The Surprising Cost of Medical Residency Interviews

Hi everyone, I’m Mr. Mechanic. Financial Mechanic has been begging me for weeks to write a guest post and I finally have a topic to share! This article gives a brief look at the cost of my medical education, the goes on a deep dive into my costs on the residency interview trail.

It’s no surprise that medical school is expensive. In 2017 the AAMC reported median annual tuition and fees for state institutions around $49.6k, or even worse $71k for private medical schools. As an in-state student at a public school and thanks to some scholarships, I am a bit below average at $40k a year. I live on a monthly living expenses budget of $1200, or around $14k annually.

One of the major unadvertised costs of medical school is residency interviewing. After completing 4 years of medical school, every student in the country interviews for spots in the specialty of their choice. For my specialty, radiology, experts recommend interviewing at 10-15 hospitals to find a spot successfully. Here’s the kicker: the whole process is on your own dime.

I tracked every dime I spent and made handy graphs like the one below to share the various costs:

Amount spent in each city
Amount spent in each city

At my school, we’re lucky enough to have an in-house financial planner to help us plan for expenses. He sat down with me in the first month and said to expect to spend a ballpark of $10k for the whole ordeal. I saved up the full $10k in a savings account and left it untouched until interview season.

This fall, I cracked open that account and hit the trail. 15 cities and 18 interviews later, here are some of my big wins, some mistakes to avoid, and the breakdown of what I spent.

Flights

I knew going in that this was going to be the biggest cost category. Interview invitations come in over several months with pretty short notice, as close as a week or two out. Worse, they come in randomly, so clustering schools in particular regions can be difficult to accomplish. To account for this, I put my first interview for each region in its own week, with a plan to fill in the week with other schools nearby as more offers came in. This was moderately successful, but not always possible; despite my best efforts, I still made 5 separate flights from Portland to the East Coast. A lot of my flights got booked a week or two ahead of time, something I had to swallow as the cost of flexibility on the interview trail.

Cost of flights to each city and running total
Cost of each flight and running total

All The Airlines

I hit almost all the major airlines in the US: Alaska, American, Delta, Frontier, Jetblue, Spirit, Sun Country, United, and Virgin (Delta is cushy, Spirit was rough). Notably missing here is Southwest. They are an excellent option for this kind of travel, offering 2 free checked bags and unrivaled flexibility to cancel/rebook flights. In my case, I checked Southwest for every leg of my journey and always found a better deal elsewhere, but I still recommend looking.

PDX airport; I got to know this place far too well
PDX airport; I got to know this place far too well

Advice on Airline Miles

One of the pieces of advice hammered into us early on was to get an airline mileage credit card, advice I echo wholeheartedly. Travel points were a huge help in my trip. I redeemed around $1000 worth of points over the 3 months. I used a combination of my Chase card, previous miles I had collected from United, and some gift miles from my folks on Alaska.

Big Win

My flight down to Santa Barbara was going to cost around $600. I realized that if I left the evening before, I could do an overnight layover in the Denver airport and get in the next morning. Admittedly it was a rough night, but I made it there for just $150 and got myself a nice breakfast instead.

Ouch Moment

I had a one-off interview in Ann Arbor the week of Thanksgiving. Flights and housing for that jaunt cost over $600, a full 10% of my total budget.

Grand total: $3300

Housing

This is the other area where costs can balloon. On the trail, you’re realistically sleeping in a different bed every night. I stayed with friends and family in the few places I could, but mostly had to find housing on my own. Most programs will provide applicants with a list of hotels in the area and many offer discounted rates for interviewees; even so, with so many nights on the road these can still seriously run up your final tally.

Financial Mechanic and I are accustomed to crashing in €15 backpacking hostels abroad, so I have no problem traveling a little rough; all I need is a bed, 4 walls, and a roof. I found much better rates with Airbnb, and as a side benefit met some wonderful people and got great tips about the cities I was seeing. This cut my housing costs in half. I was also able to choose places that would be close to the airport, downtown, or the hospital to cut transportation costs.

Houses in rural NY
A surprise snowfall made rural NY all the more beautiful, and me more grateful for all-wheel-drive.

Big Win

One night in Santa Barbara was going to run me $200. Instead, I found an Airbnb for under $40 with an older gentleman from the UK. Besides the free tea and breakfast, he made me a sandwich when I got in and we chatted for an hour about days gone by, one of the highlights of my trip.

Ouch Moment

A two-day stopover in LA for a board exam ran over $90 a night, the worst of my trip.

Grand total: $600

Ground transport

app car charging directionsIt costs a lot of money to get places. Whenever possible, I stayed somewhere walkable to everywhere I needed to go; my fitness tracker was loving life, chalking up an average of over 20k steps daily. I also took advantage of public transit, both for convenience on that trip and to get a feel for the system, as it’s an important factor when living in a city. However, this isn’t always viable (December in rural Connecticut, hello?) so I had a decent number of Uber hops as well. I also rented a car a few times for less accessible locations; as a bonus, my institution has a 10% off deal with several companies that I was sure to take advantage of.

Big Win

Uber has made it to Dartmouth, but a round-trip to my interview at the hospital was looking to be at least $30. Turns out there’s a free bus that runs to the hospital twice an hour!

Ouch Moment

The $12 bus leaving Ann Arbor for the airport was booked solid leading into the Thanksgiving holiday, which turned into a $40 Uber ride, the highest of my trip.

