Reader Case Study: Medical Student and Software Engineer Dream of a Homestead

Melissa is a medical school student who lives with her husband Gabe in a small city in New England. They’d like our help planning for a future that’ll allow them to pursue their dream of living on a homestead while Melissa establishes her career as a physician and Gabe works remotely as a software engineer.

Case Studies are financial (and life) dilemmas that a reader of Frugalwoods sends to me requesting that Frugalwoods nation weigh in. Then, Frugalwoods nation (that’s you!), reads through their situation and provides advice, encouragement, insight, and feedback in the comments section. For an example, check out last month’s case study.

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With that I’ll let Melissa, this month’s Case Study subject, take it from here!

Melissa’s Story

Vegetables from Melissa and Gabe’s garden

Hi Frugalwoods nation! I’m Melissa, I’m 32 and I live in a small city in New England with my husband Gabe, who is 36. I’m currently in medical school and Gabe works from home as a software engineer.

Though we live in the city now, our eventual dream is end up on a homestead in New England. We love living here, it’s a beautiful part of the world, and we’re close to our families–both of our parents live in the same area as do many of our siblings.

Our corner of New England has a special community we love with values that align with ours. Our dream is to have a home near family with 20+ acres and lots of vegetable gardens, orchards, berry patches, animals, and three or four kids.

Hobbies

Rainbow in New England

I love yoga, cooking, meditation, sewing, knitting, and vegetable gardening (I’m getting more into flower gardening). I’m very much a DIY kind of person. My most recent interests are baking sourdough breads, brewing kombucha, knitting felted blankets, and perfecting a beeswax-olive oil balm recipe. My husband and I are both pretty active: running, hiking, skiing, spinning, going for walks around town, weightlifting, etc.

Gabe enjoys reading, yoga, meditation, eating the food I cook (just kidding, but not really), and learning about new technologies. We tend to go to a lot of potlucks, spend time at our interfaith society, and volunteer in our community. Occasionally we’ll go out to the movies, or to a show. We both love being outdoors and gardening or working on projects, so we can really see ourselves loving the homesteader life. For the most part we’re very happy to spend our time with each other and at home.

Gabe’s Job

A summer salad made by Melissa and Gabe

Gabe doesn’t plan to stay at his current software engineering job forever. While he makes a good salary, there are some issues within the company that have been challenging.

We’ve been chatting about him taking a peek at other positions in the near future.  That being said, he’s worried that it might be a “grass is greener” situation and that changing positions might not actually solve anything.

So while there isn’t anything immediately driving him to look for a different position, it’s a conversation we’re having about how he might make a change in the next year or so. Someday, he would like to own his own product company and is exploring what his career might look like in order to achieve that and how to make it a viable option.

Occassionally Gabe does some freelancing, but he’s really scaled back on that in the past year. These days it’s infrequent that we get income from that, but when we do it goes to savings.

Melissa’s Job

Melissa at the library after midnight

I took the scenic route to medical school, and even though I’m an older student, I’m really glad I did. It took a while for me to decide that I wanted to become a doctor and to feel as though I’d had the experiences I wanted to have. Prior to med school, I worked as a first and second grade special education teacher at a school for children with psychiatric disabilities, as an in-home therapist for New American children with medical needs and/or developmental delays, as a research coordinator studying opiate withdrawal in newborns, and as an educator and medical case manager at an HIV/AIDS organization. I’ll graduate with my MD in 2022.

Medical school is a lot of work but I really love it! My mind is blown pretty much every day. Two weeks ago I was learning about micronutrients and today I’m studying brain anatomy!

I love interacting with patients and am working on an exciting community service project on nutrition education for new moms in treatment for substance use disorder. School has been way more fun than I ever thought it would be, and very affirming that I’m in the right field. I’ve been tremendously humbled by the opportunities that are available to me and am grateful to be in a profession where I’m constantly learning and able to help others. Even though there are some long days and tough exams (neuroanatomy… oof) I wouldn’t say there’s anything about my current situation I don’t like–except for the sleep deprivation that comes before an exam and the tuition. I also don’t get outside or move my body as much as I’d like, and sometimes I’d like more flexibility in my schedule. Overall, I feel like I have a pretty good balance because school has been much more manageable and fun that I thought it could ever be, and I feel thankful to be where I am in life.

I have three more years of school and plan to become a Family Medicine doctor so I’ll have three years of residency, and then might do a fellowship for a year in Maternal Child Health. I’m very interested in these areas but am also trying to keep an open mind (hey, I might love dermatology, you never know… but I have a hard time picturing it). I’ll make a salary as a resident (somewhere in the $50k-$60k range) and then my salary as a physician will vary, but around $200k is average in our area from what I’ve been told (although primary care providers have been getting paid more in recent years due to increased demand, so this might change).

Melissa’s Medical School Tuition

I chose a school where I get significantly reduced tuition. That being said, it still costs around $40k a year. Unfortunately, I learned that loan-service programs wouldn’t work for me. While there are some programs that pay your tuition in exchange for service, they require you to be geographically mobile, such as serving in the military (which doesn’t seem like an option for us, for lots of reasons) or in the National Health Service Corps Scholarship Program (while I would consider this as an option, I spoke with a representative who works placing doctors in this program and found out that this almost never happens in the Eastern U.S.- it’s usually in places like Alaska or Wyoming). Staying close to family is non-negotiable for us. Most of our family lives within driving distance, and we each have only one parent who is still alive, so it’s incredibly important to us to be near them, especially as they age and our (future) children are young. While we would consider moving within New England, moving farther away doesn’t feel right.

From Melissa and Gabe’s travels: a sunset in Central America

I also realized that Student Loan Forgiveness Programs for primary care providers are a big gamble, and one I’m not willing to take. Theoretically, I could qualify for it since I’m planning to go into Family Medicine, and I could take out my entire medical school tuition in loans and work to have them paid back for a certain number of years of service within rural New England… BUT there are lots of strings attached including whether these programs will even still exist by the time I graduate from residency (residency is like training after school to become the type of doctor you want to be) and how much we would have to contribute to the loan payback given our combined income.

Considering how long I would have to hold onto these loans (over a decade before they were paid off. We are VERY adverse to debt at this point so that seems like an unbearable amount of time) as well as the limitations on where/how many hours I would have to work to even be qualified to get them repaid… we decided it just wasn’t worth banking on that as a strategy, even though it was tempting.

I had a 0% interest loan of $15k for my first year of tuition. I took this loan, which was a little less than half of my tuition, and paid the rest out of pocket. I was offered $5,400 in 0% loans every year for the rest of my program. Additionally, I might receive a $20k scholarship for my third year of school if I’m accepted into a program where I do all of my third year clinical experiences in an underserved area.

Melissa and Gabe’s Debt

Taking a walk

It’s tough to feel like we’re making any progress financially because much of what we’ve been able to save has gone to paying back debt. Just a few months ago we realized that for the first time in our adult lives we have a positive net worth. While this is certainly something to celebrate (and it does feel good to have less debt), it also feels like we’re stuck working hard to save, and then seeing all of it get sucked up to pay another loan.

And we.are.so.sick.of.student.loans. They feel never-ending and it’s hard not to feel resentful about the cost of education. It’s great that we don’t have much more to pay back (relatively speaking) but I still have 3 more years of tuition. Right now it feels like we’ll never not have some debt or tuition to pay for. We’re in our 30s and we’d like to be in a better place financially and feel like we have something to show for all our hard work (something to show in terms of savings not, you know, flashy cars and caviar).

Melissa and Gabe hiking

To provide context, in the last several years (within the last 5 years really, but especially in the last 2-3 years) we’ve paid back about $130,000 of debt in the form of:

  • $19,600 for a car loan: $18,600 for car, and a thousand for taxes/registration/fees, etc.
  • $53,408.30 of Melissa’s student loan debt: almost all of my student debt is from what’s called a “post-bacc” which is a program for people who don’t have an undergraduate science degree and need to do coursework to apply for medical school. In retrospect, I wish I’d done this is in a less expensive way. About $20,000 of my student debt is from graduate school, most of which was paid for by a scholarship. Only the $20k could have qualified for loan forgiveness, but would have taken a long time to repay with a decent chance it might not ever be forgiven due to issues with the program.
  • $56,732.63 of Gabe’s student loan/credit card debt: these are hard to pull apart since he went to a software bootcamp, which at the time didn’t qualify for any loans, so he had to use credit cards and private loans to pay for tuition and living expenses. Some of this is consumer debt, but the majority is from schooling. He also had federal loan debt from his undergraduate degree, which is rolled into this sum as well.

If we include the $48,636.58 we’re planning to pay back this year, it totals $178,377.51 in debt payoff. We’ve never actually added this all together, and it’s definitely a surprise!

I want to recognize how fortunate we are to save so much and have the ability to pay back this debt. I know many, many people who accrue massive school loans without the possibility of paying them off for many years. I am beyond grateful that my tuition is only $40k a year, instead of around $65k (which is what it is for many medical students) and that I don’t have to take out loans to cover my living expenses. Having a spouse who is working and making a high income while I’m in school is unique and gives us a degree of control over our finances that is not available to many other students. I recognize that we have special circumstances for which we are truly thankful.

Financial Anxiety

Fall leaves in New England

Even though I know I’ll make a significant income once I’m working, I feel bad for bringing so much debt to our marriage and for having high tuition. I think I have a lot of anxiety and guilt around money.

It’s a combination of feeling nervous that we’re behind for our age and trying to catch up, and the nagging feeling of knowing my tuition is high and that it’ll be years before I make much income. My work before school didn’t pay that much (we were also less financially wise) and even though Gabe’s salary has increased significantly in the past 5 years, most of this went to debt payoff, so we have little savings or wealth accumulation from most of our 20’s.

Gabe had his own interesting journey in his 20’s that involved living in NYC, France, and helping his sister start a successful–and delicious!–gelato business.

I sometimes feel conflicted/guilty for spending money, even on perfectly reasonable purchases, such as when I needed boots for winter because we live in New England and all I had were rain boots after the zipper broke on my previous pair. I’m also worried about our ability to recover from the lack of savings in our 20s along with tuition/debt payoff in our 30s and to eventually become financially healthy.

I’d like to figure out a different mindset about our finances now. Simultaneously, I recognize how privileged we are to have the income/income potential we do, and that often feels uncomfortable to me. Especially when I’m working alongside so many nurses (LNAs, RNs, NPs, etc.) and other medical professionals, social workers, administrative assistants, etc. and a wide variety of patients who often don’t get paid what they deserve.

Looking To The Future

Vegetables from Melissa and Gabe’s garden

Gabe and I plan to have kids–possibly three or even four of them! In fact, we’re planning to start our family soon, while I’m still in school. Big picture: both of us would like to have the freedom with our work to be very involved in our family life and homestead while having jobs that are fulfilling and driven by passion, not financial need, and to have the ability to travel more.

Where Melissa and Gabe Want To Be In Ten Years:

1) Finances

In ten years, I expect to have been working for 3-4 years, depending on whether I decide to pursue a fellowship or not.

Given this, we would like to:

  • Be debt free (minus a mortgage, although we’re so adverse to debt at this point that we’ve considered trying to avoid a mortgage altogether)
  • Consistently max out our IRAs as well as our 401ks
  • Have a 6-month to 1-year emergency fund saved up
  • Probably own another car (paid in full)
  • Have savings accounts for all of our future children, with a minimum of $20k in each (we haven’t figured out our long-term savings goals for our children, but we know we want to)
  • Have investments/savings circa $1.4 million (including retirement; see math below)

Here’s how we figured out these numbers:

  • Save approximately $65,000/year x 10 years= $650,000 (this is what we save of Gabe’s salary now)
  • Minus our current debt: $48,636
  • Minus my medical school debt: $60,000 (approximately, if we continue to do what we’re doing now)
  • Plus at least $10,992 in retirement per year (what we put into Roth IRAs now) x 10 years= $109,920
  • Plus $48,234 (what we already have in Roth IRAs/Betterment account)
  • Plus $115,500 (approximate residency take-home pay for three years, if we continue to live off Gabe’s salary alone and save all of mine)
  • Plus $560,000 (four years of take-home pay for my salary as a doctor, if I work full-time and we continue to live off of Gabe’s salary alone (this is assuming I earn a $200,000 salary)
  • Maybe have some sort of passive income stream, but we haven’t figured out what this would be yet
  • Long term goal: Be financially independent in our 50s or sooner

**We recognize this is over-simplified because it doesn’t account for interest rates, and more importantly, kids. Also, it depends on us continuing to live off only Gabe’s salary, and him working full-time. Plus we didn’t factor in if/when/how we want to buy our dream home**

2) Career

Melissa’s aunt’s chickens

I see myself practicing as a family medicine doctor who focuses on women and children in a rural setting. I’d love to work at a clinic in a high-need area in New England. In ten years, I’d also like to be working on research in my area of interest, hopefully with some publications, doing public health work, and serving as a mentor/teacher to others in healthcare. I’d also like to establish a long-term partnership with a clinic in Central America.

Gabe sees himself possibly working part-time while our kids are young, and definitely at a different job than the one he’s currently in. He’d ultimately like to own his own product company and identifies that as his long-term goal.

3) Lifestyle

Waterfall near Melissa and Gabe’s town

While we both see ourselves working, it would be nice to have more flexibility to decide how we want to work: whether part-time or for an income at all. We’re not sure if we’d want to work part-time, but it would be nice to have the option while we have young children.

I’ll be delivering babies and working busy days at the clinic, but would like to have the flexibility to choose where and how I practice. Many physicians face several hundreds of thousands of dollars in debt when they finish residency, and this can influence how they decide to practice (and what area of medicine they go into). Ideally, I’d like to have my passions (for family, homesteading, and primary care) drive how I practice medicine instead of financial necessity.

We’d like to spend part of the year traveling, both for fun and for me to work in global health (we’d like to make this a family experience in which we develop sustainable, long-term relationships). Gabe is working on his Italian citizenship, and we hope to have this in the next year or so (then I will get mine through him). Long term, we would love to have a home both in New England and in Europe (probably Italy) where we could spend a fair bit of time throughout the year.

I would love to open free clinics in our home state and another in Central America (I speak Spanish, and we’ve been exploring countries we’d like to spend time in long-term) that could provide care to underserved populations, where I could establish relationships with patients and other providers. My sister (she’s the most amazing nurse and is working a long shift in the cardiology unit as I write) and I have dreamed about working together and having our own clinic one day in the future.

