Financial and Business Literacy Among Urology Residents: Is this a Problem and How Can We Better Prepare Residents for their Careers?

PURPOSE OF REVIEW: Although financial wellness is a predictor of physician burnout, we are yet to optimize financial education or wellness of Urology trainees. We assessed existing studies, compared them to those of other specialties, and discussed resources and methods to address this deficiency. RECENT FINDINGS: Urology residents tend to be less fiscally savvy (carry significant debt, and lack retirement savings or disability insurance), and 90% of trainees and young Urologists do not feel comfortable with the business of practice, including skills like coding and billing, contract negotiation, and self-value assessment. Financial and business literacy are deficiencies of Urology training, as in other specialties. Eventually, the goal should be universal adoption of a formal curriculum that is graded in nature. In the interim, we need to propose and endorse adoption of a formal curriculum, and we should support trainees by promoting a space for easily accessible and transparent information regarding best practices in personal finance and the business of healthcare.

Does personal experience with COVID-19 impact investment decisions? Evidence from a survey of US retail investors.

This paper explores the link between personal experience with COVID-19 and US retail investors' financial decision-making during the first COVID-19 wave. Do retail investors that have personally experienced COVID-19 change their investments after the pandemic outbreak, and if so, why? We use a cross-sectional dataset from an online survey of US retail investors collected in July and August 2020 to assess if and how respondents change their investment decisions after the COVID-19 outbreak. On average retail investors increase their investments during the first wave of COVID-19 by 4.7%, while many of them decrease their investments suggesting a high heterogeneity of investor behaviours. We provide the first evidence that personal experience with the virus can have unexpected positive effects on retail investments. Investors who have personal experience with COVID-19, who are in a vulnerable health category, who tested positive, and who know someone in their close circle of friends or family who died because of COVID-19, increase their investments by 12%. We explain our findings through terror management theory, salience theory and optimism bias, suggesting that reminders of mortality, focussing on selective salient investment information, and over-optimism despite personal vulnerable health contribute to the increase in retail investments. Increased levels of savings, saving goals and risk capacity are also positively associated with increased investments. Our findings are relevant to investors, regulators, and financial advisors, and highlight the importance of providing retail investors with access to investment opportunities in periods of unprecedented shocks such as COVID-19.

An Investment in Knowledge: Personal Finance Education for Medical Students.

The financial burden of pursuing a medical education continues to grow, with the average medical student now owing over $240,000 in total student loan debt by the time they graduate. This burden peaks at a time when trainees are making some of the most consequential decisions of their careers. Additionally, many students are simultaneously making important financial decisions related to personal aspirations, all before a drastic change in earning potential once they begin practicing as attending physicians. Medical trainees' financial stress is linked to specialty choice, mental quality of life, and physician burnout, with additional implications of such stress for patient health and safety.1- 3 Despite these issues, there are few examples of medical schools providing direct personal finance education to their students. Given the lack of personal finance education opportunities for medical students, the authors designed and implemented a medical student-specific personal finance curriculum at their home institution in conjunction with the Association of American Medical Colleges' (AAMC) Financial Information, Resources, Services, and Tools program. The curriculum, which is primarily delivered through interactive lectures, covers topics ranging from the basics of saving and investment to clinicians' potential future roles as administrators and innovators. The authors (1) present details regarding the creation of their personal finance education program; (2) invite fellow medical trainees and their respective institutions to start their own personal finance education programs or add similar curriculum to their health sciences coursework; and (3) call for recommendations by the American Medical Association (AMA) and AAMC in support of formal personal finance instruction for medical students on a national level.

Perceived financial burden is indirectly linked to sexual well-being via quality of life among couples seeking medically assisted reproduction.

Introduction: Medically assisted reproduction is a difficult treatment process for couples both financially and sexually. Yet, these two domains have not been examined together among couples seeking treatment, leaving couples and practitioners without guidance on how to address these domains together. Methods: In line with Couples and Finance Theory, we tested the hypothesis that perceived financial burden and couple income would predict quality of life during medically assisted reproduction, which would then predict four domains of sexual well-being (i.e., sexual satisfaction, desire, distress, and frequency). We also examined if the results differed by treatment status-that is, between partners who were receiving treatment and those who were not. Cross-sectional data from 120 couples who had undergone medically assisted reproduction in the past six months were analyzed via structural equation modeling through an actor-partner interdependence mediation model. Results: An individual's greater perceived financial burden predicted their own lower quality of life during medically assisted reproduction, which in turn predicted their lower sexual satisfaction, desire and distress, as well as their partner's lower sexual satisfaction. Household income did not indirectly predict any sexual well-being domains, and results regarding treatment status were inconclusive. Discussion: Clinicians can discuss with couples how perceived financial strain of medically assisted reproduction affects their quality of life and what ramifications that may have for their sexual well-being.