Grand total: $900

Food

This category can be sneaky because of how quickly many small purchases add up. I saved here because almost every interview included a light breakfast and lunch, and often a fully paid dinner out the evening before or after. If they served sandwiches, you bet a leftover one went in my bag. I made sure to leave for the airport on a full stomach, and every time I stopped at home in Portland I restocked with snacks like granola bars and fresh fruit. I never went hungry and managed to avoid wasting money at the airport.

On the other hand, I’m a big believer in trying the local food when you travel to a new place, so I made sure to get something authentic off the menu in every city.

Big Win/Ouch Moment

The lobster roll in Portland, Maine, was listed as “market price”, which is code for “if you have to ask you probably can’t afford it.” I didn’t know the next time I’d be in Maine so I went ahead anyway. It turned out to be $18.50 and one of the best seafood treats I’ve ever tried.

Grand total: $200

Lobster rolls in Maine
Market price lobster rolls in Maine… I don’t regret it

Wrap-up

In total, the whole trip rounded out to about $5000, a pretty hefty pricetag but still great savings from the advertised $10k. I had help from friends and family giving rides, housing, and meals (Thanks everyone!) as well as around $1000 in airline rewards travel.

I saw 8 new states and almost a dozen new cities. It went by in a whirlwind, and a few times I found myself scrambling to remember what program I was interviewing with (felt a bit like this moment from my favorite Flight of the Conchords song. I wouldn’t travel that way all the time, but it was a great way to see where we may spend the next few years of our lives.

What have you done to save on travel– whether on housing, flights, ground transportation or food costs?

Have you (or someone you know) gone through the medical residency interview process?

Leave a comment below!

14 Comments

  1. This is a very thoughtful post on expenses that most people don’t even plan for until it is too late and thus fund it with credit cards.

    Kudos to you for thinking so far ahead that you had an interview savings account lined up. Very clever of you and you were way ahead of me financially at that stage in my career for doing so.

    I graduated medical school in 1997. I went to Temple University and was out of state. I borrowed $40k/yr which was the maximum and that did cover room and board. It is mind boggling that $40k/yr in tuition alone is considered a bargain at an instate school.

    To get that many interviews at a competitive specialty like Radiology speaks volumes about your academics (I’m biased since I’m a radiologist myself). Hope all the effort ends up in a happy match for you in March. Keep us posted.

    1. The costs have definitely ballooned. Thankfully I had classmates in years ahead of me and our excellent financial advisor to warn ahead of time.
      Thanks for your kind words! I will be sure to follow up, and I’m sure FM will have lots of new material as we plan our eventual move.

  2. Thank you for this thoughtful breakdown of interview costs! I remember it being a real hassle and I definitely wasn’t as smart as you when I was doing it. I’m sure this will help many coming up being you!

    1. I tried to make it as authentic + interesting as possible, and hopefully a resource for later! I definitely benefited from the advice of years above me and need to pay it forward.

  3. Wow. The numbers are truly staggering. I went to UCLA for medical school and as a California resident, tuition was only $18,000 a year. I took out $12,000 a year for living expenses because Los Angeles is expensive.

    I spent around $1,500 on residency interviews. I interviewed at 10 places total. There’s 6 anesthesia residency programs in the greater Los Angeles area. All were easily drivable so I would put that expense as $100 in gasoline.

    I had 4 interviews in New York City. They were all in a 8-10 day span. I bought one round trip ticket and stayed at one of my friend’s high rise apartment in downtown Manhattan. He let me stay there for free, which significantly cut down my costs. The NYC subway wasn’t terribly expensive, my total was probably $100 including subway, buses, and cabs. The majority of my expenses were food and entertainment. My buddy showed me a good time in New York!

    1. Wow, I wish I could have clustered my schools that efficiently! I went polar opposite and avoided most of the bigger places like NYC or LA, but it definitely meant a lot more travel to reach those more rural locales.

  4. Thanks for lots of tips on travelling efficiently and cost effectively! Good job on getting the cost down to about half of what they warned you it would be. Its great that you tried to enjoy a little of what each city had to offer so that you could at least have some fun in what must have otherwise been an arduous process! And that Maine lobster roll looks awesome!

    1. I was expecting steaming hot, but it was cold! Fresher taste I guess, and it’s amazing how clearly the buttery flavor came through. If you haven’t guessed, food is an absolute highlight wherever I travel, that lobster roll was definitely not a regret in the slightest.

  5. Beautiful article on what can be hard to pin down logistics. Before Airbnb, there was a friend’s friend from undergrad and his or her couch, and that was a huge gift because it was free and was usually a med student (walkable to interview!). I’m impressed by your resourcefulness in the face of adversity, Mr. Mechanic.

    Interviews are basically a financial sieve with last minute transportation and so many other thoughts filling your mind, so any dollars you can save are doubly impressive achievements.

    Fondly,

    CD

    1. I hate to impose on people, so it was great to find reasonable accommodation most places. Even then, it’s crazy how high the numbers climb with so many days on the road. Also, I absolutely echo the feeling that finances and travel are at the back of your mind during the trips, being so focused on your current place makes it hard to sit down and book the next batch of flights!

  6. Wow, this is nuts! My little sister is currently pre-med and I’m planning on saving a little bit each year to help her along. I’m hoping she’ll get into NYU (free tuition anyone?!) or that more schools start offering free tuition… If not, she goes to school in California so hopefully she can become a resident before starting medical school.

    She wants to become a pediatrician (which is cool!), but I worry about $200k-$300k in medical school loans she’ll take out worst case scenario.

    1. NYU is a crazy deal! I was definitely more than a little jealous. Then again, my school is at least cheaper than many in California. If she wants to do Peds, she should do it! Much better to pursue what you love over the paycheck; even if it means more years of work, it’s work you find so much more fulfilling.

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