Residency in Hawaii -- financial issues

[lockian]

Hey all,
There was a thread about this a few years back, but my situation's a little different, so I thought I'd make a new post instead of bumping it.

I am interviewing for a psychiatry residency in Hawaii in November, and I've read on these forums that if you're a low-maintenance person (which I am), you'll probably do just fine on a resident's salary (I believe you get paid a *litte* more than average, on the order of $56,000?).

However, it won't just be me. I have a s/o who currently makes $40,000 a year (I forget if this is before or after taxes), and that's what the two of us live on in a midsized midwestern city. We have a one-bedroom apartment on prime real estate next to the hospitals, and a new 2014 Ford Focus we're half done paying off. I will have about $150,000 in loans when I graduate.

Now, my s/o wants to go back to school at least part time when I begin residency (she's on the nontrad premed track -- oy, vey), but I'm worried that in Hawaii we'd have to kiss that plan goodbye for another four years.

So, specific questions:
--If you have a spouse as a resident, how much do they need to make working to support a very basic lifestyle? (no kids)
--Do you need two cars or can one of you reasonably bike or walk everywhere?
--If you're comfortable, can you name a lump-sum figure of what your rent, food, and bills amount to in a month? (better if you're a household of 2)
--What are the rules on in-state and out-of-state-tuition if you just want to take random classes as a non-degree seeking student at a local university?
--Would me working as a resident qualify as a JABSOM connection that would help s/o in the med school application process?
--Researching real estate costs, I concluded that if it's a condo we're after, buying may actually be cheaper -- thoughts?
--Is placing student loans in forebearance a must?
--The traffic: is it really that bad? Aka is it possible to live somewhere besides downtown Honolulu and still be ok?

The pros of moving to Hawaii are that the population is incredibly interesting there, the psychiatry program is quality, being surrounded by beauty is very important to me, we are low-maintenance people who do not want kids, a big house (I actually prefer condos), or a fancy car even when I am an attending. I also understand that there's a big need for docs in Hawaii, so if I end up there for residency, that's going to be it -- I'm staying there.

The cons are... obviously, money, and the s/o premed and med school issue.

I realize that I'll probably get a chance to ask residents all these questions when I interview and that they have an info session on interview day specifically on the financial issues. But I also want to get the scoop early if I can.

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[gutonc]

Pick an online cost of living calculator. Put the numbers in. Figure out if that will work for you.

As an example, I made the assumption that you currently live in Indianapolis (just because it was the first thing that came to my mind) and it told me that the COL in Honolulu is 82% higher. So assuming the current $40K salary, you'd need ~$73K to have a similar lifestyle in Hawaii.

 

[clausewitz2]

Pick an online cost of living calculator. Put the numbers in. Figure out if that will work for you.

As an example, I made the assumption that you currently live in Indianapolis (just because it was the first thing that came to my mind) and it told me that the COL in Honolulu is 82% higher. So assuming the current $40K salary, you'd need ~$73K to have a similar lifestyle in Hawaii.

This is slightly complicated by Hawaii having a different cost distribution due to the precise identity of the things it needs to import great distances by sea. So, if you want to eat steak and take full cream in your coffee every morning before driving a car everywhere, it is going to be horrifically expensive. Eat fish and taro? Not so much.

 

[gutonc]

This is slightly complicated by Hawaii having a different cost distribution due to the precise identity of the things it needs to import great distances by sea. So, if you want to eat steak and take full cream in your coffee every morning before driving a car everywhere, it is going to be horrifically expensive. Eat fish and taro? Not so much.

That's a very small portion of the COL compared to things like housing and energy though.

 

[clausewitz2]

That's a very small portion of the COL compared to things like housing and energy though.

Housing is also a bit different from the mainland (or at least, the mainland outside of the Bay Area and Manhattan) because far more of the expense comes from the price of the lot the housing is built on. So there is a bigger differential between a townhouse/apartment and a single family home with similar square footage.

