I know what it’s like to live in a high-cost-of-living (HCOL) area as a healthcare worker. Between student loans, housing prices, and the daily cost of just existing, it can feel like your paycheck is gone before it even hits your account. I’ve been there before when I stared at my budget as a lowly medical student, wondering how to make it work. But over time, I’ve learned how to navigate these challenges, find balance, and even thrive in an HCOL environment. Whether you’re a resident, attending, nurse, or anywhere in between, you can take control of your finances and live the life you deserve. Let me show you how.

What Does High Cost of Living (HCOL) Mean?

HCOL means living in a place where everything costs way more than it should. Think rent, groceries, gas—all of it. Cities like New York and San Francisco may offer incredible opportunities, but they’ll make your wallet cry. Still, there are ways to make it work if you play your cards right.

Why It’s Tough for Healthcare Workers

Here’s the deal: housing eats up most of your paycheck, especially if you’re trying to live close to the hospital. I remember when I was a medical student juggling rent and groceries. My studio apartment was so small that I could touch almost the kitchen sink while sitting on my bed. It was the only place I could afford close to campus. Move farther out? Sure, but get ready for those marathon commutes. Then there’s that lovely reminder of your education every month, aka student loans. Add in parking fees, maybe childcare, or even just the cost of scrubs, and it can feel impossible. Oh, and taking on more shifts? That’ll wear you out fast. It’s a lot, but don’t lose hope.

Practical Ways to Manage HCOL

Get a Handle on Your Budget First, figure out where your money is actually going. Write it all down like rent, utilities, food, transportation, even those sneaky Amazon purchases. Apps like Copilot can help you stay on track. Once you’ve got the full picture, it’s easier to cut back on the stuff that doesn’t really matter (do you really need that subscription box?).

Increase Your Income Let’s face it – sometimes you just need more money coming in. Ask for a raise (yes, it’s nerve-wracking, but you’ve got this). If that’s not an option, think about picking up extra shifts or trying a side gig. Telemedicine or locums might fit nicely into your schedule without completely draining you.

Find Creative Housing Options Housing costs are a beast, so think outside the box. Can you live with a roommate? Rent out a spare room? Move to a less expensive suburb? If you’re starting a new job, ask if they offer any kind of housing stipend or relocation bonus. It never hurts to ask.

Take Advantage of Benefits Your workplace might offer perks you’re not using. Loan repayment programs, commuter benefits, childcare discounts. These things can add up. Check with HR, even if you’re not sure what’s available. Sometimes the best perks are the ones nobody talks about.

Smart Financial Tools

Health Savings Accounts (HSAs) If you’re eligible, an HSA can save you money on medical expenses. Think of it as a secret weapon for healthcare costs. Plus, it’s tax-free—a win-win.

High-Yield Savings Accounts (HYSAs) These are like regular savings accounts but better. The interest rates actually make a difference, so your emergency fund can grow a little faster. It’s simple but effective.

Retirement Savings If your employer matches contributions to a 401(k) or 403(b), take full advantage. It’s free money for your future. Even if you start small, it’ll pay off later.

Loan Forgiveness Programs Working in a nonprofit or government setting? You might qualify for Public Service Loan Forgiveness (PSLF). It’s not a quick fix, but it’s worth the effort if you meet the criteria.

Stay or Move?

Deciding whether to stay in an HCOL area or move somewhere cheaper is tough. Big cities often mean better career opportunities and access to top hospitals, but they’ll drain your finances. Maybe you’re tied to the area because of family or just love the vibe. On the flip side, a smaller town could mean lower rent, shorter commutes, and a slower pace of life. A colleague of mine moved to a smaller town to escape his HCOL city. He misses the restaurants and nightlife but loves that he can finally afford a house with a backyard for his kids. There’s no right answer. Figure out what works for you and your goals.

Bottom Line

Living in an expensive area is hard. There’s no sugarcoating it. But with some planning, it’s doable. Start with your budget, look for ways to boost your income, and make use of any tools or benefits you can. Whether you decide to stick it out in that HCOL area or move somewhere more affordable, focus on what matters most to you. One of my mentors once told me, ‘The only way to survive in an HCOL area is to pick your battles. Spend where it matters and cut where it doesn’t.’ It’s advice I’ve carried with me ever since.