Financial Planning for your Fourth Year

If you are footing the bill for medical school (and by you, I mean the US government), you’ll like receive slightly more financial aid during fourth year to cover the increased costs. However, depending on your field of interest (and the number of programs you need to apply to and interview at), it’s extremely easy to max out your loan money and end up dry.

Fourth year costs include:

  • USMLE Step 2 CK: $560
  • USMLE Step 2 CS: $1120 + travel/lodging if necessary (which it is for everyone who doesn’t live in or near Atlanta, Houston, Chicago, LA, or Philly)
  • “Releasing” Step scores to ERAS: $70
  • NRMP Registration: $50 (+$15 for couples)
  • ERAS: Varies, generally a few hundred to over a thousand.
  • Travel for interviews: priceless

For ERAS, the costs are calculated based on the number of applications within a specialty:

  • Programs Up to 10 $92
  • Programs 11-20 $9 each
  • Programs 21-30 $15 each
  • Programs 31 or more$25 each

This means that competitive specialties (for which many people submit 40-60 applications) cost significantly more. 50 derm programs, for example, will set you back $832. And of course those seeking advanced specialties like derm, radiology, rad onc, etc also need to apply to preliminary or transitional year programs. If you apply to both medicine internships and transitional years, you add at least another $184 (as one program costs as much as 10 within a single residency field).

Depending on how widely you plan to travel for interviews and how many interviews you go on, the costs can vary from expensive to prohibitively expensive. It’s difficult to find a flight and hotel for an interview less than $350 or so, for example, so it’s not uncommon for people to spend up to $10k after all is said and done. That total figure though hinges a lot on where you’re looking: if you’re focusing on regional programs that you can drive to or can at least crash at a friend’s place, then your per-interview-costs will be low. If you’re shotgunning the whole country, stay at hotels, and want to make some fun trips out of the process, expect to need some help. As a result, many students are forced to seek additional financing (even from other than the Bank of People Who Love You): consult your school Financial Aid to discover lowish-interest loans that may be available through your county and state medical societies. And then, of course, there are always traditional banks if need be.

And don’t forget, school may end in May, but you won’t get paid until July. And you probably have to move too.

For example, in Texas (where I studied and practice), medical students can partake from the Minnie Stevens Piper Foundation loans (maximum of $10k at 4%, payment starting 1 year after graduation) or TMA educational loans (which enter repayment 4 years[!] after graduation). Both of these are under better terms than a typical personal loan from a bank, so ask your school’s student aid/financial guru what programs are available to you if you need them.

After all, what’s an extra few thousand here or there, right?

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