By Rui Bouça, Guest Writer

As I sit to write my journey and financial history as a retired economist and a current medical student, I ponder how to start this essay properly. How can I engage with you so that you don’t feel compelled to drift away into the dopamine world of smartphones and easy access to virtually anything that offers instant pleasure?

Let me start by saying I have a unique tale to tell.

First, let’s talk numbers so you can follow along on my journey and see the big picture crystal clear. In Portugal, where I live and work, the average income is 1,361 euros per month. As we get paid 14 months out of the year (these represent vacation and Christmas bonuses that workers receive), this amounts to €19,054 yearly (around $20,300 in US dollars, as of this writing). As you can tell, this is very far from the kind of money you can make in big countries like the US.

However, the cost of living is also cheaper. You can rent a place in the major Portuguese cities (Oporto and Lisbon) for less than €700 (euros) a month. If you only rent a room, you can pay as little as €250 monthly.


How Much Do Doctors Make in Portugal? 

If you think this is different, wait until you realize how little doctors make. In Portugal, doctors are in a completely different ball league compared to American physician compensation. An average doctor earns less than €3,000 monthly here. This totals €42,000 annually (about $45,000). The highest a doctor can earn in the public sector (where most doctors work) is around €72,000 annually.

In Portugal, if you want to be rich, choose another career.

Now that we have established some common ground, let me introduce myself. My name is Rui Bouça, and I am a 26-year-old freelance writer and medical student from Portugal. I have wanted to be a doctor since I was 14 years old (not for financial reasons, as you can probably tell by now). In my country, when you are 18, you must choose your desired course, depending on your grades. In Portugal, you go to medical school right after high school. Despite knowing that, I did not study hard enough and did not manage to enter medical school when high school was over.

With a tricky decision in front of me, I chose what I thought would give me the most freedom: being an economist. Why is that? Well, economics is a vast subject derived from philosophy (aren't they all?). Economics focuses on human behavior toward decision-making. Besides this, economists who work in the banking sector can make a lot of money in Portugal (around €100,000 yearly).

I enrolled in college without ever having studied economics and fell in love with it. Macroeconomics is in our everyday lives. Most people cannot stick to a budget because they lack basic microeconomics concepts. But as time passed, I knew I was approaching a hard decision. I had to decide what to do with my life.

After finishing my bachelor's and master's in Economics, I was 23 years old. Fear began messing with my head. Having fantasized about being a doctor for so long, the idea of working in a 9-5 job and sitting behind a desk all day was scaring me. I feared that my work wouldn’t matter. Being a doctor was a very primitive desire because I wanted to help people—to change and save lives.

With nothing to lose and lots to gain, I joined the largest Portuguese bank to be an account manager. I managed wealthy investors and their businesses, incentivizing them to get more loans to earn commissions. This taught me valuable lessons on when not to accept loans. I saw major firms incur loans in terrible times.

The job itself was not exciting. We did the same repetitive stuff every day. In hindsight, what frightened me the most was seeing all those 50-something-year-olds stagnated in poorly paid jobs with no perspectives in life. How can you spend all your life without a purpose, without helping other people? How can you wake up every day knowing all you will do is call somebody to offer them money to buy new cars or improve the company’s installations?

The worst part was being part of the loan process. Although I merely watched and never effectively granted loans, I still felt dirty. Some people did not need loans, but the managers went with them anyway to earn commissions. At this point, the old dream of being a doctor started playing in my head again.

To me, this is what distinguishes a job in the health industry from any other job. You wake up every day knowing you can help someone. Yes, this won't be all roses, and many health professionals are not very nice people. But you cannot take this away from me: they help.

More information here:

5 Financial Considerations for American Doctors Wishing to Live Abroad


Applying to Medical School in Portugal 

With all these thoughts in my head, I started looking at how to apply to medical school. Eventually, I discovered that, in Portugal, there is a unique way to enter medical school if you have a college degree (remember, most people start medical school after high school). You have to pass a special exam that covers all the basic science. Although this alleviated my mind, something was bothering me terribly. How could I leave my first job without an emergency fund and apply to an educational course that would force me to six years of intense studying in medical school without payment? How was I going to make money?

The only nice part is that medical school is cheap in Portugal, unlike in the US. You pay €670 annually, and that’s it. The government believes that education is vital, so it covers most of the cost. The bad part is that six years is a lot of time, and I needed to make money.

