Paying for orthodontics residency

[Tennis64364]

Hey guys, just wanted to see if I could have some help about paying for my orthodontics residency.

I am currently 35 and married, no kids. It has always been my dream to be an orthodontist, and was recently accepted to a residency, however very expensive. The program is 3 years and will cost about $300,000.

I have no debts and about $155,000 in a Vanguard taxable account and $72,500 in an Ally account. I hope to have $100,000 in the Ally account by the time I start residency in July.

I’ll be about $50,000 short on tuition, and unfortunately since the program is newly accredited you really cannot get a private loan (I’ve checked). I have $110,000 in a 401K and combined $84,000 in a Roth/spousal Roth a which I do not want to touch. I will be working Saturdays to pay for my expenses during the program. Should I withdraw money from my 401K to pay the final $50,000? Any other recommendation?

[JBME]

NO. Do not withdraw the money. You put that away for retirement.

Does your wife work? The correct recommendation is to go back and accept a residency program that is less expensive. You won't make more money just because you paid more for the program you went to. Other than that drastic solution, you'll need to take out a loan. I would do that before I withdraw from my retirement account. Can you get a cheaper car? Cars are relatively expensive these days....sell yours and buy a much cheaper car. That's another idea

[Tim]

3 years opportunity cost and $300k tuition and cost of living. I would simply advise to make sure the income differential has a payback period that gives you a cost/benefit. Good luck. You can swing it, but it is costing you a substantial piece of change. Only your career plans will determine the benefits.
Concur, do not use your retirement funds.

[Tennis64364]

Thanks for the replies. I guess I have to separate dream vs financial reality. I assume the break even is probably about a decade or so when I am around 50. But it is not going to come without obstacles or completely wiping out my savings. I might have to defer the acceptance for now.

[SerrateAndDominate]

Although I'm married to a dentist, I'm pretty ignorant about how the residency selection works. Is there any way to take this offer and leverage it to get a spot at another residency?

I still think it's absolutely asinine that y'all have to pay to do residency

[F0017S0]

Yeah, why do orthodontists pay to do their training? That has always been nuts to me, on top of fees for dental school...

[Turf Doc]

Although I'm married to a dentist, I'm pretty ignorant about how the residency selection works. Is there any way to take this offer and leverage it to get a spot at another residency?

I still think it's absolutely asinine that y'all have to pay to do residency

i think its a little different though because dentists don't have to do a residency to practice, its purely optional. Dentists might look at physicians and think wow, i cant believe youre forced to do a residency and get paid peanuts while i can go out and make money right after graduating

[Max Power]

https://forum.whitecoatinvestor.com/...inancial-sense

Totally worth it.

... It has always been my dream to be an orthodontist, and was recently accepted to a residency...

Price is what you pay, value is what you get.

You will get your money back and then some (due to rarer and more valuable skill), and you will obviously get personal enrichment also. Don't listen to the bean counters... take out a loan, cash in retirement funds, do what you have to do. Make it happen.

[Hank]

No chance of getting admitted to a well established ortho program where you could get a loan?

How much more do you think you could make billing as a residency graduate orthodontist vs. doing Invisalign or taking CE courses to place traditional Ni-Ti braces as a well trained general dentist?

[orthodds]

Yeah, why do orthodontists pay to do their training? That has always been nuts to me, on top of fees for dental school...

It is ridiculous. My ortho residency made enough money from the clinic the residents were running to help cover the costs of other parts of the dental school.

I think it comes down to how residencies are funded. As far as I remember when I asked about this years ago it is due to an outdated, tangled web involving GME, Medicare, hospitals etc.

I think it’s a joke. They keep it the way it is because why would they spend more money on dental residencies if they don’t have to? People sign up to do brand new, expensive ortho residencies almost regardless of the cost and, it seems, often regardless of the quality. I’m not as connected these days so this is based on my past experience. The dental lobby just doesn’t have enough power I guess.

[orthodds]

No chance of getting admitted to a well established ortho program where you could get a loan?

How much more do you think you could make billing as a residency graduate orthodontist vs. doing Invisalign or taking CE courses to place traditional Ni-Ti braces as a well trained general dentist?

What are traditional Ni-Ti braces?

Besides money, some dentists care about providing quality treatment. The training you get via CE courses is just a tad bit different from doing an immersive, comprehensive training program for 3 years.

Also, even though I enjoy doing orthodontics, if I were a a general dentist I don’t think I would want to complicate my practice by sticking ortho stuff (supplies, different appointment types, instruments etc) in the middle of it and training staff to do ortho. That’s why most general dentists stick to dabbling in Invisalign, because the workflow is much simpler.

[Tennis64364]

https://forum.whitecoatinvestor.com/...inancial-sense

Totally worth it.
Price is what you pay, value is what you get.

You will get your money back and then some (due to rarer and more valuable skill), and you will obviously get personal enrichment also. Don't listen to the bean counters... take out a loan, cash in retirement funds, do what you have to do. Make it happen.

Not sure if you are being serious or not

[Tennis64364]

No chance of getting admitted to a well established ortho program where you could get a loan?

How much more do you think you could make billing as a residency graduate orthodontist vs. doing Invisalign or taking CE courses to place traditional Ni-Ti braces as a well trained general dentist?

I make about 250k on a good year as a GP associate. This is also with a pretty hectic schedule, getting fairly burnt out, lots of career second guessing if I could maintain this long term. From what I have heard from other orthodontists, you can make 300k as an associate fairly easy. If you could get a great location or buy a practice the numbers go up dramatically from there, but staying as an associate I assume about 300-350k. If any orthos on this board want to chime in if it’s financially worth it or not, it would be greatly appreciated.

[orthodds]

I make about 250k on a good year as a GP associate. This is also with a pretty hectic schedule, getting fairly burnt out, lots of career second guessing if I could maintain this long term. From what I have heard from other orthodontists, you can make 300k as an associate fairly easy. If you could get a great location or buy a practice the numbers go up dramatically from there, but staying as an associate I assume about 300-350k. If any orthos on this board want to chime in if it’s financially worth it or not, it would be greatly appreciated.

Depends on where you will be practicing.

[Tim]

Thanks for the replies. I guess I have to separate dream vs financial reality. I assume the break even is probably about a decade or so when I am around 50. But it is not going to come without obstacles or completely wiping out my savings. I might have to defer the acceptance for now.

Don’t necessarily understand your conclusions.
Your 35 and married without children.
3 year residency spend some money.
Then 38, start making more money.
Per you, break even in 10 years at 48.
That leaves at least 10-20 years.

Bout time you and your spouse make some choices. Build your life the way you want it.
You can “afford” it. It’s only a trade off, the cost of the ticket vs the work/life you want. Cost/benefit in this choice is not only a spreadsheet. You have life choices to make. This is probably more important than any house you ever buy. About the same cost. There is a payoff. Only you can decide if it is worth the price.