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  • #16
    Thanks, the last three replies are pretty helpful.  I don't think I am done with medicine, and it would be nice to have some lifestyle creep; the issue has been finding time and a life for the discretionary income!  I'll have a frank conversation with management about what I want (reduced schedule with flexible time off), see how willing they are to accommodate that and assume I don't have much to lose.  I guess staying the course has served me well financially, which makes it difficult to cross the Rubicon now, but it's something I've probably been talking myself out of for too long.  I'll reply with any updates.

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    • #17
      I think that's reasonable. If you could cut the hours, even if it is associated with a pay cut, but still be considered full time then perhaps you can get the best of both worlds i.e. tolerate your job long enough to get vested in the pension while enjoying a higher quality of life and reducing your burnout.

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      • #18




        Make about 250k a year

        Net worth about 1.4 mil, $450k in retirement (70% tax deferred, 30% Roth), $300k home equity, rest in taxable

        age 34

        I don’t even track my spending, maybe 35k a year?  I should probably figure that out.

        mentally and financially it makes perfect sense to sell the house and go kitesurfing, wallaby chasing, and Peak bagging for six months but professionally probably too damaging to justify.
        Click to expand...


        Financially independent at 34 years old?  Very impressive.  This would make for an inspiring guest post.  There are plenty of people outside of medicine (e.g. computer programmers) who have become financially independent in their early 30s, but very, very few physicians who have accomplished this feat.  Well done.

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        • #19
          Working as a psychiatrist at $250,000/year (-35,000/yr) x 3 years "without a strong work ethic"... and you've got a net worth of $1,400,000?....   A man has questions....

          Overall though, leave the job if you wish.  You are very far ahead.  Take 6 months off for a mini-retirement because you can. Try something new.  A new practice in a new area.  Part time, there will be more of the same.

          A man cautions against openness about your dilemma for now.  Know your employer well, and be certain about what you want to do before any discussions.  You will signal to them that it's time find your replacement ASAP, and show you the door.

          A man was in your position once.  After 3.5 years he left.  He took the 6 months off.  He left that year's-end $35K top-off into the 401k on the table.  It worked out better than great.

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          • #20
            I don't think you will find the answer to your dilemma if you focus on finances.  You are in an excellent financial position, so you don't have to focus on them.  Honestly, not focusing on finances may make the decision harder as it becomes what do you want and what makes you happy...much harder to decide on than numbers.  As I see your situation, staying the same is untenable.  The choice you think is before you is to go part-time where you are or change locations in your system. Maybe you aren't sure between those two because neither is right for you. I would recommend waiting to talk to your supervisor until you decide what you want, so you are negotiating from a position of strength. So how to decide... Pick a deadline for talking with him/her, preferably 1-3 months.  In the meantime, go on vacation, like today.  Think about what makes you, and do it.  Splurge on yourself a little.  Give some time and/or money to a cause/person you care about.  After doing these few things, reflect on which helped or mattered the most to you.  Let the bigger decision percolate on the back burner for a month or two. I often find the best solutions present themselves to me when I am not actively trying to force them.  As the deadline to talk to your supervisor nears, if you still aren't sure then go with chaos theory...pick one and see what happens.  Best wishes!  Please keep us updated.

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            • #21




              Working as a psychiatrist at $250,000/year (-35,000/yr) x 3 years “without a strong work ethic”… and you’ve got a net worth of $1,400,000?….   A man has questions….

              Overall though, leave the job if you wish.  You are very far ahead.  Take 6 months off for a mini-retirement because you can. Try something new.  A new practice in a new area.  Part time, there will be more of the same.

              A man cautions against openness about your dilemma for now.  Know your employer well, and be certain about what you want to do before any discussions.  You will signal to them that it’s time find your replacement ASAP, and show you the door.

              A man was in your position once.  After 3.5 years he left.  He took the 6 months off.  He left that year’s-end $35K top-off into the 401k on the table.  It worked out better than great.
              Click to expand...


              I love it!

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              • #22


                Working as a psychiatrist at $250,000/year (-35,000/yr) x 3 years “without a strong work ethic”… and you’ve got a net worth of $1,400,000?…. A man has questions….
                Click to expand...


