have to pay around $1800/month if that regulation pass.

I do not believe it will pass either and even if it did, it would have to be income contingent. As it currently stands, even when you have to start paying it back, its a certain percentage of your take home salary. They cannot make you pay 50% of that (which seems to be what you estimating).

I thought all residents get the same pay but it seems there are about $600 differences depending on years and specialty?

All residents in the same hospital program, at the same PGY level, get the same pay. There is usually a salary increase each year as you move up in PGY level, which generally tends to be around $1000-$1500. So the surgery residents make the same as the Derm residents, year for year.

 

[sunlioness]

I thought all residents get the same pay but it seems there are about $600 differences depending on years and specialty?

It more varies by region, I think. A resident in L.A. or NYC will make more than a resident in Pittsburgh because the cost of living is so much higher. Though it can also vary among hospitals in the same city. For instance residents at UPMC make a bit more than residents at WPAHS though both are in Pittsburgh. But a 2nd year surgery resident at UPMC makes the same as a 2nd year pathology resident or psych or medicine or whatever. You generally do get an increase in your stipend every year such that you make more as a PGY-2 than as an intern.

 

[8744]

It more varies by region, I think. A resident in L.A. or NYC will make more than a resident in Pittsburgh because the cost of living is so much higher. Though it can also vary among hospitals in the same city. For instance residents at UPMC make a bit more than residents at WPAHS though both are in Pittsburgh. But a 2nd year surgery resident at UPMC makes the same as a 2nd year pathology resident or psych or medicine or whatever. You generally do get an increase in your stipend every year such that you make more as a PGY-2 than as an intern.

This is not true at all. With a few exceptions, resident pay doesn't vary that much.

 

[minstral]

Any NYC intern might make around 50k, I'll Make 45k in a very affordable midwest city.

5k more in NYC doesnt come close to covers the cost of living difference. Two post up is way off on their resident salary knowledge
My friend in Boston has a 600 sqrft aprt for $1500 a month
I have 1400 sqrft for 900... to give you an idea on cost of living at some places

 

[buckley]

About the salary differences, I was also quite surprised myself when I was on the interview trail. I got quotes as low as 38k and as high as 54k.

Someone did refer me to the cost-of-living calculator (just google it in) and apparently it is a huge factor. 40k in Omaha was almost 70k in LA. Something like that. Honestly though, I think "cost of living" still depends very much on your lifestyle.

As for whether or not you stick it out in medicine, I only know that return-of-investment is very long in this field, depending on your specialty. You won't go hungry but you won't be living in luxury til quite some time either. My highschool buddies who went into IT, media, etc. are definitely raking in much more than me, and that will continue on for a few more years. Still, this is what I want to do, so that's why I'm sticking with it. I think you will find that the US set up with residency is actually much nicer compared to many other countries, and that is why people are flocking here.

But I really cannot fathom how expensive some of your medical schools are.

 

[DrDawg]

I am finishing 2nd year now and seriously thinking of changing to dental or something else due to my family's financial situation. My last push was when I read the article regarding the pending regulation that would prevent loan deferment during residency which would bring down the monthly spending money to mere $1300 or so. I just can't live with that having a dependent. And 3-4yrs of that appear too much misery.

Before I make my final decision, I want to know how you current residents are surviving with the money you bring home. My family is poor and unable to help.
Your honest sharing will be appreciated.

Would your credits transfer to dental?

As Zin and WS pointout your Net income will be between $3k and $4k, but your take home will between $2.5k and $3k depending on how you file your taxes. Your orginal post asked about spending money, and didn't want there to be confusion.

 

[kirurg]

The anesthesia residents at my school get paid overtime whenever they are in the hospital past 5pm. Although their base salaries are equivalent to residents of other specialties, they take home almost double.

 

[WhyMD]

.

 

[Doowai]

When talking to friends outside of medicine, always remember money is a sensitive issue. We can complain that for a few years we must try to live on $42-54,000 (before getting our real salary), but for many that is their real salary.

http://msn.careerbuilder.com/custom...6d610fbfac4d73a61d16b520ea0e1e-264600207-X7-2 Many with degrees in economics or engineering are salaried at $42-52K.

I learned this lesson years ago, when I mentioned I was saving about $3000 a month as a chiropractor, without realizing my best friend who I was talking to was not making $3000 a month.

It works the other way too. My salary when I was teaching these last two years sucked. In fact they just paid me in coupons they clipped from the Sunday paper - like 10 cents off of tuna at Sams club, or 2 for 1 on ice cream cones at Safeway. When talking about how little I was making, it made some people uncomfortable who were making much more. Disparity in incomes creates dis-ease (to borrow a chiropractic term), whether you are making much more or much less.

 

[Doowai]

This is not true at all. With a few exceptions, resident pay doesn't vary that much.

