Is a positive net worth as a resident possible? Absolutely. Are people doing it? According to statistics, obviously not. One of the most audacious goals here at Millennial in Medicine is to finish residency with a positive net worth. It’s possible. And I’m not the only one who thinks so.
So many of our decisions in healthcare, from which specialty to choose to who we work for and where, are dictated by the specter of ever-mounting debt. We try to forget about it by choosing the most lucrative path we can, in the hope we will earn so much that we don’t need to worry about the debt number, even knowing it will double (almost twice) if we don’t pay it off for 20 years. I don’t need to elaborate, especially not to you. It’s why most doctors and dentists can’t afford to practice the way they want to practice, and most never will. It’s a significant component of the healthcare crisis.
Imagine for a second that you could choose to work in any specialty, anywhere, because the burden of paying for it over your entire career is lessened. Picture logging into your various financial accounts at the end of residency, or five years after graduation, and seeing investment accounts that nearly match your student debt–or selling the home you bought when you started and now being in the black. You would be able to practice where you want and how you want. You could focus on your life and your patients, rather than the hospital management demanding you see five patients in an hour to keep a job you can’t afford to lose.
Not so long ago, this dream scenario was achievable, even expected. The generation of physicians and dentists who are just now retiring are also the end of an era, when the Feds subsidized professional school and tuition was four figures. Want to know where the idea that all doctors are rich came from? Yep, those guys. The ones who graduated in the early 80s with a handlebar moustache, $20,000 of debt, and the potential to make millions. It must have felt like being a humanitarian Pablo Escobar. Today’s world is vastly different, unrecognizable to their eyes. Debt on graduation of $250,000 or more is normal. Interest rates on government loans range from 3.5% (undergrads) to over 9% (Grad Plus loans). It’s a product of increased government and business involvement, the higher education bubble, and many of their own decisions. It’s why a lot of them no longer recommend medicine to their kids, my dad included.
But today’s world is vastly different in other ways, too, ways that dramatically alter our circumstances. Ways that should give us hope. That’s what I realized one fine spring day in my second year of residency, the day this journey really started. My millennial mind, relentlessly searching for the career and lifestyle to marry its many interests and demands, suggested we don’t need to look back at the history of medicine, at how our forebears trained and practiced. We need to think about the advantages of today’s world, and how radically they’ve transformed every other industry. It might take awhile to do the same to healthcare–we’re legendary for our stubbornness–but it can and absolutely should transform our lives. There are people with no education starting multimillion dollar online business, our contemporaries are retiring well at 28, and a plethora of tools help our generation earn money with little input, invest it effortlessly, and overcome the traditional barriers to living well at a young age.
This blog chronicles my journey in healthcare, from finance to life balance. And it’s not just me. In the Docs Outside the Box series I’ll introduce a multitude of others navigating the healthcare problem: practitioners who are maximizing life through intelligent investing, intrepid practice models, jobs that enable world travel, and their outside interests. Millennial in Medicine will delve into each of these elements: how to reduce debt and invest while a student or resident, how to make time for side hustles and passion projects, and thoughts on changing our future for the better by taking back some control over our careers.
The healthcare system needs help if it is going to remain a promising destination for talented and driven students. We’ve lost too much leverage from ballooning education costs, longer training routes, and the perpetual shaving of physician autonomy and salaries by other major players (healthcare management, insurance, and government). Millennial in Medicine is about examining these issues and finding creative solutions, as a sizeable but discreet contingent is doing already.
As for the original question, how to attain a positive net worth in residency, the answer is with strategic planning, just enough discipline, and a willingness to tackle the problem with originality. Over the coming months I’ll outline the many ways I have saved money while living well, earned significant income on the side, invested with minimal time input, and otherwise increased my chances of finishing with a positive net worth. You can track my progress with my periodic updates: so far I’ve got an education that cost $400,000 with a student loan debt of $174,000. I’ll share more specifics as time goes on, and I learn from my own mistakes. There’s much more to come about how to leverage your position throughout training to put yourself ahead of me!
Thoughts? Is this possible for the average professional student? How are you increasing your odds, and what specific challenges are you guys facing?