Assessing the Impact of a Personal Finance Elective Course on Student Attitudes and Intentions.

Objective. To address the need for personal finance education in our school of pharmacy, a finance elective was developed to help students make well-informed choices related to student loan repayment, budgeting, and planning for retirement. Personal finance education could be beneficial to help students improve their future financial well-being.Methods. A mixed-methods research design was used to determine the impact of the course. Retrospective data were collected and analyzed. Data included pre- and post-assessments, assignments, posts from discussion boards, and a follow-up questionnaire. Qualitative data were analyzed through in vivo coding, and quantitative data were analyzed using dependent t tests.Results. Qualitative analysis revealed two themes: students came to feel that personal finance was something that could be managed proactively, and they felt empowered to create a financial plan that included strategies for budgeting, paying off student loans and other debt, saving, and investing. Quantitative analysis of five of the 10 assessment questions with matching counterparts in the pre- and post-assessment showed significant differences. Most students who responded to the follow-up questionnaire had completed activities or planned to complete activities related to making changes to their personal finance habits.Conclusion. Pharmacy students are entering the workforce with high incomes but saddled with debt. A personal finance elective course has the potential to equip students with the knowledge needed to be financially successful. Schools of pharmacy should work toward offering professional development to students to assist them in learning about personal finance due to the high cost of obtaining a pharmacy degree and likelihood of entering the workforce with debt.

Impact of COVID-19 on lifestyle and financial behaviour: The implications to research in financial vulnerability.

The outbreak of coronavirus pandemic in late 2019 posted unprecedented social-economic challenges and disruptions to societies and individuals. The "new-normal" styles of living and working could intertwined with other determinants complicating the investigation of individual's financial vulnerability. The purpose of this paper is to conduct literature survey to review and consolidate the recent scattered literatures to identify some possible factors to be considered in the research related to financial vulnerability, including pandemic's impact of COVID-19 to different aspects of personal finance issues, pandemic-driven digitisation of the economy activities, changes in financial behaviour and addiction to digital technology.

Motivations for personal financial management: A Self-Determination Theory perspective.

Financial knowledge and sound financial decision making are now broadly recognized to be important determinants of both personal and societal prosperity, but research has yet to examine how distinct qualities of motivation may be associated with the way people manage their money. In two studies we applied the framework of Self-Determination Theory (SDT) to examine people's autonomous (volitional) and controlled (pressured) motivation for understanding and managing their finances, as well as their amotivation (lack of motivation) for doing so, and the differential associations these motives have with financial knowledge and financial well-being. American participants (Study 1, N = 516; Study 2, N = 534) completed detailed demographic surveys and questionnaires assessing the financial variables of interest. As hypothesized, SDT's motivational constructs were associated with financial outcomes over and above participants' age, gender, income, household wealth, and educational attainment. Autonomous motivation was positively associated with a host of positive financial behaviors and characteristics (e.g., saving/investing and financial self-efficacy, well-being, and self-awareness). Controlled motivation was negatively associated with financial well-being. Amotivation was positively associated with overspending and negatively associated with financial self-efficacy and well-being. These findings support the relevance of SDT's framework in this domain and suggest that interventions aimed at promoting financial knowledge and wellness may benefit by adopting evidence-supported strategies for optimizing more autonomous motivations and addressing amotivations.

Financial status and literacy among residents and medical students.