All I'm trying to say is that changes in lifestyle that might not make so much of a difference in a Midwestern city might be quite significant in this context.

 

[Gastrapathy]

You don't want kids. You are on your first wife. You'll be fine.

 

[Apollyon]

This is slightly complicated by Hawaii having a different cost distribution due to the precise identity of the things it needs to import great distances by sea. So, if you want to eat steak and take full cream in your coffee every morning before driving a car everywhere, it is going to be horrifically expensive. Eat fish and taro? Not so much.

Well, porterhouse at Safeway was very similar in price to the mainland, and Morton's at Ala Moana was similarly priced as Morton's in Cleveland and Toronto. Whatever. Maybe I'm all wet.

My highest electric bill, though? $521. That's in one month.

 

[Crayola227]

Biking is not a good plan as the streets are crazy and the sidewalk/streets too narrow.
With 2 cars parking is horrific and at a premium. Traffic is horrific.

Think about island fever.

It's a 4-8 hr (can't remember) flight to west coast mainland. Hard and expensive to fly to midwest for holidays if that matters.

You'll have to see what it costs to ship your car.

 

[bashwell]

Would me working as a resident qualify as a JABSOM connection that would help s/o in the med school application process?

Surprisingly, JABSOM does have a "legacy" criterion in their "Residency Screening for Application Purposes". However, I don't know if spouses would count as "legacy," and besides this is still many, many steps away from getting into med school. Anyway, I could be wrong, but I would doubt this would have a very significant impact on her admissions overall.

 

[clausewitz2]

Well, porterhouse at Safeway was very similar in price to the mainland, and Morton's at Ala Moana was similarly priced as Morton's in Cleveland and Toronto. Whatever. Maybe I'm all wet.

My highest electric bill, though? $521. That's in one month.

The major determinant of the cost of your meal at Morton's is not how much the restaurant paid for the meat.

Good point about the electricity bill, though. Sort of reinforces my point: On the mainland, if you get super zealous about minimizing obvious sources of electric waste, you save maybe 50 bucks a month. A monthly bill of 520 USD means this sum will be larger.

 

[Doctor Bagel]

It seems like it makes the most sense to figure out what she needs to do to establish residency in Hawaii (or wherever you move). That usually means working fulltime for another year, where you could possibly take one or two classes. That will open up the best options for getting admitted and definitely for having cheaper tuition for medical school and for postbacc classes. Look for how the University of Hawaii defines instate residency -- you should be able to find it somewhere on their website or at the worst contact their admission department.

 

[lockian]

Biking is not a good plan as the streets are crazy and the sidewalk/streets too narrow.
With 2 cars parking is horrific and at a premium. Traffic is horrific.

Think about island fever.

It's a 4-8 hr (can't remember) flight to west coast mainland. Hard and expensive to fly to midwest for holidays if that matters.

You'll have to see what it costs to ship your car.

I've thought about island fever. Luckily, I am the sort of person whose ideal vacation is a staycation, or to do something locally in town. My parents were all about being cosmopolitan and forced me into study/internship/volunteering abroad, as well as vacations every possible holiday. It gave me some nice things to talk about during interviews, but at heart it made me a confirmed homebody. In med school, I literally did not leave town for anything except the obligatory yearly trip to the in-laws', and the time when my medical school forced us to do a rural rotation.

Obviously, nothing is 100%, but tl;dr I do not consider travel and getting away "fun." If we can swing one trip a year to the midwest, that's all that's needed.

 

[lockian]

Pick an online cost of living calculator. Put the numbers in. Figure out if that will work for you.

As an example, I made the assumption that you currently live in Indianapolis (just because it was the first thing that came to my mind) and it told me that the COL in Honolulu is 82% higher. So assuming the current $40K salary, you'd need ~$73K to have a similar lifestyle in Hawaii.

I went the cost calculator route, and yeah, the result was +60%, which would be $64,000. There's also this: http://livingwage.mit.edu/metros/26180, which gives you what seems like the bare minimum you need. But that site also says that if you're 2 adults with one working, you need to make $45,000 before taxes, which is not too different from our income now.

