1 How a Medical Resident Does Money | The Billfold

How a Medical Resident Does Money

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Mike: Can you say how old you are, where you are based, and what you do?

Dr. Dee: I’m 27 years old, based in Toronto, Ontario, and I’m a medical resident. Also, my side hustle is that I’m a med school admissions consultant. Basically I provide med school hopefuls advice and guidance throughout their application and interview process.

Mike: How much do you make as a medical resident?

Dr. Dee: I make approximately $55,000. However—we have a lot of organization/malpractice fees, so about $5K is deducted before tax each year

Mike: But you’re expecting to make more when you’re done with your residency, yes?

Dr. Dee: Oh yes. Basically for the years I’m in residency, it’s pretty much pennies compared to my “real doctor” salary, which will be $250-$300K+. I have some years away from that!

Mike: When you contacted me, you mentioned you made it to med school after growing up in difficult circumstances. Can you talk about that?

Dr. Dee: Yes, my parents were immigrants, and my brother and I grew up in the projects. My parents are still there actually.

Mike: In Canada?

Dr. Dee: Yes. My father was and still is a janitor and truck driver, while my mom was a waitress before she was diagnosed with Parkinson’s and couldn’t work anymore and went on disability.

Growing up there was very little discipline around the house because my parents were mostly absent. My brother and I ended up playing in the streets with the other kids. Meanwhile there would be adult neighbors drinking in the complex out in public. I saw one of my neighbors on the news being escorted out by what looked like a SWAT team for militia weapons possession. The condos across from mine were set on fire. It got so bad at one point that we started having security guards that patrolled the neighborhood, and residents took turns staying up with bats in the parking lot to prevent theft.

Mike: How were you able to go from that situation to going to medical school?

Dr. Dee: Honestly, I think it had something to do with finding school as a refuge from all the chaos in my home life. I started confiding in great teachers from grade 3 onwards about the rough things that were happening at home. I had great mentors at school who I think picked up on the the fact that I was pretty s-m-a-r-t. They encouraged me with special math problems or art projects. This continued in high school. When I confided in my counselor that things were really dysfunctional at home—with my mom being diagnosed and was struggling financially, and my brother getting into legal trouble—he told me to apply to scholarships to get away from that environment. That’s when I started hustling and learning how to “sell myself,” and ended up with full-ride scholarships to college.

Mike: Impressive! It sounds like you went to a good school with educators who really cared, and, perhaps, had the resources to give you individual attention? Does this say something about the Canadian school system? Or was this kind of luck in circumstances?

Dr. Dee: I don’t think Canadian schools are particularly special, but because of the location of the projects, we were in a relatively middle class catchment area for schooling. That said, my brother—who was pretty combative and diagnosed with ADHD—was kinda shoved to the side, and he faired much worse. I think it was the combination of being relatively smart and being excited about school, or just not being at home.

Mike: How did you decide to go into medicine?

Dr. Dee: I was very focused on the arts initially—I loved performing in musical theatre and singing at school. However I also had always been a heart-on-my-sleeve kind of person. The moment that sealed it for me was when my mother collapsed onto my lap, and started bawling after her doctor’s appointment. She was diagnosed with Parkinson’s and I was the first to know. Not only did it foster an interest, but I also knew I couldn’t really do a job that didn’t guarantee that she and my dad could be supported. At that time, becoming an actress seemed like a selfish decision, so I took the alternate route.

Mike: You mentioned to me in your email that though his sounds like a Cinderella story, it’s not. Can you go into that?

Dr. Dee: A lot of people know about my past and see me as this Cinderella story. I typically get lots of ‘you made it!’ comments and it’s all smiles. However, most people don’t know about the six-figure debt that’s incurred by medical students. Even though med schools try to recruit more people from diverse socioeconomic backgrounds, it’s a struggle right from the beginning for people to get the grades, the volunteer experiences, and the financial support to apply. That disparity continues in medical school. Students who are financially independent end up being in debt much longer and for much more. In medical school, we are given lines of credit ranging from $150K to $250K at prime, which is currently 3%. We basically live off of that because there’s not a lot of time to take part-time jobs.

Mike: Can you talk about the socioeconomic diversity in medical school a little bit more? Most are students who come from families who can support them?

Dr. Dee: Yes! I love talking about this issue. Medical schools are desperately trying to increase access to medicine for students from disadvantaged backgrounds. This is because many students in a given class are from families that make over $120K a year.

