By Molly Lewis
OK, you can breathe easy- you have a job next year! But you also have less than three months to “get your affairs in order” before the craziness of intern year begins. What do you need to get done before residency orientation begins? Here’s a checklist that should get you started:
START DATE – For good or for bad, we start working before the infamous July 1st intern year start date. Figure out when your program holds their orientation, and make sure you’re moved into your new place in plenty of time.
HOUSING – To buy or to rent… what a big question! Ask residents in your new program what they recommend, but be sure to ask for more than one opinion. Also, try to ask residents in similar family situations as you.
- One option is to rent for a while to become familiar with the area, and buy later.
- For a simple formula to help you make the best choice financially, see the end of this post.
Think through what’s important in your choice: price, proximity to the hospital, neighborhood feel, etc.
- Keep in mind how much yard work, housework, etc. your new place may require.
One plus of renting is the maintenance service provided by the landlord!
LOANS -Meet with someone from your school’s financial aid staff to discuss your loan repayment options. Paying off your loans over a longer amount of time can allow you to invest some of your earnings and end up with more money in the long run.
Also check out https://www.aamc.org/services/first/medloans/ for calculators that give you the details of various repayment options. (currently enrolled med students get free access).
*** Be sure to tell your loan servicers your new address as soon as you know it!
BUDGETING – Careful! Your 1st paycheck probably won’t come until Aug. 1st or later. In the midst of your 4th year traveling and festivities, save $ for rent, groceries, bills, emergencies, etc. until then.
Even after you start making $, don’t go crazy- live within your means!
- Avoid credit card debt like the plague!
INSURANCE – When will your insurance (health and/or disability) through your residency program begin?
Does the insurance cover pre-existing conditions? (Some programs may cover these conditions, but not until you’ve been in the program a certain period of time).
If there’s a gap in coverage between your med school and residency insurance, consider paying for a temporary extension of the med school insurance.
Try to have several days off to study beforehand, but not as long as Step 1 or 2.
A plus of taking it earlier:
- you’ll be licensed and able to moonlight (if that’s allowed by your program)
Pluses of taking it later:
- It costs a lot of $, which you may not have available at the moment
- Studying for Step 3 may get in the way of studying for your new specialty
If you’re in a more general specialty (med-peds, family med, emergency, etc.), you may benefit from taking it later after you’ve learned more on the job.
If you’re in a more specialized residency, consider taking it earlier, before you forget everything from med school.
RESOURCES -Prepare your intern resources/tools before you need them:
Choose just 1 intern survival guide, and know it well
Similarly, choose one pharmacology/meds app that is well-reputed, updated often, and works well for you
A note-taking app for important phone numbers, etc.
- Little bits of paper are way too easy to lose!
A to-do app for your daily to-do list
- Again, it is way too easy to lose your patient list with all your to-do check boxes for the day. As much as possible, keep your to-dos on an electronic list that can’t be accidentally thrown away with your lunch trash.
“BRAIN ATROPHY” – Don’t let 4th year give you “BRAIN ATROPHY”
Yeah, it’s tempting to take advantage of your last few months of “freedom” and never crack a book. But, on intern week one, you’ll be stressed and your patients won’t be in the best of hands.
- (Not to mention that Step 3 studying won’t be as painful!).
Enjoy your free time, but commit to reviewing 1 key disease/diagnosis per day. Brushing up on common presentations, methods of diagnosis, and treatments for just a few minutes a day will make you stand out as an intern, as well as prevent dangerous errors.
- For example, learn how to safely write for pain meds!
Try the pdf below to start: http://www.einstein.yu.edu/uploadedFiles/Pulications/EJBM/82-85%2027.2%20Amanatullah.pdf
- (disclaimer: I haven’t read the entire article myself yet, but from the parts I did read, it seems to be quality intern advice!)
To rent or to buy?- try this simple formula!:
- Take the average monthly rent for a similar property in the area and multiply it by 12 to calculate your annual rent.
- Divide 55% of the annual rent by the purchase price for the home you’re looking at buying.
- The resulting number is called the capitalization rate on your investment.
Generally speaking, if the cap rate is greater than 5%, it makes sense to buy (a) if you’re going to be living there for at least 5 years (the average break-even point on a home purchase) or (b) if you think you can expect sufficient appreciation of the property’s value during the time you’ll be living there to offset the various costs associated with home ownership (closing costs, mortgage insurance, maintenance, etc.). If the cap rate is less than 5%, you’ll be better off renting, especially if you’re going to be in that particular location for any less than 5 years.
Rent vs. buy formula: Walter Wiggins, via White Coat Investor – a financial blog by a physician, for physicians: http://www.whitecoatinvestor.com