5 Things to Know about the Sign-on Bonus

When it comes to physician pay, things can get a little nuanced. Many of us take out hundreds of thousands of dollars in student loans for med school, then spend 3 to 9 years getting additional training while being paid much less than we are worth. But after that time period, usually when we are in our 30s, things finally start to improve. We become “attending physicians” which means we are able to work fewer hours and enjoy a drastic increase in pay. As part of the compensation package, many of us will receive lucrative salary offers which include a sign-on bonus. Similar to professional athletes who sign new contracts, the physician sign-on bonus is an amount of money we receive, in addition to our salary, for agreeing to work for an employer for a certain length of time. This sign-on bonus can be a great addition to our wallet, but there are a few nuances we all should be aware of.

1. The amount varies based on specialty. Although most doctors get one, the amount we each receive can vary greatly. Doctors who work in primary care tend to get a lot less than doctors who specialize or perform more procedures. Doctors in private practice may get a lot more than others who are employed by academic centers. A report released by a consulting firm in 2021 showed that some doctors got a sign-on bonus of only $1,000 while others got $75,000.[1] Regardless of how much you are initially given, it is important to ask for more. Oftentimes, this is one of the things that employers will be willing to increase if you ask. The amount may vary from person to person but most employers are willing to increase the amount if you ask.

2. The amount you received is taxed (so you get less than you think). Many doctors see the sign-on bonus amount in the offer letter and think that is how much they will receive in their bank account. Unfortunately, the amount that is given to you is less than the amount on the contract. Why? Taxes. You have to pay taxes on this money and it is usually taxed at your ordinary income tax rate. If you are in the 35% tax bracket, then you’ll have to pay 35% in taxes. If you are in the 24% tax bracket, then you will have to pay 24% of it in taxes. In addition to federal taxes, many doctors will have to pay state taxes on the money as well. My point? Before you start thinking of all the ways you will spend your sign-on bonus, make sure you account for taxes. Also note, that the amount you pay in taxes depends on your tax bracket for the year (so the best time to receive the money is usually in the year you are in the lowest tax bracket).

3. There’s a chance you may have to pay it back. This usually comes as a surprise to many doctors, but it happens much more than you may think. Oftentimes when employers give you a sign-on bonus, it is not just free money for you to keep. Instead, it is often structured as a “forgivable loan.” This means that you get the money as a loan, and if you stay at the company for a certain length of time, usually 2 or 3 years, then the loan is forgiven and you get to keep all the money. However, if you leave the job prior to that set time period, then you have to pay the money back. The unfortunate thing about having to pay the money back is that they usually make you pay back the pre-tax amount. If your sign on bonus was $10,000, chances are you may have only gotten $7,500 after taxes, but if you leave before that set time period you will have to pay back the full 10,000 (the pre-tax amount).

4. You should negotiate how it is structured. To avoid having to repay the full pretax amount of your sign-on bonus if you leave before the stipulated time, negotiate how it is structured. Instead of having the full amount forgiven after 2 or 3 years, get a fixed amount forgiven each month that you are there. For example, if your sign on bonus states you have to stay at the job for 2 years to keep the money (or have the loan forgiven) then negotiate in the contract that 1/24 is forgiven each month. That way if you stay for 1.5 years you aren’t on the hook for the entire amount.

5. People receive it in different ways. To my surprise, there’s a good deal of variability in when a doctor actually receives his or her sign-on bonus. Some docs receive the full amount the day they sign the contract. Other doctors don’t receive the money until the first day they work. Some employers will split it up and give you half the first year and half the second year. There are others who will give you a small portion of it as a residency stipend to help supplement your income while you are still in training. My point? The timing on when you receive the sign-on bonus can vary greatly. Be sure you understand how yours works and negotiate a different structure if you’d prefer to get it sooner or later.

To summarize, there are quite a few nuances involved with physician sign-on bonuses. Make sure you understand how yours work and negotiate a different structure if you desire.

The Dilemma of Emergency Funds - and how to solve it

I don’t think anyone can deny that emergency funds are beneficial. If an unexpected expense occurs or heaven-forbid you lose your job, having money available to use is extremely valuable. But for many folks, especially those who are younger, building an emergency fund, one with 3 to 6 months of expenses, can take many months or even a full year to obtain. The time it takes to save up for an emergency fund has a hidden cost.

