I need some advice on picking the right residency program

[deleted314290]

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Greetings everyone, this board has been a wealth of information and I am thankful for all the regular contributors here. I have a bit of a dilemma that maybe someone could help me with. As it stands, I feel that I could match to my top choice for residency in California. The program seems to have everything I am looking for in a program top to bottom...I am interested in them and they seem interested in me. On a strictly academic/professional level I would be completely happy with this program but I cant say the same on a personal/family level. My biggest concern is that we would have to move and its not cheap. I tried to crunch numbers and rent would be approximately 75% of my 1st year salary (Almost 2-3x more than my current rent). I wouldnt be able to moonlight until my second year (and I am unsure of exactly how much it pays). I would be bringing my family out there so part of me is screaming dont do it you idiot! We would be relocating, downsizing, and losing my wife's income since she would have to quit her job (I dont anticipate her finding a new job very fast). On the other hand, I could probably stay at my home institution however it wont afford me the same opportunities. I would essentially have to blaze my own path with regards to getting involved with projects and research. Rent would be about 25% of my 1st year salary so we could live comfortably. We would also be close to family, which is important to me. I would essentially be giving up professional needs in order to appease my family/personal needs...which causes me some anguish. If I were single/younger I wouldnt think twice. What would you do in this situation? Should I be selfish and go for the awesome program but financially strain my family? or should I stay put and live comfortably but not have as many professional opportunities? I am split both ways. Thanks for any insight.

 

[Psychotic]

Greetings everyone, this board has been a wealth of information and I am thankful for all the regular contributors here. I have a bit of a dilemma that maybe someone could help me with. As it stands, I feel that I could match to my top choice for residency in California. The program seems to have everything I am looking for in a program top to bottom...I am interested in them and they seem interested in me. On a strictly academic/professional level I would be completely happy with this program but I cant say the same on a personal/family level. My biggest concern is that we would have to move and its not cheap. I tried to crunch numbers and rent would be approximately 75% of my 1st year salary (Almost 2-3x more than my current rent). I wouldnt be able to moonlight until my second year (and I am unsure of exactly how much it pays). I would be bringing my family out there so part of me is screaming dont do it you idiot! We would be relocating, downsizing, and losing my wife's income since she would have to quit her job (I dont anticipate her finding a new job very fast). On the other hand, I could probably stay at my home institution however it wont afford me the same opportunities. I would essentially have to blaze my own path with regards to getting involved with projects and research. Rent would be about 25% of my 1st year salary so we could live comfortably. We would also be close to family, which is important to me. I would essentially be giving up professional needs in order to appease my family/personal needs...which causes me some anguish. If I were single/younger I wouldnt think twice. What would you do in this situation? Should I be selfish and go for the awesome program but financially strain my family? or should I stay put and live comfortably but not have as many professional opportunities? I am split both ways. Thanks for any insight.

Unless there is something manifestly wrong with your home program (malignant, the people suck), you can achieve the same career goals and can make the same academic/research opportunities for yourself there as you could at the far more expensive place. Also, have you factored in paying off any college/med school debt? Even if you have somehow magically arrived at this place in your life with zero debt, you still owe it to yourself to protect your family from this financial hole. But if like most of us you also have student debt to pay off, well this is a no brainer.

Plus, there is always the fellowship opportunity at the fancy institution that could further your academic/research ambitions assuming that still matters to you in 3 or 4 years.

 

[OldPsychDoc]

All things considered, programs are more alike than they are different. Families on the other hand...
I moved my wife & 2 kids across 4 states for residency. I loved my program, and to some extent my home program was fairly dysfunctional at that time. But the emotional toll was pretty high, and the economic expenses didn't help (pretty much half of my take-home on the mortgage...no job for wife...3rd kid...). We survived, somehow, and did enjoy ourselves in those 5 years enough that we were sad to leave there when the job brought us back, but we're really happy to be back "home" now. (I should also add that my career goals changed during residency. Maybe yours might, too. The things that took me to my residency program were not the things that I stuck with, career-wise.)

Happy wife = happy life. Easy access to grandparents: very important.
High Class Institutional Name on diploma: not so much--unless you have some irrevocably strong internal sense of being called to a high-powered academic career as the most important thing you can imagine for your future life happiness.

