Money Magazine - Young Doctors in Debt

[sakky]

<p>

Sakky, these two future doctors are making a bet that they will be able to afford the debt they are taking on when they become doctors. They are borrowing now and they are expecting their future earnings to take care of that debt.</p>

<p>Is that a bad bet?

</p>

<p>Well, let me put it to you this way. What would you think if you saw one of your kids spending beyond their means? </p>

<p>That’s what it ultimately comes down to. If you don’t have money, you’re not supposed to be spending money. Responsible parents don’t teach their kids to assume a boatload of debt and then still expect to live the same lifestyle than they would otherwise. Debt is supposed to be constricting. If you don’t want your lifestyle to be constricted, then you shouldn’t go into debt. </p>

<p>

Sakky, I don’t think this is getting us anywhere. I have no doubt that we each fully understand and appreciate the other’s points on the cable issue, but we’re arguing from very different end points - where I don’t believe there is any middle ground. I keep saying that we aren’t in a position to question the decisions they’ve made and you are saying they need to make better decisions. I don’t see where this can go any farther.

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<p>I’m simply saying that one should adjust your expenditures to match your current financial situation. When you don’t have money, you should try not to spend money. </p>

<p>I’ll put it to you this way. I know rich MBA students who were former financial analysts and who knew that they would almost certainly be heading into another highly lucrative finance job after graduation, yet adjusted their expenditure levels when they went back to school; for example, they got dirt-cheap apartments, ditched their cars and relied on mass transit, and became mavens at finding all of the free food on campus. And yes, many of them decided not to sign up for cable-TV either. </p>

<p>

In the case of residents though, all the leverage rests with the residency program. As much as the hospital needs the cheap labor provided by residents, completing a residency successfully is much more important for the resident than labor issues are for the hospital. While residency is a job, it’s also an educational component, one that if not completed leaves one’s career hopes sharply diminished. Because of the match and the timing of it, there’s almost zero freedom for residents to move once they’ve committed to a program. I believe (don’t quote me on this) that submittal of a rank-order list confirms understanding that the resident is in agreement to work where they are matched and only in extreme circumstances can changes be made. Because of this set up, residents are lacking one key component that the people you made reference to have - the ability to walk. Regular employees (of any business) don’t have to worry about the detriment to their future careers that leaving a residency program might have on a young physician’s. All the power in such a situation lies with the residency program. What options does a resident have?</p>

<pre><code>* They can stick it out and refuse to get a phone, only increasing the ire of all those they work with, yet some how manage to avoid getting fired.

• They can cave and get a phone and survive with little to no repurcussions
• They can stick it out, refuse to get a phone and get fired, thus leaving them mid July/early August with no where to go, and a dismissal on their hands that they have to explain when they go through match for the following year. (And Residency Directors most definitely talk to each other).
• They can quit on principle, still have no place to go, have no job, massive debt and have to go through the match again.
  </code></pre>

<p>Now if you’re in a city like Chicago, and a common specialty like Peds, there are probably some other options, and you can explore what nearby programs have open spots…but it’s not like there’s a whole lot of hope.</p>

<p>But if you’re an Ortho resident in Denver at the University of Colorado…at the only Ortho residency in the state, you have zero other immediate options nearby, and since ortho is so competitive, it’s not like there are open spots just laying vacant all over the country.

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<p>Well, if that’s the case, then you have to ask why don’t hospitals just press the advantage to the fullest? For example, why even bother paying the residents at all? Why not just tell residents that they don’t really have a “job”, but are simply in an extended training and educational program, and hence, they don’t have to be paid a salary? Heck, why not just make the residents pay the hospital to work there? You said it yourself: the doc’s wouldn’t be able to do anything because they have no options. </p>

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<p>Of course all this assumes that you’re some sort of weirdo anyways who has managed to live through 2007 without a cell phone (I know of one person under the age of 40 who doesn’t have a cell phone - hell, my grandmother has had three phones this decade). So who knows what sort of crazy decision such a person might make.</p>

<p>But the point is, yes, there is a chance at negotiation, and yes, the fair thing would be for the hospital to subsidize, but those things aside, the situation is more complicated than that.

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<p>There is a big difference between having a cellphone, and actually telling your employer that you have a cellphone, as well as providing your phone number to your employer. I believe you are perfectly within your rights in simply choosing not to provide this information simply because of it’s personal nature. {After all, it’s my own personal number. What’s next - do I have to tell them what my personal email address and the URL of my personal blog is too?}</p>