BACKGROUND: There is a wide perception of physicians as having minimal financial literacy, and this assumption is perpetuated through the community as the "Dumb Doctor" persona relating to financial management. This study examined medical student and resident financial behaviors and assessed their level of financial literacy using previously validated questions within the survey tool. METHODS: Two surveys were distributed to medical students and residents, 1 survey each, who are part of a single medical education system. After the initial email request, 2 additional email requests were sent at 2 and 6 weeks. Using the validated questions, "The Big 3" and "The Big 5," the level of financial literacy was assessed. RESULTS: Of the 461 possible respondents, 261 trainees responded with 65 residents and 196 medical students, for a response rate of 57%. Financial literacy was demonstrated to be higher than the average adult with 60% answering all 3 of "Big 3" correctly, compared to national average of 30%. Investment-based questions were the most difficult with 16% correct for bond price activity and 70% for stock risk. There is high level of interest with 93% open to education on financial topics. CONCLUSION: This study showed that this cohort of medical trainees demonstrated better financial habits and a very high level of financial literacy compared to the general population. There are areas surrounding investment principles that provide an opportunity to improve their financial literacy and would likely be well received based on the high level of interest for more education.

An Innovative Approach to Educating Medical Students About Personal Finance.

Background The lack of financial literacy among medical students and physicians is a well-documented problem that is yet to be sufficiently addressed. The full immersion of physicians into their scientific education and medical training makes it challenging to also comprehensively learn about personal finance. With the vast debt that most medical students undergo, it is crucial to focus on this issue. Methodology To address this challenge, faculty at The Florida State University College of Medicine (FSU COM) have created a fully online personal finance elective course for fourth-year medical students. This course, titled Personal Finance for the New Physician, focuses on critical fiscal topics that are directly relevant to future doctors. The elective is delivered remotely through the utilization of online discussion boards, weekly video conferences, and recorded lectures by financial experts. This innovative distribution model ensures that busy students can educate themselves regardless of time or location. Results Initially offered in January of 2019, Personal Finance for the New Physician quickly became the most chosen elective at FSU COM. To determine the course's efficacy, students completed a questionnaire at both the start and end of the elective. The results show substantial improvements in fiscal knowledge and confidence in managing personal finances. The average financial competence score of those who completed the course increased from a 2.25/5 to a 4.45/5. Feedback from students so far has been exceedingly positive. Conclusions Personal Finance for the New Physician has been effective at addressing the lack of financial knowledge that is prevalent among medical students. Additionally, the unique online nature of this course would allow for realistic expansion to other medical programs. Course directors will continue to receive feedback from students, financial experts, and physicians to modify and improve the elective.

Prioritizing financial knowledge and skills within the doctor of pharmacy curriculum.

INTRODUCTION: Over the past decade, pharmacy school tuition and the subsequent amount of student debt has risen significantly. Additionally, the debt-to-income ratio for pharmacy school graduates increases, making it extremely important to manage personal finance during pharmacy school and beyond. To assess a personal finance elective's effect on students' financial literacy and confidence, a course evaluation study was pursued at Northeast Ohio Medical University (NEOMED). METHODS: NEOMED's College of Pharmacy graduating Classes of 2018 through 2021 completed a voluntary, anonymous survey to determine the need and interest for a finance elective in the curriculum. Survey results were grouped by enrollment in the personal finance elective course (i.e. students enrolled and students not enrolled). Students self-identified the category describing their knowledge and confidence in financial decision-making using Likert-style scales. RESULTS: Of the 106 students who responded, 57 (54%) were not enrolled and 49 (46%) were enrolled in the personal finance elective course. Students in the elective reported significantly higher financial literacy and financial decision-making confidence in many areas, including budgeting, loans, debt, investing, and retirement planning. Ninety-seven percent of study participants determined that a personal finance elective should be made available to students. CONCLUSIONS: Students' financial knowledge and confidence can be positively impacted by a personal finance course. With the increasing student-loan-debt and expected 3% decline in the 10-year job outlook for pharmacist workforce positions, it is essential to provide future pharmacists with financial resources to make sound financial decisions impacting their careers and lives.

Who spent their COVID-19 stimulus payment? Evidence from personal finance software in Japan.

