A financial perspective to Interviewing and relocating to a residency program.
Jose Espada Oct 23, 2015
Summer and early fall, reminds me of what is at stake for fourth year medical students. After three years of hard work, it comes down to selecting a specialty area and financially investing more in the process that will help secure their future. For many, it means getting into another $15,000-plus in debt to pursue those dreams. After all, what is another $15,000 at this point when you have already invested over $250,000 in attaining your Medical Doctorate?
One of the first steps is applying to medical residency programs in the applicant’s specialty choice. This is done electronically through the Electronic Residency Application Service (ERAS) that transmits residency applications, letters of recommendation, the Medical Student Performance Evaluation (MSPE), transcripts and other supporting credentials from applicants and medical schools to residency and fellowship programs. This can be expensive depending on the advice of the student’s academic/career advisor and a host of different factors. We have seen medical students who have spent in the range of $1,500-4,000 with a few outliers on either extreme. The cost is tiered depending on the number of applications. In talking with students some have applied for more than 80 programs, especially for those very competitive programs like Dermatology, ENT, Neurosurgery, Orthopedic Surgery and Plastic Surgery. I am sure there are others.
The excitement increases in October with applications off to residency programs and students begin hearing back from residency programs inviting them to interview. You begin seeing the joy on student’s faces as they share the number of interviews they have received and see the good feeling knowing that someone out there wants them.
Most of the costs related to securing a residency position is associated with the interview. The cost of travel, accommodations and incidental expenses can vary depending on where the student interviews and how many interviews they go to. The Class of 2015 spent an average of $3,400 ranging from as little as $500 to over $15,000. Residency programs do not reimburse students for interviewing expenses. The student must budget carefully and try to keep costs contained.
The applicant is at the mercy of the residency programs on when they interview. This can get expensive. It is not uncommon for an applicant to be in New York, then to Los Angeles and back to New York again. Have you looked at the cost of flying lately? Of course, this all depends on the career and in some cases, you have to do what you have to do to secure a competitive residency position.
The National Residency Matching Program (NRMP), is a private, not-for-profit corporation that provides a uniform date of appointment to positions in the graduate medical education (GME) in the United States. The fee is minimal, but yet another cost.
Although in the financial aid world, we can account for these expenses detailed above, what we cannot account for is the expenses related to relocating to a residency program. In March, when the student finally knows where they will be going, there is the surprising relocation expenses. In some cases, relocating can cost upwards of $10,000 in cities like San Francisco, New York, Boston or Washington DC. These expenses are not provided by the residency programs and financial aid cannot not help a student with these expenses. There are private loan sources available for this and we make students aware of these resources, but keep in mind that they are private loans and can be unpredictable and expensive.
The financial pressures do not stop there. The joy of matching and finally relocating brings other financial pressures, especially when your first pay check as a resident is not until the end of July or early August. As you can see, financially speaking, why fourth year is a financial whirlwind. Preparing for this year is essential and we often suggest that students begin planning as early as possible by setting aside unused financial aid from previous years.
There are ways to save money. While traveling, keep your meal selections frugal. Often the residency programs will provide a meal or two. Take advantage. If you need to purchase new interview attire, look for specials during the off season (generally in the late spring and early summer). Research the interview location to help with transportation budgeting (shuttles are generally less expensive than using a cab). Perhaps, checking with the alumni office on alumni in the area that could recommend cheap and safe accommodations or possibly shack up with an alumnus.
Check out SmartMedTravel.com. This is a site developed by two medical school graduates in response to travel costs related to the interview process. You may find the information helpful.
Additional money saving ideas can include sharing a hotel/rental car with classmates that might also be interviewing at same program (happens more that you might think). You can get some assistance in how to do this at the AMA Alliance. Stay with family and eat their food while on the interview trail…it’s free!!! Leave the wife and kids at home! It adds expense to the trip and you cannot be reimbursed for it through the financial aid process.
There are lots of flights, hotels and cabs in big cities create a great deal of expense during the interview process. Take the opportunity to get an idea of cost in the city you interview in. A good indication is the cost of flights, hotels and cab rides can give you great insight on what you may experience, if you choose to live there. For example, a city like New York City can be loads of fun with lot’s to do, but is also extremely expensive on a resident’s budget! Keep in mind that your residency paycheck will be the same/similar if you live in a place like New York or if you in Indiana. The latter will go further as the cost of living will be a major difference. The cost of living is far more inexpensive in the Midwest and South than living on either coast (something to think about).
So, needless to say, this time of year can be stressful amidst the joy of feeling wanted.