Melissa and Gabe’s Finances

Income

Item Amount Notes
Gabe’s paycheck $10,311 Gabe’s income, minus the following deductions: health and dental insurance, taxes, and reimbursements
Gabe’s annual bonus $1,050 Gabe receives a guaranteed 10% bonus (but could be higher) minus taxes = approximately $12,600/year
Monthly subtotal: $11,361
Annual total: $136,334

Expenses

Item Amount Notes
Melissa’s Medical School Tuition $1,857 We’re on a payment plan for the spring and fall, but this is the monthly average
Rent $1,600 For now we live in town. It’s close to school/work/the hospital and we’re not sure we’re quite ready to move out of town yet. We walk everywhere and have a great quality of life. Although we’d love to have a homestead, we felt it was a bit premature to dive into that at this point in our lives. We’ll be in this area for the next few years, but don’t know where I’ll be placed for residency so it didn’t make sense to buy. That, in addition to the very expensive cost of buying a home in our area, makes us renters for the time being. We’re looking forward to owning our dream home one day…
Groceries $544 A little high for a few reasons. I’m a bit of an impulse shopper when I see a sale and end up buying things I didn’t expect to buy that day (I do try to only get things I know we’ll use though). Specifically, we live near two stores that sell steeply discounted organic food (think of an incredibly inexpensive TJMaxx but for all the amazing food…that jar of raw organic almond butter is only $2.99 because the label is torn). I’m working on this- we’ve talked about sticking to a list more, and only going to these stores once a month. Also, we live in an area that has a thriving local food scene, so we like to support local and organic food when we can, including our summer CSA. We are mostly vegetarian, eat most of our meals at home, and pack lunches. We buy almost all unprocessed foods and try to buy direct from farmers in bulk for more savings. I volunteer to get a discount at our co-op, and we stack savings there by shopping on certain days when the prices are lowered. I struggle to get around $500 or below. When we do, I find that the next month’s bill is higher so they end up balancing out.
Melissa’s health insurance $225 Subsidized through school. It’s much less expensive than getting insurance through Gabe’s work, and the least expensive plan we could find. I don’t currently have dental or vision insurance so I need to figure something out on that end. Any recommendations for affordable but good coverage?
Clothing and shoes $161 Wow! I had no idea we were spending so much in the category. It looks like we don’t buy things often, but when we do they’re expensive (running shoes, winter boots, professional clothes for me when I’m in clinic, winter jacket, rain jacket, Gabe buying new pants and shirts for the first time in 5 years…). I am trying to be more intentional and buy fewer things that I love, feel great wearing, and know I’ll have for years. Also I think we didn’t buy clothing for so long that we’re both feeling as though we want to look more put-together than we have in the past.
Gifts for family and friends $145 Birthdays, baby showers, cards, Christmas, tickets for events we go to with friends/family sometimes, etc. Gabe comes from a large family, and Christmas is a big deal in mine. We try to be mindful of how much we spend in this category, but it’s hard.
Two cell phones $123 We’ve thought about doing an AT&T MVNO but are nervous because we both tend to use a lot of data for school/work and are afraid of going over the limit and getting charged more than what we pay now
Yoga/meditation $120 Unlimited monthly yoga classes for both of us. We love our yoga studio. Each time I think about cutting this area of our budget, I just can’t bring myself to do it. While they do offer jobs in exchange for membership, they ask that it’s reserved for people who really need those opportunities. Our studio is also unique in that it’s a non-profit, so they charge very little compared to other studios and use membership dues to support all sorts of amazing programs (yoga in prisons, for people with traumatic brain injuries, in recovery from substance use disorders, Pride yoga, etc.)…So I think of this as half membership and half donating to a great cause. Gabe goes at least 5 times a week.
Household goods $118 This has been an expensive category for us since we moved into the apartment we’re currently living in (we moved in August 2018). It feels like the first “grown-up” place we’ve lived in and we’d like it to feel comfortable since we expect to be here for several years. Things like a shower curtain, water filter replacements, paint for household projects, but also new coffee mugs, cloth napkins, a rug, lamps, bedside tables, new laundry basket, etc. We’re trying to be mindful to buy only things we really either need or love and will have for many years. That being said, we feel like we’re set in terms of these up-front costs, and have been spending significantly less in this category lately. It’s been more like $23 per month for the past few months, for things like a replacement blender container for the one I broke when I accidentally left a metal spoon in with my smoothie ingredients…oops!
Travel/visit with family and friends $105 Gas driving to visit family that’s a little farther away, ferry rides, plane tickets to visit grandparents in Florida or a sibling in another part of the country, etc.
Car gas $96 We mostly walk but drive places as needed
Gifts for each other $85 Birthday and Christmas gifts…as I write this I realize we could cut this category completely and use it to fund one big trip a year.
Gas bill for apartment $76 Higher in winter, but an average (we have gas heat and stove- which we love!) and our apartment is well-insulated
Travel/Experiences us two $76 A few weekend trips a year, half marathons, apple picking, etc. We’d like to spend less in other categories and more here so we could travel more, especially internationally. We have a hard time letting ourselves spend money on travel and not save instead, so I’d love to see us be more intentional in other areas and feel more comfortable spending here. We did a big trip to Central America before I started school, and decided not to go on another one this summer for both budget and timing reasons. We’re thinking we’d like to do anther trip next winter/spring.
Car insurance $73 Through StateFarm
Food and drink with family and friends $71 Dinners, coffees, potlucks, Thanksgiving, girls night wine, etc. It’s hard not to spend here.
Giving/donations $70 We give to our interfaith society and other charities that are important to us
Gym $60 I get a gym membership with tuition, but Gabe pays for his ($33/mo) plus he does some Crossfit classes (although he’s not sure he wants to continue with those)
Entertainment $58 Netflix, Spotify, movie tickets (Gabe enjoys going about once a month), an occasional video games for Gabe, a book we can’t get from the library, a community cooking class for me, etc.
Pharmacy and toiletries $56 Soap, toothpaste, toilet paper, shampoo, floss, contact lens solution, sunscreen, etc.
Car maintenance $51 Getting winter tires changed over, new windshield wipers, oil changes, yearly registration, etc.
Co-pays $50 Dentist for Gabe, yearly check-ups, therapy, eye exam and contact lenses, etc.
Internet $40 We split with our neighbors
Peloton $39 A splurge, but I absolutely LOVE spinning (nothing else makes me sweat as much) and use this as a great opportunity to get in a workout when I otherwise wouldn’t. I’ll do a 30 min class between study sessions.
Date nights $38 We’ve been trying to spend less on takeout and instead put our funds towards one meaningful meal with each other every month
Subscription/fees $34 Chase Sapphire credit card yearly fee of $95 for 2 cards, google storage, YNAB (which we use to track our expenses and it’s been a game changer), password protector application, and Costco. We try to be aware of this and only have subscriptions to things we use regularly and are important to us.
Electric bill $27 Pretty consistent
Takeout $26 We’re trying to be mindful of this category and have been spending less here so we can instead put our efforts towards one date night per month.
Supplements $21 Magnesium, Omega 3, vitamin D in the winter, etc.
Cleaning/kitchen supplies $17 Vinegar, hand soap, baking soda, sponges, dish  soap, laundry detergent, etc.
Coffeeshops and pastries $15 Something Gabe really loves is going out to coffee a few times a week. This is a tradition he’s had since his days in NYC and Paris, and he really enjoys it. We also live in an area with some pretty amazing cafes.
Renter’s insurance $11 Just in case, and it has actually come in handy
Haircuts $11 I cut Gabe’s hair and have yet to convince him or anyone else to cut mine, so for the time being I get it cut twice a year at a salon I like to support that’s all about empowering women who work in the cosmetology industry.
Impulsive/Treat yourself $7 We should name this “Kombucha, dried fruit, and chocolate”, our go-to treats.
Postage for mailing $2
Parking $2 When we have to pay for a parking meter somewhere
Monthly subtotal: $6,107
Annual total: $73,284

Assets

Item Amount Notes Interest/type of securities held
Savings account $38,324 This is our emergency fund/other savings we’re not sure what to do with Through Capital One, earns 1% APY
Melissa’s Roth IRA $22,887 I have more in my retirement due to a rollover from my years as a teacher. Through Betterment, on autodeposit. Max out by contributing $458/mo.
Gabe’s Roth IRA $15,036 Started several years ago. Through Betterment, on autodeposit. Max out by contributing $458/mo.
Betterment account $10,039 A fund we started a while ago and aren’t sure what (if anything) to do with 80% stocks, 20% bonds set to “Moderate Risk”
Checking Account $5,310 We don’t keep much here, just what’s needed to pay for monthly expenses. Through Capital One, earns .2% APY
Melissa’s Retirement Account $575 An old account I contributed to while working per diem for a while. I keep meaning to do a rollover….ah, the paperwork! Through Fidelity, a managed fund.
Total: $92,170

Debts

Item Outstanding balance Interest Rate Loan Period/Payoff Terms
Student loan $16,637 6.80% All of these loans are currently in deferment (still accruing interest) but we were planning to have them completely paid off in the next few months
Student loan $8,156.08 6.80%
Student loan $6,907 4.60%
Student loan $6,840 4.60%
Student loan $5,048 4.60%
Student loan $5,048 4.60%
Medical School Loan $15,000 0% From my school through a specific program. I’ll be able to re-apply but likely won’t get approved for as much next year. I anticipate needing to apply for federal loans to make up the difference.
Total: $63,636.58

Vehicles

Vehicle make, model, year Valued at Mileage Paid off?
2014 Subaru Forrester Premium $13,613 76,694 Yes

Melissa’s Questions For You:

1) Does our current tuition strategy make sense?

Melissa and Gabe’s wedding

I could be paying more in tuition or less. We chose the amount we pay because it’s what’s leftover after the 0% interest loan my school offered me (we’re planning to keep that loan and pay it back once I’m in residency). If paying out of pocket for tuition is a good strategy, what do you think is a good balance to strike between paying tuition and saving? Currently we pay about $24,000 out of pocket and have $15,000 in loans for the year.

2) Two goals for 2019 are to have all of our debt (not including my 0% loan) paid off and to have $37k-$42k saved as a safety net/some other savings account we haven’t figured out yet. Do you think these are reasonable and achievable goals?It makes sense to pay back my non-0% student loans ($48k) soon since they’re accruing interest, right?

3) Where do you recommend we focus on saving so that our spending aligns better with our values?

I have some ideas of where we could start… Furthermore, what should we do with that extra money: put it towards tuition, savings, or other investments?

4) What do you suggest we do for our retirement savings?

Melissa and Gabe apple picking

We’re waiting for Gabe’s 401k at work to be set up (and pushing his company on this and other benefits–they’re a small business but have stated that they’re working on the 401k but are being really slow about it).

However, we’re not sure he’ll be there for several more years and so is it worth putting funds into one just to transfer them over to another fund? If we should still be putting funds into his 401k, how much? Should we continue to contribute to our IRAs? Basically, how would you approach retirement/savings overall and balance it with other goals (e.g. tuition)?

5) Do you think our 10-year plan is realistic, achievable, and sustainable?

If not, how do you think we could set ourselves up so that it is? What are your thoughts on our ability to become financially independent or, at the very least, have the option for both of us to work part-time at some point?

Mrs. Frugalwoods’ Recommendations

Melissa and Gabe skiing

I have to start with congratulations because Melissa and Gabe are in fantastic shape! Melissa may not see it, but I think they’re doing terrifically. Yes, they’ve paid off a lot of debt, but, you guys, THEY’VE PAID OFF A LOT OF DEBT! This can feel like treading water, but the salient point is that they’re not drowning–they’re thriving while managing a pretty substantial tuition and student loan debt load.

Let’s dive into each of Melissa’s questions:

1) Does our current tuition strategy make sense?

In my opinion, yes. I’m a big fan of 0% interest loans, as long as you have the ability to one day pay them off, which Melissa and Gabe do. Melissa should check the paperwork to determine if the loan’s interest rate is adjustable and if so, when it’s scheduled to increase. If it were me, I’d keep the 0% interest loans and continue paying the remainder of her tuition out of pocket.

2) Are our 2019 goals to have all of our debt paid off (not including the 0% loan) and to save $37k-$42k reasonable and advisable?

I am in favor of Melissa and Gabe paying off their non-0% interest debt. What I really appreciated about her debt spreadsheet is that she sorted her debt not by total dollar amount, but by interest rate. This is crucial because with any debt, it’s the interest rate that matters. You could have a $500K mortgage at a 3% interest rate and a $500 credit card bill at a 24% interest rate and the place to focus would be on the 24% interest rate debt, even though it’s a much smaller dollar amount. Make sense?

Melissa on a hike

Pay off debt in order of interest rate, not in order of dollar amount. This method is called the debt avalanche and there are others who advocate for the inverse approach—paying off debt according to smallest dollar amount, irrespective of the interest rate (called a debt snowball). While the snowball method can be a more psychologically satisfying—because you’re able to see tangible results faster, it’s not a mathematically sound approach.

All that to say, Melissa is spot on to assess her debt according to interest rate and I commend her for ignoring her 0% interest rate debt at this point in time.

This means that Melissa and Gabe are aiming to pay off $48,636 in debt this year, which I encourage them to do. Since they have the cash flow, it makes sense to eliminate this debt rather than continue to pay the interest these debts are accruing.

At present, Melissa and Gabe are spending $6,107 per month with an income of $11,361 a month, giving them $5,254 each month to work with. This is fabulous!

Since Melissa and Gabe already have a robust emergency fund of $38,324 (which would cover more than six months of expenses), I’d take the $5,254 leftover every month and plow it straight into paying down their debt. If they choose to take this approach, their $48,636 in debt will be paid off in just over nine months. Hooray!

From Melissa and Gabe’s travels: Central America

After paying down this debt, Melissa and Gabe can turn their attention to building up their savings reserves. But again, since they already have an emergency fund and since their debt is accruing interest every month, I would pay off the debt before starting to save more.

If they follow my advice and pay off all of their debt in nine months, they’ll have three months left in the year to pursue their goal of boosting their savings. At $5,254 per month x three months, they’ll be able to save $15,762, which is fantastic!!! I’m not sure where Melissa derived the savings goal of $37k-$42k, but that won’t be feasible unless they dramatically increase their income or decrease their spending, neither of which I think is particularly important for them at this stage.