Idk, I guess the truth is somewhere in the middle.

 

[lockian]

Biking is not a good plan as the streets are crazy and the sidewalk/streets too narrow.
With 2 cars parking is horrific and at a premium. Traffic is horrific.

Think about island fever.

It's a 4-8 hr (can't remember) flight to west coast mainland. Hard and expensive to fly to midwest for holidays if that matters.

You'll have to see what it costs to ship your car.

So what would you recommend if having two cars is too much and biking is not realistic? Walking? Public transit? I remember from having been that Honolulu's not that big, so if you live in the area of downtown you're pretty close to UH and the Queen's Medical Center?

 

[DD214_DOC]

To answer your questions quickly: Don't do it. Not worth it. You will be in residency, not on vacation. You really won't have time to enjoy living in Hawaii and will just end up paying a silly amount of money for a lower standard of living. A flight anywhere is a minimum 4-5 hours and $1000 or more.

Specifically:

--If you have a spouse as a resident, how much do they need to make working to support a very basic lifestyle? (no kids)
Depends; most residents I knew had roommates (like 3 or more). You can rent a dump in the ghetto for about $1100/mo; something decent will cost you $1500 +

--Do you need two cars or can one of you reasonably bike or walk everywhere?
Depends on how close you live to campus. The traffic is ABSOLUTELY HORRIBLE and you WILL BE MISERABLE ALL THE TIME. They are building a rail which will likely never be finished, so lots of roads are being closed and rerouted months at a time. The weekend isn't any better -- traffic still sucks to the point you will give up going anywhere. My 10-mile or so commute from the leeward coast to the Pearl Harbor/Aiea area was about 60-90 minutes one way with no accidents. Any accidents or stalls, 120+ minutes one way.


--If you're comfortable, can you name a lump-sum figure of what your rent, food, and bills amount to in a month? (better if you're a household of 2)
Rent $2600/mo, electric $300-$400/mo, food $500/mo, gas $200-$300/mo (most of which gets burned up sitting in traffic)

--What are the rules on in-state and out-of-state-tuition if you just want to take random classes as a non-degree seeking student at a local university?
No idea

--Would me working as a resident qualify as a JABSOM connection that would help s/o in the med school application process?
Maybe, dunno

--Researching real estate costs, I concluded that if it's a condo we're after, buying may actually be cheaper -- thoughts?
A mortgage is usually less than monthly rent, but the housing market is a bit whacky and you really do not want to get stuck with a $350,000 mortgage on a 1 or 2 br condo when you move back to the Mainland

--Is placing student loans in forebearance a must?
Probably

--The traffic: is it really that bad? Aka is it possible to live somewhere besides downtown Honolulu and still be ok?Yes, the traffic is that bad, but mostly between Honolulu and the Leeward coast (Ewa Beach, Kapolei, Waianae). The drive from the windward coast (Kaneohe and Kailua) wasn't too bad. Downtown can get really congested though. Just expect to spend a big chunk of your day sitting in traffic.

 

[Crayola227]

No there is no public transport if I remember right.

There was someone who lived way up on the hill with less busy streets that could coast/ glide on a bike to get to work. Getting back up? I dunno.

Some years back one of the residents hanged themselves if that tells you anything. Maybe it doesnt mean anything about the program, maybe it was just them, island fever, or the traffic.

I was told it was really hard to make friends. The native aren't interested in friends that are just going to fly away (most people are visitors to Hawaii even if it's just a few years, high turnover) and again, most everyone is leaving soon. This is despite the friendly hospitality you see everywhere.

Smarter move? I knew someone that did a locum tenens type position right out of residency for like year, and loved it. They had tons of time to surf. If you rent someone's vacay condo and a car or something it wouldn't be so bad on a hospitalist salary. Then you could decide if you wanted to stay.

 

[mvenus929]

No there is no public transport if I remember right

Based on my single visit to Oahu last year, I can tell you that there is absolutely public transport. It's just a matter if it goes where you need it to when you need it to.

