Showing posts with label money problems. Show all posts
Showing posts with label money problems. Show all posts

Friday, May 23, 2008

Hoping Beyond Hope

There are several items that I hope don't happen - even though I know there's a very good chance that they'll occur anyway. Like gas stopping its ridiculous and out of control move towards $4 and $5 a gallon.

What I really hope is just merely a rumor mill is this, a cut of work hours from 80 to 56 per week. I found this link from Medschool Hell - who, naturally, is in support of the move.

I've already blogged about this topic in the past, so I will allow you to read over that post and refresh yourselves. Clearly I do not believe cutting the work-hours anymore will lead to significant changes for the better.

What it will do is just lengthen an already long process with residencies adding additional years, create further punch-clock mindsets in residents entering the work-force, and leave a large topic of discussion still on the table: debt repayment.

Hell, as it is the government has been trying to get underpaid residents to pay back on loans by reducing the years that they can defer or forbear or simply removing the option of "economic hardship" from the list of reasons. So adding more years will do what? Create more financial burdens, reduce the chance to moonlight, make residency akin to a 40 hour a week job where-in doctors will become even more hesistant to do anything past 5pm? Is that what we really want?

Think about it before you'd say that working a few less hours isn't that bad.

Wednesday, March 26, 2008

Don't Do It

Ok, to buy or not to buy, that is the question.

This bastardized version of a famous, if not overly quoted, Shakespearean line (in fact I don’t even know which play it’s from – I’m that shallow) is a question many medical students face at one time or another during their education and training. Even before medical school begins there are corporations and entities out there trying to obtain signatures from the would-be doctor, playing the hand of a stable 4 years, good investment, and why throw you’re money away? I’ve heard ‘em and don’t buy ‘em. Here’s why.

As a medical student, I must ask, why on earth are you buying a home? Unless your spouse or significant other is the one making the purchase and has the money to cover the mortgage without getting you into significant financial distress, you shouldn’t borrow money with borrowed money. Plain and simple. It’s like paying off a credit card with loans – we do it, but it doesn’t make a great deal of sense, does it?

4 years of medical school sans PhD or other pursuits, is obviously not enough time to obtain a good amount of equity in a home to ensure you won’t owe once you sell. Trusting that you can stay in the area and do a residency? Don’t – it’s hard as hell to do and unless you’ve got some serious cajones and won't interview anywhere else you probably will have to move. Getting a job is great, but worrying about selling your home before you can move can cause a lot of stress at a time when you should be celebrating. Let’s not even consider that you’re responsible for taxes, upkeep, insurance, etc. etc. etc. with owning a home that won’t affect the selling price or value.

As a resident you’ll find there are more people trying to get you to buy a home. After all, you’re finally making some BIG money (which is almost anything since you’ve been unemployed for 4 years!) and you’re a doctor. Treat yourself good. But that’s the trick– assuming you should have something when, really, you’re in the same boat you were during medical school.

Look, most residencies are 3-5 years. Because you’ve likely not been able to save a tremendous amount many residents obtain 100%, nothing down loans covering the cost of everything. Any fee that comes about from the purchase of the home will go into this loan. Now, once signed, the purchased home is now more expensive than what they bought it for. 3-5 years is not a lot of time to pay off that extra money that was accrued, gain equity, and be able to sell the home once residency is completed. You’ll most likely owe and have to write out a check just to be clear of “your home”. Plus your loans are only deferrable for certain period of time and they’ll be coming due at the time or before you finish residency - leaving you owing essentially two mortgages.

And let’s not kid ourselves, many of us believe we’ll be attendings in the area we did residency, at least for a few years while we stabilize. Can we guarantee it? Can we be sure that we’ll be offered jobs by the hospitals or groups in the area? No, we can’t. Once again you’re assuming something that you can’t control. Having a house that you can’t sell, that limits your ability to accept offers in other states or cities, and that now controls what you can and can’t do will make you miserable.