In response to the COVID-19 crisis, governments worldwide have been formulating and implementing different strategies to mitigate its social and economic impacts. We study the household consumption responses to Japan's COVID-19 unconditional cash transfer program. Owing to frequent delays in local governments' administrative procedures, the timing of the payment to households varied unexpectedly. Using this natural experiment, we analyze households' consumption responses to cash transfers using high-frequency data from personal finance management software that links detailed information on expenditure, income, and wealth. We construct three consumption measures: one captures the baseline marginal propensity to consume (MPC), and the other two are for the lower and the upper bound of MPC. Additionally, we explore heterogeneity in MPCs by household income, wealth, and population characteristics, as well as consumption categories. Our results show that households exhibit immediate and non-negligible positive responses in household expenditure. There is significant heterogeneity depending on various household characteristics, with liquidity constraint status being the most crucial factor, in line with the standard consumption theory. Additionally, this study provides policymakers with insights regarding targeted cash transfer programs, conditioning on labor income, and liquidity constraints.

Understanding the Economic Behavior of the Medically Uninsured in the United States.

Previous research defining the health consequences of being medically uninsured show worse access, poorer health outcomes, and higher rates of premature death as compared to their insured counterparts. Adding to this literature, the present study investigated the associative role of health insurance with personal finance health behaviors. In a representative sample of the general population, our adjusted models indicated significant relationships (both positive and negative) between being uninsured and these personal finance behaviors. Therefore, future work using longitudinal data must build upon the present study to accurately determine the relative financial risk an individual takes on by being uninsured.

Obesity and bankruptcy: Evidence from US counties.

Using annual county-level data on nonbusiness bankruptcy for the period 2005-2017 and obesity for the period 2004-2016, this paper finds that higher obesity rates are associated with higher bankruptcy rates beyond what can be explained by local economic conditions and demographic characteristics, state-specific economic shocks, and county-specific time trends. The magnitude suggests that a one-percentage point increase in the obesity rate is associated with a 0.02-0.03 increase (or a 1.0 percent increase) in Chapter 7 bankruptcy rates per 1000 residents and a 0.02-0.04 increase (or a 3-4 percent increase) in Chapter 13 bankruptcy rates per 1000 residents.

Effect of early-stage Alzheimer's disease on household financial outcomes.

Significant limitations and rapid declines in financial capacity are a hallmark of patients with early-stage Alzheimer's disease (AD). We use linked Health and Retirement Study and Medicare claims data spanning 1992-2014 to examine the effect of early-stage AD, from the start of first symptoms to diagnosis, on household financial outcomes. We estimate household fixed-effects models and examine continuous measures of liquid assets and net wealth, as well as dichotomous indicators for a large change in either outcome. We find robust evidence that early-stage AD places households at significant risk for large adverse changes in liquid assets. Further, we find some, but more limited, evidence that early-stage AD reduces net wealth. Our findings are consequential because financial vulnerability during the disease's early-stage impacts the ability of afflicted individuals and their families to pay for care in the disease's later stage. Additionally, the findings speak to the value that earlier diagnosis may provide by helping avert adverse financial outcomes that occur before the disease is currently diagnosable with available tools. These results also point to a potentially important role for financial institutions in helping reduce exposure of vulnerable elderly to poor outcomes.

Developing and Validating the Scale of Economic Self-Efficacy.

Experiencing intimate partner violence (IPV) and financial hardship are often intertwined. The dynamics of an abusive relationship may include economic abuse tactics that compromise a survivor's ability to work, pursue education, have access to financial resources, and establish financial skills, knowledge, and security. An increasingly common goal among programs serving IPV survivors is increasing financial empowerment through financial literacy. However, providing financial education alone may not be enough to improve financial behaviors. Psychological factors also play a role when individuals make financial choices. Economic self-efficacy focuses on the individual's perceived ability to perform economic or financial tasks, and may be considered a primary influence on one's ability to improve financial decisions and behaviors. The current study tests the reliability and validity of a Scale of Economic Self-Efficacy with a sample of female survivors of IPV. This study uses a calibration and validation analysis model including full and split-sample exploratory and confirmatory factor analyses, assesses for internal consistency, and examines correlation coefficients between economic self-efficacy, economic self-sufficiency, financial strain, and difficulty living with income. Findings indicate that the 10-item, unidimensional Scale of Economic Self-Efficacy demonstrates strong reliability and validity among this sample of IPV survivors. An ability to understand economic self-efficacy could facilitate individualized service approaches and allow practitioners to better support IPV survivors on their journey toward financial empowerment. Given the increase in programs focused on assets, financial empowerment, and economic well-being, the Scale of Economic Self-Efficacy has potential as a very timely and relevant tool in the design, implementation, and evaluation of such programs, and specifically for programs created for IPV survivors.

