WELLNESS
Financial Stability and Its Impact on Resident Wellness
SAEM PULSE | JULY-AUGUST 2022
By Kevin Hon, DO, and Ryan Pappal, MD, MSCI on behalf of the SAEM Wellness Committee
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After the marathon that is medical school, residents cross the finish line to do what we dreamt of and sacrificed so much for: practicing medicine. Our progression into “adulting” and finally holding that first paycheck as a doctor is often an exciting one; however, depending on where some of us end up and after paying off the necessary evils of rent and (the elephant in the room) student loans, that first paycheck might not look so great. For some, emergency expenses, childcare costs, and family financial obligations, can quickly turn one’s financial situation into a significant source of stress and professional unwellness. As new residents, we’re expected to be completely devoted to our patients. Further, as newly minted doctors there’s an assumption that now that we have income, we can focus all our energy on learning. But surprise! We are not at all financially stable! In an ideal world, residents wouldn’t have to go
home after caring for patients and worry about making ends meet from paycheck to paycheck; but we do.
PAYE or REPAYE, this debt comes with the side effect of an ever-growing loan principal.
Modern Day Context
During the COVID-19 pandemic, with the interest-free provision from the government, most residents have not had to make any payments; however, the future of COVID-related student debt relief is uncertain and may not continue to be extended.
So how did we get here? In 2021, the average intern salary was $58,921. While resident wages tend to go up each year, they don’t always follow the inflation curve. Furthermore, raises tend to vary even between institutions. For example, this year, Yale’s resident senate negotiated an 8% raise, whereas most other programs have only given raises in the 2-4% range. As inflation hit 8% this year, our salaries have yet to catch up. Thus, residents do not necessarily have more buying power than they did previously; in many cases, they have less. The average intern starts with $200,000 of medical school loans. Because residents are not expected to make a meaningful dent in their loans at minus $300 per month, if they opt for
To account for the variable cost of living, some programs provide housing stipends and even increase resident salaries proportionally. Paying for a tiny studio apartment or living with a roommate in New York City would be nearly equal to a mortgage in Texas or Ohio. Moonlighting could be a viable way to earn extra income, provided that it doesn’t violate duty hours; however, some states, like California, have passed laws that essentially limit the ability of new residents to engage in this venture.