                He has $450K in retirement accounts and $300K in home equity. These can be significantly more than what we expect due to employer match, rising stock market, rising home values and home interest deduction.

                So he has only $650 in taxable accounts. This can also be due to the wonderful stock market gains since 2009.

                He is lucky in that he has a low annual expenses, a good salary and made all his investments at the right time when the markets were skyrocketing.

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                • #23







                  A pension where you accumulate 2.5% of your yearly salary which can be paid in perpetuity (ie after 50 years old like in the CA prison system healthcare providers) can be super worthwhile. Your current pension at 27-30k cash value doesn’t seem to have that much to offer. Even Kaiser does 2% of salary a year with 10 year vesting if I recall? Another group with a good tax advantaged retirement system (ie full 54k per year and 30k in defined benefit plan plus 3400 in HSA pretax) will have you exceed that in 6 months. If the pay is higher at the new job then you’re even better off. So far I don’t see a compelling reason to stay, or at least put out some feelers.

                  However, if you are referring to 30k in yearly income from a pension, that has a “real value” of $750,000 or so in cash equivalent which is a whole other ballgame. Stick that out for another 2 years, add in social security and you have a retirement income that most of America would be happy to have right there and the rest of your career to put a little more away as the “cushion.” Plus, as unpredictable as their payouts may seem, having a steady monthly cashflow after retirement is attractive as part of a retirement portfolio and I wish that my wife or I had one as at least a portion of our retirement plan.

                  On the other hand, it’s worth asking yourself what it is you hate so much. Is it a grind of working a lot of hours? If so cutting back even 10% could make a world of difference. I’m working 17 shifts a month in Emergency Medicine which is more than most in my group but compared to residency seems like a walk in the park…so it’s all relative. Good luck!
                  Click to expand…


                  Wait a minute. Stop and think. Does anybody really think these pensions are going to be paid out in real terms?

                  Just look at the systemic problems out there. Way too many claim checks on real wealth. We simply are not going to make it.
                  Click to expand...


                  But what if we do make it?

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                  • #24







                    A pension where you accumulate 2.5% of your yearly salary which can be paid in perpetuity (ie after 50 years old like in the CA prison system healthcare providers) can be super worthwhile. Your current pension at 27-30k cash value doesn’t seem to have that much to offer. Even Kaiser does 2% of salary a year with 10 year vesting if I recall? Another group with a good tax advantaged retirement system (ie full 54k per year and 30k in defined benefit plan plus 3400 in HSA pretax) will have you exceed that in 6 months. If the pay is higher at the new job then you’re even better off. So far I don’t see a compelling reason to stay, or at least put out some feelers.

                    However, if you are referring to 30k in yearly income from a pension, that has a “real value” of $750,000 or so in cash equivalent which is a whole other ballgame. Stick that out for another 2 years, add in social security and you have a retirement income that most of America would be happy to have right there and the rest of your career to put a little more away as the “cushion.” Plus, as unpredictable as their payouts may seem, having a steady monthly cashflow after retirement is attractive as part of a retirement portfolio and I wish that my wife or I had one as at least a portion of our retirement plan.

                    On the other hand, it’s worth asking yourself what it is you hate so much. Is it a grind of working a lot of hours? If so cutting back even 10% could make a world of difference. I’m working 17 shifts a month in Emergency Medicine which is more than most in my group but compared to residency seems like a walk in the park…so it’s all relative. Good luck!
                    Click to expand…


                    Wait a minute. Stop and think. Does anybody really think these pensions are going to be paid out in real terms?

                    Just look at the systemic problems out there. Way too many claim checks on real wealth. We simply are not going to make it.
                    Click to expand...


                    There are some really generous pensions out there. Great if they pay out and you're on the receiving end. But I wouldn't put all my faith in that alone. My parents are surviving on just a pension and social security for now and it's worked out really well for them with some excellent supplemental insurance too, but I guess I'll have to be their backup plan.

                     

                    I second the many recommendations to take some time off. 6 months in New Zealand hiking and perhaps looking to see if they have a job available in a place that you love (probably my first choice right now for location if the USA health market gets too oppressive).

