Q&A Locums And Life Between U.S.A & Ghana With $478K Debt. #472 Part3

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We help a graduating resident weigh a bold plan of using locums to pay down $478k in student loans while planning a sustainable U.S.–Ghana travel rhythm. If you’re a physician considering locums, global living, or a career design that puts family and culture first, this conversation gives you a clear, workable path forward. 

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Transcript

Listener Question: Loans And Locums

SPEAKER_02 0:00

Alright, y'all, we just finished a segment talking about the five uh financial habits that I've picked up over the last 10 years. Um, it's a really great session. Go ahead and take a listen to it. But now we're gonna be focusing on a question from our audience. All right, y'all. Listen, um, we love questions. It's a great way to connect with our audience. They also have really great perspectives that we haven't considered. So we have a question that I want to play for you all. Let me bring that up. Renee, dance for the audience while we are trying to figure it out. Thank you. Alright. Well, let me stop sharing for a second. I just want to make sure that it's going to share the sound. Are you dancing, Dr. Renee? Alright, you guys ready?

unknown 0:52

Dr.

SPEAKER_02 0:52

Renee, can you see this? Yeah. Alright, let's go.

SPEAKER_00 0:59

Hey, Dr. Renee and Nidacle. Um, my name is Jay. I am a fourth year resident in a combined family medicine and pre-banded medicine uh residency. The pre-banded medicine is my more so like the public health specialty of medicine. Um I will be graduating soon and have been thinking about my postgrad plans. Um I've had a lot of like family um things that I have to now navigate. And one of the things that might afford me the ability to be flexible is locums. Um ideally, I would be going to Ghana three to six months out the year to um support my family and some of their ventures that is going on there. And also like being over here in the US working um in order to be able to pay off my loans. I have about$478,000 in federal loans right now that you know obviously you have to find a plan to uh pay off. I wanted to um do PSLF, but that's not really the best option. So I just wanted to talk to you guys more about locums and how to make that work, especially if I'm planning to go back and forth between Ghana and yeah, just to kind of see some of you guys' recommendations or thoughts on that.

Why Locums Conflicts With PSLF

SPEAKER_02 2:17

So hey, Dr. J, or uh yeah, Dr. J, thank you so much for this question. Um, congratulations for almost being done. You're almost at the finish line. Um, so what you're thinking about, it's not just money, it's not just your career. Um, you also have to think about your family, um, identity, and even responsibility. So um this is a real question. So I have three tips. Um, Dr. Renee, do you have anything that you want to say before I get into my three tips at all?

SPEAKER_01 2:47

Oh no, I think, you know, I think it's great that he's thinking about this now, right? And that it's not just some afterthought. Um, so yeah, no, I appreciate him asking the question. So I'm I'm excited to talk about um what tips you have for him.

SPEAKER_02 3:05

So, real quick, let's just summarize. Jay is getting ready to graduate. He's carrying about$478,000 of student loans. God damn. Um, and he wants the flexibility to spend three to six months out of the year in Ghana to support family and to stay connected to home. Um and he's asking if locums is a realistic way to do that while he's paying off these loans, basically. Right? So my three tips are I'll tell you the tips and then I'll get into it. Number one, make your loan, your student loan plan stable first. Number two, establish one United States anchor locums contract, right? Remember that. Establish at least one locums contract in the United States that's gonna be your anchor job. Three, this is a tough one, is be intentional about your role in Ghana. Okay. So number one, um, the first step is you don't need to be aggressive about your student loans, Jay. You just need to have a plan. So, what I would recommend is since you're saying PSLF is really not an option for you, particularly if you're gonna do locums. So, guys, the reason why he can't do locums and get into PSLF is you have to be um an employee doc. Um, and the biggest thing is you have to be working at a uh non-for-profit hospital. Um, when you do locums, you don't really you're not employed, right? So um that in essence just takes you out of PSLF, right? We're on the same page, Dr. Renee?

SPEAKER_01 4:36

Yes.

Stabilizing Loans With The SAVE Plan

Create A U.S. Anchor Locums Gig

SPEAKER_02 4:36

Yeah, good job. So what I would say is this um you want to sign up for an income-driven repayment plan. And for you, I would recommend the Save Plan, S-A-V-E. I'll put that link in the show notes. Um, and the reason why is you want your monthly payment to be as predictable and manageable as possible, right? And the reason why you want it predictable and manageable is you want to be able to live in Ghana for six to what three to six months at a time. You need to know what your expenses are gonna be. They can't fluctuate, super important. And they have to be manageable because I'm assuming when you're with family and you're in Ghana, you're not gonna be working, right? So the amount of what you make in during your time in the United States needs to be able to carry you for several months. So super important that you get into an income-driven repayment plan. This one is save, super important that you get into that, right? And then that'll give you the space to know what your real income is gonna look like, particularly as a low-come tenant, right? Um, you can decide if you want to refinance your loans later on down the line, right? But I would say focus on um focus on being stable first. Then you can get the speed later on. This is just real talk, right? Um, number two, establish one US anchor locum locum's job, right? So you want to get to a job that you, when you come back and you leave Ghana, that you go and you work there consistently, right? You don't want gaps in the jobs that you have, right? Or you don't want to have a gap where you're trying to find a job if you can help that, right? So you don't want to be going to 10 different places. You want to get on that plane, that delta plane, you right, to take you to JFK, and then you know exactly where you're gonna go after that. It's gonna be tough for you to be trying to do credentialing while you're in Ghana for hospitals in the United States. Like you just don't know what's gonna happen. So try to find one or two places that can be the place that you go back to consistently. You want predictability. Remember, predictability is what you want. Remember, you're gonna be in Ghana for three to six months, you don't know what's gonna happen. You need stability and predictability, right? So you work a bunch of blocks or shifts in the United States, and then you go on back. It's just a 10-hour flight, right? Come in, slide back out. No scrambling, there's no searching. Um, I think what I'm basically saying is you you want to find one or two jobs that'll give you rhythm, right? That'll give you the rhythm of coming back and forth and make this sustainable too, right?

