From the beginning of time people always assumed that physicians made a lot of money, that they were rich compared to the rest of us, and that their lives were so easy financially… but the early years after residency can be very tough on a young physician. There are so many different choices and hoops doctors have to jump through just to reach their finical success and freedom like the rest of us. At times I feel bad for doctors and the amount of debt most of them carry with them. To give you a better idea as to why young physicians have so much debt let me break down the process of becoming a board certified Cardiologist so you can see how expensive it is just to be a doctor.
First you start your undergraduate degree at well renowned university. Applying to colleges like the rest of you friends leaving high school, going on campus tours, and ultimately trying to get into an honors college and or pre-med program (if you’re lucky enough to know you want to be a doctor by 17 years old). After applying to your undergrad locations you await the letter of offer and take your favorite one. Sometimes scholarships are available and may your will get a few thousand dollars here and there to help cover books and three or four credit hours, but most likely you will apply for a student loan. Living in the dorms is ideal for your first two years at college, so you spend money on housing and the traditional dorm room essentials. Your bed, microwave, décor, etc. the meal plans in undergrad could be a rip off or money saver depending on how you use it, and once your onto your third and fourth year of undergrad, living off campus in a house with friends is definitely a must.
Renting a house vs. apartment living, which is better for your pocket? At this point in your education, studying should be more important than your social life or bank account. Choosing a quiet, study-friendly environment with a good roommate or none at all could make or break your MCAT score. Put yourself and your future first, even if it means accumulating more debt and getting more loans just to live in a one bedroom apartment. There are ways to save money if you live on your own, don’t buy a lot of extras, and try to save money the best you can. Look into getting a part time paid internship to help with you spending cost. Using the least amount of your loans is important. The cost of furnishing a house is sometimes not a priority when you’re in college, so most doctors just buy the essentials for their environment. People buy a bed, tv, and a desk, a couch and entertaining space are not necessary when trying to get into medical school, focusing on the future and trying to save as much money as possible is more important.
Applying to medical school can be one of the most stressful times in a doctor’s life. Deciding where you want to go and what state you want to live in is only part of the stress. Choosing an MD or DO school is a big decision to make, along with thinking about a backup choice or two to an international in the Caribbean if you don’t get accepted into your American medical schools of choice. Once you have been accepted to your medical school and make a decision on where you want to spend the next few years of your life, you have to apply for more loans. Applying for medical school loans can be tricky and doing your research about your own financial future is one of the best things you can do for yourself. No one else is going to take care of you finical future the way you will so being knowledge on your debt, loan payments, and interest rates is key. If you thought undergrad was expensive, then you have no idea how pricey medical school can get. Most people don’t work during medical school, and even if they could have a part time job, their grades would probably suffer. Living close to campus the first two years of medical school is important for your social life and grades and if you go to a Caribbean medical school, living on the island can be a huge adjustment. Remembering everyone at school is new too. and in the same boat as you can help ease the stress of starting medical school, but the exams you have to take over the next four years are life changing.
There are three major exams each medical student needs to take prior to starting residency, and each exam isn’t cheap. Step 1 is a make or break exam taken at the end of your second, beginning of the third year. The exam can set the tone for what type of residency and specialty you can pursue in the future. Step 2 CK test your clinical knowledge and Step 2 CS test your clinical skills. The exam scores are looked at by all your potential residency programs and if you fail one it will be on your record forever.
During you’re third and fourth years of medical school you are doing rotations in different specialties at multiple hospitals. If you aren’t lucky enough to be at an establish US medical school you might need to find your own clinical rotations and travel across the country to complete your requirements. Transportation, room and board, and food are all on your own dime when doing these rotations. For reasons like this, you will be using your student loan just to live and fulfill your basic human needs. Doctors aren’t throwing away their loan money; they are using it to complete their education.
Once you’re in your fourth year of medial school it’s time to apply to residency! If you thought getting into medical school was competitive, that’s nothing compared to residency. Remember the Step exams you took? Well good scores will set you apart from the pack, and bad score will come back to haunt you. Every program you apply to cost money for the application. Once the applications are received, the programs review them through filters, and if you don’t meet their criteria they don’t even see your name. If you’re lucky enough to get an invitation to interview at a residency program you applied to its on your dime to fly there, pay for your own hotel room and find transportation to the hospital where the interview is being held. Buying a nice interview suit and attire is essential for residency interview season and all those things cost a lot of money. If you are good candidate then interview season can cost a lot of money. With the traveling and hotel cost there is no cheap way to get through residency interview season. Depending on where you went to school, your opportunities may vary. Internal national graduates have a more difficult time getting residency positions than US graduates but no matter what type of school you went to, spending your loan money on all those interviews is a necessity.
Once you finish interview season and finally “match” into residency, it’s time to review your contracts, benefits, and extras that come with the deal. If you want to become a cardiologist you first have to complete three years of Internal Medicine residency, and with residency comes a salary. Once you have a job the government wants you start paying back your student loans, but make sure you ask your residency program to defer your loans for you. You will have to file the paperwork and once again, educate yourself on your financial options and methods for payback. Understanding your loans and how much you need to pay per month will give you peace of mind. During residency doctors don’t make more than $55k per year, and having to pay for a house, car, and loans makes living life very difficult. After two full years of residency its, time to apply for Fellowships in Cardiology.
This application process is very similar to the process from medical school to residency, and cost just as much! Flights and hotel stays for interviews can rack up, so hopefully during this time you aren’t paying back your student loans just yet. After fellowship interview season is over, it’s another three long years in Cardiology fellowship making at most $60k per year. There is not overtime pay, and vacation time is few and far between during fellowship. Passing your internal medicine board exam is priority in the first months of fellowship and then through the three years of fellowship you have study for your cardiology boar exam. The amount of hours you work vs. the amount of money you make are comical.
Once all is said and done, becoming a cardiologist takes a minimum of ten years and puts you in over a quarter of a million dollars of debt….at least.