Plus the obvious factor coming into play is the status of economy. 3 or 4 years ago the housing market was doing well - now people can't sell to save their lives. Do you want to risk that?

To further explore the benefits of delaying instant gratification, let's consider what renting could offer. Are you throwing money out the door when you rent? Well, for the insurance, taxes, upkeep, housing association fees, utilities, etc. that come with home ownership you can see how, after 4 years, renters are more likely to come out on top. They’ve not been forced to pay for appliances that break, broken water heaters, home owner’s insurance and possibly mortgage insurance. Every increase in property taxes doesn’t instantly affect them or -god forbid - having entered into a variable rate mortgage, every swing of the interest pendulum won’t suddenly double or triple their monthly payment.

Instead they pay their rent, utilities, renter’s insurance and not much else. Something breaks? Call the landlord. Broken water main? That sucks, but they aren’t paying. Appliances? Unless you’re a shmuck and rent a home where you have to provide the fridge, stove, and dishwasher you’re not paying to replace these or fix them either. An increase in rent can occur, but you’re not stuck having to pay something that you don’t accept. Once your contract is over you can move to a cheaper place if the monthly payments become too much – you aren’t suddenly crippled if the landlord wants another $500 each month.

And if you’re considering the tax deduction that comes with a home – the savings overall per year from a renter are often similar, if not more than those deductions even with a higher monthly payment.

Sure there’s the pride of ownership, but it can wait. It’s just not worth it to get in over your head simply because of pressure to fit a persona, a lifestyle, that you can’t meet anyway. Yes you’re a doctor, but you’re really not - so don't behave like you're set and secure. You’re still a student and it would be wise to think that way.

Tuesday, March 25, 2008

Exit Interviews

We received an abundance of financial information yesterday – enough to cause some mass confusion amongst the graduates. Perhaps the revelation that a couple loans came from the school and we were going to be paying them – or the group that purchased these loans from them – and they wanted lots of information and repayment options at that moment caused a great deal of alarm. The discussion was further muddied by the combination of dental and medical students, with loans being discussed that were only for dents or meds. Chaotic mess.

Really anytime you get medical students together and start talking about money, debt, and loan repayment we cringe. I hate the topic, because there’s really not much I can pay back and the idea of all the debt out there that needs to be repayed, well, scares the bejesus out of me.

There was some helpful information from a couple financial groups and I appreciated their time. It was extremely nice to learn that there’s an option for private loan consolidation that can reduce payments or provide some deferment time and that I'd most likely be able to take advantage. I had been laboring under the assumption I would have to pay back through the nose starting in 2009.

It was also nice to hear that a financial group that had beseeched us during the first week of med school to avoid purchasing a home* also advocated the same during residency. You just don’t know where the market will be and you can lose out on good opportunities since you’re stuck with a mortgage. Wife and I decided a few weeks ago to forgo purchasing and continue renting.

Money, money, money – it never stops. I wallow in repressed anxiety whenever the topic comes about or I review my loans.

There were some representatives from the US Army who wanted to talk to anyone about loan repayment through service. No thanks…I’ve seen what happened to a couple people who entered the military during med school. It occurs to me that you lose a lot of options and freedom for money – almost like you’ve sold your soul.

* I will discuss this in an upcoming post to more clarity. I think it is extremely important to consider why buying a home can lead to so much stress and possible loss of assets.

Wednesday, February 13, 2008

Enough Already - Please!

A trend that has started since my class has been mandated to be in attendance at a course similar to our "Doctoring" courses during 1st and 2nd years. Essentially the executive body of the class has taken this opportunity (as they rightfully should) to talk to us about dues, class gifts, monetary "responsibilities", etc. since we're all together - perhaps for the last time before graduation.

Fine. I would do the same. What's upsetting me, though, is the amount of money that's being asked for and how often I've been asked to give to some charity, event, dues, or other item. It's beginning to get really upsetting as I'm budgeting to make it through July with little to no money to spare.

