The HCA Stipend Program

November 02, 2010

On the topic of augmenting your income while working as a resident or fellow: Do you know that many employers are offering stipend programs these days?

I had no idea that these sort of stipend programs exist until I met a newly minted urologist who had just moved to town to take her first job. During our first conversation she advised me to check out the stipend programs that some of the larger hospital companies, like CHS and HCA, offer. I was kind of shocked to learn that we, as residents, could start to earn some extra money like this, before we finish.

If we weren't paid so much as residents, I know everyone would have signed up for one of these programs by now! No, but honestly, life can change during the 5-8 year period when you are in training. Families can get started or grow during these years, and this can stretch the somewhat meager resources we are provided. I know this feeling; we are anticipating our first child in January and I'm often thinking: "How am I gonna pay for that?" I'm sure I'm not the first one to have those thoughts, and many of you have probably already been there.

Just as the military recognizes these issues and offers that STRAP program and loan repayment program I discussed in my last entry, so do many of the hospital systems around the country. They know that by offering stipend programs, they can create a win-win situation: a resident can provide better for his or her family, and the hospital can help land a qualified physician to care for their patients.

I wish I had great insight or advice when it comes to evaluating these programs, but I am not yet an expert in this field. My advice is, as with any type of contract, to make sure you review the details and read the fine print. The details of these stipend programs are usually not made available until you start speaking directly with the in-house hospital recruiter. So, strike up a conversation with a recruiter and find out more.

I do know that HCA (with more than 200 hospitals around the U.S.) does advertise their stipend program a little more than the rest of the crowd and they have created a web site for it. They even have a person within their company that is focused on outreach to residents and fellows. I have gotten to know Ms. Kay Gerth (Vice President; HCA Training Program Outreach and The HCA Resident/Fellow Educational Stipend Program) here recently and she has a lot of useful info for residents and fellows. If you want to learn more about what HCA has to offer physicians in training, visit the HCA stipend website. You can also email Ms. Gerth directly with your questions at: They also put on some lunch and dinner seminars. I'm planning on attending one of them next week here in Nashville, so hopefully I'll gain some better insight to pass along here as well.

Again, I hope that this is of some interest to some. Email me with any questions, or leave a comment.


jheinlen writes:

Ian, thanks for the update. I am an HCA recipient - OU Medical Center is run by HCA and so I have a lot of exposure too. The biggest question right now that I am working with a tax attorney on is what is the taxability of the stipend. Since there exists the possibility of having to pay it back with taxable money, then it really is more like a loan and needs to be taxed when it is "forgiven" or after you've worked the two years necessary to repay the stipend. Of course...that means the marginal tax rate on the stipend would be MUCH higher. It's probably worth it though since the reason to take the stipend is CASH FLOW.

It's definitely something to consider before taking any stipend since it bumps us up into a higher tax bracket. If legally possible I am not going to claim it as income this year, but wait until I either repay it or am forgiven the amount.

ian.thompson writes:

Thanks for your comment! Very good questions to consider.

I received an email re: the comment that might help in answering your question. The stipend is taxable income within the calendar year that it is received and you should receive a 1099 reflecting this.

This is different from money you are given as part of a recruitment agreement where you pay tax as it is forgiven, when you are in practice.

I think that it is probably more beneficial to pay taxes on the stipend money now at your current tax rate (as a resident), even if bumped up to a higher bracket, I would assume you would still be at a lower rate than you would be when you take your first job. (Disclaimer: I am not a CPA or lawyer, so I would probably stick with your tax attorney for real advice)