Top 10 Things to Do Before Starting Residency

Congratulations on matching!! I remember the immense relief my wife and I felt after finding out where we would be heading for residency and spending the next few years our lives.

You are probably wondering, like I was, what you should be doing to prepare for residency.  

After living through this myself, and talking to numerous other residents,  here are my top 10 things to do before starting residency.

 

1. Vacation Abroad

Travel Abroad - Residency

After graduation in May, you will have 1-2 months without any school or work related responsibilities. During residency, you will be working 70-80 hours a week and on call every other weekend.

I highly encourage you take this opportunity to travel. If your funds are limited, this works great as a graduation gift (if you can talk your family members into it *wink wink*).

Take advantage of this time in your life, this will will likely be your last opportunity to do this until well after residency is over.

 

 

2. Spend time with friends

Hang out with your friends to celebrate and see what plans they have for their time off.

As much as you say you will keep in touch and see each other periodically while in training, this very rarely ends up actually happening.  Limited free time, being on different schedules (nights/days), and the sheer distance between programs is not conducive for long distance relationships.

 

 

3. Upgrade your gear

Cardiology IV - Residency

Finally getting paid during residency might sound awesome, but your budget is going to be tight, real tight. Now might be a good time to go ahead and replace some of your equipment. You don’t want to have to penny pinch if they end up breaking on you in the hospital next year. 

I, like many of my classmates, bought a relatively cheap stethoscope for my clinical rotations which didn’t hold up well. The incessant shoving into my backpack/short white coat pocket and leaving on the seat of my truck turned it into a wet noodle.

You will be using day in and day out, unless your an Orthopod. I would encourage you not to skimp here and get something of quality that will last.

I highly recommend upgrading to the 3M Littmann cardiology IV. There was a huge difference in the clarity of heart and breath sounds after the switch.  

It is a quality piece of equipment that, with proper care, should last you the rest of your career.

You can also snag replacement ear-tips and diaphragms for fairly cheap online here if they ever need replacing.

 

 

4. Find a place to live

Rental for Residency

For most places, rental properties for June/July move-ins will start listing at the end of February. Websites like Zillow and Trulia are great free tools you can use to get started.

Figure out how much a month you can afford in rent by using a free calculator like this one hereThis will help narrow your search down a bit.

If you have children, keep an eye on the school district the property is in and the safety ratings. Something relatively close to the hospital (10-15 minutes) is also not a bad idea. Minimizing your commute will help to maximize your time with family and friends away from the hospital. 

Talk to current and outgoing residents about where they live. As new interns start every year, graduating residents are moving on and leaving their house behind. And with residents, for the most part, being ideal tenants, many landlords will opt to continue renting to us.

My landlord dropped the price of our rent just to keep us as a tenant.

Being able to move into a house that has already been vetted by someone else can take a lot of the headache out of searching for a place.

You may have noticed, I haven’t mentioned buying a house here. There are too many variables to suggest an overarching recommendation here. If it is something that makes sense for your situation, this isn’t necessarily a bad decision.

I do, however, highly recommend renting as a residentSomething will inevitably break and need repaired. Putting this burden on the landlord will save you precious time and money in repairs.

 

 

5. File your taxes

But wait, I don’t have any income. Why should I file a tax return?

Filing your taxes now will show a $0.00 income.

use your income from the previous year’s tax return to calculate your monthly payment.

This means you will have 12 months of paying $0.00 which will count toward the total number of payments needed before loan forgiveness!!

This is true for any of the traditional IBR plans and with Public Service Loan Forgiveness.

 

 

6. Develop a Game Plan for your Student Loans

When it comes to paying off your student loans, many of you are probably considering forbearance. This is when you delay making any payments on your loans during residency and start making payments once you have a higher income.

However, while in forbearance, interest will still be accruing on your loan amount.

The average amount of debt upon finishing medical school in 2017 is $189,000. You will owe an additional $39,000 in 3 years or $69,000 in 5 years just in interest. (at the average 6.5% interest rate).

Taxes Before Residency

With the income based repayment options IBR, PAYE, and REPAY now available, forbearance is becoming less and less common among current residents.

These allow you to begin paying off accruing interest in reasonable recurring monthly payments (as a married PGY-2, I am currently paying $267.00 a month with PAYE).

