Bringing Home the Bacon in Residency: Retention Stipends.

Subjective:

Want to get paid every month for doing nothing other than accepting a future rural family medicine job? I can tell you from personal experience that this made medical school and residency significantly less stressful. There is irony in the whole “Oh, you’re a doctor, so you must be rich” thing, as most of us are profoundly broke, in debt and financially vulnerable during the early stages of our careers.

Making bacon is a good post-call activity.

Receiving an extra $1500-2000/month throughout residency significantly helps ease the financial stress of being a delayed saver while not pushing your salary beyond the point where you would miss out on tax programs and roth IRAs. For targeted financial advice, I would steer you to The White Coat Investor, as Dr Dahle site/book is a great resource.

Back to stipends though, I think this is a great option for residents and some medical students who know where they want to practice. The financial impact of an extra $18000 or so annually is tremendous in residency. With my stipend I was able to establish an Emergency Fund, max out a roth IRA and invest in my residency’s Roth 403B. I will admit I did have a “post-call” slush fund for those so satisfying but entirely unnecessary purchases. The stipend helps buffer us from these less than ideal uses of money.

It would seem that all the benefits fall to the recipient (you or I) and that the future employer may balk at the cost. However, with the cost of recruitment and the frequent failure to retain those recruited doctors, I believe most clinics/hospitals will come out ahead with this arrangement. There is of course risk on both sides of the deal, as nearly all the letters of intent/preliminary contracts contain a clause requiring payback should the resident not follow through with their intent to work.

Objective:

Short and sweet here. If you have matched into a primary care residency (FM being the most common that goes rural) then you should at least consider this option. A couple of my residency colleagues signed similar "Letters or intent" with retention stipends. Most did so in their R2 and R3 years. I recommend consulting with lawyer before you sign any binding contracts and discussing this with faculty advisers for additional advice.

• Location: You name a state, there is need. (hint, Idaho is 49th out 50 for a (1))

• Season: Post-match for MS4's and all years of residency

• License: MD, DO, DDS, PA, ARNP to name a few

• Required gear: Cowboy boots?

• How to videos: NA

Assessment:

Retention stipends provide a valuable source of additional income during residency when wealth and time are in short supply. They also provide a sense of "ownership" in your future practice and the rural community it will serve.

Plan:

• AAFP's Practice management document on physicians contracts can be accessed here

• FPM's blog on most recent physician compensation available here

• I am happy to provide further consultation if you questions

References:

(1) State Physician Workforce Data Book . AAMC 2015. https://www.aamc.org/download/447170/data/idahoprofile.pdf

-Andrew Schweitzer MD