I think it’s a perfectly reasonable approach for Melissa and Gabe to prioritize paying off their debt this year and accept a slightly smaller (but still impressive) savings rate.

3) Where do you recommend we focus on saving so that our spending aligns better with our values?

Spring in New England

Ahh yes, you know I love it when people ask about their expenses, because I’m going to review them anyway! I like reviewing spending because, often, it’s the simplest thing a person can do to immediately impact their finances.

You don’t have to wait for a raise, you don’t have to wait for investments to grow, you don’t have to wait until you’re finished with school or until you find a new job… you can start saving more money TODAY. After all, all you have to do is… nothing. You just have to stop buying some stuff!

That being said, Melissa and Gabe aren’t extravagant spenders and, as outlined in question #2, they’re not far off from being able to achieve all of their goals this year already.

In every Case Study, I like to point out that what you choose to save or not save is a very personal decision. Cutting every last expense is NOT the right answer for everyone and I am NOT an advocate for making yourself miserable in the process of achieving financial stability. I AM an advocate for values-based, goal-oriented spending. I think it’s important to assess whether all of your expenses bring you fulfillment and a good return on your investment.

I think it’s also important to question if your rate of savings will help you to achieve your long-term goals. But what you spend on? That’s a very personal choice and one you have to make for yourself. My job is to identify areas where you might be able to save, but only you can decide what level of savings is right for you. If you’re struggling with where to save more and how to map out a longterm financial plan, I encourage you to take my free 31-day Uber Frugal Month Challenge.

Since Melissa requested, I’ve combed through their expenses and identified several areas of discretionary spending where they could save more:

Item Current Amount Proposed New Amount Amount Saved Mrs. FW’s notes
Melissa’s Medical School Tuition $1,857 $1,857 $0 Fixed expense, no change.
Rent $1,600 $1,600 $0 Fixed expense, no change.
Groceries $544 $400 $144 Melissa noted that she can be an impulse shopper in this category and that she sees where they might save more every month. I encourage her to explore what she can do to reduce this.
Melissa’s health insurance $225 $225 $0 Fixed expense, no change.
Clothing and shoes $161 $50 $111 It sounds like Melissa and Gabe haven’t bought any clothes or shoes in a long time and so may now be experiencing the need to build out their wardrobes. That being said, this could be an area where buying used (thrift stores/garage sales, etc) might reduce their costs. They also might consider doing a clothing-buying-ban after they feel like they have adequate wardrobes.
Gifts for family and friends $145 $50 $95 Whoa! I’m all for giving gifts to family and friends, but $1,740 per year seems like an awful lot. This may be a priority category for them and they may wish to spend this much, but, there also might be ways to reduce this through incorporating some of the frugal gift giving ideas in this post. Melissa mentioned she loves to DIY and so making homemade gifts might be something that she’d enjoy.
Two cell phones $123 $20 $103 Nope, that’s not a typo. MVNOs can be as cheap as $10 per month per phone. The savings are so dramatic that I strongly encourage Melissa and Gabe to investigate the data usage offerings (since she noted that’s their reservation) and find one that works. The best part about MVNOs (other than their cheapness) is that it’s very easy to switch between them. So if you don’t like one? Switch to another.
Yoga/meditation $120 $120 $0 Oooooooooohhhhh you know this is a tough one for me because I love me some yoga. It sounds like this is another sacred cow priority for them and if that’s the case? Keep it!

What I question is the yoga membership + the gym membership + the Peloton membership. All told, they’re spending $219 per month ($2,628 per year) on fitness memberships. There’s nothing wrong with this and there’s no reason to cancel them if they’re all being used. I just want to highlight the total overall cost to ensure that Melissa and Gabe are consciously choosing to spend this amount.

Household goods $118 $50 $68 Melissa noted that this was mostly in start-up costs for their new apartment and that the amount’s been much lower in recent months.
Travel/visit with family and friends $105 $105 $0 So I have a similar comment here as I had under “gifts for family and friends”: this isn’t exorbitant, but it’s also not cheap.

Melissa and Gabe noted that spending time with family is important to them and I agree! However, they have three different categories of spending related to this: gifts + travel + food w/family = a total of $321 per month ($3,852) per year.

Again, not a bad thing and not necessarily something they need to reduce or eliminate. I just want to bring their attention to these categories.

Car gas $96 $96 $0
Gifts for each other $85 $0 $85 I’m going to agree 100% with Melissa’s note on this category: ” …as I write this I realize we could cut this category completely and use it to fund one big trip a year.”
Gas bill for apartment $76 $76 $0
Travel/Experiences us two $76 $76 $0 Per Melissa: “We’d like to spend less in other categories and more here so we could travel more, especially internationally.” Sounds good to me!
Car insurance $73 $73 $0
Food and drink with family and friends $71 $25 $46 See my note above under “travel/visit with family and friends”
Giving/donations $70 $70 $0
Gym $60 $0 $60 See my note above under “yoga/meditation”
Entertainment $58 $58 $0 Going to leave this as is for now, but it’s another category Melissa and Gabe can assess for priority level.
Pharmacy and toiletries $56 $56 $0
Car maintenance $51 $51 $0
Co-pays $50 $50 $0
Internet $40 $40 $0
Peloton $39 $0 $39 See my note above under “yoga/meditation”
Date nights $38 $38 $0
Subscription/fees $34 $34 $0
Electric bill $27 $27 $0
Takeout $26 $0 $26 Per Melissa: “We’re trying to be mindful of this category and have been spending less here so we can instead put our efforts towards one date night per month.” Sounds good!
Supplements $21 $21 $0
Cleaning/kitchen supplies $17 $17 $0
Coffeeshops and pastries $15 $15 $0 This goes back to the main goal of identifying priorities and spending only on those. If this is a true priority, keep it! If not? Nix it.
Renter’s insurance $11 $11 $0 Definitely keep the renter’s insurance! It’s inexpensive and important to have!
Haircuts $11 $11 $0
Impulsive/Treat yourself $7 $7 $0 This is a pretty negligible amount for impulse buys, so I say, keep it!
Postage for mailing $2 $2 $0
Parking $2 $2 $0
TOTALS: $6,110 $5,275 $777

If Melissa and Gabe decide to implement the savings I’ve outlined, they’ll be on track to save an additional $777 per month ($9,324 per year). They’re not in a dire situation and they certainly don’t have to make these changes to their spending. But, if they decide they want to accelerate their savings goals, these are some ways to do it.

Credit Card With A Fee?

From Melissa and Gabe’s travels: Italy!

One expense I want to discuss a bit more is their Chase Sapphire Preferred credit card with an annual fee of $95 for two cards. I’m assuming they have this card for the fabulous travel rewards but, if that’s not the case, there are other, no-fee cards they could switch to. The only reason to pay an annual fee on a credit card is if the benefits/rewards you’re accruing far outpace the annual fee.

Chase Sapphire is an amazing travel rewards card, but if Melissa and Gabe just need a reliable cash back card without a fee, they might consider either the Fidelity Visa (which provides an unlimited 2% cash back) or the Chase Freedom Unlimited card (which provides 3% cash back up to a certain amount). Both of these cards offer decent cash back percentages and don’t have an annual fee (these are affiliate links). For more on how to manage a credit card strategy, check out: The Frugalwoods Guide to a Simple, Yet Rewarding, Credit Card Experience.

4) What do you suggest we do for our retirement savings?

A farm near Melissa and Gabe

If Gabe’s company starts a 401k and if his employer matches any percentage of employee contributions, Gabe should definitely contribute. An employer match on a 401k or 403b = free money. Since Gabe might not be staying at his current employer, he’ll need to consider any vesting requirements (when an employer requires you to work at the company for a certain number of years before you’re eligible for matching funds).

Melissa and Gabe each have a Roth IRA, which is great! I’m going to do a quick rundown on IRAs for our general edification.

Roth IRA (Individual Retirement Account):

  • A Roth IRA is a retirement account that’s post taxes.
  • This means you pay taxes on the money you put into a Roth IRA, but you don’t pay taxes when you withdraw the money in retirement.
  • A Roth IRA grows tax free.
  • You need to be age 59.5 before you can withdraw money penalty-free (although there are exceptions).
  • Your eligibility to contribute to a Roth IRA depends on your income and your particular tax situation. Melissa and Gabe should examine these factors and determine if a Roth IRA or a traditional IRA (see below) makes the most sense for them.
  • I like this Nerd Wallet article on Roth IRAs if you want to read more.

From Melissa and Gabe’s travels: Italy!

Traditional IRA  (Individual Retirement Account):

  • A traditional IRA is a retirement account that’s pre-tax
  • This means you don’t pay taxes on money you put into an IRA, but you do pay taxes when you withdraw the money in retirement.
  • There are no income limits. Anyone can contribute to a traditional IRA.
  • You need to be age 59.5 before you can withdraw money penalty-free (although there are exceptions).
  • More about traditional IRAs here.

The bottom line is that contributing to some sort of tax-advantaged retirement account (such as a 401k, 403b, IRA, Roth IRA, SEP IRA, etc) makes sense for most people in most circumstances. Gabe and Melissa are already contributing to Roth IRAs, which is great. As their income increases and their employers change, they should re-evaluate what makes the most sense in light of their tax bracket. As I noted above, if either of their current or future employers offers to match their contributions to a 401k or 403b, they should take advantage of this free money.

Asset Allocation and Money Management 101

View while blackberry picking

In addition to an expense review, I’ve started including an overall asset allocation review in every Reader Case Study to help folks track where they are. Below are the basic money management steps I advise just about everyone to follow. I’ve made notes of where Melissa and Gabe are on each step and, spoiler alert, they’re doing very well.

  1. Track your expenses religiously. Know exactly what you’re spending every month. If you’re not tracking your spending, you can sign-up for the free service Personal Capital, which is what I use and recommend for expense tracking (affiliate link).
    • Melissa and Gabe are doing this through You Need A Budget (YNAB), which is fine, but which does have a subscription fee. If they’re comfortable converting to a free service (such as Personal Capital), that could be another area where they could save.
  2. Pay off high interest debt. List all of your debts in a spreadsheet and sort by interest rate. Prioritize paying them off in order of highest interest rate first.
    • I outlined above how Melissa and Gabe can attack their debt and have it all paid off (except for the 0% interest loans) in just over nine months.
  3. Build an emergency fund. An emergency fund should be kept in an easily-accessible bank account, such as a checking or savings account, NOT in investments, retirement funds, or cars/houses/expensive china. An emergency fund is money you can access immediately in an emergency. I recommend saving three to six months’ worth of expenses (meaning three to six months worth of what you spend every month, which is why it’s important to do #1: track your expenses).
    • Melissa and Gabe have a combined $43,634 in their savings and checking accounts. At their current rate of spending ($6,107 per month), this would cover them for seven months, which is a tad overboard. They might consider funneling a bit more of this cash into their brokerage account.
  4. Contribute to retirement accounts. Especially if your employer matches your contributions, putting money into a 401k or 403b is a no-brainer. Here’s more on why: 401ks Are Your Friend: Demystifying Personal Finance Part 3.
    • We’ve amply discussed this above for Melissa and Gabe.
  5. Melissa and Gabe on a winter hike

    Start investing! Investing in the stock market is how you grow your wealth. Without this crucial step, you won’t reap the advantages of compounding interest and you’re unlikely to build your net worth in a meaningful way. I personally invest in low-fee total market index funds through the brokerage of Fidelity. Vanguard offers a similar product. You can do this yourself (it’s just like any other form of online banking) and there are more details here: For the Love of Frugal Hound, Manage Your Money Yourself! (by following The Simple Path to Wealth).

    • Melissa and Gabe have a brokerage account through Betterment, which is a robo advisor. This is fine; however, it’s likely they’re paying higher fees than if they managed their investments themselves, such as through low-fee total market index funds. If Melissa and Gabe want to take their investing game to the next level, exploring the DIY route could save them money in the long run. However, the salient point is that they are invested, which is great!
    • Melissa was wondering what to do with their investment account and the answer is: nothing! Investments are to keep and hold for the long term. Allow them to grow over time and reap the probable rewards many decades in the future.
    • If Melissa and Gabe decide to save up for a downpayment on a house, then they can consider scaling back their contributions to their brokerage account. You don’t want to invest money you’re likely to need in the short term (such as within the next five years or so).
  6. Explore other options for investing in order to achieve diversification. After completing steps 1-5, you should continue investing in your low-fee index funds (and rebalancing them) on a regular basis (I recommend automating this process) and you can also start to look around for diversification options. This might include, for example, real estate. Mr. FW and I rent out our home in Cambridge, MA for a profit. Renting a property can be a fabulous financial decision and it can also be an absolutely abysmal one. It depends on many factors, including the rate of return you’d receive. For more on renting out properties, I recommend the site BiggerPockets, which discusses real estate investing.
    • Melissa and Gabe aren’t quite here yet, but they can consider more diversification in the future.
  7. Analyze your income. Concurrent with all of this should be an analysis of your net income (that means the dollar amount you bring home every month, minus taxes and any other withholdings). In some cases, the best route to financial stability will be to increase your income while also lowering your expenses. Income is the crucial second piece to this equation and, the more you make, the more you can save. That’s a solid math fact.
    • This will be more relevant once Melissa is working, but it’s always something to keep an eye on.

5) Do you think our 10-year plan is realistic, achievable, and sustainable?

Gabe and Melissa on a flying lesson

I don’t think I’ve ever seen such a detailed, well constructed ten year plan. When I encourage people to create a ten year plan (in the Uber Frugal Month Challenge, for example), THIS is what I’m talking about. Melissa and Gabe dug deeply into their career aspirations, their plans for starting a family, and the financial underpinning that’ll make those dreams reality.

I’m impressed with their ability to project long term and I think they’ll be just fine if they continue in such a thoughtful manner. Let’s look at the specific goals Melissa outlined for their 10-year plan:

Goal #1: Be debt free (minus a mortgage, although we’re so adverse to debt at this point that we’ve considered trying to avoid a mortgage altogether)

This is totally doable. My caution is for Melissa and Gabe to not allow their aversion to debt to cloud the math of a mortgage:

  • Gelato!!

