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Vagabond, if you don't think that medical school is the right place, would residency be a better choice? Residents definitely have more ways to directly apply the knowledge than medical students.
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Vagabond, if you don’t think that medical school is the right place, would residency be a better choice? Residents definitely have more ways to directly apply the knowledge than medical students.
Probably, but at this point, many are already in the hole and making bad decisions (i.e. Buying property, not contributing to retirement plan, mismanaging loans, etc.) And in residency, who is qualified to instruct? The guy who made a killing in managed futures (yes, we had a guy who transitioned his radiology professorship into a managed futures firm that he sold for in excess of $100M)? Should it be done at the university or hospital level, outside the residency program-that makes the most sense for larger programs?
Why does it have to be spoon fed to med students or trainees like gross anatomy? Can't people just pick it up on their own? While there are a lot of rules and laws that need be followed, we are not talking rocket science here.Comment
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In case anyone isn't in tune with my tongue-in-cheek critique of the majority of articles posted on KevinMD, here's a tounger-in-cheekier one from my favorite medical satire site: http://gomerblog.com/2017/03/kevinmd-burnoutComment
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Great article, WCI. Unfortunately, one article won't make the change happen overnight, but with a million baby steps, we'll chip away at this problem. I've been working on an article in a similar vein as yours for the past few weeks that I'm planning to submit to KevinMD. We'll see if the KevinMD editors are on board with pushing for improved financial literacy among physicians.
- Wall Street PhysicianComment
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I like the message.
I'm not sure what my thoughts are on medical education. I teach residents a lot and they do seem interested - at least near the end of the residency. I remember making up spreadsheets and investment plans and researching retirement savings accounts when I was a teenager. I have always been interested in making life easier for my future self. Others do not care. Forcing them to take required training may or may not help. If they find it boring or they lack "the X factor" maybe it would be futile.Comment
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Vagabond, if you don’t think that medical school is the right place, would residency be a better choice? Residents definitely have more ways to directly apply the knowledge than medical students.
Probably, but at this point, many are already in the hole and making bad decisions (i.e. Buying property, not contributing to retirement plan, mismanaging loans, etc.) And in residency, who is qualified to instruct? The guy who made a killing in managed futures (yes, we had a guy who transitioned his radiology professorship into a managed futures firm that he sold for in excess of $100M)? Should it be done at the university or hospital level, outside the residency program-that makes the most sense for larger programs?
Why does it have to be spoon fed to med students or trainees like gross anatomy? Can’t people just pick it up on their own? While there are a lot of rules and laws that need be followed, we are not talking rocket science here.
While it sounds good, the problem in practice is it simply doesnt work.
It makes sense in med school, but thats a stop gap measure. We really need this at every stage of school, along with courses on probability, statistics, and critical thinking. Those four changes long term could really make a difference.Comment
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In case anyone isn’t in tune with my tongue-in-cheek critique of the majority of articles posted on KevinMD, here’s a tounger-in-cheekier one from my favorite medical satire site: http://gomerblog.com/2017/03/kevinmd-burnout
I actually think you bring up a good point here and one that has always struck me except I thought I was the only one who noticed. I went to med school at age 31 after working for several years and had been to graduate school. I couldn't help noticing early on, that med student "journals" and newsletters, and now blogs etc., seem to focus on invented issues like how bad we feel that not everyone gets world-class health care, how concerned we are about burnout and work-life balance, and new forms of art therapy for patients with learning difficulties. Well I guess some people are honestly concerned about those things. But while we are focusing our minds on those topics, with only so many hours in the day, we are choosing to ignore reality and real world issues like what the WCI is raising in his excellent article. I really think those Med Student journals are doing a disservice to their readership by this incessant distraction: Pay no attention to the hammer about to drop on your head when you are $300,000 in debt at the end of Residency--instead let's focus our well-honed intellect on pet therapy and its effect on patient satisfaction surveys! Med students are mostly people who have never worked a real job and just have no idea where they are headed--they are being starved for reality-based guidance in personal financial planning so it's great to see the WCI calling in the wilderness. As an aside, one of my good friends in med school was a former attorney before med school and he and I used to talk about how basic legal education for future doctors is also severely lacking--most students in our class just had no concept of liability, torts, insurance, etc. and this is also critically important.Comment
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Well-written, as always, but I take issue with one point. I do not believe that it is the responsibility of the medical school to educate the physician on personal finance issues, any more than it is the responsibility of the engineering school or the law school. I believe that a basic education on personal finance should be part of the education of everyone. Do you think it would destroy our math curriculums in K-12 if we taught one week of basic money competency every year?
I agree that medical schools should help physicians by keeping costs down as much as possible (yeah, right!), and a business of medicine course is a must. The basic personal finance education belongs further upstream, IMO, as everyone would benefit from it, and it really falls outside the mission of a typical med school.
I respectfully disagree with you about medical schools not having some sort of responsibility to teaching students about personal finances. Mostly because I feel like that is the best time to help students. My medical school took the time to at least warn us repeatedly about the dangers of going into too much student debt and when the rates were about to go up in 2005 they strongly encouraged us all to refinance immediately. I had no idea what I was getting myself into at the time, but I took their advice. It saved me big time. I was able to refinance the first 2 years of school loans at 2.6% fixed and the rates jumped to over 6% after that. I am SO thankful now they took the time to do that for us. I was so clueless back then about personal finances. I actually believed that I would be so rich as a doctor that money and debt wouldn't matter and so therefore I didn't have to worry about it.
