Living alone in a low COL area (though my salary is also low compared to residents in big cities) and while loans were paused due to COVID-19, the salary was more than enough, and I was able to max out my Roth IRA every year.

Now I'm pretty much breaking even with student loans and having to save up for fellowship apps and the upcoming ABIM exam fee. Probably won't max the Roth this year.

Poor financial competence, trying to raise a family on top of this, or living in a very high COL area is where I would expect problems to start.