    I personally am (usually) a fan of getting a mortgage at a low, fixed rate. This debate is as old as the hills and people fall into one camp or another, but for what it’s worth, here are my thoughts:

    • A paid-off house is a wonderful thing, but you can’t use a paid-off house to buy groceries or pay for health insurance if you’ve lost your a job (you might be able to get a Home Equity Line Of Credit, but that’s not a guarantee and certainly not if you’ve lost your jobs). A paid-off house is an illiquid asset (unless you’re able to sell it quickly, which is an unknown).
    • There are opportunity costs to paying off a mortgage. Namely, you’re missing out on the potential investment returns you’d enjoy if your money was instead invested in the stock market. Mr. FW and I choose to hold mortgages on both our primary residence and our rental property because, mathematically, our money is better deployed in the stock market thanks to the average annual rate of return (7%) that you can expect after many decades of remaining invested in low-fee index funds. Essentially, money is better leveraged in the stock market than in a paid-off house.
    • If you have a low fixed interest rate mortgage, then from a mathematical standpoint, I wouldn’t pay it off early. I view holding a mortgage–and having money properly invested in diversified assets (aka low-fee index funds)–to be a much less risky decision.
    • A mortgage is an excellent hedge against inflation. Inflation is when money becomes less valuable and the neat thing about a mortgage is that it’s denominated in the dollars you originally paid for the house and so, over time, as inflation increases (which generally happens), the money you’re using to pay off your mortgage is “cheaper.” Essentially, it’s not bad to hold a mortgage and it’s actually a fine component of a diversified portfolio of assets. Paying off your mortgage to the detriment of investing is a lot like putting all of your eggs in one basket.
    • It’s not that it’s a bad thing to buy a house in cash–it’s just that it comes at the expense of other opportunities to grow wealth. Many of us who are early retired/financially independent choose to hold mortgages–even though we could afford to pay them off tomorrow–for the above reasons. Bottom line: financial independence can happen with a mortgage; but it absolutely cannot happen without cash on hand.

From Melissa and Gabe’s travels: Florida to visit grandparents

Goal #2: Consistently max out our IRAs as well as our 401ks

  • This sounds totally reasonable and within reach for Melissa and Gabe.

Goal #3: Have a 6-month to 1-year emergency fund saved up

  • Check! Melissa and Gabe already have this.

Goal #4: Probably own another car (paid in full)

  • Sounds reasonable and probably necessary if they choose to live rurally and have multiple kiddos. I highly recommend they pay cash in full for a used car. More here: Why We Buy Used Cars And You Should Too

Goal #5: Have savings accounts for all of our future children, with a minimum of $20k in each (we haven’t figured out our long-term savings goals for our children, but we know we want to)

  • This is the only goal I question a bit because:
    1. Melissa and Gabe don’t have any kids yet and don’t know how many kids they’re going to have.
    2. More crucially, this should come AFTER all of their other financial goals are met. A kid can pretty easily take out a loan for college, but it’s nearly impossible to take out a loan to fund your own retirement. I think Melissa and Gabe will have no problem meeting all of their other goals and then saving for their kids, but I just want to reiterate that they need to secure their own retirement first.
      • Sidenote: when the time comes, Melissa and Gabe should research 529s in their state (this is a tax-advantaged college savings account that CAN make sense depending on your tax rate and a number of other variables. For reference, I have a 529 for both of my kids).

From Melissa and Gabe’s travels: visiting family in New England

Goal #6: Have investments/savings circa $1.4 million (including retirement; see math above)

  • According to Melissa’s calculations, this should pan out!

While I adore the detail of their ten-year plan, I also see some shades of Melissa’s financial anxiety coming through here. It’s impossible for any one of us to accurately predict the rest of our lives. While there’s a lot we can do to prepare for a financially secure future, there are unknowns that no one can account for. And that’s OK. Melissa should feel confident that she and Gabe are on the right track and that they’re not doing anything wrong from a financial perspective. It’s easy to feel behind when you’re in school and not earning a paycheck, but Melissa has identified one of the most important elements of life: her vocation.

Summary Advice:

  1. Pay off all of Melissa’s student loan debt with interest rates. Don’t pay off the 0% debt prematurely.
  2. Review their expenses and determine if they’d like to incorporate any of the strategies I outlined for potential savings.
  3. Evaluate if it makes sense to have a credit card with an annual fee.
  4. Explore the possibility of moving from Betterment to a self-managed total market index fund with low fees.
  5. Relax into the knowledge that they’re doing just fine financially and that no one can map out the entirety of their financial life with a high degree of accuracy.

Ok Frugalwoods nation, what advice would you give to Melissa? She and I will both reply to comments, so please feel free to ask any clarifying questions!

Would you like your own case study to appear here on Frugalwoods? Email me (mrs@frugalwoods.com) your brief story and we’ll talk.

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119 Responses

  1. Meg says:

    Physicians have some unique career issues. I’d cross post this to the White Coat Investor forum for advice.

  2. Elizabeth says:

    Hi Melissa,

    You are doing great! As someone who also went into my current career a little later than most, it can be tough not to compare yourself with others who are at the same place as you (but younger), but don’t do it! You are on your own journey, and it sounds like some of the experiences that you had (that others didn’t!) were very informative in making you go into medicine and making you who you are.

    Two quick tweaks:
    1) Capital one has a money market account that functions in almost the same way as their savings account (FDIC insured, etc) but pays 2% interest!
    2) Regarding your credit card fee. If you really like the Chase Sapphire card, you could consider opening a new card for whoever is not the primary card holder on your current card (and then obviously canceling the current one). You often get the first year free. It can be a slight hassle to switch recurring payments from one card to the next, but it might be a) a good way to reevaluate whether you want to keep those items and b) it might be worth it to save the $95.

    Good luck and we’d love to see an update on how you are doing in the future!

  3. Julia says:

    You guys are amazing. You sound full of energy and passion and I have no doubt that you will achieve fabulous things throughout your life. Just a thought regarding starting your family while you are still studying. My experience of being a student with a young baby was not a good one – my son was fretful and a poor sleeper, and I’d underestimated (or more likely never heard of) the phenomenon of ‘baby brain’, how I went from writing complex papers to almost overnight being unable to concentrate on a lightweight novel. I was so exhausted and knocked for six by late pregnancy, childbirth and breastfeeding that I was unable to continue wit my studies. In my case it wasn’t a big deal but if I’d been close to completing medical school it could have been very difficult. You may well be lucky and sail through it all, producing contented sleepy babies, but I just wanted to mention that you can’t always predict how these things will go. But good wishes to you!

  4. Kara says:

    It warms the cockles of my heart to see someone so thoughtful pursuing medicine for the best possible reasons. And your finances are beautiful. However, from someone with two little kids to someone starting that journey, I just want to mention that our society’s treasured idea that a woman can reproduce, keep calm and carry on is a LIE. Many people do reproduce and carry on, but many of them are not calm. My friend had her first child the year she finished her PhD, and it was HARD, y’all. I watched her baby for her and she spent 45 minutes on my couch every day for a year sad and hopeless and stressed while he hit her and cried, and you can bet it was many extra months to get that schooling done. And he was a relatively easy baby. My son, in spite of being medically healthy, did not eat or sleep, and it was a full time job just to manage him for the first year. I could not have been employed and also kept him alive. I have been seriously disabled at several points in my life, like unable to dress myself disabled, and let me tell you that pregnancy, while it’s a hormone-soaked glow for some people, many many others find it difficult or impossible to get off the couch for nine months for very legitimate reasons, much less continue rigorous schooling. You can predict and resolve you’ll be one of the happy ones, but you just don’t get a choice. Two families that are close friends of ours had their hearts set on 4 kids, and both of them stopped at 3 so as to not loose control of their lives, and neither of them have 2 careers. They are the smartest people I know. And homesteading is glorious, but around here, garden+house+children+property maintenance+goats and chickens consumes the total productive capacity of 1.5 adults, and the 55 hour a week job that actually sustains us has to be squeezed out of that other 0.5. We are not lazy people. We built a house with our hands when we had two toddlers. But we don’t have other hobbies anymore. I think your dream is beautiful. I hope you go for it. Just watch for overfilling and stop before you do, because it’s harder to back off after you’re stuck in.

    • Julie says:

      After raising 3 kids while working full time at a job that offered me a lot of flexibility in my schedule, I had similar thoughts. Being a doctor, a mother and homesteader might not all be possible at the same time as there are only 24 hours in a day, and you have to sleep at some point. My doctor friends have told me it takes quite a few years before you get to the point where you have any flexibility with your schedule as you first have to “pay your dues.” They waited until they were a little older to start their families, and Kara is already starting this process later in life than most. However I do wish you the best as you pursue your goals.

    • H. Ann says:

      Similar thoughts, as a mom of 2 now school-aged children who works FT outside the home. I am TIRED and just managing to do my job (which is NOWHERE) as demanding as a physician’s role and raising my kids (they have homework, sports, etc). The home improvement projects – small ones, like simply weeding my garden – often fall by the wayside and we end up hiring out for someone to do this for us. I would LOVE to spend time in my garden doing more of that myself but it’s honestly just not feasible to do it all and do it well. Have aspirations, 1000%. But be careful of overextending yourself to the point where you are exhausted always. You can do lots of wonderful things in life – career, parent, hobbies, homestead – just not at the same time and something will have to give.

    • Beth says:

      I would echo these comments. A while ago I listened to an interview with a woman who was the CEO of a MAJOR cooperation. She was asked, “how do you do full time mothering and handling your company?” Her answer, “I don’t.” Her extended family was very involved with raising her kids, which may be an option for you. But as some have mentioned you can’t predict pregnancies. Or babies. You just need to evaluate your ultimate priorities. Is it ok if a high risk pregnancy totally sidelines your schooling? Or is it more important to start your family before you get older and may have risks associated with age? I love the rest of your dreams – international travel and living, homesteading, working for underserved communities, raising a family. But all of that together sounds like a lot to handle in 10 years. Maybe pick the top two to work on for the next few years. Then after your kids are older you can evaluate what the next step will be. I have my BSN and at one point considered going for my NP. Instead I got married, moved overseas to teach, started a family. Now we’re back in the States and I’m a stay at home mom with three little kids. I wouldn’t change that. I’m introverted and have energy issues so I CAN’T do the career and mom thing but I don’t miss it. Eventually I may get back into my field or go back to school but I’m happy where I’m at (most of the time ;). If finishing school on time is super important (and that’s fine if it is!) then maybe consider waiting on the babies.

    • Robyn says:

      Hi! It’s all in the timing. A full quarter of the women in my med school class (including me) had a baby our fourth year, especially after interview season ended. We had ten weeks of flexible time for interviews and USMLE and I took another 2 course credits via flexible reading electives which was great when I was dealing with status migrainus for 5 months and then after the baby was born. I even rescheduled a core course to start during winter break to better match my due dates. Earlier than MS4 or during early Internship/Residency might mean extending your training, but that’s totally do-able. A lot of people start residency “off-cycle” or after 1 Jul.

  5. Fellow Grad Student says:

    Thank you for sharing Melissa! I’m also married and in graduate school and it’s SO hard not to feel guilty about my current lack financial contributions. I decided to TA a few classes to earn a little extra. It’s not much but it helps me feel like I’m contributing and mitigates some of my guilt. Might be something you can look into?

    Quick question for Mrs. FW – extending the logic around mortgages to student loans, does it make sense to pay off student loans as quickly as possible? Given Melissa’s student loan rates are below the 7% conservative return rate of the market, should she pay the minimum every month and put additional funds toward investments? While it’s probably more satisfying to pay off student loans, mathematically it seems to make more sense to shift toward investments. It’s something I’m currently debating and would love your thoughts!

    Mrs. FW

    • Melissa says:

      You’re right- it’s so hard not to feel guilty!! I have the most wonderful, supportive partner I could ask for and it’s still hard! Even knowing I’ll be in a field with a great earning potential, there’s just something about wanting to contribute that gets to me. I think that’s why I focus so much on budget/planning- it’s one way I can contribute.

      Good idea on being a TA! We don’t really have that for medical school, but I could tutor. I’ll look into that!

      • Jason says:

        My wife is an internist, and I was a post-doc and then worked in Biotech while she was in med school, and internship/residency. Please don’t feel guilty about not contributing income. Medical school is your job, and it will eventually pay dividends. The better you do at your job now, the easier time you will have when you decide to become a dermatologist instead of a family practitioner (kidding, mostly).

        Best of luck. I will also add that you are doing great financially. It took my wife and I >15 years post residency to pay off her ~147K in medical school loans. Further, she is finally hitting her peak income, but it took leaving a practice she bought into (please don’t ever do that) and joining a large multispecialty group. The primary care physicians are an important component of that type of group, and the large group can accurately monitor your quality metrics and insure you earn what you are worth while supporting the provision of quality and compassionate care.

        Best of luck!

    • Mrs. Frugalwoods says:

      Great question! Thank you for bringing it up. This is one of those depends-on-your-situation answers. Since Melissa and Gabe already have an emergency fund, are already contributing to retirement accounts, already have investments, and have the cash flow available, I think it makes sense to wipe out their debs. If the debt load was a lot larger, or at a lower interest rate, or they had less cash on hand, I might advise a different approach. But, since they can be debt-free in such a short period of time, I personally would prioritize that since the relative gains in the market would likely be nominal (though of course, who knows!). And the interest on their debt is still accruing. Does that help? I realize it’s not a precise answer, but that’s why I love the Case Studies so much–it lets us dig into very specific examples!

    • Anne says:

      Keep in mind that you have to pay capital gains on investments, but not on debt repayments. They are paying about $250/month in interest on the debt right now, it would be impossible to get that guaranteed post-tax investment from the market

  6. Katie says:

    Morning! You guys are doing fabulous and are so detailed with your budget! Great careers, income and future earning potential!!!

    I agree with Ms. Frugalwoods about paying off any student loans that have interest and keeping the 0% for now. As well as paying for the future tuition out of pocket. You seem to be very debt adverse, so I think you may want to get it all out of your life fairly soon which I think is a good psychological win so I agree with paying it off during your residency with the extra income. I would have the fully funded EF in place and a stocked “new to you” car fund first before going back after the 0% loans.

