First post - question about career path

[Beginner MD]

Hi everyone!

Long time follower/lurker and first time poster.  I am a little apprehensive about posting because I know colleagues of mine also read this site, so trying to maintain some anonymity but also providing enough info for advice.  Since WCI graciously decided to create this new subforum for beginners, I decided to take a jump and see if anyone has any input to my situation!  Thank you for reading!

Just stating in advance, our net worth is higher than most typical people in our situation because both my spouse and I worked a couple years prior to medical school (and started putting money in Roth IRA and 401k then) and also worked as a hospitalist right after residency before pursuing fellowship. My spouse had no student loans and I had low-six figures worth of debt when I graduated medical school, but paid it off prior to starting fellowship.  We were also given an inheritance that has helped us.   But the main reason is because I discovered WCI during medical school and applied many of his principles early on and have been living like residents!

Stage of Life: Fellowship in a specialty within internal medicine

Social Situation: Both working, one young child at home (dual-physician but both in fellowship)

Annual Income: $100-150k+ depending on how much my spouse and I moonlight

State of residence:  OH

Insurance Policies: Life insurance  30 year term 2M each

Adequate auto and home insurance

Debts:  None except credit cards that we pay in full monthly.

Assets:

Home: ~ $350-400k

• His 401(a): 60k


• Her 401(a): 85k


• Her 401(k): 60k


• His 403(b): 40k


• Her 403(b): 35k


• Her 457: 65k


• His 457: 20k


• His Roth IRA: 50k


• Her Roth IRA: 85k

Question:

1) I actually don't have questions in regards to investments because I basically buy all index funds and just set it and forget it.

2) Main question is in regards to career path - many people who post on this forum seem to work in private practice, but we don't seem to hear often from academic physicians.  I think our financial situation overall is pretty good overall, as long as we continue to live below our means and sock away as much money into retirement as we can - barring from any major catastrophe in our lives. *knock on wood*

I am thinking about pursuing an academic career and am about to apply for a T32 and later on, if things go well, plan to continue to apply for institutional grants or K grants, etc in the future.   As people have stated in another threat, doing research is very tough and hard to get tenure.  I actually don't want to be 100% research and would still like to do some clinical work, but I am just curious if there are any people out there who have gone through this and can give some honest feedback.  (Although it seems to me that most people complain about being in academics, although the people at my institution seem pretty happy!)

I feel like I should try it out and see how it goes.  Worst case scenario, I can go into private practice if all else fails?  Fortunately, my spouse should have a decent income once he becomes an attending, so even though my salary will decrease, we should still do ok overall financially.

3) Any tax implications when being on a training grant?  Since you are no longer considered an employee of the hospital, you are paid via a stipend and you get no retirement benefits from what I was told.  Should I just start a taxable account to contribute what I would have contributed in my 401(a), 467 and 403b?

[The White Coat Investor]

Well, it's been almost 3 days. The hope of the moderators with this forum was to encourage participation from those too intimidated to both ask and answer questions, so we'll continue to let them sit a bit before responding to them. But at the same time, we don't want those willing to ask questions to never get an answer.

1) Cool! Good job.

2) I agree it is far easier to go into private practice from academics than into academics from private practice. But it is critical that you maintain some clinical time in order to do so. If you go 100% research, you're not going to have the necessary skills to go private practice, nor will you likely feel comfortable doing so.

3) Figure out if the training grant is taxable and if it counts as earned income. If they're taking out Social Security and Medicare taxes, it is likely taxable, earned income and can be used to go toward retirement accounts, even if they don't let you use theirs. That probably means nothing but a Backdoor Roth IRA though, so if you want to save more, you'll have to do it in taxable. If it isn't taxable, earned income then you can't even put it in a Roth IRA (although can likely do a spousal Roth IRA as long as your spouse makes $11K+) and will have to use taxable.

[MPMD]

I'll weigh in despite not being a beginner now that Jim has.

I'm in academics and have been since I finished at major urban academic med centers.

There are challenges to doing clinical research but if you are on the grant pathway your career will be far easier in some ways than that of an educator, admin person, or clinical workhorse. You'd be hard pressed to find a major center that wouldn't absolutely salivate over a funded researcher or a Dean that wouldn't aggressively hire one. This is the wave of the future and it isn't going away. There are a few brutal "publish or perish" shops but those are few and far between. If you are bringing in grants you will have basically no pressure to do other stuff. If you're on the slower side clinically but are funded, no one is going to care or say anything ever.

As far as complaining about academics, I wouldn't do that. Frankly in many parts of the country the delta in salary between a productive academic doc and a private practice person doesn't seem to be life changing. You're also comparing apples to oranges sometimes when you compare a community EM doc who does 14 x 12h to a academic person who does 10 x 8h.

I've been doing academic EM for 5 years, admittedly I moonlight some but not excessively. My worst year has probably been $265k and my best $310k. Some of my friends in PP make more in my geo area but not stupidly more and they work a ************************ of a lot harder.

You're in great shape, academics is going to be a positive thing for you.

[jfoxcpacfp]

I don't have anything substantive to add to the above, but want to compliment you on a fabulous job with your finances. Sometimes, later-in-life physicians come to the first meeting almost apologetic for starting "late". You and your hubby, otoh, have shown us that's it's possible to turn this into a positive situation. Bravo.