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  • Am I crazy?

    I have been an avid reader for a while and have whipped a lot of my and my husband's financial situation into shape but I am having a lot of turmoil of choosing what to do after residency. When I read this blog and FIRE's posts about Drs A-D I can't help but feel like a dope for becoming a doctor but never being able to come close to earning the baseline $300k no matter where or how I live.

    I'm currently midway through a well respected residency program in Pediatrics and have fallen in love with primary care pediatrics, especially in my continuity clinic where I see an underserved population that is probably 99% Medicaid. Fortunately everyone in Pediatrics gets paid on the low end so most fellowships are a wash. I do have colleagues doing second residencies in better paying fields and I can't help but feel jealous of the pay, though I absolutely love this field and feel lucky that this is my job. I am motivated and rewarded despite the challenges of residency.

    I also read WCI and would like to live comfortably and be able to have kids and retire someday. Meanwhile I have student loans to pay since my parents couldn't contribute to med school. I chose my very cheap state school but still ended up with about $200k including some loans from my expensive undergrad. We are in REPAYE and if I do primary care I'll hopefully have PSLF eventually. My husband has no debt but also makes about $50k and won't likely earn much more over his career unless something wild happens. Of course we also live in and love our high COLA, close to my family and the shortest distance from his family that we could be while still in the USA.

    We invest in a Roth (about 5% gross annual income right now), are 2/3 of the way to our 3-month E fund (about 7% gross going in right now), pay my loans (8%), and try to live modestly. I have disability insurance and my car is paid for. But I'm afraid that despite all this we're going to have to watch my med school classmates sail by us in terms of lifestyle because I chose a rewarding but low paying specialty. I try to avoid coming on this forum before bed because it gives me so much anxiety that we'll be stuck in this tight-feeling place forever!

    Is that crazy? Is it that eventually we can have it all but not all at the same time? Or do I need to accept moving away from home and try to find a high paying private practice job?? How much do we as doctors have to sacrifice in one direction or the other--either for the satisfying job or the highest paying one?

  • #2
    If you love your job you've already won.

    That's true for teachers, professional dancers, the local tennis pro, and travel bloggers as well, and you will make more money than any of them. Most FIRE folks wish they had a job they loved.

     
    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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    • #3
      well, thats peds. if money is all you wanted you went about it the very wrong way. but i digress...

      you need to live like a resident and save like crazy early on. dont forget, you wont be poor. you will be in the top 5% of the country most likely. you will have nice things, just not all of the things.

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      • #4
        Stay with the satisfying job. I could move and possibly double my salary but I want to live near my family. When you are making six figures you have options. If you live off the US median salary $60k/year you can definitely retire early. But retiring early is not the end goal. Often the end goal is finding a satisfying purpose, which sounds like you just did.

        I'll give you a brighter perspective if you want to play the comparison game: you already have more retirement savings than most US 60 year-olds. Look up the studies. It will shock you.

         

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        • #5
          IMHO, Choose what gets you out of bed in the morning with a bounce.

          Does private practice in a higher SES NOT make you happy?  There are options out there beyond full time Community Clinics.

          We have a highly specialized Pedi surgery friend who does enough private practice then does missionary work on off months and very satisfied with that split.

          How about an academic University that is nicely salaried and associated with a free clinic?  That will qualify for PSLF, good benefits, pay, and usually in metro areas that appear to be your preferred setting.

          We were saddled with $150k debt 20 years ago and still did fine on VA pay and 1/2 PSLF type forgiveness.  Now mid-career, doing fine in nice home, best school district in HCOL San Diego.  Sure, we don't drive Tesla S and X but we're not destitute either.

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          • #6
            Why do you care what anyone else does financially?  Income doesn't equal wealth.  Net income = wealth.  Find a number you and your husband are comfortable with, enjoy each other, save as much as you can to achieve your number while still living a comfortable life.  You have choices too - you don't HAVE to live in a high COL area.  That is a choice that diminishes your net worth.  Also, there are plenty of things you can do with your degree to earn more income, especially if you're willing to put on your entrepreneurial hat.

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            • #7
              You love your chosen field. Thats great. Dont watch those other people, makes life a lot easier.

              You live in a HCOLA, thats a total bummer. Moving would obviously increase your realized pay.

