US medical residency: routine, adjustment and living costs after the Match

Matching into residency is an achievement. To plan the next stage, assess three aspects of each program: how work is organized, who you can turn to for support, and what living in the area will cost. A hospital's name and its gross salary alone cannot answer those questions.

This Inside the Match guide offers questions for physicians from Brazil and elsewhere in Latin America. It is an editorial analysis, not a personal account or an interview attributed to the people in the photograph.

How can you understand the routine before arriving?

Ask the program for a sample schedule and descriptions of first-year rotations. Identify inpatient, outpatient, intensive care and overnight assignments where they form part of the curriculum. Also ask how teaching activities fit alongside clinical care.

For accredited programs, the ACGME Common Program Requirements address supervision, learning and well-being. They can guide your questions, but they do not describe your chosen hospital's specific schedule. Consult the version applicable to your training period.

Take these questions to program coordinators and residents:

• Who supervises residents on each rotation, and how is help requested overnight?
• How are handoffs organized, and who covers absences?
• When do teaching sessions and evaluations take place?
• Which tasks require prior training in the electronic health record?

PGY-1 means the first postgraduate year of medical training. It should not be confused with the undergraduate clinical internship in Brazil. A handoff transfers responsibility for care; rounds involve clinical discussion or patient visits with the team. Understanding how these terms are used locally is more useful than simply memorizing translations.

How can you prepare for differences in communication?

Avoid assuming that all US hospitals have the same culture. Use orientation to ask how to present cases, document questions and discuss errors. As a practical exercise, rehearse three situations in English: summarizing a case, explaining uncertainty and requesting supervision.

Agree with your supervisor on how to receive feedback and check that you understood instructions. Outside work, plan ways to stay connected with family and build a local support network. Asking about the program's support channels in advance may make it easier to seek help when needed.

How should you compare salary and living costs?

Request the pay schedule for your training year and a list of benefits. Estimate take-home pay after taxes and deductions, including expenses for dependents if relevant. Do not use the earnings of a physician who has completed training as a benchmark for resident compensation.

A 2023 housing study, using 2022–2023 data, found regional differences in rental affordability for residents. It provides historical context, not a price estimate for 2026. Check current prices around the hospital.

Build your budget in three parts:

1. Arrival: travel, temporary accommodation, rental deposit and moving costs.
2. Monthly expenses: housing, utilities, food, transport, health care and personal commitments.
3. Reserve: unexpected expenses and the period before your first paycheck.

Compare specific housing and commuting options. Cheaper rent may lose its advantage if it requires expensive transport or a commute that does not fit your schedule. Also confirm whether hospital allowances are recurring, reimbursable or one-time payments.

What can Match data tell you?

The NRMP's 2026 tables present results by state, specialty and applicant type. They describe that cycle: they are neither a list of currently open positions nor a prediction of individual success.

Use these data to understand the landscape. To assess life in a program, gather information directly from the hospital about its curriculum, support and compensation.

Frequently asked questions

Does a higher salary mean a better choice?

Not necessarily. Compare take-home pay, benefits, family expenses and training conditions. The best combination depends on your priorities.

Can I plan my move using only social media accounts?

Use personal accounts as starting points for questions. Confirm operational details with the program: another person's experience may refer to a different year or rotation.

What can I prepare while studying for the USMLE?

Alongside your study plan, maintain a list of questions about programs, practice clinical communication in English and organize documents. Avoid committing to moving expenses before confirming the requirements that apply to your situation.

Where does MedCof USA fit into this preparation?

Explore the USMLE preparation offering and meet the team on the MedCof USA website. When speaking with the team, explain your stage of training and which steps you want to organize. Confirm the course's scope and terms before enrolling.