    I am not as frugal as I could be (I lean 50%YOLO/50%FIRE) Working on it Ms. Frugalwoods! You can see my case study from a few months back (chronically ill) When I read your case study, you appear to lean much more frugally naturally. You say above that one thing you really value is travel, but it seems to be taking up a very small portion of your budget…I wonder if/when you plan on having that be more of a priority. I just read “playing with FIRE” and an activity they did was create a list of the top 10 things every week that make them each happy as well as a list of the top 10 things they spend their money on each week. You could make it a monthly list, etc to account for travel experiences. Then share the lists with each other and discuss. This may be a helpful activity for you to see how well your values are currently aligning.

    YNAB does a free subsciption (or at least they used to) if you are a student. All they required was for you to email them a pic of your student ID and its free for I think a year.

    I live in MA and started a 529 through the NY plan…I stopped contributions for now as we don’t have children yet (I had created it in my own name) but MA doesn’t have any extra tax benefits so feel free to shop around at other states plans when the time comes if the state you live in doesn’t come with extra benefits.

    I wish you all the best!

    Katie

    • AW says:

      50% YOLO/ 50% FIRE 😂 Me too! My kids are on summer break and we are doing all the free and very cheap things in our area. I spend half my day packing snacks so we don’t spend on snack bar food. But we are taking the kids to Legoland next week for $$$. This approach makes sense to me though, it’s all about prioritizing spending. I am happy to do some YOLO stuff as long as it doesn’t eat into our savings or cause us to go into debt.

  7. Melissa says:

    Elizabeth, thanks so much for the encouragement! You’re right- it can be hard not to compare my financials to others who are the same age. I am so happy I had other experiences before school and I’ve been very lucky to have enjoyed all the career adventures I’ve been on so far. This post has definitely got me thinking about switching credit cards since we probably don’t benefit enough from the rewards to justify the fees.

  8. Melissa says:

    Hi Katie! Nice to e-meet you, I loved reading your case study!!

    Good point on the car/EF before tackling the 0% loans. My understanding is that these are 0% during school and residency, and then they kick in once you start working, so hopefully at that time we can knock them out pretty quickly. And you’re right- we are suupppeerr debt averse at this point. We’re just so sick of paying back loans so I can’t wait for the day when they’re all out of our life.

    We try to only spend on things that are meaningful to us (other purchases definitely sneak in though!) but even so it can be really hard to let ourselves enjoy spending more in certain areas. You’re right- we would love to travel more, but it’s a struggle for us to feel like we can give ourselves permission to spend here…even when we do manage to cut back in other areas. I’ll check out the “playing with FIRE” activity- thank you!

    Also, what?! YNAB is free for a year for students?! We’ve been using it since 2017 so I’m not sure if you need to be a new user to get this benefit but I’ll definitely look into it- thanks for the tip! I’ve tried using other budgeting tools but this is the one that has worked the best by far for us, so we stick with it despite the kinda steep yearly fee.

  9. Katie says:

    If you’re not particularly attached to Capital One for your savings account, you could consider switching to a savings account with a higher APY. I am personally a huge fan of Ally Bank. Their APY is 2.2% and they raise it almost every year–seriously, when I first joined as a customer it was ~1.15% and that was ~5 years ago. Plus, their online interface is the absolute best I have ever used (and over the past couple of years, I’ve also used Chase, Santander, Discover, Wells Fargo, Wealthfront, and TD Bank). I believe there are a few other savings account that also offer APY ~2%, like Marcus by Goldman Sachs, which offers 2.25%. For me, that 0.05% difference between Ally and Marcus by Goldman Sachs was not enough to justify re-opening several savings accounts and updating all my repeating transfers… but you only have one account to switch over! Regardless, it sounds like you and your husband are doing wonderfully! As for the financial guilt and anxiety– everyone has had those feelings at some point in their life, especially if they had a significant amount of debt or a partner who contributes a greater share of the household’s financial income. I think the best way to combat those feelings is to truly embrace the best of the Frugalwoods mindset: value-based spending. Identify what matters to you and your family and prioritize your resources towards those expenses. It has made a world of difference for me. Best of luck with everything!

    • Melissa says:

      Good info 🙂 Will definitely check these out. You’ve done your homework!

      Thanks for the empathy re: guilt/anxiety. It is tough not making an income. I know I’ll make it later, but it’s still hard sometimes- even with an incredibly supportive partner. And yes to value-based spending. Good point that if we’re focused on that, then it will help to clarify our “why” behind purchases and mitigate any emotional conflict I might have.

  10. Stasia says:

    You guys are in such great shape financially! And I agree that it’s so nice to see someone going into medicine for all the right reasons. One big thing that I feel wasn’t really addressed – childcare expenses. Given you guys want to have a baby soon, this is going to be a big expense line item in the near future. Unless you have family that can watch your baby/babies full time while you are in school and Gabe works full time, you’ll have to research and factor in childcare expenses. All of this advice above assumes that Gabe stays at his current level of income and your expenses stay the same/are decreased. That’s not really a safe assumption factoring in a baby soon, at least for the next 3 years or so years until all of your schooling is completed. And during residency/fellowship/etc you made need more childcare than a traditional dual-income,
    40-hours-per-week family otherwise it may be very hard on both you and Gabe. I’m not saying don’t have a baby of course, just factors to consider! Family nearby is the best village and you guys have that!

    • Caitlin says:

      Yes! I had this thought as well. Along those lines–paying for childcare is an investment in your future. Pay for good childcare and you won’t be worried about your kid(s) while you are in school/working. Also beware of thinking that nearby family can/will watch your kid, and don’t necessarily plan on Gabe quitting his job to watch the kids either. There are just a lot of unknowns and watching an infant or toddler (let alone multiple babies/kids) can be really tough and isn’t for everyone. A trial period using some vacation time might be helpful.

      • Melissa says:

        Yes, flexibility is going to be very important! Life is unexpected 🙂 We’ve checked out local daycares and have a good sense of about how much this will cost per month. Like I said, our vision was very much over-simplified because it didn’t really factor in kids and changing incomes (but hey, that would be a suuppperr detailed vision if we got that nitty-gritty!). If Gabe works part-time (if he decides he wants to) that will decrease our income, and we’ll have to readjust our budgeting with daycare/savings/tuition.

        • Tori says:

          I just finished up my fourth year with an au pair watching my three young kids. They can work any 45 hours a week, which works well with odd schedules. Several of the other families in my area with au pairs are doctors, so it might be worth looking into when the time comes. It’s also a great/easy way to build relationships with people from other countries and have your kids learn a second (or third) language! The au pairs can take care of anything related to the care of the kids – including cooking, laundry, etc. Of course you do need to have the space and willingness for them to live with you and be part of your family, so it isn’t for everyone. I found that with multiple young children it was the cheapest and most practical option for us!

  11. Erin says:

    Hi Melissa,
    It sounds like you’ve worked very hard to put yourself in a great position and are passionate about your future career. We’ll done!
    However as a GP (=family physician) in the U.K. without kids, I’d encourage you to consider your future work-life balance. It’s tough, and most of us (men and women) are less than full time in order to survive. The system and pay are different in the U.S but I’m sure many of the demands have a lot in common. The postgrad GP training (equivalent to your residency) is harder than med school, and I’ve seen many colleagues struggle to balance having a family with their training and early career. I don’t personally know anyone who has had a child whilst a medical student; anything is possible if you want it enough, but I’m sure that would be very challenging. It took cancer in my 30s to give me permission to drop the superwoman act! You may be the exception who finds they thrive on being a full time physician plus being a mother to 3-4 and running a homestead, but I’d definitely suggest building some slack into your future expectations and finances, particularly as you are a mature student. Just like the FI mantra of you can afford anything but not everything, as professional women we can achieve anything, but maybe not everything.
    I’ve found the Frugalwoods blog invaluable in helping me identify my life (and spending) priorities and adjust painlessly to a lower income post cancer. Thank you Mrs FW!!!
    Good luck Melissa

    • Melissa says:

      It’s interesting to hear what your experience has been like in the UK. We actually have several students in our class who are parents- and more in the other classes! In fact, there is actually a student group specifically for parents. It’s not the norm, but it certainly isn’t unusual. Our school is very supportive of students who are parents, and some of my classmates are also planning to start their families in the next year or two.

    • Jason says:

      My wife and I had our first child when she was a second year resident in internal medicine. She went from every 3rd might call, to an outpatient rotation, to the maternity ward, followed 6 weeks later by every 3rd night in the micu. It was very stressful, but we made it work. I would imagine you could plan a pregnancy for 4th year clerkships, and have the baby sometime late that year.

  12. Stephanie says:

    I love your vision for the future! Truly a good life. You have an ambitious plan and are disciplined. As you have children, I would encourage you to keep an open mind about your time line. Children will literally take your life energy, and although you sound like a high energy person, I hope you give yourself permission to readjust your plan and financial goals as you need to. My husband and I are both working professionals with a toddler. Some days it is a miracle to get dinner on the table. Although we are frugal minded, we have given ourselves permission to outsource certain services (like having our house cleaned and our lawn mowed) because we just. can’t. do. it. all. We also have expenses that didn’t factor in before, like life insurance and day care. I wish you and your family all the best on this amazing journey of building a family and a career.

    • Melissa says:

      Yes absolutely! We’ve talked about me taking some time off when we have kids. Alternately, my husband is very interested in being a part-time SAHD while I’m in school. We’re definitely open minded and life is unexpected, so our 10 year vision is more like a guide than something we expect to follow in a detailed way.

  13. Pinnel says:

    Hi there! I would like to weigh in and I’ll try to be as kind and polite as possible. First of all, I became a mom 15 months ago and it is REALLY hard to combine the primary baby years with work, let alone with medical school, let alone with three to four kids. As one of the readers has already commented, your body changes, but also your brain is not at full capacity during those first months when you are sleep deprived. I’m not trying to discourage you, you are not me, but it seems like you’re planning a very, very busy life for yourself. What I would also like to say is that both of you are currently dependent on your husband’s salary, and you will be for the next couple of years. In my opinion, I’m not sure that is all too fair towards him. Especially since you mentionned that there are some difficulties in his job. Is there room for your husband’s personal development? Did you plan for him possibly not having a job for a while? I’m speaking from experience 😉 best of luck

    • KN says:

      I will say as someone currently pregnant this is so heartbreaking to read. I feel like I’m staring down the barrel of a gun.

      • Melissa says:

        KN, if you mean that some of these comments are heartbreaking, I’d suggest you scroll down- there are others that are very supportive and encouraging!

        • KN says:

          Yes, that’s what I mean. People wonder why pregnancy related depression is a thing. A good number of comments here about how baby brain will make you essentially incompetent, how hard it is, how tired you’ll be. And a pregnant person should be excited? I’m trying my best to tune it out but I still wonder why my partner and I even bothered with this.

          • Rachel says:

            I feel you. I’m currently going through IVF and it’s so grueling that I’ve had to block out all the stuff I’ve heard/read about how incredibly hard having a baby is. I think it’s really different for everyone. If you have a supportive partner, if you have family or friends nearby to help, if you are financially comfortable, all these things make a huge difference.

          • Beth says:

            I write this while I feed my third baby boy banana and cheerios. You will be tired (a different kind of tired from pregnancy tired. I mostly prefer the baby tired.) And in all honestly you will have days where you at least feel “essentially incompetent.” But it is SO worth it. I think the negative comments are trying to offer “knowledge is power” advice. Our culture today puts a lot of pressure on families to “do it all”. Both parents should have full time fulfilling careers. At the same time parents should invest fully in their kids, be the kids biggest influencers, cheerleaders, etc. And live a healthy, fulfilling life outside of kids and work. And make sure their kids have all the opportunities. There just aren’t enough hours in a day. Parenting is totally worth it but it’s important not to set such high expectations that you feel like you’ve failed in everything because you don’t have enough resources (physical, financial, emotional). I’m a stay at home mom right now. Totally my choice. I could easily get a job in my field but for now I want to be with my kids as much as possible. Some families dad stays home. Other families both parents work part time or one part time and one full time. The families I know where both parents work full time tend to be dissatisfied. Kids need YOU. A lot of YOU. And that’s ok. I need my kids too and I enjoy my kids (mostly 🙂 ). It just seems like our culture says “Have kids but continue living as if you don’t have kids.” Everything of value requires sacrifices and kids are totally worth the sacrifice. My husband and I joke that God makes babies cute so that in the really rough, sleepless times we’d say, “we’d send you back but you’re too cute!”

          • Clementine says:

            Dear KN,
            Someone told me that you will never ever regret having a child, and I do not believe anyone ever does, once they are born. It is possibly the greatest joy of our lives. All that these honest and accurate, in my experience, observations, are trying to point out is that there is a great opportunity cost with having children too. If you are having children, prepare for great happiness but also prepare to make it a big, if not biggest, priority so that you can actually do it right, do it well, and enjoy it rather then suffer through it. That is all.

          • Liz Bishop says:

            Hi, KN,
            A good friend told my husband and I, as we waited for an adoption match, that parenthood is “the hardest job you will ever love”. He was 100% right. I was 47 years old when our son entered our life as a newborn. Those first few years were HARD, but so rewarding. I don’t regret any of it. My husband and I both work full time, and while our house is rarely (if ever) sparkling clean, we have an awesome life, and our son is a huge part of that.

          • KN says:

            I can’t reply to the individual comments below–we both have to work full time to afford this kid, so one of us not working isn’t currently an option (as much as I’d love to permanently remove myself from the workforce). Hoping when the baby’s here it actually feels worth the decades of sacrifice ahead. Sometimes I do feel a bit excited but when I look at the financial and lifestyle implications I know in my gut it was the wrong path for me personally and now I’ll just have to suck it up.

          • Karen B. says:

            Hi KN, please talk truthfully with your partner, doctor and maybe a therapist. Your hormones are all over the place right now. It would be nice if you could enjoy your pregnancy and feel good about it and the forth coming baby. Good luck.

  14. Helen G says:

    You sound like a lovely couple and congrats on your great finances.
    IMO the major hole in your plans are the issue of children. If you are lucky enough not to have fertility problems the arrival of just one child will completely upend your budget and plans which are based on your current family of two. You have lots of family support and you are smart so will probably still be in good shape after the blessed event. Just recommend if you haven’t already both get a medical fertility check to se how much time is left to conceive naturally.