Research shows that med students tend to end up practicing in their own communities, and currently our student/resident makeup does not accurately reflect our community at large.
It’s pretty predictable why that is, though. Med schools look for people who are super impressive on paper: lots of volunteer work (sometimes globally), leadership, varsity sports, scholarships, while maintaining close to a 4.0 GPA. This is hard for someone who has to work at, say, McDonald’s to support himself through pre-med.

I cite McDonald’s because I remember one of my classmates was working there; he didn’t end up getting into med school and I’m not sure if he’s still trying. And note: as a previous applicant and current admissions committee member, I can tell you that ‘working at McDonald’s’ is sadly not as impressive as all the other accolades mentioned above. Even if it’s your only way to get through education. So in essence they’re perpetuating a disparity that they’re simultaneously trying to address.

Mike: Have they used you as an example?

Dr. Dee: No, they haven’t reached out to me personally. I don’t think they’ve ever pointed out individuals to say, “Look! We beat the statistics and here’s proof.” Though that would be pretty funny. However, I do market myself to students I meet personally and professionally. I want them to know that if they want to go to med school, it’s totally possible, and I can help them.

Mike: Will you continue your consultancy when you’re done with your residency?

Dr. Dee: I think once I’m done I’ll direct my energy to helping disadvantaged students for free. Despite the busy residency schedule I get super excited working with these people—helping disadvantaged students all the time as opposed to providing a for-profit service in my current situation.

There’s definitely guilt about potentially contributing to this med school disparity by helping people who can afford my support, but I’m hoping I’m neutralizing this effect by helping clients for free the majority of the time. Otherwise I wouldn’t be able to sleep at night.

Mike: You mentioned your mother and brother are still living in your old neighborhood.

Dr. Dee: Yes.

Mike: And that your brother wasn’t able to find the kind of success that you did. Do they want to leave? Do you feel a pressure to help them do that?

Dr. Dee: I absolutely do feel the pressure.

Mike: Have they talked about it with you?

Dr. Dee: It’s pretty much assumed that I will financially support them once I become a doctor. Sometimes it’s frustrating because I get this attitude of, “why aren’t you buying us X, Y, Z yet? Why aren’t you treating us out?” But they don’t understand that my LOC barely covers a bajillion years of education and non-employment.
I think there’s a lack of understanding around finances after being poor for so long, so they think I’m now set. And that the world will keep hemorrhaging cash right on my lap now that I’m a fancy doctor. However, I do feel it’s important for me to support them eventually. After all, my dad scrubbed toilets throughout my childhood to feed me. I feel forever grateful to them.

Mike: So what does the future look like for you? You’ll earn $300K, support your family, pay off debt and save some for yourself?

Dr. Dee: I envision myself to be on the super-saver end of things. I’ve studied my spending and I can be happy living on less than $24K a year while in a cosmopolitan city. If I can fight lifestyle inflation, I could quickly pay off my debts and a house for my parents. And continue to save over 70 percent of my income to provide a more stable future for my own potential family.

Mike: If this were a kind of Cinderella story—the story isn’t over yet.

Dr. Dee: Haha no it’s not over yet! And I hope I can move away from the ‘Cinderella story.’ My mom told me that when I was four years old I declared I would never depend on a man. So if there were a Disney story to reflect that then I’m all over it.

Mike: It’s the ‘Dr. Dee’ story.

Dr. Dee: I better get royalties.

Mike: Anything we haven’t talked about that you wanted to mention?

Dr. Dee: Oh yes, my boyfriend wanted to mention that he’s a musician who can’t get a LOC, but for the longest time was letting me live rent-free with him and was the breadwinner. Oh the irony.



12 Comments / Post A Comment

jenny0 (#6,933)

Would love to know more about her side- hustle. Is there a way to contact her? I’m in school in NY too and have been looking for ideas– and it seems like I could do the same here- I got into every school I applied to. Dr. Dee?

Mike Dang (#2)

Yup! This is the website: http://medadmissions.ca/

Dr. Dee (#7,478)

@jenny0 Hey Jenny, you can contact me at drdee@medadmissions.ca.

Take care!

I’ve been waiting for a resident post since that’s the path my husband has gone down – he’s in fellowship now. The debt really is staggering yet it’s hard to fight lifestyle creep after so many years of going without during school and training.