Money you set aside in a savings account (to build an emergency fund) is losing value day-by-day in a savings account (due to inflation) and it also isn’t growing (because it isn’t being invested). The opportunity cost or hidden cost of building an emergency fund is the difference between the value of the money you have in the emergency fund and the value of what you could have had if you had invested that money in the market instead. Stated differently, stacking money in an emergency fund means there is less money you can use to invest in the market. Although there is no guarantee that money you invest in the market will increase in value, on average, the market tends to go up over time and money invested in index mutual funds (groups of stocks) tends to increase in value over the course of each year. My point? Maybe you would have been better off investing your money instead of stacking it in a savings account to build an emergency fund...

As if this wasn’t enough, it seems the timing of building an emergency fund is off. When we are younger in our careers with lower income and a big need for an emergency fund, it’s harder to save up for one and the opportunity cost of saving this money, instead of investing it, is quite high. However, when we are older in our careers with a higher income, it is much easier to save money for an emergency fund, but the emergency fund is not as crucial (because we are more financially stable and more likely to be able to cover the cost of an unexpected expense with money from our paycheck or money we already have invested in the market). What does this mean? Emergency funds are most useful at the time in our lives they are the hardest to get and less useful when we are better able to afford them.

So what is one to do?

When we need an emergency fund the most, it’s hardest to get. When we need it least, it’s easier to have. It is because of this dilemma that many folks have begun to question the traditional cash emergency fund. Perhaps opening a HELOC (home equity line of credit) from your mortgage makes more sense. Other people state if you can get a zero-interest credit card then what’s the problem?.Or, maybe it just makes sense to invest that money?

When it comes to pure math, many of these ideas make sense. The problem is that when it comes to personal finance a lot of it hinges on our individual behavior not our ability to do math.

Zero interest credit cards give us the ability to quickly purchase things we desire. Although it can be good for emergencies, many people end up using these cards even when they don’t have emergencies. They spend a lot more money than they would have if the money were being taken directly from their checking account or emergency fund. My point? Credit cards make it too easy to spend money we don’t have on things we don’t need. Most of us need less temptation, not more.

Opening a HELOC from your mortgage can be a great option but since many young professionals are just starting out in their careers, they may not even have a mortgage yet. If they do have one, they may not have much equity available to use. Plus, I personally don’t like the idea of putting my house at risk for an unexpected expense I could have planned for in advance (via a cash emergency fund).

Investing the money in taxable accounts via apps like Robinhood gives you the chance to allow your money to grow. However, if an emergency does arise, you’d have to sell your stock in order to use the money and selling the stock creates a taxable event which decreases your profit. Plus, it may take a few days to sell your stock and have the cash deposited in your account.

A Roth IRA seems to give you the best of both worlds. It allows you to invest money and take out your contributions at any time (while leaving your profits in the account) but it isn’t perfect. There is still a chance the market could experience a downturn and if that happens during the time you need your money for an emergency, then there is a chance that you may not have the amount of money you need when an emergency arises. My point? If you invest the money you take a risk that the money could go down in value and having less money available when you need it most is not ideal.

So how do you handle the dilemma of emergency funds?

Should you prioritize saving money in cash or just invest money in the market? The right answer for you depends on a lot of factors like your household income, job stability, monthly expenses, and net worth. If you’re wondering what I, as a senior family medicine resident, heading to fellowship next year, do…I do both.

I keep about $1000 to $2,000 in a savings account, save about $200 a month for large expenses like a vacation or Christmas gifts, then have the rest of my emergency fund money invested in index mutual funds in the market. Most of the money is in a Roth IRA but I do have some money in a taxable account (that I got as stock options from a previous company as a part of their compensation package). I also invest a portion of my income in my work retirement account. I’m pretty risk averse, so once I become an attending physician (and experience an income boost), I do plan to have 3 to 6 months of expenses in cash. My point? The right answer on what to do with an emergency fund may differ for each person, but having a little extra in cash, especially as a resident or person making the median income, is helpful. Just don’t forget to invest a little along the way.

