During my time at the University of New Mexico School of Medicine, I had the privilege of teaching incoming residents about disability insurance—thanks to an introduction from a dear friend, a real estate agent whose passion was guiding new physicians through their first home‑renting and buying decisions. Together, we saw how overwhelming it can be to juggle budgets, benefits, and logistics while also gearing up for the long hours you'll work in your first job out of medical school.
In this post, you’ll find key tasks—from must-buy items to financial decisions—so you can hit the ground running and focus on what really matters. If you're saying to yourself, “I’ve matched . . . now what do I do?” this post should provide some context. Here's a comprehensive checklist for incoming residents before they start residency.
Housing: Renting vs. Buying
Renting: The Practical Default
Renting requires low upfront costs, frees you from property‑maintenance headaches, and lets you relocate easily if your program or personal situation changes, allowing you to focus on training (and catch more sleep!) without worrying about leaky faucets or yard work.
To find better deals on rent, check out resources like local hospital or university housing boards (many GME offices maintain roommate and housing lists) and apartment search tools with “basement” or “room for rent” filters (Craigslist, Facebook Marketplace). You can also tap into social media groups for your training program or city, ask Facebook friends, or work with a savvy real estate agent who knows the off‑market basement apartments and house‑share opportunities in your area.
Buying: The Exception, Not the Rule
Many new interns feel like they’ll miss out by waiting to buy. As Dr. Jim Dahle, WCI's founder, points out, fourth‑year medical students often believe that owning a home means they’ve “made it,” yet most residents probably shouldn’t buy. He recalls renting in Arizona during the housing bubble: classmates who bought early doubled their money, but those who followed the hype right before the 2008-2009 crash were left underwater when they tried to sell after residency.
That said, some residents buy because they have a partner’s income, plan to stay long‑term, and want the freedom to customize their living space. Physician‑specific loan programs, even with low or no down payment, make it easier to start building equity during training.
Living Arrangements
Solo living: This offers privacy and control over your environment, which can be important during stressful periods. However, it typically comes at a higher cost. In a residency subreddit thread, several residents shared how they made it work by choosing low-cost-of-living areas, commuting farther to save on rent, or sticking with minimalistic housing options to keep monthly expenses manageable.
Roommates: This can significantly reduce costs. Make sure you’re compatible to maintain a pleasant living situation. In a post on The White Coat Investor Forum, a second-year medical student shared how paying over $1,100 per month for a one-bedroom apartment while carrying credit card debt had them seriously considering living out of their car. They later acknowledged that getting a roommate, even someone they didn’t know, could have dramatically lowered their expenses and improved their situation.
Married or partner living: Living with a spouse or partner during medical training brings both support and its own set of challenges, especially if you're raising children or relying on one income. On another residency subreddit thread, many residents said the key to making it work was choosing affordable housing, budgeting tightly, and getting help from extended family or childcare assistance programs. Dual-resident couples or those with working spouses could often afford a modest home or apartment, but made sacrifices like driving one car, buying secondhand baby items, or cooking at home instead of dining out.
Budgeting for Housing
Aim to keep housing to no more than 30% of your total monthly income. Factor in utilities, internet, parking, and various types of insurance. Including these in your monthly budget gives you a more realistic view of what you can comfortably afford.
More information here:
How to Buy a House the Right Way
Is Renting Better Than Buying? Why We’re Financially Independent and Renting
Buying Insurance
Disability Insurance
Your ability to earn an income is your greatest asset. Own occupation, specialty-specific disability insurance protects that income if an illness or injury keeps you from working in your field. Look for policies with key features like a Future Increase Option (so you can grow coverage as your income rises, especially once you're an attending), a Residual/Partial Disability Rider (for partial loss of income), and a Cost-of-Living Adjustment (to keep benefits in line with inflation).
The best time to get coverage is now. Waiting can be risky. A medical event like cancer, depression, or even a minor diagnosis could lead to exclusions or prevent you from qualifying at all. A WCI-vetted insurance agent can guide you through the process.
Term Life Insurance
If you have dependents or significant debt, term life insurance provides financial protection for your loved ones in case the unexpected happens. It’s more affordable than whole life insurance, making it the right choice for most people. Even if you’re not married or don’t have children yet, it’s worth considering early. Like disability insurance, the best time to buy term life is when you’re young and healthy, locking in lower rates and reducing the risk of being declined later due to future health issues.
Keep in mind that most federal student loans are forgiven at death, but private loans may not be, so it’s important to review your specific loan terms before deciding how much coverage you need.