I don't know, for example I interviewed at 2 places in Ohio. I am speaking off the top of my head but this is close : family medicine residency in Wilmington (population 12,000 , VERY affordable) paid around $54K plus a savings plan, which could result in something like $15,000 by the end of residency in the bank saved up (plus 4 weeks of vacation - 28 days, with a week of paid education from year one). Youngstown Ohio , paid $42,000 plus no real savings etc. That is $12,000 within the same state.

 

[AwesomO]

Even if you aren't given a deferment you are guaranteed to be granted forbearance during residency. The difference being that your subsidized loans will gain interest where as in deferment they would not have. So you will not have to repay your loans until you are done with residency.

 

[Dr Serenity]

Even if you aren't given a deferment you are guaranteed to be granted forbearance during residency. The difference being that your subsidized loans will gain interest where as in deferment they would not have. So you will not have to repay your loans until you are done with residency.

This is a key thing to remember, even if the economic hardship deferment option goes away for residents. For lenders of federal loans, forbearance is MANDATORY (ie, they have to grant it if you request it) during your residency.

The main downside to deferment going away is interest accruing on your subsidized loans (as well as the unsubsidized)...this interest can be capitalized as often as quarterly. However, for most residents, not having to pay on your loans (even with accruing interest) on a meager resident's salary beats having to eat ramen noodles for 3-7 years.

 

[WhyMD]

Fed subsidized loan is only half of my loans. And there is limit to the length of forbearance I think, at least for private loans. Not so comforting when I'm trying to maximize monthly income.

 

[zinjanthropus]

Fed subsidized loan is only half of my loans. And there is limit to the length of forbearance I think, at least for private loans. Not so comforting when I'm trying to maximize monthly income.

Are you at a U.S. allopathic school? I think you need to sit down and have a discussion with your Dean of Student Affairs. Your understanding of your current and future financial picture sounds skewed.

 

[hippiedoc13]

Even if you aren't given a deferment you are guaranteed to be granted forbearance during residency. The difference being that your subsidized loans will gain interest where as in deferment they would not have. So you will not have to repay your loans until you are done with residency.

This runs exactly opposite to what I was told by my financial aid counselor during my loan exit counseling. He said that (according to the current laws) you have a right to deferment during residency (provided you meet the income/debt ratio qualifications), but forbearance is up to the lender.

 

[hippiedoc13]

A resident in L.A. or NYC will make more than a resident in Pittsburgh because the cost of living is so much higher.

This is absolutely incorrect. I interviewed at UPMC and the resident salary was higher than most of the programs I interviewed at in California...and the cost of living is waaaay higher in CA. If I was moving to Pittsburgh, I'd be able to buy a decent house on my resident salary. In California, I can only afford to rent a one-bedroom apartment.

 

[WhyMD]

Are you at a U.S. allopathic school? I think you need to sit down and have a discussion with your Dean of Student Affairs. Your understanding of your current and future financial picture sounds skewed.

I'm meeting with him after the last finals this Fri. Hopefully I will get a more realistic picture. Yes, I go to a US allopathic school ranked in top 10 according to the meaningless Newsweek. But you know what you are going through, how much you are taking home and you have a better view of what life is like in medicine ahead. That's why I am asking here. The dean may paint a rose picture to keep me. I would like to stay if I could. I must also mention that I am much older than most med students.

 

[Dr Serenity]

This runs exactly opposite to what I was told by my financial aid counselor during my loan exit counseling. He said that (according to the current laws) you have a right to deferment during residency (provided you meet the income/debt ratio qualifications), but forbearance is up to the lender.

I recently underwent my loan exit counseling...according to my counselor, residency forbearance for federal loans is mandatory; that is, the lender of your federal loans must grant it to you. One caveat...you need to be sure to specify residency forbearance when you request a forbearance, since different types of forbearance do exist. You have a right to residency forbearance for the length of your residency...there are time limits on other types of forbearance.

Another caveat...I don't know what forbearance terms are for private loans...I guess that depends on the lender.

As far as an economic hardship deferment for federal loans is concerned, the time limit on that is 3 years. After that, you can only request forbearance. Now, I say that assuming that Congress will reinstate the 20/220 formula such that it won't be eliminated in 2009 (which is something I cannot, unfortunately, guarantee).

Anywhoo, a big take-home point from what I've said above is that residents do not have to make payments on federal loans during residency. Again, with private loans, it may be a different story...I wouldn't know that much about private loans, since I (fortunately) didn't need to use them to finance my medical education.

 

[gutonc]

This is not true at all. With a few exceptions, resident pay doesn't vary that much.