Tell me, what do you think? What are your feelings about emergency funds? Do you have one? How much have you saved? Where is the money located? Have you decided to invest as you save (via a Roth IRA)?

The Benefits of Having an Emergency Fund

If you’ve ever listened to Dave Ramsey or ventured along the journey of personal finance, you’ll hear a lot of people talking about the importance of an emergency fund. An emergency fund is money that you have readily available, usually in a savings account, in case you incur some type of emergency or unexpected expense. If the air goes out in your home, your car breaks down, or heaven forbid you lose your job, you can quickly access money in your emergency fund to cover expenses.

Many folks have found emergency funds to be quite useful. We can’t always predict when we will incur various expenses but most of us know that they will inevitably occur. Emergency funds help lessen the shock. If the brakes need to be replaced on your car or your iphone stops working, yes you may be annoyed and inconvenienced, but with an emergency fund, the expense itself stings a little bit less. When you know you have money to cover the costs, you tend to be less stressed or bothered by these unexpected expenses.

Is an emergency fund necessary?

For those of us who are still building wealth or who may be 1 or 2 paychecks away from being unable to pay our bills, then yes. An emergency fund is necessary. If we are going to build wealth or at least become financially stable, we have to minimize our need to take out high-interest consumer debt, like credit cards, when expenses arise. One way to do that is to save money in advance, via an emergency fund.

How much do you need?

Like a lot of things in finance, it depends. How much money do you already have saved or invested? How reliant are you on your paycheck to pay your bills? How stable is your job? How consistent is your income? Do you spend most of your paycheck or do you frequently have money left over?

The general rule of thumb for young professionals is to start with $1,000. $1,000 is usually enough to cover minor car repairs, a new phone, a laptop, or a last-minute flight home. As prices have risen lately, perhaps $2,000 is a more accurate number. Regardless, the point is to start off with a reasonable amount to cover expenses and unexpected costs.

The next step, and where most people land, is to save up 3 to 6 months’ worth of expenses. Notice I said months of expenses, not full paychecks. You need enough to cover you in case you lose your job unexpectedly, have to quit, or get laid off. The importance of having this type of emergency fund was ever so present in March of 2020 when the world shut down from the COVID pandemic and even folks with stable jobs, like doctors, were forced to take pay cuts or close their clinics for months at a time. Having money that you can tap into during unexpected times like this is key. The exact amount is up to you.

How do you save up this money?

Unless you have an extremely high income, it may take time to save up this emergency fund. And that’s okay. Most people have to save money from several months’ paychecks in order to reach their desired amount. When I first started my emergency fund, I wasn’t making much money and I was always tempted to spend that money on something else. In order to prevent that from happening. I had a certain amount from each paycheck deposited into an entirely different checking account. I used some of the money in that separate account to pay down debt and left the rest of the money in the account to build over time as my emergency fund. Before I knew it, I had saved $1,000. It increased even more from there.

To summarize, emergency funds can be quite useful, especially when you are starting out in your career. Having money to use in emergencies prevents you from having to take out high interest credit cards when expenses occur unexpectedly. Tell me, have you started saving for an emergency fund?

I Paid off $10K in Credit Card Debt as a Resident, here's how

Like many other resident physicians, I had credit card debt when I started working. I accumulated the bulk of it during my postgraduate days living in a high-cost-of-living area when I was 22, but I added to that amount when I had to pay for med school applications, secondary essay fees, and travel costs to interview. During my time in med school, I lived off student loans, but during the 3 months between my med school graduation and my first paycheck as a resident doctor, I had accumulated even more. I needed money to move to a different state, pay my first month’s rent, and cover things like food and gas while I was awaiting my first residency paycheck. I didn’t have a spouse to help and my parents, while loving, didn’t give me the money I needed either. Before I knew it, I had $10,000 in credit card debt. Fortunately, I was able to pay this off in a year a half after starting residency. Here’s how:

I realized I didn’t like being charged interest on money I’d already spent. My first temptation was to delay paying it off. I was only making around $60,000 per year as a resident so I didn’t have a lot of extra money to spare. I knew that my income would increase when I finished residency, so it seemed logical to just wait to pay it off when I got the income boost. That changed the minute I logged into my online bank account. I was shocked when I realized I was being charged $100/month in interest. When I looked further, I saw that the interest rate on my credit card was 12%. This meant that I was going to pay an extra $1,200 a year in interest until I paid off the debt. Seeing how much interest I was being charged motivated me to pay it off quickly, even while I was still in residency.

