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    For parents of medical students and physicians

    What the path from medical school to practice costs and pays at each step, and the points where a parent's money or signature can enter, each with its source and check date.

    The path in years and dollars

    1. Medical school

      4 years

      • In the AAMC's October 2024 fact card, the median four-year cost of attendance for the class of 2025 was $286,454 at public schools and $390,848 at private schools. 71% of 2024 graduates had education debt, with a median of $205,000 among those who borrowed.
      • New MD and DO students can borrow up to $50,000 a year and $200,000 in total in federal loans.

    2. Residency

      Three to seven years by specialty: 36 months for family medicine and internal medicine, 60 for general surgery, 84 for neurological surgery.

      • Median first-year (PGY-1) stipend: $66,986, rising to $72,000 by PGY-3 (2025-2026).
      • ACGME rules cap a resident's clinical and educational work at 80 hours a week averaged over four weeks, with one day in seven free, and limit a shift to 24 hours plus up to four for handing off care.

    3. Fellowship, for some

      Subspecialty training after residency

      • Median stipend in PGY-4 to PGY-6: $76,000 to $83,031.

    4. Practice

      The first attending job

      • In the AMA's Physician Practice Benchmark Survey, the share of physicians in private practice fell from 46.7% in 2022 to 42.2% in 2024, and the share in private-equity-owned practices rose from 4.5% to 6.5%.

    The medical student or resident in the family can run their own numbers in the Match Day money plan and the loan repayment comparison.

    Example valuesjoinandwise.com/parentsAAMC, ACGME, AMA and federal loan ruleschecked October 21, 2026amounts entered are masked

    Where a parent's money or signature can enter

    What financial aid asks of a parent

    For the school's financial-aid office: does institutional aid use parent information, and how does the award change if a parent does not provide it?

    Borrowing in a parent's own name

    For the lender or servicer: which repayment plans can this loan use, and what happens to it if the borrower dies or becomes disabled?

    Co-signing

    • Under the FTC's Credit Practices Rule, a lender gives a cosigner a separate notice before the cosigner is bound. It says the cosigner may owe the full debt plus late fees and collection costs, and that the lender can collect from the cosigner without first pursuing the borrower. 16 CFR 444.3, Notice to Cosigner, checked November 10, 2026.
    • For a private education loan agreement made on or after November 20, 2018, the lender must release any cosigner once notified that the student has died, and may not declare a default solely because a cosigner died or went bankrupt. 15 U.S.C. 1650(g), checked November 10, 2026.

    For the lender: what does cosigner release take, how many on-time payments, and is it automatic or by application?

    Giving money

    • The annual gift tax exclusion is $19,000 per recipient for gifts made in 2026. IRS, frequently asked questions on gift taxes, checked November 10, 2026.
    • Tuition paid directly to the school is not a taxable gift, with no dollar limit and on top of the annual exclusion. It covers tuition only, not books, supplies, housing or board, and the payment has to go to the school itself. 26 U.S.C. 2503(e); 26 CFR 25.2503-6, checked November 10, 2026.
    • 529 plan withdrawals are tax-free for qualified expenses at an accredited postsecondary institution eligible for federal student aid, and up to $10,000 over the beneficiary's lifetime can repay their student loans. IRS, Publication 970, chapter 7; 26 U.S.C. 529(c)(9), checked November 10, 2026.
    • A 529 beneficiary can roll up to $35,000 over a lifetime into their own Roth IRA, within each year's Roth contribution limit, once the account has been open 15 years. Contributions from the last five years, and their earnings, cannot be rolled over. IRS, Publication 590-A, 529 rollover to a Roth IRA; IRS, Topic 313, qualified tuition programs, checked November 10, 2026.
    • Fannie Mae accepts a down-payment gift from a relative, a domestic partner, a fiancé or fiancée, or someone with a long-standing familial or mentoring relationship. The donor signs a letter giving the amount, stating that no repayment is expected, and naming their relationship to the borrower. Fannie Mae Selling Guide, B3-4.3-04, Personal Gifts, checked November 10, 2026.

    For a tax preparer: does this payment count against the annual exclusion, and does a gift tax return apply?