 

[gutonc]

Based on my single visit to Oahu last year, I can tell you that there is absolutely public transport. It's just a matter if it goes where you need it to when you need it to.

Which is true of essentially every single US public transit system not in NYC, Boston or Chicago.

 

[Apollyon]

Which is true of essentially every single US public transit system not in NYC, Boston or Chicago.

TheBus is the only public transportation system to be rated best in the nation more than once. TheBus WILL get you anywhere on O'ahu.

 

[lockian]

To answer your questions quickly: Don't do it. Not worth it. You will be in residency, not on vacation. You really won't have time to enjoy living in Hawaii and will just end up paying a silly amount of money for a lower standard of living. A flight anywhere is a minimum 4-5 hours and $1000 or more.

Specifically:

--If you have a spouse as a resident, how much do they need to make working to support a very basic lifestyle? (no kids)
Depends; most residents I knew had roommates (like 3 or more). You can rent a dump in the ghetto for about $1100/mo; something decent will cost you $1500 +

--Do you need two cars or can one of you reasonably bike or walk everywhere?
Depends on how close you live to campus. The traffic is ABSOLUTELY HORRIBLE and you WILL BE MISERABLE ALL THE TIME. They are building a rail which will likely never be finished, so lots of roads are being closed and rerouted months at a time. The weekend isn't any better -- traffic still sucks to the point you will give up going anywhere. My 10-mile or so commute from the leeward coast to the Pearl Harbor/Aiea area was about 60-90 minutes one way with no accidents. Any accidents or stalls, 120+ minutes one way.


--If you're comfortable, can you name a lump-sum figure of what your rent, food, and bills amount to in a month? (better if you're a household of 2)
Rent $2600/mo, electric $300-$400/mo, food $500/mo, gas $200-$300/mo (most of which gets burned up sitting in traffic)

--What are the rules on in-state and out-of-state-tuition if you just want to take random classes as a non-degree seeking student at a local university?
No idea

--Would me working as a resident qualify as a JABSOM connection that would help s/o in the med school application process?
Maybe, dunno

--Researching real estate costs, I concluded that if it's a condo we're after, buying may actually be cheaper -- thoughts?
A mortgage is usually less than monthly rent, but the housing market is a bit whacky and you really do not want to get stuck with a $350,000 mortgage on a 1 or 2 br condo when you move back to the Mainland

--Is placing student loans in forebearance a must?
Probably

--The traffic: is it really that bad? Aka is it possible to live somewhere besides downtown Honolulu and still be ok?Yes, the traffic is that bad, but mostly between Honolulu and the Leeward coast (Ewa Beach, Kapolei, Waianae). The drive from the windward coast (Kaneohe and Kailua) wasn't too bad. Downtown can get really congested though. Just expect to spend a big chunk of your day sitting in traffic.

Oi... Sounds scary. Do you mind if I ask how hard or easy it was to find a job in Hawaii post-residency then? One of my home program's graduates said it was difficult without connections, and flying out to interview every time is a big pain.

Oh well... I guess if nothing else my residency interview is already set, so I'll just go and talk to people and have a mini-vacation.

 

[DD214_DOC]

Oi... Sounds scary. Do you mind if I ask how hard or easy it was to find a job in Hawaii post-residency then? One of my home program's graduates said it was difficult without connections, and flying out to interview every time is a big pain.

Oh well... I guess if nothing else my residency interview is already set, so I'll just go and talk to people and have a mini-vacation.

I moved off the island, but I also didn't have a choice. Most of the JABSOM people I knew were relocating to the Mainland after training. Physicians in HI end up making considerably less than their mainland counterparts due to the high cost of living but average income potential.

Get a mai tai at the lounge in the Trump Tower in Waikiki. Best on the island.

 

[lockian]

I moved off the island, but I also didn't have a choice. Most of the JABSOM people I knew were relocating to the Mainland after training. Physicians in HI end up making considerably less than their mainland counterparts due to the high cost of living but average income potential.