Thus far I've been asked to pay dues of almost $200, to pay for a dinner for my AOA induction ceremony (which I'll attend of course), to give to various clubs and charities, asked to consider committing to 4-5 years of a monthly donation in regards to a class gift, and have been told about the commencement invitations and cap/ gowns we have to purchase in the very near future. Let's not even consider the fact that I'll have moving expenses, licensing fees, and a host of other forseeable and unforseen costs in a few months that are more pressing and concerning to me than a lot of these "extravagances".

I'm about to lose it.

I haven't graduated yet, received a fucking paycheck yet, or even know if I'll have a job yet and the vultures are already at my door. What I find is that this makes me less inclined to give anything - because I'm freaking out.

***Addendum*** Now, since I just attended an AOA meeting the other day and I was told about the dues, dinner, and other events that are quickly approaching I freaked out a bit. I'm planning on paying for this society since I worked hard to get accepted and know the priviledge that's involved. The other stuff, though, is getting a little ridiculous. It's like they can sense our student fees are slipping out of their grasp and it's a last ditch attempt to get anything from us.

And as far as freaking out about my, ahem, upcoming divorce? Let's not be jerks, shall we?

Thursday, November 29, 2007

Debt Discussion

Further follow up from the last post is needed since there were some interesting comments about debt. I don’t think that the public is aware of the amount of money that medical education requires, how it increases regularly, and the overall push by the current administration to decrease or eliminate certain loans for this type of education.

The amount of debt you have varies based on several factors, but some of the more common include whether you’re in a state or private school (private usually being more expensive), if you have a family or are single, if you’ve been able to save prior to med school or have family that’s helping out, and if you’re married to another medical student. Being at a private school my tuition is 2-3 times higher than some state schools and therefore my amount of debt is that much higher as well. The average of $150,000 is based on all these factors, government incentive programs, and does not clearly account for many medical students.

Take me as an example: I have a family, attend a private school, and have only been able to qualify for a few small scholarships that are sometimes shared amongst several medical students (political reasons are mostly to blame for my pitiful scholarship awards). My tuition has ranged from $35,000 to $45,000 over the last 4 years and I have to max out on loans in order to be able to support my family.

My wife’s income has helped, but we ran out of our savings quickly in the first year and have to rely on my refunds at this point to pay rent, bills and put food on the table - all of which totals my overall loans out to about $55,000 on average per year. Now, multiply that by 4, add in some undergrad debt, and you can see how I’m looking at about a quarter of a million in student debt which doesn’t include mortgages, car payments, or other financial strains - like credit cards.

Many people aren’t aware of these astronomical burdens carried by new physicians, often deferred through residency (since you’re making like $8-9/hr), with increases each time your interest is capitalized. Many people in the healthcare industry don’t realize these costs either - since I’ve heard nurses call residents “overpaid”.

Once you leave residency this places a tremendous burden on your shoulders and has become a main reason many medical students are staying away from primary care. You can’t make enough to pay these bills, your overhead, and yourself anymore. After all of this sacrifice there is a need, completely understandable and quite appropriate, to be compensated adequately. But the idea of docs being rich right out of the starting gate is really just not true. I'd also bet that there are a lot of physicians out there that have been in practice for some time and still barely scrape enough together to have a decent lifestyle - probably primary docs mostly.

Tuesday, November 27, 2007

Debt to No Income Ratio

In an all too common occurrence, I've been reflecting on the amount of money I owe. It’s quite terrifying to think about the amount of debt that I’ve accumulated in the 8 years of pre and post graduate training I've endured. What’s even more fun is to think about gathering even more since I’ll most likely have 4 years or more with my residency/ fellowship all within the same area and have a distinct chance of staying on as faculty after finishing, at least for a year or two...so why not buy a house?

When I see the amount of debt that I have, what we owe on my wife’s car, and the credit cards (oh so stupidly used at times) I have flat out panic attacks. I freak out, consider the option of getting a part time job on the weekends, and briefly ponder robbing a bank. Briefly, people, briefly, but I still think about it.