 

[psychattending]

You have a tough choice to make. In general I recommend to my students that they go with the better academic place since it leaves more options open and prepares one better. Then after finishing residency, they can then move to where ever they want to practice. However, if rent is going to eat up 75% of your salary, it is not clear to me how you will be able to meet your other expenses on just 25% of your salary.

 

[Nasrudin]

It's a good topic. I'm also weighing economic leverage and trying to counter-balance expensive locations. With a smaller dose of program strength consideration and no kids in the mix. I have seen researchers blazing their own paths at less academic programs. Think of the extra time you will have to do so when your fully operational support system has you doing what you want instead of scrambling to moonlight in order to break even. But...I understand the allure of program strengths hitting your points of interest....so best of luck.

 

[deleted314290]

Thanks for replying all. I will also have outstanding student loans so yes that's even another factor. Those are all very good points/advice so I will continue to digest them. Thanks again.

 

[SteinUmStein]

I will second happy wife = happy life. Have you tried asking her what she wants to do and where she wants to live? I found a useful exercise was having my spouse fill out a rank list of the programs I interviewed at with the only considerations being her career and her quality of life/city preference. It was really helpful to see that list and understand what SHE would be sacrificing for certain programs. Just based on what you posted here I think your home program is a slam dunk but you BOTH need to be happy with the decision you are making. As you well know, once you have a family it's no longer just about you and your career. You'll be able to provide for them no matter where you go.

 

[SmallBird]

Greetings everyone, this board has been a wealth of information and I am thankful for all the regular contributors here. I have a bit of a dilemma that maybe someone could help me with. As it stands, I feel that I could match to my top choice for residency in California. The program seems to have everything I am looking for in a program top to bottom...I am interested in them and they seem interested in me. On a strictly academic/professional level I would be completely happy with this program but I cant say the same on a personal/family level. My biggest concern is that we would have to move and its not cheap. I tried to crunch numbers and rent would be approximately 75% of my 1st year salary (Almost 2-3x more than my current rent). I wouldnt be able to moonlight until my second year (and I am unsure of exactly how much it pays). I would be bringing my family out there so part of me is screaming dont do it you idiot! We would be relocating, downsizing, and losing my wife's income since she would have to quit her job (I dont anticipate her finding a new job very fast). On the other hand, I could probably stay at my home institution however it wont afford me the same opportunities. I would essentially have to blaze my own path with regards to getting involved with projects and research. Rent would be about 25% of my 1st year salary so we could live comfortably. We would also be close to family, which is important to me. I would essentially be giving up professional needs in order to appease my family/personal needs...which causes me some anguish. If I were single/younger I wouldnt think twice. What would you do in this situation? Should I be selfish and go for the awesome program but financially strain my family? or should I stay put and live comfortably but not have as many professional opportunities? I am split both ways. Thanks for any insight.

If you don't mind me asking, how does rent end up being such an expense? Have you spoke not to other residents in the program about where they have been able to find affordable housing?

Good luck!

 

[Nasrudin]

If you don't mind me asking, how does rent end up being such an expense? Have you spoke not to other residents in the program about where they have been able to find affordable housing?

Good luck!

Smaller, geographically confined area that is highly desirable like San Francisco, NYC, or even less expensive places. It happens. Particularly when you have 5 people or so to house. What's complicated?

 

[deleted314290]

The program is in the Bay Area so you are paying approx $3000-$4000 a month (depending on # bedrooms). Some residents lived further away mainland but said the drive is over an hour each way and traffic was horrendous some days. Their only advice was to start moonlighting as soon as possible. Some of the residents had spouses who also worked which made it easier.

 

[Firewood]

I was in a similar position while interviewing last year; trying to reconcile my desire for a prestigious program and my need to be somewhere my family would be comfortable. Ultimately, I picked my current program because it was the best fit for my family. I'm 6 months into residency and couldn't be happier. I feel I am getting a great education, and still have time to be with my (also very happy) family. I also think "blazing a trail" (which I'm considering) will probably be less daunting of a process if you are content with your family & work life.

Other things to c0nsider when you're crunching numbers: don't forget to include health insurance costs for your family, things like parking & meal compensation, and mandatory retirement plans & FICA (all of which will affect your take home pay).

Best of luck in your decision.