Get a mai tai at the lounge in the Trump Tower in Waikiki. Best on the island.

Oi, I wish everyone would stop going on about physician salaries.

I am low-maintenance and a homebody.

I just want to pay off my loans and have a condo and nice clothes.

 

[Crayola227]

There's a garlic shrimp shack that's world famous a 2 hr drive to one end of the island. There were some of the tallest waves ever there, famous for surfing.

I interviewed Jan I think and it was the right time of year for snorkeling with the baby dolphins and see the whales.

I liked the Paradise Cove luau, even if people bitch it's not terribly authentic, it was fun and I liked the food quite a bit.

Helena's kitchen has the "best" most authentic food on the island, but as a haole, I thought the pork was waaaay to salty which is of course true if you're not from Hawaii.

Lomi lomi salmon is a tough one to like. It's like old fermented fish. Haupia I really like, kinda gelatin/pudding that's coconut flavored. Poke is very good.

There's some sort of special breakfast you can get from McDonald's that's distinctly Hawaiian.

The macadamia nut banana pancakes with coconut whipped cream and coconut syrup are the best I've ever had, I went to Eggs n Things, it has a nice view.

 

[DD214_DOC]

Oi, I wish everyone would stop going on about physician salaries.

I am low-maintenance and a homebody.

I just want to pay off my loans and have a condo and nice clothes.

You will change your mind when you actually are out of training.

 

[RadOncDoc21]

I agree with the above post!

Sadly, I felt the same way when I got out of residency, but you soon realize your cost of living goes up in regards to bills, family, paying back student loans, board exams, TAXES!

Granted I recently bought a nice home, nothing fancy but I would have thought for sure I would feel "comfortable" after seeing my paycheck increase 4-5 fold each month. It takes awhile to recover and more time to actually establish wealth, so be mindful when you come out of residency.

 

[lockian]

I agree with the above post!

Sadly, I felt the same way when I got out of residency, but you soon realize your cost of living goes up in regards to bills, family, paying back student loans, board exams, TAXES!

Granted I recently bought a nice home, nothing fancy but I would have thought for sure I would feel "comfortable" after seeing my paycheck increase 4-5 fold each month. It takes awhile to recover and more time to actually establish wealth, so be mindful when you come out of residency.

I don't know, I really, really, really like to keep my life as simple as possible. That's why no house, no family, and no travel.

Also, when it comes to the "it's residency, not vacation" thing, I think it's going to be worth its weight in gold to be able to come out after a long day and look around and be like, "damn, I'm in Hawaii." What I see around myself even on a regular day is very important to me. That's why I'm kind of dying in a cold, pefectly flat midwest.

(Paul Rudd voice). They've done studies, you know. Apparently you need about 80K a year to be happy, let's say this is 120K in Hawaii due to higher cost of living, but you can make that fairly easily once you're in practice.

 

[dpmd]

I don't know, I really, really, really like to keep my life as simple as possible. That's why no house, no family, and no travel.

Also, when it comes to the "it's residency, not vacation" thing, I think it's going to be worth its weight in gold to be able to come out after a long day and look around and be like, "damn, I'm in Hawaii." What I see around myself even on a regular day is very important to me. That's why I'm kind of dying in a cold, pefectly flat midwest.

(Paul Rudd voice). They've done studies, you know. Apparently you need about 80K a year to be happy, let's say this is 120K in Hawaii due to higher cost of living, but you can make that fairly easily once you're in practice.

For the money you will be making i don't know how nice your immediate surroundings are going to be. Things will be better is your gal keeps working of course (or gets loans to cover living expenses). I just saw a house hunters show for a guy looking for a condo in Honolulu and the prices were pretty damn high for stuff not close to the water and with views of parking structures and what not. Also, even though the mortgage will be less than renting, don't forget about hoa dues and other costs of ownership that add up (i bet property taxes are high there too). Not saying it isn't doable, but there are other places where you would have a nice setting with lower costs.

