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Esidencyofficial Publication of the Residents/Fellows Committee, American Academy of Dermatology Keeping Financially Afloat During Residency by Dean Monti

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Esidencyofficial Publication of the Residents/Fellows Committee, American Academy of Dermatology Keeping Financially Afloat During Residency by Dean Monti irinections D Fall 2016 ResidencyOfficial Publication of the Residents/Fellows Committee, American Academy of Dermatology Keeping financially afloat during residency By Dean Monti Resident lives are saturated with books, charts, and a considerable amount of study- ing. With boards and the rest of their careers looming ahead, there is obviously a lot of associated stress. One area of education that’s generally not covered in residency pro- grams, however, is debt. Directions recently reached out to residents about this topic, and received plenty of feedback regarding their concerns, fears, advice, and more. One resident we talked to, Jeffrey Kushner, DO — a PGY-3 at Saint Joseph Mercy Health System in Ann Arbor, Michigan — has been augmenting his studies with a strong inter- est in investment and personal finance. He has researched and read extensively on a variety of financial topics that dermatology residents face early in their careers, and has discovered some universal principals that all don’t realize that they’re lacking the skills 2016 discussed the staggering additional dermatology residents should be aware of. or knowledge to handle their debt until it expense of simply applying to dermatology He has subsequently lectured and given pre- becomes a reality. residency! sentations to his fellow residents on finance For most of us, having a growing moun- Fortunately, not everything is doom and and investment topics. He has no conflict of tain of debt is an anxiety-provoking issue, gloom. We as dermatologists are still well- interest — which is often a concern for those but it can lead some to take an “out of sight, compensated compared to our colleagues seeking advice. He just hopes to provide out of mind” approach. This is undoubt- in other specialties, so the ability to over- helpful, unbiased information as a fellow peer edly a surefire way to create an even big- come debt and carve out a strong financial to any resident with limited knowledge about ger problem from an already unfortunate future is certainly possible. debt and personal finance. situation. For those who try to tackle it For this issue of Directions — after solicit- head on, some of the most common fears ing feedback from residents — we encapsu- See FINANCIALLY AFLOAT on p. 3 include: Will I ever be able to pay the debt lated some of the most prevalent concerns off? Where and how do I start? How will and included them here, with responses from this affect my decisions about where to Dr. Kushner. practice, when to start a family, and when Insidethis issue to ultimately retire? DIR: Residents indicated to us that Today, the increasing medical school debt is a pervasive issue through- 1 Keeping financially afloat in residency tuition and looming threat of decreasing out residency. reimbursements are clouding our financial Dr. Kushner: Debt is a highly com- future, and it’s only going to get worse. 4-5 Boards’ Fodders: Neonatal Ichthyosis & plicated issue. It affects many different Compounding the problem even further is Neonatal Infectious Dermatoses aspects of resident life both personally and our “late” capacity to earn money in life. professionally. The majority of physicians, We usually don’t start making a significant Race for the Case however, do not receive the proper train- salary until our early- to mid-thirties, put- 6 ing on how to manage debt in a timely and ting us “behind the eight ball” compared effective manner. Since it is hardly ever dis- to our friends in engineering or business. 8 Message from the Chair cussed in dermatology training, residents Furthermore, a recent JAAD article from April “Embracing Change is the Key to Skincare Success” The past decade has seen unprecedented changes in professional skincare. Increasing demand. Better results. And distribution that left the control of the physician. That’s why I founded ZO®. We have advanced skincare protocols based on my philosophy of skin health. And our zero-tolerance of product diversion keeps physicians in control. Over 7,000 physicians have already made the change. Experience the ZO® Difference. DR. ZEIN OBAGI Dermatologist and ZO Medical Director DR. ZEIN OBAGI RESPONDS TO CHANGE Created the Science Conceived the Ended relationship Founded ZO Skin Developed new Now Exclusively of Skin Health original Obagi with OMP Health, Inc. medical products Recommends ZO® Nu-Derm® and protocols 1981 1988 2006 2007 2012 zoskinhealth.com | 888.893.1375 The ZO® Difference Better Results | More Referrals | Patient Loyalty | Enhanced Revenue ZO Skin Health, Inc. and Dr. Obagi have no business relationship with Obagi Medical Products, and Obagi Medical products does not sell or endorse using ZO products. FINANCIALLY AFLOAT from