My point is that most of the mistakes doctors make in regards to their finances begin in medical school. Therefore those years are an excellent time to start educating students on personal finance and potentially prevent a lot of very costly mistakes. A short course that forces students to look closely at what various spending habits and debt levels can do to your ability to retire and live your life the way you imagine would be very helpful in my opinion. That post by POF on 3 different doctors spending habits is a great example of the sort of thing medical students need to be hearing at that stage.
However, with that being said, I do agree that financial education needs to occur throughout life, though I don't know how much it would help in the earlier years. Most starry eyed twenty somethings are completely disconnected from money and personal finance and would likely not pay any attention to advice anyway. I think that's especially true for those that come from lower income backgrounds where money management isn't a thing that's readily taught to children because there's not much money to manage. My parents lived paycheck to paycheck their entire lives. So, I got ZERO advice from them on how to save, budget, invest, etc. Not that that's an excuse to do a poor job as an adult, but until I became aware of these issues I had no idea what I was doing.Comment
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WCI beat me to it with this -- my journal article on physicians is in final revision right now and hopefully will be published soon. In the discussion I make specific recommendations about the need for physicians in training to be taught personal finance.An alt-brown look at medicine, money, faith, & family
www.RogueDadMD.comComment
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I think the article was great and hopefully more people are listening about this issue. From the article, "In addition, medical schools need to incorporate a business of medicine class into the latter half of the fourth year curriculum. This should include not only “professional” topics such as practice management, coding, and billing but also “personal” topics such as budgeting, student loan management, investing, estate planning, and asset protection"
I would argue that the "professional" topics would be better taught in residency as they are so specialty specific. The biggest bang for the buck is my opinion is on the "personal" topics especially as MS4s are choosing residencies. My school not only did NOT teach this but they went out of their way NOT to offer advice. For instance my medical student fellowship was paid out as a 1099 misc and I was hit with a surprise tax bill when I thought it would be considered scholarship money. The financial aid office would not give any advice but kept telling me to contact my tax professional which was laughable for a MS4. Regarding paying back student loans they would simply point us to the online tutorials but did not explain basic examples of physician take home pay and what a student loan payment looks like after taxes and paying for other life necessities.
WCI is completely responsible for my financial "awakening", and I try to preach it to other physicians but many are not interested. Anytime I meet a medical student I write down the website and tell them they should really start to learn about the financial side of things ASAP.
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I submitted a workshop outline to the med school I am affiliated and got turned down - since they "do enough." I prolly should ask what their 1 day workshop with some guy from the AAMC is really about.
I do think it needs to start in med school. They need repetition. The seeds needs to be planted early. Should also be taught during residency. They may not listen but hopefully one day they will. Most of my residents now have Roth IRAs.Comment
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I think general personal finance in medical school would be great. Residency should teach you how to evaluate an employment contract and how to set up a business in your specific field. I really believe this does not happen in part because the focus is training people to go into academics. I know this was the case where I trained so business knowledge was never mentioned.You leave residency deeply in debt with no idea of what to do except a predatory job offer from a hospital because you are afraid and clueless as how to set up a practice. Some people want to do academics and this is fine and necessary but it would be useful to help students and residents understand that private practice can still be done.Comment
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I think general personal finance in medical school would be great. Residency should teach you how to evaluate an employment contract and how to set up a business in your specific field. I really believe this does not happen in part because the focus is training people to go into academics. I know this was the case where I trained so business knowledge was never mentioned.You leave residency deeply in debt with no idea of what to do except a predatory job offer from a hospital because you are afraid and clueless as how to set up a practice. Some people want to do academics and this is fine and necessary but it would be useful to help students and residents understand that private practice can still be done.
At my residency, where 90-95% of trainees go into private practice, they scheduled a yearly noon conference on the "Pearls and Perils of Privare Practice" (or some such title) taught by academic faculty who washed out of private practice. There was some material on the financial aspects as part of the discussion. Overall, the presentation was somewhat comical as the faculty were clearly very negative about their private practice experience, and that is what I remember the most.Comment
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I think general personal finance in medical school would be great. Residency should teach you how to evaluate an employment contract and how to set up a business in your specific field. I really believe this does not happen in part because the focus is training people to go into academics. I know this was the case where I trained so business knowledge was never mentioned.You leave residency deeply in debt with no idea of what to do except a predatory job offer from a hospital because you are afraid and clueless as how to set up a practice. Some people want to do academics and this is fine and necessary but it would be useful to help students and residents understand that private practice can still be done.
At my residency, where 90-95% of trainees go into private practice, they scheduled a yearly noon conference on the “Pearls and Perils of Privare Practice” (or some such title) taught by academic faculty who washed out of private practice. There was some material on the financial aspects as part of the discussion. Overall, the presentation was somewhat comical as the faculty were clearly very negative about their private practice experience, and that is what I remember the most.
I've heard those as well. They are funny due to their giving it only because it didnt work out from them whatsoever. Not a great source of "pearls".Comment
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I wouldn't argue "Med School or Residency?" I would do something in both.Helping those who wear the white coat get a fair shake on Wall Street since 2011Comment
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