In Portugal, medical school is longer than in most countries because we have three years of theoretical studies (basic science, anatomy, histology, pathology, etc.). Then, there are three more years of clinical practice, where we do our rotations. After this, we have one “common year” where we rotate again through multiple specialties—this time without grades. This is meant to stimulate us into making the life-changing decision of choosing a specialty. It’s five years of specialty training, and then voilà, you are officially a doctor.

I could have asked my parents for financial help, but that would have been tricking the game. I think of life the same way I think of card games. When I was young, I studied magic tricks. Because of this, I can basically rig all card games. But just because I can, it does not mean I should. Tricks are for shows. The real magic is pulling off miracles with nothing up your sleeve.

medical school in portugal

I thought I could only survive a part-time job while attending medical school. So, I needed to find a way to make as much money in as little time as possible. The question was, which part-time job?

Since I needed to study a lot for medical school, I could apply that knowledge instantaneously and teach it to someone else. In Portugal, that job pays well (around €20-€25 hourly). I started tutoring people who wanted to get into medical school, teaching them basic science. I joined various WhatsApp groups of people who had, like me, a previous college degree and wanted to enter medical school.

During those times, I worked five hours and studied 6-7 hours daily to pass my admission exams. Since this coexisted with COVID times and I still lived with my parents, my expenses were kept to a minimum, and I stocked up an emergency fund.

More information here:

When Everything Clicks into Place: How Foreign Travel Can Make You a Better Doctor


Common Personal Finance Mistakes 

When it comes to personal finance, there are three mistakes that most people commit:

  1. People think it is too complicated. Let me tell you, it is not. You need to grow your stack of money, first by increasing your salary and then through intelligent investments.
  2. People act out too often and too soon. Before you act, you have got to plan. Think about your own clinical practice. You only practice it after you have spent years learning the theory. Formulate a plan, and stick to it.
  3. People are unrealistic. Start with achievable goals in the short and medium term. Expecting to achieve life-changing money in a couple of years is unrealistic and a highway to dissatisfaction, frustration, and misery.

Starting Side Hustles 

I worked as a tutor for some time, but then I got tired of it. Besides, in the summer, you earn next to nothing. I realized that if I kept tutoring, I would have had to start taking money from my emergency fund. I took it as a sign that I must change something. And I did. I performed one of the most ridiculous searches in my browser history: “how to make money online.”

An economic concept that is very present in my everyday work life is output per hour. The reality is that I am not interested if I earn a lot of money at the end of the month. What I want to do is increase the amount of money I can make per hour. So, my output has to be maximum. This led me to search which industries had the highest output and added value.

This is how I discovered Search Engine Optimization (SEO). It is basically doing a Houdini routine on written content to rank No. 1 in all Google searches. This was the perfect job. It's about writing content, and it can be done at any time. I could do it at midnight after a long day at the hospital if I wanted.

This leads us to where I am. Today, I manage the SEO for three websites, and I am building my own website as well. It involves lots of sacrifices. I cannot attend any theoretical classes and only go to school whenever I need to (basically, if it’s an evaluation or a practical course). I start studying one month before exams, and my routine is simple: I work from 9-4 or 9-5 and then study until I can no longer keep my eyes open. Sleep, rinse, repeat.

In terms of my salary, I am not making life-changing money, but I made some financial compromises. I accept not making much money now and having the possibility to conciliate medical school with work. I accept delaying purchases that, even though they may seem relevant now, may disrupt my financial future. I accept that to achieve our dreams, we have to pay the price.

Looking at the future, I hope to find more SEO clients and get my websites rolling. I want to achieve financial independence, because I do not want to be paid to practice medicine. Being a doctor is my dream, and I cannot stain it with money.

I hope my story can provide value to you. Keep pursuing your dreams and hopes, as they can be conciliated with being financially independent. Never forget that the earth is 4.5 billion years old. You were dead for most of it, and depending on what you believe, you may be dead for many years to come. In the best scenario, you get 80 years of a healthy life. Do not let fear push you back.

Move forward. Toward where? Your dreams, your infant palace where dreams are possible. Move toward yourself.

If you live or have lived in another country, does this medical school experience sound familiar? Would six years of medical school be worth it? Can you fathom the idea of paying only a few hundred euros per year for medical school? Comment below!

[Editor's Note: Rui Bouça is an SEO specialist, retired economist, and medical student in Portugal. This article was submitted and approved according to our Guest Post Policy.]