p. 1 DIR: Some residents said Dr. Kushner: Consider refi- that their financial situa- nancing your loans. Many of DIR: Many residents we talk- tion directly impacted their my peers believe that the 6.8 per- ed to expressed surprise and career direction. cent Stafford Loan received during concern when they realized medical school is our only option, their finances didn’t match Dr. Kushner: Keep in mind and we are obligated to keep that their lifestyle. your future finances. This rate. Some of you will be getting “Embracing Change is the remains a dilemma for many resi- loan forgiveness through a govern- Dr. Kushner: Live like a resi- dents. While financial considerations ment program which is excellent, dent. This is easier for some than did not dictate the field I ended up but for the majority of dermatology Jeffrey Kushner, DO, others, but it’s probably the most residents, this isn’t the case, and is a PGY-3 at Saint Key to Skincare Success” choosing, it encouraged me to learn important factor: Do not live above as much as I could about debt, you should refinance your loans! Joseph Mercy Health System in Ann Arbor, your means. Once out of residency investing, and finance in general Your offers will depend upon your Michigan. and making significant money for to make myself better prepared to salary to debt ratio, and whether you The past decade has seen unprecedented changes in the first time, gradually grow into handle the monetary aspect of medi- want a fixed or variable option. A professional skincare. Increasing demand. Better results. your attending salary. Or better yet, cal practice. The good news is that if common misconception is that refi- And distribution that left the control of the physician. never fully grow into your attending you live like a resident, you can take nancing your loans can only occur salary! If you have the discipline any job in any location and be suc- as an attending. This is a fallacy. That’s why I founded ZO®. We have advanced skincare to do this after residency gradua- cessful. A strong savings rate is the For instance, Darien Rowayton Bank offers refinancing rates to residents. protocols based on my philosophy of skin health. And tion, you can easily wipe out all of most important take-away point of your debt within five years, regard- They have even established a busi- our zero-tolerance of product diversion keeps physicians this article. However, achieving your less of how much you have. An financial goals is definitely impacted ness relationship with the AAD (for in control. arbitrary but good goal is to save by your salary and earning potential. those who missed their booth in at least 20 percent of your gross Private practice tends to pay more Washington D.C.). I have personally utilized them and subsequently cut Over 7,000 physicians have already made the change. income for savings, debt reduc- than academia; rural pays more than ® my interest rate in half. And more Experience the ZO Difference. tion, etc. For the majority of resi- urban. Your emphasis should always companies are joining the mix every dents, debt is inevitable. The thing be based on happiness, but if you day. I’d encourage you to apply with to avoid, if you can, is debt on top got a late start to your medical multiple lenders and choose the of debt. If debt is a concern, hold career or have higher than average best rate. Again, only apply if you will off whenever possible on burden- debt, you may want to consider the not get loan forgiveness. ing yourself with purchases and more lucrative position… at least lifestyle changes that will put you initially. DIR: Residents feel intimidat- DR. ZEIN OBAGI any deeper in debt. Many residents ed by debt because they lack want to have academic careers, or DIR: Another common dilem- Dermatologist and the expertise that they’re so to give back to their communities ma for residents is figur- ZO Medical Director used to exhibiting in their with volunteer work, but student ing out whether to refinance professional lives. debt makes some of those ambi- or stay in government pro- tions unrealistic. grams. See FINANCIALLY AFLOAT on p. 7 Financial information for medical students Do you have a story to tell about Many residents we spoke to cited The White Coat Investor (whitecoatinvestor.com), a site created and managed by James residency or a spe- cific item of inter- Dahle, MD, who is a financial writer and a practicing emergency physician just a few years out of residency, as a key source of DR. ZEIN OBAGI RESPONDS TO CHANGE est? Study tips, financial information for medical students. Directions asked Dr. Dahle about resident debt. work life balance, Created the Science Conceived the Ended relationship Founded ZO Skin Developed new Now Exclusively unique images, ® of Skin Health original Obagi with OMP Health, Inc. medical products Recommends ZO What is the average debt for dermatology residents? iconoclastic views? Nu-Derm® and protocols I’ve never seen it broken down by specialty, but the most reliable stats are published each year from We’re now accept- the AAMC.
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