              Otherwise...the obvious thing is you have to be careful and go slow. Focus on keeping fixed costs low, live like a resident (which is still better than most) and build the savings up.

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              • #8
                I am here to regretfully say that you cannot have it all. The good news is that most docs can't have it all, so you are in good company. The bad news is that you are making choices that will limit future options to do and have things such that the 45 year old you might curse the 27 year old you for taking some things off the table. It sounds like you are also internally conflicted about it, so you might want to rethink some elements of the current plan.

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                • #9
                  You're not crazy, but you need to temper your expectations and not covet. Being the lowest-earning practice type of the lowest-earning specialty in a high-cost of living area may not have led to what you thought your life would be like as a doctor, but it's your life.

                  If it's worth it to you, you could make more money, like in urgent care, but I have a feeling you'd find time with your family more valuable. You could also take on another specialty - I think a Sleep fellowship might still only be a year - if it means that much to you or you decide you don't like Peds that much.

                  People say things like "money doesn't matter," but here we are on a money site. Truth is, just like every other vital aspect of our lives, money does matter. It's a spoke in the wheel with your health, your family, and your other basic needs in the greater sphere of your contentment and your life. I'm not talking about having nicer houses, cars, boats, purses, and vacations than your med school classmates: I'm talking about being able to move your parents close to you so they can be with their grandkids, a family trip for Thanksgiving, knowing you can replace your material needs in a pinch, having dinner delivered if you just don't have time/energy to make it, and not working more years than you want to or should work.

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                  • #10
                    +1 with Vagabond -  You looked at PoF's Dr A-D.   Now read up on his IPS and create one of your own.  Create goals, spending charts, and then measure out the needs to get there and see if your dream job matches up.  If so, viola done!

                    If shortfalls occur, where can you make adjustments in goals, spending, or income levels that will work for you?   Money isn't everything (such heresy!)

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                    • #11
                      You should focus on the things you can change and not worry about the things you can't.

                      With regards to your personal finances -

                      You can't:

                      • Have less student debt or a higher net worth right now

                      • Easily change your specialty into a higher paying one

                      • Alter the wealth of your classmates

                      • Easily increase how much your husband earns


                      You can:

                      • Live below your means

                      • Move to a low COLA

                      • Pay off debt quickly

                      • Save aggressively for retirement


                      As nearly as I can tell, most people on this board save aggressively because (i) they dislike their jobs  / are burned out and want to do something else with at least some of their time or (ii) are naturally thrifty and like accumulating wealth as a game of sorts.  The posters on this board aren't representative of the physician community, but are self-selected to be so interested in accumulating wealth that they spend their free time writing about it.

                      Don't feel bad if you can't keep up with your classmates or posters on this board.  If you like your job or don't envision getting burned out, then you have plenty of time to accumulate for retirement and don't really need to save that aggressively to retire early.  At a 6% return over 30 years, you need to save 32 cents annually for every dollar you want to spend annually in retirement using the 4% rule.  Figure out what you want to spend annually in retirement and start saving towards that goal.  As a pediatrician, you probably will never go on that WCI heli-skiing vacation in Japan, but most people won't so don't worry about it.  Someone will always have more money than you.

                       

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                      • #12


                        Why do you care what anyone else does financially?
                        Click to expand...


                        +1
                        Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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                        • #13


                          At a 6% return over 30 years, you need to save 32 cents annually for every dollar you want to spend annually in retirement using the 4% rule.
                          Click to expand...


                          6% after-tax, total, real return investing in broad US stock and bond indexes over next 30 years? Not. Gonna. Happen.
                          Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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                          • #14
                            I think it's great that you love your job.  I'm jealous of that!  If you're happy and healthy, it doesn't matter what anyone else is doing/earning/thinking.  Right?

                            If it's any consolation, your husband make 3x what my wife does....

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                            • #15





                              At a 6% return over 30 years, you need to save 32 cents annually for every dollar you want to spend annually in retirement using the 4% rule. 
                              Click to expand…


                              6% after-tax, total, real return investing in broad US stock and bond indexes over next 30 years? Not. Gonna. Happen.
                              Click to expand...


                              38 cents at 5% and 45 cents at 4%.  6% is already below historical levels and for retirement, it could be in a tax advantaged account, so this is not exactly stretching on assumptions.

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