How a Medical Student Does Money

Photo by Marcelo Leal on Unsplash.

Katherine (not her real name) is a 24-year-old medical student on the West Coast.

So, Katherine, how much are you earning?

Almost nothing! I make a few hundred dollars a month by participating in research studies and babysitting, but it varies a lot because school is my full-time job.

Do you have a scholarship or a stipend? How are you paying for school and your living expenses?

I have some financial aid, to decrease the cost of my tuition. So far, my family has loaned me the money for tuition and rent, and everything else I’ve paid for with my own savings. I anticipate that I’ll take out federal loans for my third and fourth year.

Do you have a number on how much you’ll probably owe after graduation, both to your family and to the loan companies?

I’m estimating I’ll need $68K of federal loans to cover the last two years. I already owe $58K to my family and there was a $20K gift too (my college fund, because I had a full scholarship for college). So that puts me at $146K total for my degree, and $126K total of loans.

Got it. How will those loans compare to your starting salary, do you think? I know the typical conversation about student loans for professional degrees is “doctors can pay it off, no problem.” Is that actually true?

I think so, although it also depends on the choices you make. There’s so much variation in pay and expenses between specialty, location and lifestyle (including things like having family to support) that it’s possible to pay them off easily, and also possible to feel pretty stuck and weighed down by the debt.

That makes sense.

As of now (still early on), I’m most interested in academic primary care (the lowest paid of just about all the specialties), but I’m confident I’ll be able to pay off my debt within five years of having a full attending salary.

Nice. What do you mean by academic primary care? Is it different from a primary care doctor?

Primary care, but you’re working for a medical center with a medical school instead of in a private practice. So you generally get paid a salary, instead of getting paid based on how much money the practice makes.

Oh, that’s fascinating. I love learning more about how other industries work!

I want to go into academic primary care because I think I’d like to teach medical students in addition to being a doctor.

On the subject of medical students, you had mentioned when you emailed me that your classes included a lot of unexpected expenses — like, you have to buy your own penlights. What kinds of costs do you have that most people aren’t aware of?

Equipment, like your penlights and your stethoscope, study materials, fees for licensing exams (these can be steep, several hundred to more than a thousand dollars, plus travel and hotel to get to special test centers). All fees and travel associated with residency interviews, and transportation to get to clinical rotations during third and fourth year. I live in a city and don’t have a car now, but when I start rotations I’ll either have to buy a car or spend a lot more money on public transport and Uber/Lyft (because shifts are at weird hours when the transit might not be running).

And shoes. People spend a lot of money on shoes because you’re on your feet so much.

Are y’all wearing Crocs, or is that just a stereotype? 😉

I’m not! The most popular shoes are Dansko clogs, which are like $120, but I’m not sure if I’ll go for those or not.

How do you feel about your financial situation, both currently and in the predicted future? Are you happy with it? Comfortable? Anxious?

I was more anxious before I started medical school, because I didn’t know exactly how much it was going to cost — and there’s so much panic over student loan debt. Now I know, and I’m a lot more comfortable with it, especially because I took out a lot of the loans from my family (which is very fortunate and I’m grateful, because most people don’t have that).

I’ve always been a saver and a planner. The plan is working so far, and I’m confident I’ll be able to handle and plan for whatever comes next.

How are your savings doing? Do you have savings at present? Are you adding to them? Do you have any retirement accounts?

I have about $15K in retirement accounts, from the year I spent working between college and medical school. I also have $12K in my slush fund/emergency fund account. I’m spending money out of that account for groceries, trips, clothes, whatever. Once it gets down to $8K or so I’ll probably switch to using loan money for that stuff and keep the rest as my emergency fund. I’m drawing it down more slowly than I expected to because of the income from the side hustles. 🙂

That’s good!

The conventional advice is not to work at all in medical school, which is probably good advice for most people, but I feel a lot more secure having some money coming in, even if it’s not much in the big scheme of things.

The benefit is 75 percent psychological, 25 percent financial.


And it’s a good way to build relationships with people! I moved to this city for school, so I had few connections here, and medical school is a weird bubble (a wonderful bubble, but still a bubble). Babysitting for families in my apartment complex, getting to know the research staff for the studies I’m in, and the volunteer tutoring I do all help me feel more like a part of a community, especially in a huge city where it’s easy to feel anonymous.

That is a smart move. When I was in grad school I rarely interacted with people outside of my program, except for the one summer when I got a temp job at an insurance agency.

It’s a way to contribute in the short term. As a student, you feel pretty useless and clueless a lot of the time. You know all the time studying and learning will pay off some day, but it feels nice to earn money and feel like a competent person and help someone out every once in a while in the meantime.

That’s such a great perspective.

Last question, then: what advice do you have for Billfold readers?

Plan ahead, but know that you can only plan for so much. And use your Billfold experience to talk more about money in daily life. I’ve had some good conversations about money and life with classmates and friends, I think because reading The Billfold has helped me feel more comfortable talking about money in an open but also sensitive way.

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