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Residents and Financial Trifecta

Do you have a “financial trifecta”?: 6 digit debt load, 4 digit monthly income and 0 digit savings account.

Dealing with Money Stress in Residency

Do you ever feel anxiety or stress around the topic of money? Perhaps, it’s not knowing how to make or responsibly manage a budget, not knowing how much to save or even feeling like you are not making any headway in paying off student loans or lines of credit. Other common causes of stress I’ve helped residents manage include; challenging employment prospects after residency, concerns regarding starting a family or feeling pressure to buy into the real estate market.

By working with Dr Stacy Sprague and her team at Vancouver Coastal Health EFAP (Employee and Family Assistance Program) we provide Resident Doctors of BC members with a holistic approach to managing money stress through personal counselling, annual tax preparation clinics and financial literacy coaching.

Over the past 12 years of serving residents and medical students as a financial literacy coach, we’ve identified 2 main causes of money stress that a growing number of physicians in training are experiencing, especially as medical students transition into residency and as residents transition into practice. Moreover, we have also identified best practices to help physicians in training manage these stressors.


This common financial stressor among residents sounds like it’s from a Facebook relationship status update, but it relates to how a number of residents feel when they come and see me for a financial literacy coaching session.

The statement that stands out for me was from an R1 resident: “Alphil, it’s complicated because I have a ‘trifecta’; a 6 digit debt load, a 4 digit monthly income and a 0 digit savings account.” Moreover, it gets even more complicated when residents get trapped in comparing themselves to their friends outside of medicine who seem to have progressed towards marriage, buying a condo, starting to save for the future or have started a family.


For those who know me, I am going through a “complicated” late stage glaucoma diagnosis in my left eye due to prolonged exposure to hydrocortisone to treat eczema on my face and left hand. Whenever I visit Dr S. Holland, Dr P.Ma, Dr P. Mackenzie or Dr. V Wong, I always walk away with a prescription for Lumigan, Combigan or Vigamox and it is up to me where to have it filled.

This routine over the past 20 years got me thinking why can’t we do the same thing for residents who require a treatment plan for their top financial concerns. Every resident in BC has access to 3 hours a year of financial literacy coaching wherein they receive an integrated financial, tax and legal “prescription.” Simply reach out to me at alphil@flci.ca or 604.620.6630.


Another common stressor is the toll residents experience when their living expenses exceed their income over a long period of time past medical school.  Psychologists and mental health experts call this “drowning” and it begins when you make a habit of living on borrowed money from parents, credit card companies, banks etc… and when it seems like it’s going to end soon, it doesn’t because there’s always other shiny objects/ toys that capture your attention once you make more and more money.

According to Dr. Stacy Sprague, the Executive Director of EFAP, “Although income is a key determinant of health, in my 30 years counseling residents and practicing physicians, I’ve come to realize that there is tremendous correlation between earning higher amounts of income and being stressed because as your income increases so does your lifestyle expenses.”

Best Practice 1: What does money mean to you as a doctor?

The key to figuring out if you are going to be chronically dependent on IF-COME is to identify early on what money means to you so that you are aware of what you are susceptible to.

Does money mean….

Consumerism/ Materialism – For those who experience short lived pleasure from buying material goods and services. They may struggle with a sense of acceptance as well as inadequacy that has roots in being compared to others.  A slippery slope for doctors because their potential for high incomes also gives them access to lines of credit that allow them to borrow to buy things they cannot afford to impress people they really don’t care about. IF-COME POTENTIAL 10/10

Power/Control – For those who have an insatiable desire to control outcomes in an unpredictable world. Spouses and children of these individuals can often be dysfunctional, even hurtful and abusive. IF-COME POTENTIAL 8.5/10

Freedom – For some, having money allows them to do what they want, when they want. IF-COME POTENTIAL 7/10

Stability/Safety – For these individuals, money can be a foundation that yields a mental sense of security. Potentially problematic if compelled to borrow money to afford a sense of security. IF-COME POTENTIAL 5/10

Generosity – For some giving away money expresses gratefulness and appreciation for those around them. Often, they are humble and content and realize that money is simply a tool and does not form their core identity and therefore are happy to donate to charities and/ or start a foundation to serve a pressing need in the community. IF-COME POTENTIAL 2/10


Living within your means in residency while you are earning between $50,660-$71,290 (CaRMS 2016) is possible when you have the courage to have an honest adult conversation about finances rather than procrastinating and making excuses that you will get to it later on.

There are 8,760 hours in a year and for most residents, they will spend 43,800 hours (5 years) in training increasing their competency and skills in their respective specialization. It’s time to ask yourself how many of those hours are you going to invest to increase your financial literacy and develop the habits necessary to be financially sustainable after residency.

This article was written by Alphil Guilaran, co-founder of Financial Literacy Counsel. Since 2011, VCH EFAP and the Financial Literacy Counsel have been working with Resident Doctors of BC because they are committed to helping residents manage stress as well as become financially literate doctors through workshops, tax clinics and one on one consultations. They encourage you to reach out to them by either visiting www.efap.ca or calling EFAP at 604.872.4929 or across BC at 1-800-505-4929. 

author: Melissa Nilan