    • Johanna says:

      I thought the same thing. Time is unfortunately not on the womens side. 🙁 I myself had to try 4 years until Baby decided to arrive. Fortunately the health insurance in Germany paid for nearly all expenses including fertility diagnostics and meds. I wish them both all the best in this department and a swift conception. 😉

  15. Shannon says:

    First of all, kudos to you for wanting to do family practice in an underserved area–there aren’t a lot of people out there who genuinely want to do that so it’s great to hear someone excited about it! The one nice thing about it being a relatively small group of people interested is that there are a lot of options for scholarships. It sounds like you’ve done a good deal of research, but have you looked into anything state specific? My sister got a scholarship for rural practice in Georgia–since it’s a scholarship and not a loan forgiveness program, it doesn’t matter if it still exists when she’s done with residency (med school has already been paid for!) and since it’s Georgia specific, she’s guaranteed to be able to stay in Georgia for the payback period which she really wants. I did some brief googling, and it looks like Maine at least has a similar program (not sure what part of New England you’re in):
    https://services.aamc.org/fed_loan_pub/index.cfm?fuseaction=public.program&program_id=112

    The other thing I noted was your comment about being worried about data with an MVNO provider–have you tried turning cellular data off for awhile and trying to live just on wifi? It takes a bit more planning, but I’ve found it very doable with the prevalence of free wifi these days. I still keep cellular data off on my phone now that we’ve switched to an MVNO provider to prevent my phone from doing background tasks that eat through wireless data, and we’ve kept data usage very reasonable (<500MB/month for my husband and I). Really, the only time I've needed to turn it on is when I'm lost in an unfamiliar place!

    I would also second the idea of being very careful about biting off more than you can chew with medical school and kids.Kids are exhausting, especially in the earlier years, but one thing I've noted from watching my sister is that medical school and residency is even more exhausting! Even in family practice, you do a lot of inpatient work the first year or two of residency which means long hours and a lot of on calls. Have you considered taking a year off between med school and residency (which I know is hard when you already feel behind your peers) to have your first child? Honestly, if I had had the opportunity to spend the first year with my kids instead of jumping back into work after three months, I would have loved it. I would also caution that you should be ready both financially and psychologically for Gabe to quit/cut back his hours after you have kids if you are still in med school/residency.

    • Melissa says:

      Good idea about the MVNO! We’ve talked about it, but were always hesitant because of the data and associated fees that can come along with going over. We could try to turn off our data for a month or two and see how it goes.

      Also, yes- I did look into state programs, and unfortunately ours is pretty specific about the number of hours you have to work per year in order to have your loans forgiven. Considering that we’d like to have the option to work part-time, it didn’t really make sense for us to count on this as a tuition strategy.

  16. Sarah says:

    What a wonderful case study. One thing that makes me nervous – I’m a wealth advisor in Canada and have seen this happen over and over again – what happens if one of you loses the ability to work, especially in the near term? A gap I see in Melissa and Gabe’s plan is insurance – probably a term life policy for each (better to get when you’re young and healthy, as your premiums will be cheap) to bridge the gap until you’re no longer working. More importantly, disability insurance – as costs often go up if one spouse is disabled and unable to work and you no longer can leverage their earning potential. You may have these through work / school and I’m not sure what rates are in the US, but just thought I would bring it up – I’ve seen firsthand how having some prudent, carefully considered insurance has really saved the day (or hasn’t been put into place and has irreversibly altered families’ financial paths). It’s when we’re young that these things seem so far away, but would have the biggest impact if they did occur. Good job you guys, all the very best!

    • Melissa says:

      Great point! Yes, we’ve talked about getting insurance soon. We had thought about life insurance, but not disability, so this is something we’ll take a look at.

      • Shannon says:

        One thing to consider as you shop around–most insurance salesmen are going to try and sell you a lot more insurance than you really need because they usually base their numbers off potential earnings. I would take their recommendations with a grain of salt and instead only buy what you need to be financially independent/comfortable. Instead of figuring out how much you need based on your potential earnings, think about how much you would need per month to live on if the other person was to pass away/not be able to work anymore (I know no one wants to think about this, but it’s an important consideration). Given how well you’re doing, this is almost certainly not the same amount as Gabe is currently making (or the amount you will make in the future)!

        • Melissa says:

          Ah, good point! I suppose it’s kind of like getting a mortgage- you’re often presented with the largest amount you can “afford” based on your income.

          • DL says:

            As mentioned above, the White Coat investor has great information on term and disability insurance for med students/doctors. That website has some of the most relevant financial information for you and I would strongly encourage you to read every single article that relates to your situation. That and Physician on Fire are two of the best FREE resources regarding doctors and their finances.

  17. Michelle says:

    Hi Melissa, your 10 year plan sounds terrific! As a primary care physician ( in Europe) who has just gone back to work after our first baby I noticed the lack of future childcare costs! Not sure if this is on your radar yet or you have family who you know will help but definitely something to consider especially as potentially multiple kids = child care costs for several years.

    • Melissa says:

      Hi Michelle, yes it is on our radar- and childcare in the US is pretty expensive and can be hard to find. Like I said, our 10 year plan is over-simplified, so it’s more like a general road map rather than a blueprint. We’re also very lucky that we have family nearby (especially my sister) who are able to help. That being said, kids aren’t cheap!

      • Anne says:

        You may want to consider when the time comes getting an au pair. It would be less than daycare for 2+ kids, and would provide flexibility of having another adult there. Having family around to help is great, but probably wouldn’t provide the kind of hours and flexibility that hiring someone does. And personally I would hire an au pair from a developing country who would view it as a well-paying job that helps them save money and improve their English, as opposed to someone from Europe who is more likely to view it as a time to live somewhere new and travel.

      • Allison says:

        A word of advice regarding family who live nearby: make sure you communicate very clearly with them and find out before you have kids how much they will be available and will be willing to babysit. Even if a family member says they would “love to babysit,” this might mean they would love to babysit once a month so you and your husband can enjoy a date night, not every day. Also, do they expect you to pay them or are they willing to do it for free? You’re obviously a very smart lady, and you may have already had these types of conversations, but I know a lot of new parents and parents-to-be make assumptions about their family members providing childcare, and they end up disappointed and have to put their kids in daycare. I also know several grandparents who don’t want to spend their retirement taking care of kids every day, but are happy to babysit occasionally…

        • Melissa says:

          I may have given the wrong impression, we don’t plan to rely on family as our primary source of childcare, but expect to enroll in a local daycare. We’ve checked out some options in the area, and have a decent sense of how much this will cost per month. Good reminder to have really clear conversations with family ahead of time 🙂

  18. Julie says:

    You have great income, but have you ever looked at Dave Ramsey’s financial advice? You don’t seem that upset about how much you are already in debt with your spending. I would do anything to get out of debt, so I know I’m not the American norm, but you could really cut back and not suffer. I’d stop contributing to retirement until you’re debt free then you can really load things up. It’s not maybe typical advice, but I know how much margin that could give you. If you want to live on less later, then you can. Do what you want, you’re an adult, but I would not be spending anything I didn’t have to while in that much debt. I’d recommend reading the Next Millionaire Next Door, if you want to read the data on what builds wealth. It’s not debt.

    • Allison says:

      Julie, I have to agree. I know Mrs. Frugalwoods doesn’t agree, but the snowball method for paying off debt DOES work, because debt is more about psychology than math. If someone pays off smaller debts first, they have a sense of accomplishment and get some momentum going, then they can tackle larger debts. I don’t agree with everything Dave says, but I think his advice about the debt snowball is SPOT ON.

  19. Julie says:

    I don’t have too much advice regarding the finances specifically – it looks like you’re doing a great job – but I wanted to say that a from someone who was in a similar situation career-wise, it DOES get better!

    I was a medical student when I got married to someone not in the medical field, and as soon as we got married he went from finally positive net worth after recently paying off his undergrad student loans to instantly $200k plus in debt due to my med school loans. We lived a pretty frugal lifestyle throughout the rest of medical school and into residency, which made a big difference – earning $50-60k per year in income as a resident is not great compared to the long hours you work, but it’s nice to be actually earning money and not paying tuition! My husband and I kept living the same fugal lifestyle when I was a resident and we were able to finally get to a positive net worth again, even earlier than we were expecting. I am now finishing my 4-year residency and will be making $200k+ a year to do a job that I love, with somewhat flexible hours (at least way more flexible compared to residency, ha!), in the area that we want to live in. So in summary, at least my experience is that if you keep up the frugal life during the rest of med school and residency, and don’t get overwhelmed by the mental anguish of student loans, slow and steady will win the race 🙂

    Ps: to anyone who says not to have kids during medical school, I say: if it seems like the right time to you and your husband, go for it! There will always be good things and challenging things about when you chose to expand your family, in medicine in particular but in life in general as well. I had my first during residency, which had its challenges for sure, but I would not have wanted to wait until I was done. If we had been ready as couple sooner, part of me wishes we would have had our first during med school even.

    Good luck with your journey!

    • Melissa says:

      THANK YOU!!!! I’ve seen time and time again that women can be in medical school and be great moms- in fact, I have friends who are amazing mothers and in medicine. I remember having a conversation not too long ago with a group of men in my class and NOT A SINGLE ONE had been asked how they would balance being a dad with being a doctor. We really need to be encouraging and supporting women who want to be in these fields and be moms.

      • Robin says:

        I couldn’t agree with you more about the no one asks men these questions or gives these warnings. It’s just assumed that they’ll work it out, which should be true for women too. While the physical issues associated with pregnancy and recovery from childbirth are real, that part doesn’t last for ever. When you are ready both mentally and financially to have a baby, I second the go for it! Will it be hard? Of course, but that’s not a reason in my book to not go for what you really want. I started and earned my PhD in chemistry while a single parent to a small child with zero involvement in any form from the dad. Then after the post doc years I got married, started a biotech company, and had more kids. Is it all sunshine and roses, nope, but I love it just the way it is. The investor who seemed annoyed that I got pregnant and asked how I was going to do my job and have a baby will just have to (insert your impolite phrase of choice here). I wish you the very best on all of your life journeys.

        • Melissa says:

          Hi Robin,
          Thank you for sharing your story! I’m so inspired when I hear of women doing amazing things. My mom grew up low income and got her bachelor’s when I was almost 1, then started her master’s program when I was 6 (and my siblings were 5 and 3) and graduated when I was 10- then went to work at an Ivy League institution! It took her a little longer than other students, but she did it- when the culture she grew up in didn’t expected her to graduate from high school. Yes, it was tough at times but that had such an impact on me- to see my mom going for her goal even when it was challenging. I think part of me is so comfortable with having kids in medical school exactly because I got so much inspiration from my mom. It’s chaotic and hard but can be so, so worth it- and hey, you might even enjoy the ride!
          Like you said- of course it will be hard! But that’s even MORE reason to encourage each other! It’s hard to be a mom and have a career (we ALL know that!) and it is very important to share our struggles so we can destigmatize any shame that comes with difficult experiences. That being said, there’s a difference between authentically and bravely sharing struggles in order to help someone else who might be experiencing something similar, and being negative or discouraging towards someone’s journey. The key is to empathically support each other!

      • Julie says:

        Yes! I am in Family Medicine residency right now and have birth to my son last year (in my second year of residency). Yes, it is busy, and yes, you will be tired… But it is doable! Both motherhood and medicine can be exhausting and challenging. At the same time, both aspects of my life are so rewarding and fulfilling.

  20. Heather says:

    This is a great write up. It’s really interesting to read about personal finances in regards to your fields. I am currently pregnant at 33 y/o involving a brief stint of infertility and a planned entrance into graduate school with an infant. I’ve been discussing time to conception (fertility can be seriously fickle) and subsequent parental leave + academic work with other professionals in the U.S. and continue to see and hear very empowering and encouraging stories. My primary care physician in particular had her first child in medical school and her second in residency. This was managed through very consistent communication and cooperation with her partner – whom she would poke in the middle of the night to get their child, bring it to her in bed, and change/place back in the crib after she fed. My physician and her husband received very little financial support or time off (most of us don’t in the U.S.) however she succeeded through planning and positivity, which I am finding to be essential in whatever endeavor one undertakes. Congrats on the progress so far and good luck with your upcoming plans!!!

    • Melissa says:

      Heather, thank you so much for writing! Yes, planning and positivity are key! And congrats on your pregnancy and awesome for you starting school with an infant!! I love hearing empowering and encouraging stories- they help all of us. I can’t tell you how many people have been discouraging of me being a mom and having a career in medicine. I’ve learned to understand that most people have good intentions when giving (unsolicited) advice but to basically ignore the negativity because everyone has their own journey and the best thing we can all so is to show empathy and lift each other up.

      That’s wonderful your primary care physician has such an encouraging story. Having a supportive partner makes a huge difference- I feel very lucky to have a husband who is so supportive and a big believer in gender equality. That being said, I also know a few single moms in my school! Now they deserve a shout-out!

  21. Kelly says:

    I’m a pediatrician who became disabled after just 1.5y after fellowship (public global health). My residency program had disability insurance for us and a broker who transferred us to a guaranteed issue policy right before residency graduation. I almost did not sign up as I initially thought I would be classified as a fellow in graduate medical education & therefore under the current policy. My fellowship turned out to be under the postdoctoral office so I needed to transition to the privacy policy. I am super grateful for the policy I have as I am living off of that policy now. Please make sure you have a solid policy, get it as a resident if your program does not have it. We make huge investments in our education and time to do a skilled profession. Stephanie Pearson has a website for physician disability insurance. I recorded a podcast about it with Martinis and Your Money (Disability Insurance 201 with Kelly). Another consideration on student loans. I was in the process of refinancing mine when my health started to decline. Thankfully I did not and was able to put my loans on deferment while disabled. If the loans remain federal, you can qualify for a disability discharge (I just got approved for it). These options are not available if refinanced, but refinancing can get a lower rate (looks like yours are pretty low, so may not help much).
    Best of luck to you two! I’m hoping you guys will not face this disability stuff but it does happen so this is my lesson to share.

    • Melissa says:

      Hi Kelly, YES- I will definitely look into disability insurance. Thank you for sharing your story and I’ll take a look at those resources. It’s unfortunate but probably true that most people don’t think they need it- until they really need it.

    • Stephanie says:

      Yes to this!!! I am not a doctor but my health went down the toilet and received a death and disability discharge for my student loans as well. It is not easy but possible, l didn’t have disability insurance though but you had better believe that we made sure my husband does now.