If you do decide to opt into an income based repayment plan, you should consider enrolling in the public service loan forgiveness program. Payments you make during residency will count toward the 120 payment total you need for loan forgiveness. This will open up more opportunities when searching for a job later on. Lower paying non-for profit positions may end up being more viable than the high salaried private practice when factoring in loan forgiveness.  

There will be an upcoming blog post about this later on in the month going into more detail about PSLF. 

 

 

7. Read about finances and investing

For most of you, myself included, residency will be the first “big boy/girl job” you have ever had. And, like me, your financial literacy is likely extremely low.

The good news is that you have time to do something about it. 

If you haven’t heard about The White Coat Investor yet, this is a great place to start. Referred to as the bible of physician finance, this book (and blog) has high yield information that will save you from making silly mistakes with your money. This will also help you during your orientation when making decisions about and choosing funds for your 401K/403B accounts.

White Coat Investor - Residency

The vast majority of the information can be read for free at his blog White Coat Investor. You can also pick up his book in audio or paperback online at amazon here.

You can also Try Audible and Get Two Free Audiobooks to use one on The White Coat Investor.

 

8. Do some Spring cleaning

The only thing worse than having to pack up all your belonging before moving is having to go through and organize at the same time.

Moving is, unfortunately, a necessary evil that many of you will have to experience prior to starting residency. And after four years of medical school, if you are anything like me, your place is likely less than pristine in the cleanliness department.

Slowly start working on going through your old clothes and donating those that you don’t wear any more (or no longer fit).

Some residencies will give you a relocation allowance, but I do not think this is common practice.

Most moving trucks will charge by the square foot. Getting down to your essentials will help with the hassle of moving and overall hit to your wallet.

 

 

9. Get in shape

Getting Fit During Residency

Let’s be realistic, you have put on a few extra pounds during medical school. Unfortunately, getting into the gym will only get harder during residency.

If you start getting into the habit of going to the gym now, it will be easier to continue when you start working.

Exercise has also been shown to help combat depression and anxiety. This, which I am sure you are well aware, can run rampant in residency programs.

If you are new to exercising, there are plenty of great beginner programs for free on bodybuilding.com.

Improve your physical health while protecting yourself from the mental demands of residency.

 

 

10. If you have to, Study, but do it passively

I contemplated putting this on the list at all. In my opinion, you should not concern yourself with trying to study right now.

 

Instead, you should be enjoying your time off.

 

But I know some of the gunners out there just can’t resist.

 

Some of students have to do some type of studying to prevent you from going into full blown panic mode. If this is you, you should at least do it as passively as possible.

 

There are a ton of great podcasts available that covering high yield material in short (10-15 minute) episodes.

 

These episodes are just long enough to finish during your morning commute into your radiology elective.

Primary Care Rap - Residency

EM:Rap - Residency

 

 

 

 

 

 

 

 

If you are going into primary care, Primary Care RAP by Hippoed is a great podcast. Many residents, including myself, listen to these on a daily basis. Hippoed is the same company who produces EM:RAP which, by this point, I am sure you have heard of.

 

They also have a podcast for Pediatrics and Urgent Care.

 

There is an annual membership fee of $95.00 for residents. If you use my referral link here or code “kutrionu” at checkout, you will get a $25.00 discount.

 
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Current PGY-2 Family Medicine resident at a Full-Spectrum FM residency program in the south. Fitness enthusiast, Investor, Husband, and future father come October 2018.

KT

Current PGY-2 Family Medicine resident at a Full-Spectrum FM residency program in the south. Fitness enthusiast, Investor, Husband, and future father come October 2018.

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The Physician Philosopher
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Great first post! I like your advice a lot. Really solid.

I would be curious to know why you chose PAYE over REPAYE given the interest paid during REPAYE. I assume it’s because you plan to do PSLF and your spouse has a significant income. Otherwise, REPAYE usually wins hands down given the interest that gets paid by the government.

I look forward to reading more posts from you guys. Writing posts consistently takes a lot of work, but I think it’s a great outlet!

p.s. your website looks great!

 
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I Really appreciate the kind words. This is the cumulation of things we have been discussing between each other for a while now. We are hoping that by sharing our thoughts and experiences we can help others not make the same mistakes we did. You are correct, REPAYE is typically the better option. My wife’s income is about the same as my own. The idea was to do PAYE while filing taxes as married filing separate to cut our monthly repayment in half. Since I am in primary care, and doing PSLF, I was not too concerned about the differences… Read more »