It didn't take long to realize that being an intern/resident and getting a paycheck didn't mean that much. In fact, in some ways if felt worse than being a medical student! That wasn't supposed to happen, was it? I mean a paycheck was a symbol that you were moving up in the world, that you were making your own way, that you had arrived. Isn't that what everyone was waiting for?
We were 6 months into our internship year and each month we watched as our savings account edged closer and closer to zero. We were in crisis mode and didn't see a light anywhere. We had just had our second child and the bills were going to put us in the negative (see my previous post about insurance), the home we purchased was in need of major repairs (see my previous post about our big mistake), and we couldn't see a way to stay afloat. As it was we weren't spending any money, it was beyond tight and I worried constantly about what we would do.
One day in January I looked through the Community Newspaper that our local paper sends out as a courtesy once a week, and saw an add for a work at home position with a local mail-order company. It was an answer to prayers and literally bought us some time. I was certainly over-qualified, but my current circumstances, a mother of an almost 2 year old and a 4 month old, really limited my options if I was committed to staying at home and raising my own children - which I was. So I took the job. I didn't like the work. It was tedious, it cut into the time I was able to be with my husband when he was home because it was difficult to get to work when the kids were awake. I didn't get much sleep during that time, but it did meet our needs for that year and I am grateful for the timing. We paid our medical bills and put a new roof on the house.
As time went on, it was obvious that my job from home would not be a permanent answer to our financial difficulties. My life was taking care of our children, and working. Not an ideal situation for someone in a new community, with small children, who needed to make friends and get out of the house occasionally. There wasn't time for it, and honestly I didn't have the energy either.
So what were our options? Some residency programs allow their participants to moonlight at ER's or Urgent Care Centers, where they can make hundreds of dollars in just 1 shift. Our contract with the hospital specifically forbids moonlighting so that was off the table. Our next option was the military. Besides the different branches of the military they also have different degrees of activity. The first being he could sign up and they would pay us a stipend during residency, and after completion of residency he would owe them 1 year full-time active duty for each year they provided a stipend. They would assign him to a military installation and once our time was fulfilled he would find a job in the private system.
The other option was to join as a reservist. They also provide a monthly stipend in exchange for reserve time to be completed after your residency at a ratio of 2 years reserve time for each year of residency you receive a stipend. You get to join the practice of your choice in whatever state you choose and they assign you to a unit (if you are near a unit). Two weeks a year, one weekend every month, and the possibility of being deployed for 90 days at a time no more than once every two years (don't quote me on that, I may be wrong about the frequency).
After much consideration we decided that going the route of a reservist would serve our families needs the best. With children who would be school-age it was important to us that we not be moving every few years and could settle down somewhere. It was also important that we get to choose where we live rather than having the military decide for us. The trade-off being that we are indebted to the military for a longer period of time. In our case we joined in the second half of our PGY2 and our time commitment to the military is 9 years.
There are days when I feel guilty about "pawning" my husband to the military just so I have the luxury of staying home with my children. I feel like maybe I didn't do enough, maybe I wasn't as frugal as I could have been (I know that isn't true, but I still think it), maybe we could have made it somehow. But I marvel that we made it is long as we did without some sort of supplemental income. Sure we could have gone into debt, but I couldn't even see how that would have worked. We didn't have the money to make credit card payments! More importantly when we got married we committed to never use credit cards to pay for things we couldn't afford. That is a promise we have been able to keep and have never broken.
Another thing that was of great importance to me was being at home with my children. When my first child was born I left a great job with a great salary. My co-workers couldn't believe I was willing to walk away from it so I could stay at home with my newborn (I don't think anyone had ever not come back from maternity leave) and that my husband didn't have an income. It did sound crazy, and it was scary, but I couldn't imagine it any other way. It wasn't fun going from being able to buy and do whatever I wanted to doing and buying nothing! But I don't regret that decision for a moment.
It is hard enough being married to a resident without taking on the added pressure of working and being a mother. For me I wanted to be available when my husband was, and that was unpredictable. Taking care of our home, my husband and our children is now my full-time job.
So that is our formula for making ends meet on a resident salary. The math doesn't work without extra income from some source (job, family, more debt), especially if you have children and want to stay home. If you are able to make it work completely on a resident salary - I applaud you.