  22. Clara says:

    I’m a family doc in CO. I finished residency at 32 and had 3 kids between 35 and 39 while in private practice. My husband almost stopped working altogether for the first 3.5 years of having kids and was a stay at home dad. It was great for schedule but the loss of his income hurt and even taking maternity leaves for only 10-12 weeks really hurt my income. I now work 3 days a week to save my sanity and still enjoy medicine and hang out withe kids ( and I’m employed by a hospital) I make about $150,000 which is fine for us but just know going part time will have a significant financial impact. Also, I recommend disability policies at least once you are in residency.

    • Melissa says:

      Yes, the plan is for us to have the option to work part-time once I’m done with residency if we feel like we’d like that for more balance. Keeping our expenses low will help with that, and I feel lucky that I can still make a good income working part-time. Good point about the disability insurance- will check that out!

  23. Rebecca A Beach, MD says:

    Hi! Older and (slightly) wiser doctor mom here, not yet to the homesteading stage.

    To reinforce the important points–financially, you guys are doing great–it feels frustrating right now but you are getting there. If you keep going with this sort of basic plan you are going to be fine. Lots of people on here affirming your awesome, detailed plans. I’m going to jump to the lifestyle issues on which as a 54-year-old female family doctor who had kids in my 30’s, I can give you more specific guidance than some folks.

    Medicine, especially family medicine, is rewarding and awesome. Providing the full spectrum family practice with OB is an incredible way to be part of a community. The attachment between doctor and patients is like an extended family.

    However, the investment in time and energy is a lot like adopting an extended family. It starts being hard to have a spinning class because you get paged 2 or 3 times with patient questions, and you get up at night with your kids and it feels like with everyone else’s kids too! Motherhood and full time work is a challenge. We lots of us have always met that challenge head on. But Family medicine with OB is not a 40 hour week; it’s somewhere between 60 and 100 depending on how busy your practice is. Surveys of practicing physicians that actually know what they are doing list “sleeping” as one of our favorite hobbies/activities for on vacation. Many practicing physicians do not find time for the things they like to do. Having lots of non-clinical life can decrease risks of burnout–but only if you give yourself permission not to also expect yourself to work “full time.”

    I worked full time (with OB) when I was having my kids. I also got divorced.

    If I had it to do over, I’d find a way to work about 60% time (aka about 40 hour-60 hours a week real time) during my child-bearing years, try to focus down on what was most important for me-enough gardening to help my soul recover from stress, and enough exercise to stay healthy and some social activities and try to label the rest of the supermom stuff “not going to happen.

    I’m 54 now and way out of shape and financial recovering from another divorce and it’s still not too late to look into homesteading. I know it’s easy to be impatient when you’re in your thirties, but you have lots of time ahead.

    Please give yourself time to not do everything at once. You guys are already awesome over-achievers financially. You will be in super-incredible shape once the tuition stops. If you are looking at working in small towns, you are still likely to have lots of non-federal loan repayment programs/signing bonuses available so that if you keep the total reasonable, your first post-residency job may wipe any final debt you have after residency so you guys’ll be ready for a maybe 10 year mortgage. lol

    Bless you guys and good luck–I hope your career is a long and joyful one, and that your family grows in joy.

    • Melissa says:

      Hi Rebecca,

      Thanks for the encouragement on our finances- I appreciate it! Sometimes it’s hard to see it from a long-term perspective, but it’s nice to hear that we’re in good financial shape. Ultimately, our goal is to have the option to work part-time and it’s great to hear that we’re on our way.

  24. Alison in New England says:

    You have so many things that money can’t buy – like a passion for your career and aspirations. It’s so nice to see. The prospect of having a fulfilled life is fantastic. I had my first and only child at 38 and am now 45. As relatively even keeled, responsible, independent woman, I was really surprised at how much of a toll child bearing and rearing has taken on me. And my daughter is a good sleeper and my husband is pretty much a part time stay at home dad. You sound like someone who can adjust to whatever happens, given all you are able to get done and want to get done, but like so many comments above – kids are nuts. I’ve re-assessed my FIRE goals and am still working. I have days when I wonder why and I have days when I wonder how I could leave. It’s never a bad thing to be prepared – and that’s the part you totally have covered. Don’t feel guilty. Life’s too short. Enjoy what you have earned and what you are working towards!!

    • Melissa says:

      Yes, we’re very open to reassessing FIRE. Honestly, I wouldn’t say FIRE is something we feel like we are absolutely working towards (especially since with both of us working part-time we’ll still have a high income) so it’s more like a gentle trot rather than a race to the finish line. It’s pretty hard to estimate our future expenses, so we wouldn’t really have an exact number to work towards anyways. Our financial goals are more to be financially secure and manage our debt so part- time work can be an option.

      Thanks for the reminder to enjoy- you’re right, the sweetest things in life are often the things money can’t buy!

  25. Kelly says:

    As someone whose spouse finished residency/fellowship in the last 12 months, I think you’re doing fantastic! It is SO hard not to compare and is such a long road. I encourage you to look into “moonlighting” (working extra hours at the hospital or clinics for pay) as you get into residency/fellowship. My husband made a ton of extra money this way, and that extra money helped us keep his student loans in check those last few years. Good luck!

    • Melissa says:

      Thank you! It’s great to hear from people who have been through the experience and can encourage others on the same path. We all have our unique journeys and it’s true that “comparison is the thief of joy”. I’ll keep the moonlighting tip in my back pocket 🙂

      • Anne says:

        You mentioned feeling guilty about not bringing in an income while in school. However, if I were in your husband’s position I would be saying “Cha-Ching! 200k+ in a few years!”. Especially if he wants to start his own company or work part-time in the future, yours will probably be a see-saw marriage in terms of income. As Long as your marriage lasts Long-term, it can be very healthy and equitable.

  26. Kate says:

    Melissa. You are doing so well. I am a lot like you: a family doc who delivered babies for 6 years after residency in New England. I just stopped L&D for reasons a bit beyond my control. Long story short my husband made about as much money as yours does when I became an attending and I had $100,000 in debt. He had one $10,000 student loan. We easily paid almost all of it off in 6 years, even accounting for him losing a job and taking one that paid less, is having a child in daycare, etc. If you don’t inflate your lifestyle the jump to an attending salary feels enormous and you can easily pay off the debt. You’re so far ahead of most.

    A lot of family docs in NE who deliver are at FQHCs and I’m sure you know about National Health Service Corps but I’ll just put it out there as a good way to pay back loans.

    You’re really doing great, I wish I thought more like you in med school.

    • Melissa says:

      Hi Kate, thank you!! I can’t tell you how wonderful it is to have encouragement on this path. I feel like many people have disheartening opinions- whether they’re about debt or how hard it is to be a mom and a student/doc. It’s amazing to hear from women who have been through the process and can provide guidance and inspiration to others on the journey.

      Our hope is to fight lifestyle inflation like you did and pay off this debt as fast as we can. Medical school debt is tough to have perspective on- I know I’ll have a good income, but it’s still a lot of money. Thanks for the encouragement!

      • Stephanie says:

        Hi Melissa! I saw med student, and I knew I would love reading this case study! I’m a med-peds hospitalist in the midwest, and finished residency 3 years ago. I love all the wonderful plans you have for your future as a physician, and I loved hearing you describe med school as fun, because it was absolutely that way for me!!

        You have set so many goals for yourself: future practice at home, working abroad in Italy and Central America, public health, published research. And they are all wonderful goals. As someone 10 years on the other side (graduated 2012)…I don’t know how to say it exactly, I just see things differently than I did when I was an M1. I’m in academic medicine, actively participate in resident/student education, and have several research projects going. And I LOVE what I do. But there are days when I feel overwhelmed. It’s hard to achieve everything at work and have balance for family time. Particularly when it comes to your goal of working abroad, that takes a lot of concerted energy and time to do well in a sustainable way. It can also be difficult to leave a busy primary care practice for long stretches–the inbox doesn’t stop–and if you’re also doing obstetrics, neither do the babies. (Perhaps a shameless plug for hospitalist work…) Just remember it’s okay to focus on one goal at a time.

        A few financial thoughts I had while reading your story:
        – I worked for Kaplan during M1 and M2 years. I really enjoyed it and it worked well with my schedule. M3 year you can’t work. Unless it was something totally online that you could truly do on your own time, but even then I wouldn’t recommend it. You never know when you’ll leave the hospital, and then you still have to study. And it’s still awesome 🙂
        – I hope your school has a research program for M1 summer that you can get a stipend for (I was able to get~4200). This is your last summer, so enjoy it, but also take advantage of the time to make some additional money.
        – Regarding children: I had several female classmates who had children during medical school, and they are wonderful mothers and doctors! You should absolutely do it if it works for you and your husband. My only suggestion is to ask what your school’s policy is on maternity leave, and how you make up the time. All the women I knew except one ended up taking a 5th year for med school, because once they got off schedule (missing a rotation block, etc), it was hard to make up. This is much less of an issue in residency because you can always finish residency a month or two late. But you can only go through residency match and graduate med school once a year. Just make sure you know what other women at your school have done so you aren’t surprised 🙂
        – I had ~106K in student loans coming out of med school, and paid them off in 5 years (1 year after finishing residency). At the time I wasn’t married, so it was just my salary. It’s totally doable. Full disclosure I did not have kids so it was easy to keep my expenses low.
        – When you’re interviewing for residency…ask about food money. Obviously not a reason to pick a program you don’t like otherwise, but in all seriousness, I ate breakfast and lunch at the hospital for free pretty much every day. Except for those days when I turned around and realized the day was over and I hadn’t eaten…#residency. But that didn’t happen too often.
        – Agree with others, definitely sign up to keep your disability policy when you leave residency. I was able to do this and it was unisex (which is advantageous for women I’m told) and occupation specific.

        You and your husband are doing awesome! Best of luck with everything! I know you love family medicine…but have you considered med-peds?!? Happy to discuss the merits 🙂

        • Melissa says:

          It’s great to hear that med school was fun for you too! It’s been hard work, but wow is it cool. And congrats on paying off all your debt!

          Thanks for this info, I appreciate it- these are really good points to consider (hey, every free breakfast counts!). I just spoke with my school about their leave, and I was really surprised by how supportive they were. It seems like you’re actually able to take off a decent amount of time and also have the option to take off a year or two off if you want.

          Yes, much of our vision (especially the career/international part) was more like a “lifelong” perspective rather than specific to a 10-year timeline. I realized that sounded like a lot to do in 10 years, and that wasn’t really our intention in writing it. More like, “some of these would be nice in 10 years and the others we’ll work towards over a few decades”. I’d love the opportunity to work part-time when our kids are younger, and then dig into the global health and other academic pieces later.

  27. Connie says:

    I found s job at the FQHC that I wanted to work at, then applied for the loan repayment program. You can’t count on it, because you never know for sure if you will be accepted into the program. It depends upon how underserved your area is and how many others have applied that year, etc etc. But it could be a great bonus (tax free too) and something to consider when looking at salaries after finishing residency.

  28. Jen says:

    I agree with the commenter above who stated that you just have to do what feels right with regard to having kids. And you’ll inherently make the plans one pregnancy at a time. I had two kids in med school and one in residency, and I wouldn’t change anything. There are pros and cons to waiting vs having kids now, but as long as you do what YOU (and your husband!) feel is right at this time, you’ll have fewer regrets. The type of pregnancy/kid/postpartum moods/etc. you’ll get dealt are a crapshoot, and one person’s experience will be different than another’s. I did extend med school to 5 years to have more time at home with my kids between rotations, and I have no regrets whatsoever. Residency is MUCH less flexible. My husband starting staying at home with our kids once I started residency, which was a huge sanity and marriage saver since I had so few hours at home anyway. We did not have family in the area, so if you have a ton of family around, they may also be willing to help here and there while you’re in the worst of the training (ie residency).

    Some non-financial advice — keep an open mind about what specialty you want. Maybe you already know now (FP w/ maternal/child focus is great!) but if you prematurely mentally narrow, you may miss out on the specialty that is really meant for you (and you don’t want to eventually do a 2nd residency!)…

    Also – it sounded like you were referring to the Public Service Loan Forgiveness Program, but then you said it was only for primary care, so maybe you’re talking about a different program, but just wanted to make sure you know that you don’t have to be primary care for PSLF (though it probably doesn’t matter because it sounds like you’ll get out of debt before 10 yrs anyway).

    • Melissa says:

      Hi Jen,

      Thank you! I wholeheartedly agree- having children and when to do so is a very personal decision and ultimately, we are the ones to decide what’s best for us since it’s our marriage/children/lives. Making this decision based on how we feel and our personal values is the best way to go about it, and we all have such different experiences. I didn’t expect getting so many comments focused on this part of our lives- especially given that all of my questions were specifically focused on finances!

      Good to know about PSLF- but you’re right in that those programs didn’t make a lot of sense given a) my smaller debt load and b) our ability to pay off debt much sooner without strings attached.

      I’m definitely trying to keep an open mind and explore all areas of medicine before settling! It’s exciting to see how it will all unfold.

      • Alex says:

        My very first thought when reading the case study was–watch out for how different things get when kids come along. Then I read the comments and started laughing. Sounds like a lot of other people had the same thought!

        I think it’s because so many of us professional women are so gobsmacked by the mismatch of expectations and reality when we had kids (I have a 4 year old and a 2 year old and I’m 39; I’ve been a high school English teacher for 16 years and continue to work full time). I’m in the middle of a new book called “Women’s Work” by Megan Stack that addresses a lot of the issues involved.

        Sorry that you’re getting so many raised eyebrows on the having kids thing. Speaking for myself, some of that comes from a place of “how dare you think about trying to ‘have it all’ when I thought I’d try to ‘have it all’ and finding myself mostly destroyed by ‘it all'”–in other words, not the nicest place.

        I find myself mentally responding this way every time a friend of mine who has a serious career talks about getting pregnant. And I bite my tongue every time. There’s no way anybody could have told me about what having kids would be like before I had them. It’s just something you have to experience for yourself, I think.

  29. Maria says:

    Congrats on doing a great job with your financial health! I work with residents who are almost uniformly in massive debt so you will be way ahead of the curve. I had my first baby as an attending but I have friends who had kids in med school, residency, and/or fellowship and you just make it work. Things to consider going forward will be: great individual disability insurance policy early in residency (there are graded policies where you pay lower fees while in training), umbrella insurance to cover personal liability, maxing out your Roth IRAs, and putting at least enough in 403b/401k to get a match if eligible. Once you have or are seriously considering kiddos you’ll need a really solid term life insurance plan too (think on the order of 1-3 million for 30 years). Your description of doing clinical, research and advocacy sounds like an academic job- these are usually lower paying but have other wonderful rewards. If you are tied to a university you may have access to a pension and/or 457 in addition to the usual retirement savings options.