To look at 2 examples of states that have, overall the highest cost of living, CA and NY, using imperfect (but likely universally imperfect) FRIEDA data, PGY1 IM salaries vary quite a bit:

CA: $36565 - 50100 (w/ the bulk of programs falling in the $40-44K region)
NY: $39800 - 55000 (the majority of programs fall in the mid-$40K area, interestingly, neither the high or low are in NYC)

In general, salaries at programs tend to bunch together in a given area or given "level" of program but there are clearly huge tails on the curves in both directions.

Having said all that, if you let base salary, above all else, be what determines where you apply for and rank residencies you will (and IMHO deserve to) be miserable for your 3-5+ years there.

 

[BlondeDocteur]

To WhyMD--
Your situation does indeed sound very difficult, and my heart goes out to you trying to support your mother and sister. I will say this though-- if your family's income is low enough to qualify for food stamps, your resident's salary will be quite a boon to them. As many people above pointed out, you can expect to make at least $40,000 a year as a resident. The average income in America for a family of four is $38,000 a year. Your resident's salary, as injust as it might seem for your level of education and years of sacrifice, will put your family smack in the middle class.

If you quit now to teach and apply to dental school it will be at least five years before you will see any income (1 year teaching/ applying + 4 years dental school). If you power through third and fourth year, then do a short residency, that will be five years as well. You will make a middle class income in two years, and you will make an upper middle class income in five.

Some dentists do make a good deal of money, but the average dentist who graduates in this country starts out their first couple years of practice to the tune of $50,000 a year. As they "build their practice"-- something you do NOT have to do in medicine-- their reimbursements gradually increase to six figures.

Someone at this junction will rush in to point out that their friend so-and-so who is an oral surgeon has a cash only practice and makes $1 million a year, or their endodontist who works 30 hours a week and makes $600K. Yes, those people are out there, but they went through competitive residencies and do not represent the average DDS.

So I'd say, don't throw away the two years of school-- two years for which you will have to repay your loans-- that you already have under your belt. In two short years you'll be able to provide for your mother and sister.

Also, as an aside, if your family income is this low, surely you qualify for a good deal of grants that you don't have to pay back? Your loan burden shouldn't be too steep, right?

 

[deleted109597]

When talking to friends outside of medicine, always remember money is a sensitive issue. We can complain that for a few years we must try to live on $42-54,000 (before getting our real salary), but for many that is their real salary.

That's why you always preface it with "the quarter of a million dollars I have in student loans".

 

[Pir8DeacDoc]

Net income will likely be between $3100 - $3700 per month.

Not sure where you are a resident but that's a pretty hefty number.


I live in a state without income tax and still don't bring home close to that number. I think I get around 1400 or so every two weeks.

 

[Coastie]

If the deferment option does not continue past 2009 (indications are that it likely WILL), then there will be an income sensitive 15% repayment on federal loans or a minimum of about $350. Thus, no matter what, you will still see more than $1300/month. Net income will likely be between $3100 - $3700 per month.

Net income that high for a resident? Maybe PGY5.

You must be getting paid alot in a state without income tax.

 

[MSHell]

People are confusing net vs. gross.

The "$3100 - $3700" I see is most probably gross (multiply by 12 and see for yourselves).

 

[zinjanthropus]

People are confusing net vs. gross.

The "$3100 - $3700" I see is most probably gross (multiply by 12 and see for yourselves).

Net probably more like $2500 - $3000 and gross more like $3500 - $4000. My apologies for the earlier error.

PGY-1 here gets 44K a year and that equates to a net of about $2600/month.

 

[WhyMD]

Thank you all for sharing the info.

I've made my decision. With my mental and physical capacity I feel I can offer much better living condition to my family and my future family than what I can offer by staying in medicine.

Medicine is a great profession undoubtedly if done for the sake of advancing knowledge and service to people primarily. It's not good as a means of living, at least not practical to people like me.

Maybe I will come back later and work as a PCP when I've taken cared of my financial situation just to help out the country's medical crisis.

 

[Pinkertinkle]

Maybe you shoulda thought about this before you started medical school huh?

 

[Danbo1957]

Standard basic pay at UT Southwestern in Dallas, Baylor in Houston, internal medicine:

PGY-1 $41,674.00 - $43,221

PGY-2 $43,051.00 - $44,840

PGY-3 $44,804.00 - $46,054

PGY-4 $46,593.00 - $47,913

 

[razorback58]

I would think this would be for NEW loans and not those existing at present. If the new law passes I would think they would have to honor the contract and agreement you signed when you took out your loan. Any new loans could be subject to the new rules - if they pass.

I would not worry and go forth in residency. I know after health insurance and taxes I only get about $1300 every two weeks.

As far as helping ourtyour family on student loans as previously posted. If that be an actual fact, then why do they give more loans to people with dependents and low income or unemployed spouses.

If anything, I think they will let your defer your loans only your interest with start accuring instead of being paid by the government during deferrment. But again, I think that should apply only to NEW loans - otherwise it would be illegal create a new law and make it retro-active - this is called ex-post factor.