California

[civilspouse]

DH really likes one of the places he applied to in California. I was hesitant for him to even apply there because the cost of living is so high. Now he wants to put it at the top of our list. I just can't get over how expensive things are. We were considering me staying home, but there is no way we could do that there. Rent for a 2 bedroom appt is double what our mortage payment is now on a 15 yr loan. Daycare costs would be about 2k more per month than what we currently pay. I'm sure some of my reluctance comes from the fact that in the state I grew up in people always complained about Californians moving to the state. DH is from CA and moved to where I'm from when he was 11 or 12. The program is good, he would be well trained. The other school at the top of his list is in the midwest. After residency we would prefer to be in the west and we've heard that it's easier to get 'the job' in the region that you train in. The school in CA also has name recognition so hopefully that would help in the job search. I just don't know if it would be worth the price tag. How do people make it work in high col areas?

[bobk]

I seem to remember that UCSF gave a stipend on top of the standard resident salary to help offset the high cost of living (like around $20k). Maybe other programs offer that as well.

[Pollyanna]

We loved our time in Northern CA but you are right about the cost of living. It's as bad as you think times 2. No one believes me until they get there and then say, "holy crap, it's expensive here". Does the program he's looking at have a married student housing option for residents (it's rare but available in some places)? I'm not sure about training in a certain region making it easier to get a job. We trained in the southwest and are now in the southeast. Things are already tight in residency, don't do anything to make it even harder unless you feel you really need to. Good luck!!

[peggyfromwastate]

I have loved being in northern CA these past two years. But we have fallen more into debt when really we should've been climbing out... The kid expenses are insane. The cost of renters insurance is really really high. The cost of car maintenance, food, gas, eating out... Everything is much more expensive. Our biggest sticker shock was preschool. Yikes. Then swim team. Ouch. Then taekwondo. Holy cow... And we came from metro DC which is not known for affordability.

But I do love the area. The weather is great and the parks and nature trails are amazing.

I wouldn't mind coming back here as an attending spouse--- my dh would be paid market value then which is about 2.5 times higher than national norms. As a person in training, I think it would be really tough. It is tough for us and we are in a special situation (military).

[DrBandMe]

DrBtobe really liked Sacramento but California's col in general scares me.

[GreyhoundsRUs]

DH applied to a few CA places for fellowship, but after looking at COL, he's only accepting 1 interview (name beats COL ). You can take out additional loans to help. Would you make enough to justify going back to work (I wouldn't). Would you consider watching another child in your home for some extra money?


Wife of a PGY-4 Orthopod

[SuzySunshine]

We lived in Palo Alto for medical school, granted that was almost 10 years ago but we LOVED it and yes, its expensive. We didn't have kids at the time but had several that did, some chose to live in the married student housing which wasn't great but a lot less expensive, we had other friends who chose to live off campus and just went into debt. But I will say that the name opened a lot of doors for DH when it came to residency. At that time in our life, we'd do it again.

We did have friends that went to UCSF for residency and yes, some of them went further into debt but they loved it.

[metroguy]

depending on speciality, brand name residency can be important. ucsf (or any brand name) would have greater # of residents/better attending which would make resident's life easier/happier. also it would mean better chance of a brand name fellowship. of course, it can mean higher debt. and your kids may feel like they're living in the poor house which doesn't help in their development. it's a trade-off. i'm not sure if i would do it. it depends on how long the residency is, how much more debt. and seriously, residency is a family decision--not an individual decision. the happiest yrs for me was when my spouse live 10 minutes away from the hospital (community prog). sure, there's no brand name, and she didn't make any brand name connection--but she was able to get an hr more sleep per day which can make all the difference in the world (in terms of mood/happiness/well being). post call+ some lectures(30+ hrs),she was able to drive home and hit the bed in one piece. it was great.

[OrionGrad]

DH is interviewing at a number of CA programs for fellowship. I expect COL will be a factor in our rank list, but it obviously won't be the most important factor. Anything is doable if that's where your DH matches, even if the living situation isn't ideal. And to echo what someone else said, I know of a few CA programs that offer an extra housing stipend for residents/fellows. Worth seeing if they offer that at the program you're looking at.

[Pollyanna]

Whatever you think it will cost you to live in CA just add 30-40% more and that will be closer to the real number. Really, just do it when you're planning the match list, this way you're going in knowing what you're getting into.

[Thirteen]

Whatever you think it will cost you to live in CA just add 30-40% more and that will be closer to the real number. Really, just do it when you're planning the match list, this way you're going in knowing what you're getting into.

Very sound advice.


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[alison]

We loved California and the program where dh did his fellowship had a lot of connections up and down the West Coast, and especially where we ended up in the PNW. It was extremely helpful to have that year in CA under his belt when it came to searching for The Job.

And it's so beautiful and sunny.

[civilspouse]

For now I think we've decided it will be at the top but not number one. I think we could make it work if I have a job. If we didn't have kids I would be more willing to go for it. At least the elementary schools look decent in the area. Making the list is tough and I feel like we are agonizing over what should be number one when we both know we may end up at number ten.


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[houseelf]

...and just to dogpile a bit (sorry). We recently had a CA contract in front of us that required 7% of the physician's earning to go to a tort/med mal fund on top of the already high state income taxes. This was for a locums gig, but it makes me wonder if all attendings have this sort of requirement. Besides the "obvious" high COL in CA due to real estate, it seems like there might be a lot of hidden costs. Believe me, if it was financially reasonable, CA would be at the top of everyone's lists.

[The White Coat Investor]

I applied to 5 residencies in California and interviewed at all of them. I ranked one of them pretty highly. In the end, I'm glad I didn't match there.

As an attending, living in California is insane. High cost of living, poor Medi-Cal reimbursement, ridiculous tax rate, same (or worse) pay, competing with the .com millionaires for housing in the good school districts, paying thousands for public school fundraisers vs paying thousands for private school....it's a toxic wasteland for physicians.

I love California. But I will never practice there.