 

[Chimed]

All things considered, programs are more alike than they are different. Families on the other hand...
I moved my wife & 2 kids across 4 states for residency. I loved my program, and to some extent my home program was fairly dysfunctional at that time. But the emotional toll was pretty high, and the economic expenses didn't help (pretty much half of my take-home on the mortgage...no job for wife...3rd kid...). We survived, somehow, and did enjoy ourselves in those 5 years enough that we were sad to leave there when the job brought us back, but we're really happy to be back "home" now. (I should also add that my career goals changed during residency. Maybe yours might, too. The things that took me to my residency program were not the things that I stuck with, career-wise.)

Happy wife = happy life. Easy access to grandparents: very important.
High Class Institutional Name on diploma: not so much--unless you have some irrevocably strong internal sense of being called to a high-powered academic career as the most important thing you can imagine for your future life happiness.

All I can say is that ever since you left, the football here has gotten worse. I think you should return some of that positive mojo you stole. 😉

 

[shan564]

There are plenty of strong academic not-too-competitive psych programs in the not-too-expensive cities in the Midwest... is there any reason why those aren't on your radar?

 

[deleted314290]

I have a few interviews coming up in the Midwest, pretty much everything was on my radar except the East. I just don't foresee any of those programs offering the same opportunities that this one particular program has. I will keep an open mind though. I was already surprised once.

 

[shan564]

They might not offer precisely the same opportunities, but they might give you a nice compromise between the two extremes...

 

[Shikima]

Best residency? The one you can match into and complete.

 

[eastcoastdr]

I would pick family first. I think I'd rather have all the comforts of home and family and "blaze my own trail" rather than be lonely and poor somewhere while trying to earn a fancy residency certificate. Plus with the added stresses of residency it would be nice to have the family support.

Also unless you are looking for something VERY specific that this high-class institution provides I would stay at your home program. I mean you will come out of your home program a competent, well-adjusted psychiatrist, right? There's nothing wrong with "blazing" your own trail, you might even make a name for yourself doing it 🙂

 

[notdeadyet]

The program is in the Bay Area so you are paying approx $3000-$4000 a month (depending on # bedrooms).

Folks in the Bay Area in residency aren't paying that much for rent. You can rent a 4 BR house in San Francisco for that within a quick commute on public transport from UCSF or CPMC. You don't mention the number of kids you have, but if it's 2 or less, you can get away with a 2 BR apartment and can pay $2500/month for that. Anything outside SF in the Bay Area will be cheaper. There are folks that might be paying $4K for rent, but it's because they want to (e.g.: have independent funds and couldn't be bothered finding something cheaper).

Folks from out of area tend to overpay for rent because they try to replicate their lifestyle from where they moved. You will not have the same size place you left, in all likelihood. SF is similar to Manhattan in that rents are exorbitant so you have to get used to smaller space to afford it. On the upside, in most fields, your wife will probably be earning a higher salary.

But I side with the group emphasizing taking your wife's thoughts into consideration. I don't know how long you've been married, but if she's been with you through medical school, I can say with confidence (and experience) that she will find the "supportive wife" role hard to maintain through the slog of residency. It's just a long time for anyone to play second fiddle, and anything you can do to improve odds for her being happy day-to-day, having a satisfying job, and being surrounded by people engaged in her life, will be much better for her, yourself, and your marriage.

I love the program I'm at, but I chose it above a program that would have suited my professional goals better solely out of consideration of what would make my wife happy. And I don't regret it for a second. You will have a lot of miserable moments in life that come from overlooking your wife's needs or taking her for granted; you will have almost no regrets from putting her first.

 

[SmallBird]

Smaller, geographically confined area that is highly desirable like San Francisco, NYC, or even less expensive places. It happens. Particularly when you have 5 people or so to house. What's complicated?

It's not that I am saying its complicated, but, as notdeadyet has pointed out, there are people paying considerably less for rent in the bay area. And certainly in NYC (a market I am more familiar with) you shouldn't be paying 75% of your salary for a 2 bedroom apartment, if you are willing to stay in a less than lovely area and tolerate some commuting. If the OP needs three bedrooms, or a larger amount of space for a specific reason I could understand the $3000 to $4000 frame, hence my reason for asking this question 🙂