Renters Insurance
If moving for school or work, renters insurance is a smart and affordable way to protect personal belongings from theft, fire, or other damage. It also includes liability coverage in case someone is injured in your home, helping cover legal or medical expenses. If you have roommates, each person will need their own separate policy because only the belongings of the named insured are covered. In addition, renters insurance is very inexpensive.
Umbrella Insurance
Umbrella insurance provides extra liability protection above the limits of your auto or renters policies. While many residents may feel it's unnecessary due to limited assets, it's still worth considering, especially if you drive regularly or have any risk of being involved in a serious accident. You may not have much to protect now, but future earnings can be at risk in a lawsuit. Some residents on The White Coat Investor subreddit mentioned that although the likelihood of needing it is low, the peace of mind might be worth the $150-$200 annual cost for a $1 million policy.
If you have zero tolerance for financial risk or just want that extra layer of protection during training, an umbrella policy can be a low-cost way to reduce your exposure to the unexpected.
Managing Loans and Financial Planning
Student Loan Strategy
As a resident, it’s critical to start your student loan repayment strategy early. Income driven repayment plans can help keep payments on your six-figure student loan debt manageable during training, and they may offer forgiveness opportunities if you work in the public or nonprofit sector. If possible, avoid deferment or forbearance unless it's absolutely necessary. The reason is that interest may still accrue, and you might lose credit toward forgiveness programs.
If you’re not pursuing forgiveness, refinancing might make sense after training, once your income and credit profile improve. New graduates should also consider a direct federal consolidation to start repayment right away. Planning ahead now can save you thousands later. Consider meeting with Student Loan Advice for student loan repayment strategies.
Establish an Emergency Fund
Residency doesn’t leave much wiggle room, which is why having a basic emergency fund is essential. Aim to build up at least three months' worth of essential living expenses, enough to cover things like rent, utilities, groceries, and transportation. This cushion can help you handle unexpected events like a car repair, a sudden move, or even an illness or injury that disrupts training before your disability insurance benefits begin. Even starting small—setting aside a little each month—can go a long way.
Banking Solutions
Look for banks that understand residents, like no-fee checking accounts, abundant ATM access, and high-yield savings options. A good account should make it easy, without the surprise fees. Online banks and credit unions often offer better interest rates and lower fees than traditional banks.
More information here:
Student Loans 101: Ultimate Guide to Student Loans
Healthcare and Professional Preparedness
Health Insurance
Before starting residency, understand health insurance options. Most programs offer coverage, but read the details—like premiums, deductibles, and what's actually covered. If insurance isn’t provided, expect to shop for individual plans through your state’s marketplace or a private insurer.
Contract Review
Thoroughly review your residency contract, and make sure you're paying attention to benefits, salary, and policies on moonlighting or additional work.
Lifestyle and Wellness Preparations
Here's a relocation logistics checklist:
- Set up mail forwarding through the post office.
- Update your address on bank accounts, insurance, student loans, and other key documents.
- Update your driver’s license and vehicle registration if moving to a new state.
- Learn your transportation options. That could include public transit, parking, or bike routes near your hospital.
Take a Vacation
If possible, take a vacation or a little time off before residency begins. This may be one of the last longer breaks you have for a while, and even a simple getaway, extra time with family, or a few quiet days at home can help you recharge. Residency is demanding, so going in rested and mentally refreshed can make a real difference.
Work-Life Balance
Residency is intense, and the lines can become blurred between personal and professional life. Setting realistic expectations and protecting time for yourself, even a 20-minute daily walk, can help prevent burnout and support long-term well-being. Make room for hobbies, relationships, and quiet moments that remind you who you are outside of medicine. Burnout is one of the greatest threats to a physician’s career and financial plan. Finding your “why,” your purpose and motivation for choosing medicine, can help keep you grounded. If needed, seek coaching or peer support. Developing healthy habits early can help you build a more fulfilling life inside and outside of medicine.
More information here:
From Fourth Year to the Real World: Transitioning from Med School to Residency
The Bottom Line
Residency is your launching pad. Yes, it’s challenging. But it’s also full of growth, purpose, and the chance to shape your passion for medicine and your personal values. Taking the time to plan ahead, staying grounded in your “why,” and taking care of yourself along the way will make you unstoppable.
What other advice do you have for new residents? What did you do right when you came out of medical school? What did you do wrong?
The White Coat Investor may receive compensation from White Coat Insurance Services, LLC; licensed in all states including MA and DC; CA license #6009217; NY license #1758759 (exp. 6/2027); Registered address: 10610 S. Jordan Gateway, #200 South Jordan, UT 84095. This does not affect the cost or coverage of insurance.