Medical

Transitioning to “It Gets Better”

Have you heard of “IGB”? I wasn’t aware of this term until I joined the Lives of Doctor’s Wives Facebook group back when my husband was in medical school. Many posts referred to “IGB”. I eventually looked up the acronym to figure out what in the world these women were talking about! IGB means “it gets better,” as in, after medical school, residency, and fellowship, you’ll be done with training and “life gets better.”

My husband recently graduated residency and is just starting his new IGB job. We are currently in the throes of transitioning to “it gets better”.

Although being done with residency feels FANTASTIC, we were a bit unprepared for the financial strain that has come with this transition. We were so focused on how we’ll finally be making money and can start paying down debt and meeting our financial goals that we overlooked the financial investment required for the transition into IGB.

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It’s helpful to understand that while this transition is exciting with plenty of good, it’s not all sunshine and roses. Transitioning and adjusting to IGB can be another time that brings quite of bit of stress and uncertainty.

Let’s take a look at the financial – and psychological – challenges of the “it gets better” transition.

Things to Know About Transitioning Out of Training

Details will depend on your situation. Keep in mind that there will be many expenses right out of the gate, before your SO starts making any money. Just when you think you’re done stressing about making ends meet, you’ll have another round of expenses without much (if any) income.

Take a moment to think through what those expenses might be for you and your SO.

1. Paychecks and “time off”

Your SO will receive their last paycheck at the end of June or sometime in July. If they have remaining vacation days, they might receive a payout for these days. Bonus!

Even if your SO begins work right away, they will likely have to wait 2-4 weeks before receiving their first paycheck. A substantial amount of any sign-on bonus will be withheld for taxes. Only a portion of that bonus amount will be entering your bank account.

If your SO is taking a break between graduating residency/fellowship and beginning their new job, you could be without income for a month or longer. Ask yourself the following questions:

  • Will your SO start their job right away or will there be some much needed, yet unpaid, time off? How much time off? A few weeks or a few months?
  • When do you expect that your SO will actually receive their first paycheck? Two weeks after starting work, a month after? You might need to directly ask the recruiter about this often-overlooked fact.
  • Will you be working during this transition to provide income for both your and your SO? Or will you be transitioning without cash coming in?
  • Are you taking a fun vacation during your transition? Vacations are fabulous and absolutely necessary for our well-being. However, they do come with a price tag. Factor in the financial side of how much vacationing you plan to do.

2. Healthcare

What will you do for health care coverage in between jobs? This can be a significant cost during a time when you have no income.

COBRA allows you to continue your employer-sponsored health plan after you leave residency. COBRA is offered to most graduating residents but comes with a shocking price tag – sometimes over a thousand dollars a month!

There are short-term health plans (so-called “catastrophic coverage” plans), but there are many restrictions on these, including pregnancy. If you don’t qualify, you’ll be stuck with COBRA or purchasing an ACA plan from the health insurance marketplace.

One idea we had was to use travel insurance in case of any catastrophic problems that occurred while we road-tripped between jobs. Unfortunately, my SO’s new job doesn’t provide health insurance benefits until 45 days after starting the new job, something we overlooked. So we had to buy a real medical insurance plan.

Whatever your situation, be prepared for a potentially large healthcare cost during transition. Start looking into healthcare options now to get an idea of what your budget needs to be.

3. Moving for the new job

Many of us will likely be moving for this new job. It could be across town or across the country. Regardless, you’ll have to pay for moving expenses that can range from hundreds to thousands of dollars.

Even if you have a moving allowance from your SO’s new position, be prepared to pay for the moving expenses up front and be reimbursed later, sometimes much later. You’ll have to pay for the those expenses out of your cash reserves or pay finance charges to float it on credit until you receive reimbursement.

As a personal example, my family moved in July and paid for all our moving expenses with a credit card so we could save our cash/savings. We will get the reimbursement for the moving expenses in my husband’s first paycheck. We have time-off built in, so he doesn’t begin work until September and he will be paid monthly – at the end of the month. So, his first paycheck will not arrive until October 1st. That’s almost three months of floating those moving costs.

What might your situation look like? Do you plan to move for your SO’s job? If so, how do you plan to pay for it?

4. House, cars, and “stuff”

Where will you live? Will you rent or buy? Either way, be prepared for upfront costs through either security deposits or closing costs, as well as hookup fees for utilities.

Will you need home furnishings? Once you’re in your new space, you may find that there are some much needed items that you’ve been holding out on purchasing until IGB. Can you wait a few more months to purchase, or do you need the items soon? How much do you plan to spend?

How are your cars? Have you run that beater of a car into the ground during residency? If you need a new vehicle fairly quickly, you may be picking up a new car payment.

How to Prepare for your Transition

Considering your answers for income and moving, vacationing, healthcare, and home/car expenses, how much money do you think you need to meet your regular bills and these additional expenses during your transition?

Thinking about transition expenses can be overwhelming, especially when many of us are barely making ends meet as it is. “There’s no extra money!!” you might think, and likely this is true.

However, it’s important to realize that, like the costs you accrued at the end of medical school to apply, interview, and move for residency, this transition holds a similar financial burden. The upside is that unlike residency, your IGB job will come with a sizable salary to help you recover from this financial strain.

Be informed and realistic about your transition financial obligations. Stay calm and brainstorm possible solutions:

  • Can you start saving cash reserves now to help support you through the transition?
  • Can you look at options to increase your income as you prepare, such as by moonlighting?
  • If not, can you discuss with your SO how you plan to pay for all this? Credit? Personal loans?

You’ll do yourself a huge favor if you have your eyes wide open going in.

It Gets Better” happens RIGHT NOW

I’d like to end with a word about the IGB sentiment. The idea that there will come a magical time when things all of sudden become “better” or “work out” is helpful during the rough patches of medical school and residency. But it’s actually a farce.

We’ve all been alive long enough to know that life doesn’t work this way. We long for a time or a thing to make life “better” or make us “happier” but it often doesn’t come or doesn’t meet our expectations. If it does come, it’s all temporary and we end up back where we started.

Wherever you are in the crazy journey of medicine, remember you are not alone. Our Spouses and Partners community gets what you are going through. It can be easy to bury your head in the sand, especially regarding finances. However, I encourage you to have courage and shine some light on the realities you’re experiencing now and the ones coming in the future. You will thank yourself for being aware and honest as you face whatever new challenge is before you. Good luck, my fellow SOs!!

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