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                    • #25
                      I think that you have the leverage in the negotiation with the current employer. They would likely rather you stay part time than hire someone else ("the devil you know..."). It might even work out better financially or operationally for them. I would recommend having the conversation, and be prepared to give notice if you do not like the outcome.

                      Good job!

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                      • #26
                        I too wondered about pensions. I think the military pension is probably the safest thing out there and I still think there is risk to all pensions. Let me start a different topic as this is not what the original poster is asking about.

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                        • #27


                          take some time off. 6 months in New Zealand hiking and perhaps looking to see if they have a job available in a place that you love
                          Click to expand...


                          Just an anecdote for the NZ working option - one of my referring physicians went over there to work for 6 months in order to have a change from his urgent care / family care stressful work in USA. I knew about it when a mutual patient told me about it as he wanted me to refill his primary care medication..

                          Upon his return I contacted him and he said he loved the work. He worked with the indigenous Maori people and did primary care which he found more satisfying than doing the same in USA. No insurance paperwork or hassles. The salary was competitive though the prices of goods were a bit higher. No exam is needed to practice there on these stints as long one had USA qualifications and the license is in good standing. A few months later I found he has returned to NZ for a 2 year stint.

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                          • #28
                            You don't need the job or the money, but it may be that you just need an extended break without quitting.  See if you can take a 3-month hiatus or sabbatical or whatever the right term would be.  If that isn't an option there's no reason you have to stay (particularly if part time isn't an option).  However it sounds like you need an extended break from work and you've got the resources to make that work for you without the pension/vesting.  Just going part time may not solve your underlying dissatisfaction with your job.

                            Also kudos on the net worth -- wonderful job saving!
                            An alt-brown look at medicine, money, faith, & family
                            www.RogueDadMD.com

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                            • #29
                              OP, I was in a similar position as you last year at this time (although, my finances were nothing like yours...WOW).  I was 34 y/o, totally burned out, wanting to leave medicine altogether.  As a result, I was completely miserable at home too and my wife was ready to dump me.  Fortunately, after she forced me to see a counselor, we came to the conclusion that I needed to change my job and get control of my life.  I have since found a new position at a different hospital with an easier schedule, lower patient load and life is 100% different now.  I credit not only the better working conditions, but also learning about mindfulness and some new ways to approach stress (Eckhart Tolle for example).

                              My advice to you is to go ahead and find a new job right away.  Look for one with a better patient load, working conditions, colleagues that you like, etc.  Don't worry about the pension or anything else.  Happiness is way more important.  Sign up for a part time status at first. You can usually go as low as 0.5 FTE and still retain full benefits.  I would not recommend telling your current employer anything about being burned out at this point.  Wait until you have another position lined up and you're ready to give your resignation notice.  I made the mistake of being too frank and honest with my employer and it ended up back firing on me a little (they started watching my every move and assuming I was going to be making mistakes or do shitty work, when in fact I was not).  It might be worth asking to go part time (maybe 0.8 FTE?) with your current employer now.  You don't have to tell them much if you don't want.  Just say that you'd like to start doing some traveling or something.

                              Before starting your new job, take a much deserved vacation (take a month or two off if you want). That will refresh your soul a bit and you'll come back home ready to start a new, easier, more enjoyable job.  Life is too short to be miserable for even a day.  You're doing incredibly well for someone your age financially speaking so you are very fortunate to have this opportunity to start over.  Get excited about the fact that life is going to improve for you very soon.  Change is scary at first, but if you shift your perspective it can be really exciting and fun.  Focus on making new friends, finding a significant other, pursue a passion/hobby.  Make those things your top priority each day and start putting your job in the number 2 slot.  You'll probably find that your job becomes more enjoyable once your life outside of work improves.  I know for me that has definitely been the case.  I used to get a sick feeling in the pit of my stomach when I would think about going to work each day.  I don't feel that way anymore.  In fact, I kind of enjoy it now.

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                              • #30
                                Lithium:

                                Spend more money.  Have more sex.  Eat more food.  

                                If the hours are that atrocious, definitely see what else is out there.  Don't let ~$40k of vesting in a retirement account hold you back.  Get a good feel for what other jobs are on the table before you burn your current one.  But I'd be tempted to ask about loosening the schedule and see where it takes you.  If they decide to dump you just because you asked, then they've made your decision a lot easier.

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