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Budgeting, a Medical Professional’s Nightmare

9 Nov

piggy bank money budgeting medical school

I realize that the word budget is usually thought of as a bad word to those in medicine.  Especially those that are medical students and residents since our “income” is so severely limited to what we could all potentially be making if we decided to be like our undergrad non-medicine classmates and go into law school, business, etc.  I have been living off of financial aid loans throughout medical school, therefore that is the perspective I’m taking in this post.

However, as a first year resident in now November I can happily say I finally paid of my credit card from all of my moving expenses.  This is a happy thing but also something I wish I wouldn’t have had to battle for the last 5 months.  It would have been nicer to have that money to start paying off my student loans during this “grace period” or put some of it into savings since right now I have $150 in savings.

Sometimes I wasn’t always so informed about the unexpected fees for medical students that pop up throughout the year. So, here are some budgeting tips for medical students & new residents (which I’m sure after I get through residency I’ll have a ton more budgeting tips for residency since from what I can tell licensing, testing and getting a job is big money too!)

First Year of Medical School: 

– Money you need to live/play in the summer.  That time is usually not budgeted in to your financial aid, you will receive one check in January that is expected to last you until August or whenever school starts again for your second year.

Second Year of Medical School:

– Save for registration of USMLE/COMLEX Step/Level 1 (~$600+)

– Purchase of study materials for board exams. Some professional organizations list discounts in their member benefits section, ex: AMA member benefits

– Save for hotel/travel if you are traveling for Step/Level 1

– If you are relocating for clinical rotations, save $$ for this:

  • Rental applications
  • Deposits & First/Last month’s rent
  • Moving trucks
  • New furniture, etc, if applicable
  • Deposits for internet/cable/water/sewage/garbage/electric/gas/rental insurance, etc.

– Clothes for rotations, you will need professional clothes and comfortable shoes for rotations (I recommend Danskos ~$120)

Third Year of Medical School:

– Registration for USMLE/COMLEX Step/Level 2 board exams (~600+)

– Purchase of study materials for board exams. Some professional organizations list discounts in their member benefits section, ex: AMA member benefits

– Travel/Hotel fees if traveling for step/level 2

– Registration for the PE exam

  • If DO, it’s in Conshohocken, PA and cost me around $2000 in registration (~$1200), plane ($500), hotel ($200), and taxi/shuttle ($60).
  • If MD, there are more local areas available (LA, Chicago, etc), however I have heard estimates around $1700 for this test too.
  • Register early (beginning of third year) to plan and not have to wait until 4th year to do this.

– Apply for Audition Rotations (some fees include application, background checks, immunizations, postage, etc.)

Fourth Year of Medical School:

This is the year that really surprised me how much money I spent.  I ended up moving out of my apartment at the end of third year, moved my stuff into my parent’s storage and just lived on financial aid.  I spent only $2000 on rent this year while traveling from rotation to rotation and still ended up in debt at the end of it by about $5000.  I had $2000 reimbursed by my residency program for moving expenses so it was $3000 total and took me 5 months to pay off with my resident salary. Plan wisely for this year but still enjoy it because it really is a great year to see a lot of things and be free before working 80+ hours a week. 

– Audition/Away rotation travel

  • Housing – make sure to plan your housing out month(s) before arriving to get the best deals, some hospitals offer free housing on a first come first serve basis, community members offering up inexpensive room rentals or even great hotel discounts if you’re looking at a hotel stay.  When you apply for audition/away rotations in Feb-March of 3rd year ask about housing then!
  • Food – some hospitals give you free food for the entire rotation, some give none.  Depending on the hospital food may run you ~$5 a meal, others $10.  Plan for this, and plan for shopping.  I lived in a few places without a refrigerator, so that month was more expensive because I found myself eating out more.
  • Gas / Car maintenance / Rental Car / Public transportation – This really depends on each individual situation but make sure whatever you’re driving is maintained and fueled up.  The last thing you want is to break down on the freeway driving through Detroit, Chicago, NYC, etc.  If you get a rental car you may want to look into professional organizations that you are a member of since many have member benefits listed (like 25% of Budget car rentals, etc).  ACOEP member benefits, AMA member benefits, AOA member benefits.
  • Fun.  Your 4th year can take you to a lot of fun and exciting places, remember to save some money for a roller coaster park, a national museum or park, game by your favorite sports team, great dining, and a few nights on the town too.

– Residency application & fees with ERAS

  • School fees for transcript request (my school was $10 per transcript)
  • ERAS Board score transcript upload, $70 for USMLE, $70 COMLEX
  • USMLE transcript release $65 from NBME
  • COMLEX transcript release $55 from NBOME
  • Application fees:Image

– Match Registration

– Interviews

  • Suit, buy one.
  • Travel $, Hotel $, Rental Car/Shuttle $, Food $ – the sooner you plan for your interview travel costs the more deals you’ll find.  Check out the hotel’s website for taxi/transportation/shuttle pricing and recommendations.  Again, look at membership benefits sections of your professional organization affiliations for discounts on these items.

– Residency & Physician Licensing Fees

  • I had to fill out a lot of papers and pay some bucks once I matched so my program could do another background check, pay for some state licensing fees, request some more transcripts from my school, etc.  I can’t remember exactly how much this cost me but it will vary between programs you’re accepted to, depending on what they will pay for you.  I’d plan for a couple hundred dollars for this part and if you don’t have to pay any then that’s a bonus for you.

– Graduation and graduation fees (depending on what your school pays for you)

  • Graduation application fee (mine was $0)
  • Graduation cap & gown (mine was $35)
  • Graduation announcements/postage (mine were $50)
  • Graduation travel/hotel ($500 for me as I was no longer living in my university’s city when I graduated and had to get a hotel for 4 nights since we had required events for 4 days leading up to graduation)
  • Graduation photos ($60 for me)
  • Graduation fun – everyone should go out for dinner/drinks with their classmates at graduation, plan for this!  It’s the last time you may get to see these people!

    champagne celebration, end of the year, medical school, graduation

– Relocation

  • Some programs do not pay you for orientation, and mine was one of them.  I didn’t get paid until the end of the second week into residency even though I had been in training for 4 weeks by then.  Pay checks lag behind one week so I got half of a paycheck ($750)
  • Rental applications
  • Deposits & First/Last month’s rent
  • Moving trucks/Gas, hotels if driving far
  • New furniture, etc, if applicable
  • Deposits for internet/cable/water/sewage/garbage/electric/gas/rental insurance, etc.

First year of Residency:

– Registration for USMLE/COMLEX Step/Level 3 Board Exams (~$750-800 +)

– Purchase of study materials for board exams. Again, some professional organizations list discounts in their member benefits section, ex: AMA member benefitsAOA member benefits

– Loan payback starts in November/December depending on when you finished your last rotation in 4th year.  Start looking into loan repayment options early on and keep up to date on this stuff.  I ended up deferring my loans for an extra month which cost me an extra $1000 because I didn’t have my loan payback type approved yet.