Old Age Support in Urban China: The Role of Pension Schemes, Self-Support Ability and Intergenerational Assistance.

With the aim of probing into the life satisfaction of retired urban elderly in China with respect to old age support systems, this study examines the effect of pension reform with its existing inequalities across demographic and social groups on the life satisfaction of retired urban residents. The complementary role of intergenerational assistance and self-support on the life satisfaction of beneficiaries and non-beneficiaries of the pension scheme was analyzed using an ordered logit regression model with 2015 national representative data from China's Health and Retirement Longitudinal Survey. Our sample consists of a cross-sectional data set of 3815 retired urban elderly aged 60 and above. The empirical results depict that though enjoying benefits from the public pension scheme generally enhances life satisfaction, beneficiaries of the Government and Institution Pension and Enterprise Employee Basic Pension are more advantaged than beneficiaries under the Urban-Rural Social Pension Scheme. The pension inequalities existing at provincial levels and across social groups such as gender and residence registration status also affect life satisfaction adversely. Women and rural 'Hukou' registered retired urban residents are at an apparent disadvantage. Getting financial and emotional support from children broadly improves life satisfaction. Non-beneficiaries of the public pension benefit more from the financial support of children than public pension beneficiaries. There is also a positive effect of cohabiting with children on life satisfaction when retired urban residents are single as compared to being married. Financial and physical self-support ability in forms of good health, home ownership and wealth management enhance life satisfaction significantly. However, largely, retired urban elderly have a higher life satisfaction when they are financially independent of children and are supported by state pension schemes. Our findings indicate that self-support ability of the elderly together with pension benefits are more effective in enhancing the life satisfaction of retired urban elderly in China. It is recommended that government institute policies to promote personal finance initiatives by the elderly while improving the pension scheme and reducing pension inequality.

Don't spend, eat less, save more: Responses to the financial stress experienced by nursing students during unpaid clinical placements.

Using an online survey, this study explored the impact of participation in unpaid clinical placements on the financial wellbeing of 160 nursing students attending an Australian university. The research found that the majority of respondents struggle financially during clinical placements, yet are financially adequate or secure outside of semester or during normal periods of study. Increased transport costs and loss of income are the most significant financial stressors during this time, with additional meals, work-appropriate clothing, purchasing additional resources and materials, and childcare costs other causes of financial stress. Most students used savings, budgeting, borrowing, and changed expenditure patterns to cope with the financial impact of unpaid placement. These findings have important implications for the ability of students to successfully complete their nursing degree and draw into question the equity of unpaid clinical placements as a formal degree requirement. However, while participation in unpaid clinical placements can impact financial well-being in the short term, participation does have the potential to increase the financial resilience of students over time, as students learn and grow from these experiences. To achieve this, however, greater attention must be placed on the financial support and personal finance education available for nursing students.

Lessons Learned From the Creation of a Business of Medicine Course.

This article was migrated. The article was marked as recommended. Knowledge, attitudes, and skills required to successfully manage business and personal finances are rarely taught within traditional medical education. This has contributed to low financial literacy, high stress related to educational debt, and burnout among physicians. To address this deficiency, we created the Business of Medicine course for fourth-year medical students which teaches basic business and personal finance topics. As we have reflected on lessons learned in the creation and implementation of this course, we have recorded them for the benefit of others who desire to partner with us in teaching this important topic to the next generation of physicians.

The Affordable Care Act Medicaid Expansions and Personal Finance.

Using a novel data set from a major credit bureau, we examine the early effects of the Affordable Care Act Medicaid expansions on personal finance. We analyze less common events such as personal bankruptcy, and more common occurrences such as medical collection balances, and change in credit scores. We estimate triple-difference models that compare individual outcomes across counties that expanded Medicaid versus counties that did not, and across expansion counties that had more uninsured residents versus those with fewer. Results demonstrate financial improvements in states that expanded their Medicaid programs as measured by improved credit scores, reduced balances past due as a percent of total debt, reduced probability of a medical collection balance of $1,000 or more, reduced probability of having one or more recent medical bills go to collections, reduction in the probability of experiencing a new derogatory balance of any type, reduced probability of incurring a new derogatory balance equal to $1,000 or more, and a reduction in the probability of a new bankruptcy filing.