 

[DD214_DOC]

I don't know, I really, really, really like to keep my life as simple as possible. That's why no house, no family, and no travel.

Also, when it comes to the "it's residency, not vacation" thing, I think it's going to be worth its weight in gold to be able to come out after a long day and look around and be like, "damn, I'm in Hawaii." What I see around myself even on a regular day is very important to me. That's why I'm kind of dying in a cold, pefectly flat midwest.

(Paul Rudd voice). They've done studies, you know. Apparently you need about 80K a year to be happy, let's say this is 120K in Hawaii due to higher cost of living, but you can make that fairly easily once you're in practice.

Heed my warnings, but in the end it's your life -- do what you want. I know the current dept chief there (or at least he was the chief a few months ago) and he is an awesome guy and will teach you amazing things. Unless he's moved.

But really, Oahu completely sucks. The other islands are way, way, way, way better. I'm assuming you've never actually been to Hawaii. So, whatever image of Hawaii you have in your mind, realize that's not Oahu. Likely, it's Kauai or Big Island. Definitely not Oahu.

I would only ever go back to Oahu to change planes for an interisland flight to Kauai or Big Island.

 

[dpmd]

Heed my warnings, but in the end it's your life -- do what you want. I know the current dept chief there (or at least he was the chief a few months ago) and he is an awesome guy and will teach you amazing things. Unless he's moved.

But really, Oahu completely sucks. The other islands are way, way, way, way better. I'm assuming you've never actually been to Hawaii. So, whatever image of Hawaii you have in your mind, realize that's not Oahu. Likely, it's Kauai or Big Island. Definitely not Oahu.

I would only ever go back to Oahu to change planes for an interisland flight to Kauai or Big Island.

Well there are places away from Honolulu that are very nice and do fit the image of Hawaii, but yeah the other islands are far superior. Although i think a commute on any of them would be frustrating (either due to traffic or just the slow speed limits). I think about moving there sometimes but hasn't seemed worth it. For now we are satisfied with a trip or two a year there.

 

[RadOncDoc21]

I don't know, I really, really, really like to keep my life as simple as possible. That's why no house, no family, and no travel.

Also, when it comes to the "it's residency, not vacation" thing, I think it's going to be worth its weight in gold to be able to come out after a long day and look around and be like, "damn, I'm in Hawaii." What I see around myself even on a regular day is very important to me. That's why I'm kind of dying in a cold, pefectly flat midwest.

(Paul Rudd voice). They've done studies, you know. Apparently you need about 80K a year to be happy, let's say this is 120K in Hawaii due to higher cost of living, but you can make that fairly easily once you're in practice.

Oh no doubt, location is very important and you know more than anybody what makes you happy and money shouldn't be the deciding factor. I'm just saying I thought I had a set amount I could live on and have already surpassed that... I need Donald Trump money!

 

[lockian]

Heed my warnings, but in the end it's your life -- do what you want. I know the current dept chief there (or at least he was the chief a few months ago) and he is an awesome guy and will teach you amazing things. Unless he's moved.

But really, Oahu completely sucks. The other islands are way, way, way, way better. I'm assuming you've never actually been to Hawaii. So, whatever image of Hawaii you have in your mind, realize that's not Oahu. Likely, it's Kauai or Big Island. Definitely not Oahu.

I would only ever go back to Oahu to change planes for an interisland flight to Kauai or Big Island.

I've been to Hawaii, twice. The first time was just your regular tourist fare that included Oahu and the Big Island. The second time was more off the beaten path activities and we I stayed with locals in Honolulu. (Granted, said locals lived in Manoa, which is supposed to be quite nice). I had a rental car and drove everywhere, though I imagine not during peak traffic times as I did not find the congestion at all bad. Point being, I am not completely clueless. I even shopped for groceries.

And I also understand that Hawaii's got a big doctor shortage, especially in not-Honolulu? That sounds like a good a post-residency career move from what I'm reading here, I just need to figure out how much (if at all) a Hawaii residency would help with that.