I know that there are residencies out there where you can moonlight or earn extra money working past a certain time of day, but these are clearly not readily available nor are some of the programs tolerable beyong this fact. While these types of programs are quite tempting to apply to or rank highly I realize that residency is transient and a horrible training experience will only sour me on my profession, my chosen field, and the patients I care for. Plus my marriage will get the shit kicked out of it for a few extra bucks and a divorce would only increase the debt burden.

What frightens me the most, though, is the notion that I can’t make more money during this training. It’s not like I can get a 2nd job when times get tight or when unexpected bills fall on you. Not like medical school where an additional loan here or there could be applied for or the occasional male-strip club dancing that netted me a little fortune here and there from fat, desperate women (ala Dr. Hibbert).

I just keep hoping that my car will last long enough to make it through residency. I hope that the kids won’t need braces or any expensive medical care during this time. And I sure as hell hope that all the talk my wife does about once we “have money” is just talk and not serious – because it just makes me freak out more.

Thursday, November 15, 2007

More Money

How much do I want to party? Is it worth $100 or more for a bash?

Our class dues this year were elevated to help pay for some items that the senior class has traditionally done. This includes a class gift, planning an event the day of match as a celebration for 4 years of hard work, etc. However, I have recently seen that the dues are to be increased by over 200% for the year to pay for these “responsibilities”.

I was planning on paying for the initial class dues this year, but more than $100 is way too much for this guy. I mean, God, I’ve had to increase my debt further in order to even interview this year since the school’s tuition hike killed any travel money I was set to receive. I have a couple private loans that will be due upon graduation and cannot be deferred through my residency. The fact that the “elected” class officials (ran unopposed) are now increasing the amount they want from us in order to throw some fucking party irritates me.

I guess I just won’t plan on going to our match celebration if this is how they’re going to try and fund it. Citing low class participation in fundraisers as a reason to increase the amount needed as an entry fee isn’t reason enough. There are people who are on aways, are too busy with life, and just don’t care anymore about helping “the class” out anymore. Personally, I’ve been trounced one too many times in the past to give a shit now.

It’s sad to think I won’t be able to hang with some of my friends and celebrate our accomplishments, but I thought the amount last year was ridiculous and we’re doing the exact same thing here.

Friday, October 19, 2007

Money - It's a Gas

Part of the process of applying for residencies requires you to spend money. Money on travel, hotels, and rental cars/ cabs. All of this comes at quite a price, especially to those lucky enough to have to apply to more than one residency (like me) as well as the fact that this is all done during the holiday travel season and prices soar.

Because medical students are already walking the financial tightrope there are loans out there for travel as well as relocation expenses. These are private loans that can be deferred during residency and a lot of students take them out in order to interview at enough spots to increase their chances of matching. Many students take out between $2,000 - $7,000, but a student I spoke with last year told me that she needed over $10,000 to interview! Without it she wouldn't have matched - lots of flying in December apparently.

So I've been trying to obtain one recently from various lenders and have been turned down repeatedly. Apparently they consider the fact that I have a large amount of debt including some from credit cards (alright – a lot of credit card debt) and tuck tail and run from this credit nightmare known as MSG. So I've been pulling my hair out trying to think what to do and what my best options include. Of course there’s the option to just get a cosigner, but that’s just so demoralizing.

Here I am, almost 30 years old, less than 7 months away from being called “doctor” and I still have to call mommy and daddy for help. Embarrassing and irritating all at once. I wonder if other students have had this trouble. If I’m not able to get a loan I’m going to be very limited in where I can apply and basically run the risk of “suicide matching*”.

So now I'm just going to have to bite the bullet, call up my parents, and ask for some help. Up till now I've been able to do everything on my own and this just hurts the ol' pride a little. But it's necessary, so I need to get over it.

*Term used by med students and residents when talking about interviewing at 3 or fewer programs. The more you interview at and rank the better your chances to match – law of probabilities.