I decided to pay it off in less than 2 years. As most folks know, a resident’s salary is not very high. Paying off $10,000 in credit card debt when you’re only making $60,000 a year can be tough, but I made a decision to do it. I knew that if I delayed paying it off, each dollar I was paying in interest was less money I could use to invest and build my net worth. Although I could have dragged the payments out during my entire time in residency, I really wanted to pay it off sooner so I could have the freedom to invest more money. This motivated me. I made a goal to pay it off in 2 years. (One year would strain my budget too much but 2 years gave me a realistic goal I could look forward to).

I lived with a roommate to make extra monthly payments. As a resident, I knew I would be working a lot. Although I really wanted my own living space, I knew I wasn’t going to be home very often to enjoy it. I figured I might as well share the space with a co-worker and use the money I saved in rent to pay down my debt faster. So that’s what I did. I got a 2-bedroom 2 bathroom apartment for $1700 a month. My roommate split the rent, electricity, cable, and internet bills with me. Instead of paying almost $2000 a month for rent and utilities, I only had to pay half of that cost. Saving nearly $1000 a month in living expenses gave me extra room in my budget to not only pay down my credit card debt but to also save a little money in cash to start an emergency fund.

I set up automatic deductions to pay $500 each month. This seems aggressive but $500 was my number. I knew I wanted to pay this exact amount each month, but I also knew I couldn’t be trusted to make this payment of my own volition. Thus, I had 20% of my net pay go to an entirely different checking account, which I called my “wealth building account.” I set up a $500 deduction from this account to my credit card each month and let the remainder of the money build up in that account as my emergency fund. Because this money was deposited and deducted from an entirely different account, I never saw the money in my main account and thus didn’t miss it too much. I got used to living on the remaining 80% of my net pay. Doing this did make me feel more “broke” than some of my co-residents who had more disposable money to spend each month, but it made me feel good to know that I was paying down my credit card debt and building up my emergency fund at the same time.

I used money from my tax refund and the first stimulus checks to pay it off. When I was in my first year of residency, coronavirus hit. While this was devastating for many reasons, the silver lining of this occurring meant I got a stimulus check. I used most of the money I got from this stimulus check and my tax refund in early 2020 to make extra payments on my credit card debt. While many other folks went online shopping with their money, I was paying down my debt. When I got the second stimulus check, I was able to pay off the credit card debt completely. A goal I had set for 2 years, had been accomplished in 18 months. I was thrilled.

I was diligent about not accumulating more debt once the balance had been repaid. Making that final payment to my credit card felt great, but I’d be lying if I said it lasted forever. Ironically, I was very tempted to charge even more expenses on my credit card, especially when I wanted the newest iphone, newer clothes, or the ability to take more vacations with my friends. Many people argued that I could just charge the money on my credit card and pay it off when I became an attending, but I chose not to go that route. I hate debt and the more debt I had the less I could invest to grow my net worth. Plus, I didn’t want to set bad habits. As someone who blogs a lot about personal finance, I know that finance is more about changing behavior than being good at math. If I got into the habit of buying things that I couldn’t afford now, I would likely buy more than I needed, accumulate substantially more debt, and have a harder time being debt free as an attending. I wanted a different life.

What about you? Are you developing bad habits by purchasing things you can’t afford using debt or are you willing to do what it takes to pay down your debt quickly and start investing, even while you’re in training or making the median income? If I can be credit card debt free, so can you.