SPEAKER_01 7:18

Yeah.

SPEAKER_02 7:18

Um, anything you want to say about that, Dr. Renee? No, I'll let you finish. Go ahead. Uh-oh. She's like, I'm gonna let you finish. All right, Kanye. So um. Oh man. Then the last one, this one is not really related to work. This is really more about you. Um, be intentional about your role in Ghana. What I mean by that is um decide ahead of time what your purpose for your trip will be. Like, are you there to rest? Are you there to help family? Are you there to support a project? Um, do you want to just be present in the culture? Do you want to eat fufu and you know, tilapia and red red and you know, dairy? And do you want uh black sheet all? Do you want, you know, what red sheet? Do you want palava? Do you want palava? You you know? Um, the reason why I'm saying that is it's super important because to you want to be very intentional about why you're there. Because if you don't define a role, then what ends up happening is you're gonna try to try to do everything for everyone. And that's gonna be draining, right? And it's very important to know what your purpose is, because once you know what your purpose is, then you know how to protect your energy. So that's why I think that third one has really not much to do with your job, but more about what your boundaries are going to be, and to make sure that you can't do everything because sometimes some people will look at you like you can do everything, but you can't. Those are my three tips.

SPEAKER_01 8:58

So one was what?

SPEAKER_02 9:00

Uh one was um make a stable loan plan. And two was make sure you have one job that is very consistent and that you're gonna go to consistently, and then three was just be intentional about your role in Ghana.

Define Your Role And Boundaries In Ghana

Timing Your Moves And Building Stability

SPEAKER_01 9:14

Okay. So I think I think all those tips are valid for sure. Definitely the loans, um, that's I mean, that's a no-brainer, right? Um, I know you're in your fourth year and you're getting ready to graduate. I would say the one thing that I would add is figure out what your timing is to go, right? What's the timing? Um, because you have so much in loans, you have so many things that you want to do. What exactly is the time frame for you to establish all of this and then go to Ghana back and forth? Is that a year? Is that two years? Is that five years? What does that look like? Because, you know, what you don't want is you graduate, you get your first, you know, your first locums position, and then boom, three months later you're out, you come back, and things are not stable. You know, you haven't really established yourself at this particular facility. Um, or you don't, you know, you you haven't figured out, you know, how to handle your finances. So I would say, you know, figure out what the time frame is going to look like because you're going to need to give yourself some time. I'd say at least between nine months to a year, so that you can establish, you know, what you what this would look like for you. I don't know what your family situation is, so I don't know if you have that much time um to be able to do that. But if you do, I'd say give yourself at least a year um to be able to save up as well. If you are going to Ghana, I do think why are you there is going to be a really important remember you're going back to Ghana as a as a doctor. So you know what that means. What is it? Good word. Okay. So you need to know if you're going to be going there, exactly what your um what your financial situation is going to be and how you are going to navigate, how you are going to navigate letting people know that your financial situation isn't their financial situation. You're you're really gonna have to navigate that, coming back as a US trained doctor. So I I will end that point there. But I think that that's gonna be really, really, really important for you.

SPEAKER_02 11:51

Yeah. So, Jay, um, thank you for writing in. I do think your plan is is doable. Um, I think that you know you're on the right path, you're on the right path. I think that's bold of you to be thinking about going back home, reconnecting with family, doing the things that you need to take care of, as well as foregoing PSLF. Because I'll be honest with you, PSLF is very attractive, right? But it's not for everybody. It wasn't for us, or actually really wasn't available for us at the time. Um, but I definitely think locums can bridge locums can bridge that gap between financial um responsibility and like a cultural connection, right? That's that's what I'm getting from you. So I would just say, look, stabilize your loans first, um create one anchor gig here in the United States and um be intentional about your time there. You got this.

SPEAKER_01 12:47

So um keep us posted.

Encouragement And Community Call For Questions

SPEAKER_02 12:50

Yeah, I would say to everyone, listen, if you're out there and you got a question like Jay, um, something like wrestling with or something that you're wrestling with, just you know, let's say you're trying to figure it out in real time, hit us up, you know, hit us up in the show notes. Um, drop us a voice message. We listen to that, we'll answer it. If you can if you don't want us to answer it on a show, you can even tell us and we won't answer it on the show. Um, but don't overthink it, don't try to be polished. Um, just talk to us. We hear. Um, and your questions are what make our community real. Right, I'll leave it at that. Um, so look, um, I think we'll end the show on that accord, Dr. Renee. Um, anything you want to say to finish it off or are we done?

SPEAKER_01 13:34

Nah, I I'm done antagonizing you for the day.

SPEAKER_02 13:37

It's all good, guys. Pray for us. Guys, we will catch you guys on the next episode of Docks Outside the Box, y'all. Peace.