Couple of things that are either different here in the US vs. Canada or not mentioned above that I have encountered while trying to do money with a partner in medical school and then residency…

- Dr. Dee mentions it being difficult to hold down part time work, but many medical schools in the US do not allow students to work period, because in their third and fourth years their rotations through hospitals are seen as unpaid positions. You can be kicked out of medical school for working on the side.

- Ditto with a side hustle. You often cannot “moonlight” your first year or two of residency where you pay is relatively low. Then, you usually need to get approval from the head of your program to moonlight, and they can revoke that privilege at any time based on your performance.

- Probably the same in Canada, but resident salaries are more or less the same for all programs and not adjusted for cost of living depending on where you do your residency, and I don’t have to tell people here that $55,000 goes a lot further in say Indiana than in NYC, but conversely most of the best training programs are in large cities. This Salon article is a great summary of stagnating residency wages over the last 40 years: http://www.slate.com/articles/health_and_science/medical_examiner/2014/05/medical_residents_pay_doctors_in_training_are_organizing_for_collective.html

- The saving grace is you can put your loans completely in deferment for the entirety of your residency and fellowship.

@JNC Musings Factory I’ve also thought about this as a post for the billfold as well, but haven’t written anything because, well I’m not a writer, and its my husbands situation more than mine. Though we’ve been married long enough that our situations are well intertwined. He graduated from residency about a year ago. We were married and financially independent and young and broke when he started med school, but he got into the military health professions scholarship program which he applied to right after he was accepted, and they paid for everything including a living expense stipend. He makes more now during his military service than as a resident, but not “real doctor money” (its about double his residency salary), but its still probably one of the best bargains we’ve ever made. But its not over yet so maybe I should wait before I say that. We have no debt now, except for my relatively small grad school loan.

Dr. Dee (#7,478)

@JNC Musings Factory Hey there, it’s me Dr. Dee! Regarding the differences in Canada, there is nothing barring a resident from doing a side hustle; I personally know a few residents who work part-time in medical school admissions consulting and MCAT coaching. Moonlighting is possible in Years 3+ for specialties, and in The Maritimes as a family medicine (2 year) resident.

Dr. Dee (#7,478)

@Punk-assBookJockey I totally feel you that the medicine experience becomes completely intertwined in the partners’ lives; it’s so all encompassing for better or worse. The military option is a sound one and I’ve met a few residents who went that route for financial reasons.

WriteBikeBobbi (#3,938)

@JNC Musings Factory , you were able to defer loans? My husband could only put them in forbearance, equaling $45,000 of capitalized interest during residency, as we were unable to pay on a resident salary (obviously). I’ve not heard of anyone being able to defer and avoid the interest.

WriteBikeBobbi (#3,938)

@Punk-assBookJockey We too thought about military service, as my husband was an Air Force reserve medic for 10 years, which paid for his undergrad. But after those 10 years, in which he was sent to 18 different countries and in war zones for three different wars, we decided against re-joining to have them wipe away his medical debt. I often wonder if that was the right call, because the lure of having that debt disappear is very strong. You may not make “real doctor money” for a while, but the tradeoff, being med debt free, is probably an incredible feeling!

DebtOrAlive (#5,233)

SO VERY RELEVANT TO MY INTERESTS RIGHT NOW. Bookmarked to be read upon passing my first exam.

Dr. Dee (#7,478)

@DebtOrAlive Are you a med school hopeful or a resident in debt? I’m super curious!

WriteBikeBobbi (#3,938)

Nice to see a post related to medical debt, as my husband and I struggle with how to manage his. He is two years out of residency, working as an ER physician in a very well-paid position in the West (which is tough to find) and I, as the one who manages our finances, still feel overwhelmed and burdened by the debt load and our incredibly high Federal Direct loan interest rate (6.375%, on about $360,000, because he attended a costly east coast medical school). I’m a minimalist, our needs are simple, and “lifestyle creep” is not really an issue. We would like to travel more, and we just had a child and they seem expensive no matter how conscientious you are, but we don’t live any kind of luxurious lifestyle, and that’s fine with me. We basically pay our bills and put the majority of our income toward retirement (because we started late and must catch up) and debt payoff. We’ll pay off his educational debt in 12 years IF we’re lucky. He loves his job and we love where we live, so we feel fortunate — but I struggle with how to allocate money each month, no matter how much there is. I don’t feel great building up a savings account when that great amount of debt is sitting there at a high interest rate.

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