4 Reasons to Start Investing on a Median Income

In case you’re unfamiliar with doctor pay, there are two different tier systems: Resident physicians and attending physicians. Resident physicians are doctors who recently graduated from medical school and are still getting training in their field of choice. They are working as doctors but still actively learning at the same time. Attending physicians are different. They are doctors who have graduated medical school and have a minimum of 3 to 7 years of experience. They have a full state license, tend to be board certified, and make substantially more money. Resident physicians make the median household income ($55,000 to $75,000 per year). Attending physicians an average of $300,000 and beyond. If you’re a resident physician or a young professional who makes the median household income you should still invest money. Here are 4 reasons why:

1. Investing prevents your money from losing value. In case you haven’t heard, inflation is higher than it has been in awhile. Because of inflation, things like cars, homes, gas, and groceries cost more now than they have in the past. If that weren’t enough, the rate in which these prices are rising is putting a strain on our pockets and our lifestyles. We may have to delay buying the home we wanted, forgo that vacation we were planning, or drive our old cars for much longer than we anticipated. Since costs are rising so fast, we can buy fewer things with each dollar, than we could in the past. Unless we intentional about growing our money, it will continue to lose buying power just sitting in a savings account. One of the main reasons to start investing now as a resident, or young professional on an average income, is because it prevents our dollars from losing value. Investing gives our money a chance to grow which brings me to my next point…

2. Investing allows your money to grow much faster. You could stack money in a savings account, but that money will not grow much at all. The minimal increase of 0.25% that many people get by keeping their money in a savings account is not enough to keep pace with inflation and the rising cost of goods. Investing helps combat that because not only does it allow your money to grow, but it allows it to do so much quicker through compound interest. Compound interest is when your money makes more money (called interest) and then that interest stacks onto your original amount and begins to make even more money (added interest). This ability for you to make profits (interest) on top of existing profits (other interest), means that you get even more profit than you thought (compound interest). It is this compound interest that allows your money to grow much faster.

3. Investing gives you the chance to reach your financial goals sooner. Because investing allows your money to grow, it is through investing that you can accumulate a higher net worth sooner than you other wise would. As your net worth increases and the value of your investments rises you will be able to reach your financial goals sooner. For some people, these goals may be to accumulate a certain amount of money for a down payment on a home to use when they become attendings, for others it may be to have the ability to cut back to part time or just work one less day per week. Whatever your financial goals are, investing gives you the opportunity to reach them sooner. As your net worth grows, you start to accumulate wealth and one of the best things money can buy is control over your time. Think about how nice that would be.

4. Investing allows you to invest as you save. This is perhaps one of the biggest perks of investing as a resident or young professional. Investing money through a Roth IRA (that you can open by calling a place like Vanguard or Fidelity) gives you tons of options including the ability to invest as you save. What do I mean by that? You can contribute money to a Roth IRA then choose to invest it however you’d like (preferably in low cost index mutual funds like VTSAX or VIT). With a Roth IRA, you also have the option to take your contributions out of the account at any time. This means you can open a Roth IRA and contribute $500 per month up to the yearly maximum of $6,000 per year. During your time in training and career building this money is growing and gaining compound interest. Once you finish training you can choose to take your contributions out of the account (and use the money for a wedding, fancy vacation, or down payment on a home) but keep the profits you made on that money inside of the account. In other words, you were able to make money on your investments and still save for the big item you planned for. You can also choose not to take out your contributions and instead keep all the money inside of the Roth IRA until you retire. Having the option the take your contributions out of the account at any time allows you the flexibility to use this account as a backup savings account that actually earns interest.

What do you think? If you’re a resident physician or young professional making the median income, will you start investing money this year?

New Goals for the New Year (2022)

It’s 2022 and many of us want this year to be better than last year. Instead of just hoping this happens, let’s make some realistic goals and put steps in place to achieve them. Here are some of my 2022 goals:

1. Continue to invest at least 10% of my salary in retirement accounts. Investing money gives me the opportunity to allow my money to grow. Because of inflation (the rising cost of goods and services) money sitting in a savings account is actually losing buying power by the day. In order to prevent this, I keep a certain amount of money in an emergency fund and make a habit to invest the rest. Since I know I can’t be relied upon to actively put the money into investment accounts each month, I make it automatic by having 10% of my paycheck automatically invested into my work 403b (similar to a 401K) before the money hits my bank account. I also have a set amount automatically invested into my Roth IRA. You can do the same thing. The amount you choose to invest is up to you, but having automatic contributions into your 403b or Roth IRA will allow you to start building wealth long before you retire which will create more options for you in the future.