    Example valuesjoinandwise.com/parents14 facts from 21 statutes, regulations and agency pageschecked October 21, 2026amounts entered are masked

    Dates for a 2027 graduate

    Friday, March 19, 2027 Match Day
    Match Week opens Monday, March 15, 2027, when applicants learn whether they matched; SOAP offers to those who did not run through March 18. Match Day, at noon Eastern, tells them where.
    May 2027 Graduation
    Leaving school starts the federal loan grace period.
    July 1, 2027 Residency starts
    The NRMP verifies that each matched applicant is eligible to start graduate medical education on July 1 of the Match year.
    November 2027 Grace period ends
    Direct Unsubsidized loans enter repayment 6 months after leaving school. The payment depends on the plan chosen and the latest tax return.

    The Match Day money plan lays these dates out with take-home pay in the state where the resident matched.

    Example valuesjoinandwise.com/parentsNRMP and federal loan ruleschecked October 21, 2026amounts entered are masked

    Residency from the outside

    • ACGME rules cap a resident's clinical and educational work at 80 hours a week averaged over four weeks, with one day in seven free, and limit a shift to 24 hours plus up to four for handing off care. ACGME, Common Program Requirements (Residency), effective July 1, 2026, §6.20–6.22, checked November 10, 2026.
    • ACGME Institutional Requirements §4.8: residents and fellows have at least six weeks of approved medical, parental and caregiver leave at least once during an accredited program, from the day they are required to report. The first six weeks of the first approved leave are paid at 100% of salary, at least one more week of paid time off is reserved for use outside them, and health and disability insurance continue during approved leave. Programs must explain how a longer leave affects completion and board eligibility. ACGME Institutional Requirements, including FAQs (2026), §4.8, checked October 27, 2026.
    • Moonlighting, paid medical work outside the program, counts toward the 80-hour limit, and PGY-1 residents may not moonlight. ACGME, Common Program Requirements (Residency), effective July 1, 2026, §6.25, checked November 10, 2026.
    • Andwise reads 8 posted resident union contracts for their pay, leave and housing terms. Andwise union contract benchmarks, checked October 26, 2026.
    • The Committee of Interns and Residents (CIR/SEIU) says it represents more than 40,000 interns, residents and fellows. CIR/SEIU, Our Union, checked November 10, 2026.

    Pay per hour on a 60- to 80-hour week: resident pay per hour. Leave during training: what a leave costs.

    For a parent who trained as a physician: what changed

    Words the family will hear

    PGY (postgraduate year)
    How far a resident or fellow is into graduate medical education overall, which can differ from the year within one program. A first-year fellow after a three-year residency is a PGY-4. ACGME, Glossary of Terms, Post-graduate year
    Intern
    A resident in the first year of training, the PGY-1 or internship year. AMA, What is residency?
    Resident
    A physician enrolled in an accredited residency program, training in a specialty after medical school. ACGME, Glossary of Terms, Resident
    Fellow
    A physician who has completed a residency and trains further in a subspecialty, such as cardiology after internal medicine. ACGME, Glossary of Terms, Fellow
    GME (graduate medical education)
    Residency and fellowship: the training after medical school that prepares a physician for independent practice. ACGME, Glossary of Terms, Graduate medical education
    ERAS
    The AAMC's Electronic Residency Application Service, which sends applications to the programs an applicant chooses. It is separate from the NRMP, which runs the Match. NRMP, The Match terms and topics
    SOAP
    The Supplemental Offer and Acceptance Program: during Match Week, applicants who did not match apply to and receive offers from positions left unfilled. NRMP, The Match terms and topics
    Moonlighting
    Paid medical work beyond a resident's or fellow's program, called internal at the program's own sites and external elsewhere. ACGME, Glossary of Terms, Moonlighting

    Contract words, from tail coverage to wRVU: the contract guide.

    Passing a page along

    Help someone with a decision lists each decision by stage, with a message to send with the page. The figures they enter stay on their device.

    The First Contract Kit covers the residency agreement and the first attending offer, as a PDF to forward at graduation.

    Example valuesjoinandwise.com/parents30 cited facts and terms, with the site's loan, stipend and non-compete datachecked October 21, 2026amounts entered are masked

    This is not a substitute for the advice of an attorney. Andwise is not affiliated with or endorsed by the U.S. Department of Education or any lender or loan servicer.