Career and Life Planning Guidebook for Medical Residents

R E A D : Location, Location, Location One of the key factors to consider when deciding where to practice is the cost of living in relationship to your salary. Some of my favorite places in the world are in California. I love the variety of natural resources, from the beaches of San Diego to the High Sierras; I even enjoy its thriving cities (when the smog is not too bad!) However, although the pay may be slightly higher, the cost of living is often dramatically higher in California. For example, a house that may cost $300,000 in Arizona, Nevada, or Utah could run as much as $3 million in parts of California. Combine the cost of livingwith difficult reimbursement, higher state income taxes that are progressive (the 9.3% bracket starts at less than $48,000) and competition for housing in the best school districts, and it is easy to see that it will be difficult to get ahead as a doctor while practicing in the otherwise beautiful Bay Area. There are many similar places across the country on both coasts. You don’t have to live there, and you may be much better off financially if you choose not to. States like Indiana and Texas offer low taxes, a low cost of living, a favorablemedico-legal environment, and incomes comparable or even better than you’ll find in California or Manhattan. You only live once, of course, and money isn’t everything. If your entire family and everything you want to do is located in San Francisco, then you’ll need to deal with the consequences of that and find a way to balance those needs and obligations. Just realize you’ll be swimming upriver from a financial perspective. SECTION III: T MINUS ONE YEAR CAREER AND LIFE PLANNING GUIDEBOOK FOR MEDICAL RESIDENTS 354 “Physicians, like everyone else, are motivated by job op- portunities that offer financial incentives and job security. Most community hospitals still offer substantial student loan repayment; however, we are now taking a more concentrated effort to help our newphysicians understand the value of financial planning. With every new hire, we plan on using this guidebook which does an excellent job of assisting physicians in creating a strong financial plan with a budget they can stick with.“ Suzanne Cooner, CEO, Audubon County Memorial Hospital and Clinics