2. Make more money from side hustles (increase passive income). As a senior resident physician who is starting fellowship next year, I haven’t gotten the “big bucks” just yet. I make more than I did as a first-year doctor, but I still haven’t gotten that attending salary boost. Although I’m anxious to get paid more, I refuse to put my life on hold for a year and a half until that time comes. While many people choose to moonlight (work extra shifts as a physician) to supplement their income, I’ve always been concerned that doing so might cause me to burnout from medicine. So, I've tried to increase my income a different way. For me, that means monetizing my hobbies and increasing passive income. I’ve made tens of thousands of dollars doing that as a resident physician and would encourage other docs to consider passive income ideas, or monetizing some of their hobbies, to increase their monthly income as well.

3. Avoid accumulating consumer debt. When I first started residency, I had lots of credit card debt. Most of it I accumulated before I went to med school. I was unable to pay it off while getting my degree so when I graduated and started residency, I still had it. My credit card interest rate was 10% which means that each day I had the debt I was being charged extra money in interest. It didn’t take me long to realize that the sooner I paid off the debt the more money I’d save in interest fees. When I got my first job as a doctor, I prioritized making large credit card payments and paid off the debt in less than a year a half. I’m still credit card debt free, so my goal for this new year is to avoid accumulating more. It can be so tempting to use my credit card to book flights, pay for vacations, and purchase other items on sale but resisting that urge has served me well. In 2022 I hope to continue this practice.

4. Save money for future vacays. In order for me to avoid accumulating credit card debt one of the things I do is plan ahead. I save money in advance for large expenses like vacations, travel, holiday gifts, and friends' weddings so that I don’t end up charging these expenses on a credit card. I also have a percentage of money from each paycheck deposited into an entirely different bank account. I use the money in this bank account to save for future large expenses. Having these automatic deductions into a separate bank account prevents me from having to rely on my memory or self-control. I plan to continue this same practice in 2022.

5. Carve out time for self-care. As a senior resident physician who will be starting fellowship next year, life is busy and occasionally stressful. One of the ways I plan to decrease stress and improve my own wellbeing is by investing in self-care. For me, that means reading more books, finding time for rest and relaxation, having periodic therapy sessions, and maintaining healthy eating & exercise habits. Life can be hectic, but making the time for my own self-care and happiness is better for my overall mental health and longevity.

Tell me, do you plan to do some of these things this year? What are some of your goals for the new year?

5 Things To Do Before The New Year

1. Show gratitude for good health in the midst of this pandemic. Whether you’ve made a full recovery from coronavirus or have been one of the lucky few to have never gotten infected, you’ve made it to the close of another year. Show gratitude. We are alive and healthy enough to make a living, be in our right mind, and make it through the Christmas holidays. That is a blessing. Good health is one of the things many people take for granted while they are young and spend a fortune trying to maintain when they are older. Be different. Part of showing gratitude for good health means making a commitment to take care of your body and preserve that health for as long as you can. Enjoy the holidays but make a commitment to exercise, eat healthy, and maintain a good mental state going into the new year.

2. Practice good self-care to become a better version of yourself. It’s not enough to just have good health habits. You also have to put in the work needed to become a better version of yourself. You are too smart and have too much potential to stay stagnant. You have to grow. And in order for you to grow, you have to practice good self-care and commit to getting better. That means doing what it takes to improve mentally, emotionally, physically, intellectually, and financially. You may have to hire a personal trainer, see a dietician, get a therapist, take a few courses, read some new books, and surround yourself with a social circle who will motivate you to strive for more.

3. Get optimistic about next year and refuse to stress about the unknown. You’re a young professional with a promising career, good health, and a sound mind. There’s nothing you can’t do. Instead of worrying about your job, your bills, or other things that used to cause you stress, adopt a new mindset. Before this year ends, make a commitment to write down some goals for next year. And dream big. Think of what you plan to accomplish, the money you plan to invest, the places you intend to travel, the people you hope to impact. Then visualize it. Picture yourself doing all these things and think about how it would make you feel.

4. Reaffirm your commitment to invest money and grow your net worth. If you’re like most people you desire to live a life of significance and get paid to do work that you enjoy. Perhaps you also want to travel the world, spend time with family, and live in a nice home. Your ability to do these things will be much improved if you build your net worth. The more money you have, the less dependent you will be on your job and the more options you will have to live life on your own terms. Make investments now to give yourself that chance. Set aside 10-20% of your income for building wealth and use that money to invest, pay down debt, and save for large purchases. One of the best things money can buy is control over your time. Do what it takes now and make the necessary investments to build your net worth so you can live the life you desire.

5. Never forget the importance of faith and family. Maya Angelou once said, “People will forget what you said, people will forget what you did, but they will never forget how you made them feel.” So do your best to let your family know how much they mean to you. Regardless of how much money you have, regardless of the type of career you build, or the kind of possessions you acquire, it’s vital that you remember what’s important in life. The love and support of your family/friends along with your faith and positive belief that you are here for a purpose and can do anything you put your mind to is vital. Take the time to tell people how much you love and care for them this holiday season and renew your faith in God who has allowed you to make it to this moment and all the future moments to come. Finish 2021 off with a bang and head into 2022 with a plan for this to be your best year yet.

Healthy Ways to Lower Stress During Match Season

Trying to match into residency or fellowship can be stressful. I’ve gone through the match once for residency and I’m currently going through it a second time for fellowship so if you are going through it too, I understand your plight. There are many variables that are out of our control and as much as we may desire to match in our desired specialty at our desired location and this uncertainty can lead to anxiety which has the potential to worsen our mental and physical health. Here are some things we can do to decrease our anxiety during this time. 

Lean on the support of others. While we are all pretty good at handling difficulty situations in medicine, we don’t have to do everything alone. Not when it comes to this. Although it can be tempting to keep this process to yourself in an effort to avoid the reactions from others in case things don’t go as well as you’d hoped, I’d caution you against that. You may not have to tell the world your plans, but leaning on the support of family and friends around you can help more than you know. Our loved ones help remind us that we are more than our careers and that we will have their support and well wishes no matter what happens. Being reminded of their unwavering support can help remove some of the pressure we place on ourselves and make the process much less stressful. 

Recognize that some things are beyond your control. As medical students or residents, we got to this point in our lives by being smart and completing the necessary steps to get through training. We are good at doing what needs to be done to achieve our desired goal. The match process is a totally different beast. Once you submit your application, you are then waiting for programs to review it, hoping they send you an interview invitation and praying they rank you high enough to match. As you go through this process it’s important to remember that what happens after we submit the application is beyond our control. Worrying about what will or won’t happen will not affect what happens so we must fight against the anxiousness we may feel. I often find that the process is much easier to manage when I transition from worrying about nonideal outcomes to instead hoping for pleasant ones.

Practice mindfulness with prayer, meditation, and therapy. It is entirely possible that you can try to think positively and know things are not in your control but still have moments of anxiety. During these times it’s imperative that you practice mindfulness. If you’re religious, try praying. If you don’t identify with a particular religion, you can also consider meditation. There are plenty of apps and YouTube videos that can help you learn techniques to quiet your mind and bring you a sense of peace. Many people, such as myself, find therapy helpful. Contrary to popular belief, you don’t have to have a mental health disorder to attend therapy. It can instead be used as exercise for the mind that helps you process things in a productive way, better understand your behaviors, and improve your thought patterns. Whether it’s prayer, medication, therapy, or a combination of all 3, practicing mindfulness can decrease anxiety and bring us more peace.

Find healthy ways to de-stress. Along with practicing mindfulness, it can also help to find active ways to de-stress. Consuming unhealthy amounts of alcohol, caffeine, or comfort food may make us happy in the moment but can have a negative impact on our overall health. To avoid this, consider other ways to destress that align with your sources of happiness. Are you someone who likes to workout? Do you enjoy yoga? Do you like to cook? Are you an avid reader? Is binging mindless tv at home your happy place? If you’re not exactly sure, explore a few ideas and figure out which ones you like. The key is to find ways to de-stress by engaging in activities that take your mind off of the process.

Be optimistic about the future. One of the best things we can do for our mental health during this period of uncertainty is remain optimistic. Being optimistic doesn’t mean you ignore reality or become naïve. It is the belief that most of the time, most things will work out for most people. It is realizing that although things are uncertain, the odds are in your favor. Adopting this mindset can put you more at ease. It can help you to worry less and hope more. During this time, healthy doses of optimism can go a long way.