    • Melissa says:

      Maria,

      Thank you for such a thoughtful response. I’ve spoken with lots of people who do medicine and kids in all sorts of ways and you’re right- you find a way to make it work.

      Thank you for the encouragement- it’s great to be reminded that we’re doing well financially! Sometimes I forget that even though we feel like we’re catching up, in many ways we might be ahead of the curve more than I give us credit for. As Mrs. FW noted, paying back debt can feel like treading water and I think our arms got a little tired treading for so long without seeing big gains in our savings.

      And thanks for financial advice re: disability insurance, IRAs, 403bs. We’re absolutely going to look into life insurance once the time comes.

  30. Emily says:

    New Englander here! I’m married to a resident, and we had our first child in med school and have had one in residency. A helpful piece of advice he received was to try to take the written step 2 exam before our first child was born, but maybe this is too specific to the timing of our first child’s birth to be helpful to you. My husband was actually able to take more time off as a med student (7 weeks!) than he was as a resident (he went back to work after one week), so you may find you have more flexibility in taking time off in med school, especially in your fourth year. If you have kids during residency, you may find that you end up having to extend your residency a bit (I believe there is a cap on the total amount of time you can take off), but I’m sure most programs can make adjustments as needed.

    Residency can be tough with a young family (I don’t say this to discourage you from having kids, I just say it based on our experience), and you may find you value the time you spend with your children more than the additional money moonlighting opportunities could provide. To that end, it could be worthwhile to identify residency programs that have a lower number of reported work hours per week and put more of an emphasis on work/life balance. I know that residency applications are a couple of years down the road, but it’s something to consider.

    These are just a few of my random thoughts. Good luck with the rest of your training and starting your family!

  31. Becca says:

    I am a physician in Denver with a small urban farm, decent local gig, great savings, and one…working on 2 ie 20 months….kiddos. My student loans were way higher than yours when I came out but should be paid off within 10 years of graduating from residency ie next several months. My interest rates were lower however. I did buy a house 5 years ago which has become our urban farm. Was a great choice given our housing market over paying off the loans. Docs have lots of career options: locums, 1099, part time, full time…a combo. Find out what meets your family/career/finance goals. Do your research….and your own taxes and investing. You will be better in the end. You can do this….I did.
    Btw, white coat investor is pretty generalistic. Doesn’t seem to apply to the frugal, simple living docs out there from my experience from his talks or blogs. I’m sure you will find what info is useful to you on your chosen site. The Collins book was a decent read when you are covered in texts fyi. Hang in there. It’s a long, hard road but usually worth it in the end.

    • Melissa says:

      Great to hear you made it happen! And a good reminder that there are lots of career options that can fit different goals people may have.

      Congrats on almost being done with your loans!

      • Bri says:

        Coming late to comment, but wanted to echo the white coat investor as pretty general. My husband is in health care with $100k+ in loans and my brother is entering year 4 of med school now, so I understand the intricacies of medical school debt repayment. If you haven’t already, check out Travis at the Student Loan Planner. He is our age (millennial) and married to a physician. His background is in finance and has positioned himself to be an expert on medical school-related student loans, but also highlights strategies for investing, living frugally, and tax implications as a physician. He has a blog and podcast, but also offers one-on-one appointments to plan repayment options. We have always been impressed with how thorough his approach is to all this. You are doing great, so I’m sure you will have many options. Best of luck in the remainder of medical school!

  32. CJ Rae says:

    I have some very specific advice regarding debt repayment. I would pull the money out of the Betterment taxable account (around $10k) as well as some of the money out of your emergency savings and wipe out the two biggest loans you have at 6.8% interest. That’s a guaranteed 6.8% return as opposed to the 1% the emergency fund is earning right now or the potential for the Betterment taxable account to drop with the markets. This will leave you with an emergency fund of approximately 3 months of your current spending, which is low, but still within the 3-6 month guideline. With the $5k free cash flow you have coming in every month, you could either knock out the remaining 4 loans at 4.6% out in about 5-6 months or you could take a little longer and build the emergency fund back up. But right now the cash you have is deployed in a very inefficient manner, especially considering the stress that you’re describing from having these loans hanging over your head.

    I’ve seen other comments mentioning Dave Ramsey and I think that, in your case, there might be something to be said for his approach to debt repayment, which is that you SHOULD be uncomfortable while holding debt. If you were to actually do his program, he’d be encouraging you to take the emergency savings account down to $1,000 and use the rest of that to wipe everything else out. However, you do have enough money coming in that you don’t necessarily need to make yourself that uncomfortable, if you’re willing to pay a few extra months of interest.

    No matter what you choose to do, best of luck to you both!

    • Melissa says:

      CJ,

      Thanks for the financial feedback! Definitely something to think about. That was kind of what I was asking in the Case Study when I referenced what to do with the $10k in Betterment. Let it sit or use it for debt repayment?

      I have somewhat mixed feelings about the Dave Ramsey method. I know for some people it works great and others have their critiques. For us having only $1000 in an emergency fund feels a little too risky. I appreciate his perspective on rice and beans till it’s all gone, and we’ve focused on putting around 65% of our income to debt/savings (and now tuition) these past few years. Granted, we could have increased that percentage but we felt like it was a value for us to have a bit more flexibility in our finances.

      We’re very much looking forward to having all of our non-0% debt wiped out soon. That will be such a relief, it’s been a long journey of debt repayment these past few years and we’ll be very grateful to be on the other side of it.

    • Bri says:

      YES! I’m glad to read this. I did the same thing with student loans and looked at it much like you described. In savings it was barely earning anything. Same with the Bettement account. If you don’t know what to use it for, use it for debt! The faster you’re done, the faster you can pay yourself back, which is how I looked at it. I really enjoyed paying myself back and seeing the numbers go UP after I saw the numbers in debt get SLASHED. Psychologically, I benefitted from seeing my debt take huge hits. I am also pretty conservative and never like my emergency fund to get too low, but almost 40k not invested seems overkill too. So, if it were me, I’d take some time to decide how much feels comfortable (I like the idea of keeping three months set aside), then taking off a huge chunk of debt with that and the Betterment money. Afterwards, you’ll be VERY close to being student loan free, and all that money can refill your reserves. You have lots of fun years ahead of you. Do it all Melissa; I’m glad you are dreaming big — Cheers!

  33. Allison B says:

    This is totally a personal values thing, but the $200+ per month on fitness just seems so high. Youtube has a bunch of free spin classes. If you live in a substantial town, is there a cheaper gym? Gym is non-negotiable for me, but I shopped around local gyms and found a gym for <$20 a month. Lastly, are you open to paying less to yoga studio for fewer classes per week? Could you save money w just 3 visits to the studio and 2 youtube/online yoga classes? Listen to your values, but each category where you splurge like this is a direct loss of something else you might want more.

    • Melissa says:

      Hi Allison,

      Fitness is an area where I personally feel pretty conflicted. On one hand we get SO much value from these memberships, and fitness is a big priority for us. That being said, it does add up and we’re very aware of the cost per year. We’ve looked at each of the memberships (gym, yoga, and spin) individually and really thought about whether they’re something we could cut. Sure, we could absolutely live without them if we needed to, but we both get a lot of value from them and it’s a question of quality of life.

      Technically I don’t pay for a gym membership since it’s included in tuition, but Gabe does and he uses it around 5-6 times a week. We’ve checked out other ones that would be much less expensive (something like Planet Fitness) but the issue is that they require a long enough drive that it would get cumbersome or deter us from actually going and using the membership. That being said, we think we figured out another solution for Gabe to pay $45/ month which is at lease a little less expensive.

      The yoga classes are something I really feel conflicted about. It isn’t cheap to pay $120/mo for 2 unlimited memberships (they don’t have a tiered plan, just the one), but we absolutely love our studio. One thing I’ve thought about is picking up more teaching gigs there (I substitute teach sometimes) to cover the cost of at least one of our memberships. Gabe uses his all the time. I don’t use mine as much, so I could also think about paying per class, but that might end up either shaking out in the end, or in a weird way deter me from going when I could really benefit from it because I’d feel paying for each class instead of an auto-subscription even though per month I might pay less (I know that doesn’t make sense, but know what I mean?). Maybe I’ll try it for a month and see how it feels.

      Definitely something to think about, thanks for bringing it up!

      • Bri says:

        Is there a way you can rotate out these interests so you aren’t paying for them all at the same time? Say, four or so months highly focused on yoga =paying for it. During that time you cycle around town, and work out at home via youtube or with friends or hubby, but the yoga is main focus and you get totally engrossed in it? Then, x-number of months are up and you switch. You get all excited for the switch because you’ll get your cycling classes back (paying) and do yoga then at home, still work out there too etc. Then switch again paying for the gym, you get the idea. So if you rotate the fitness you pay for you’ll save and get pretty excited to be highly focused and better skilled in the area you are paying for, but still enjoying the others.

        Also, I’m sure you know more about such things from medical school but I was surprised you took supplements when your diet and grocery bill is what it is, with fresh foods, organic etc. I would think you could adjust your foods to provide you whichever nutrient of choice so you didn’t also have to buy them as supplements. Seems like you both are really into health and nutrition, so I think you can get there with your food as your medicine, and you’d probably have fun geeking out on what foods, recipes etc would be the best sources etc. I know I would!

        And so I don’t end up posting three zillion times in different spots my last thought was that reading your expenses it seemed like another area of high expense and repetition was family. Well, I just wondered if you could get creative in those departments in finding ways to gift or to see one another that merely cost less. Families are wonderful in that, they’re pretty darn wonderful even when exactly zero dollars are spent. So, you can make gifts if they are necessary, or instead plan experiences together, make memories from holidays/birthdays. I did treasure hunts for my nieces and nephews on Christmas morning that led to teensy little gifts at the end and they were begging for me to repeat the hunt even the next day with no gift at the end. One time I got a groupon and took the whole family to a big aquarium. Another time, I surprised them with a fancy family photo shoot. For special day at all I made a huge deal about taking my brother’s kids to a big “Read to a Dog” event at my local library when they were up visiting. Having never been to their aunt’s library, they were super excited to go on an “adventure”. Not to mention the dogs they read to. Those are still times adults and kids alike remember and talk about to this day. I imagine your future homestead will serve as one heck of a (free) adventure ground for the family. They sure are lucky to have you so dedicated and loving and so nearby!

        So yeah! Just encouraging you that it’s all totally possibly and I’m looking forward already to your followup. Seems like you are just the person to achieve all the things that you want! Many hugs!

  34. Kera says:

    I was so pleased when I read that you aren’t counting on student loan forgiveness. I’m a doctor and many of my classmates planned on paying the minimum on loans with the hope the government would pick up the rest- I think it’s a risky strategy and there’s no guarantee. When we signed a loan, it was with the lender, not a 3 way contract with someone else paying the debt. I’m only 1 year out of fellowship and I’m so proud to say I am set to pay off my loans by the end of 2019. I was able to accomplish this by continuing to live like a medical student in residency and doing lots of moonlighting as a fellow and new attending. I would by lying if I didn’t say that my standard of living has improved now – it used to be that a $5 hot and ready Little Caesar’s pizza was a huge treat for me and my husband, and we lived in a 500 square foot efficiency apartment, and now we eat a real dinner out once a month and bought a house. However, we are not “keeping up with the Drs. Jones”- I’m not trying to “live like a doctor,” we still grocery shop on a budget, buy used clothes and baby gear, and take all the hand me downs. The other thing I would mention is that I planned carefully to have my first pregnancy at the end of fellowship, and my husband is a stay at home dad. Since I went the traditional route of schooling I was only 32 when baby came and didn’t have fertility issues. Child care is a huge expense, and maternity leave during medical training is worth it, but for most people children and such an important part of their life that I would encourage you to have kids when you’re ready. Making up medical training will sort itself out. Anyhow, I just wanted to encourage you that your goals are realistic and I’m impressed you’re planning ahead to get out of student debt!

    • Melissa says:

      Hi Kara,

      It was sooooo tempting to think about loan forgiveness programs- it would be much easier to just take out the loans and deal with the logistics later. We played with the numbers a lot, and just couldn’t find a way for them to make sense give our combined income and vision of being able to work part-time. I took a detailed look at the requirements of these programs and got hesitant about being able to fulfill them when the time comes.

      From what I’ve seen of docs who do pay off their loans early, it’s all about fighting that lifestyle inflation. I’ve heard it’s very hard to manage this once you get your first “real” paycheck but that’s what makes all the difference. Congrats on being almost done with you debt! You can take one of those “we’re debt-free” photos!

  35. Laura says:

    This is a really interesting case study – thanks for sharing. I really wanted to comment and say that I hope you and your hubby have the careers and the kids that you dream of. I’m not a parent (slight regret, but hey, we move on) but my sister-in-law has 4 kids and she is just is just rocking the career and the kids and the whole works. She is a teacher, so totally different than being a dr., but it is do-able. Especially with a supportive family, which is sounds like you guys have. Is she tired some days and stressed out? Sure. She had her first during her final semester of teacher’s college (in Canada that is a 1 yr post undergrad program – maybe 2 yrs now??) The school was super about accommodating her for the practicum portion of her program.

    And actually, my coworker sitting beside me has 4 kids and she and her hubby both work full time. They live close to family and are quasi-homesteaders as well. So, some version of what you are dreaming of is totally do-able! 🙂

    • Melissa says:

      Thank you for sharing these stories! Hats off to your sister-in-law. Teachers have incredibly important and HARD jobs!

  36. Tara says:

    I don’t have any expertise in this field but I will say I have a friend who did have kids while in medical school and she’s a family practice doctor now and doing well. I do think she had them before her residency though.

    I also am close with a NICU mom (we stay together, NICU parents) who had FOUR kids close in age while working as a podiatrist (who also does a lot of in-home visits with homebound patients in addition to surgeries and office hours) and she still is rocking it to this day. Plus, she kept up her work even while her child was in the NICU for nearly 6 months (luckily she works at the hospital her child was in the NICU so she could visit often). For many people, that sounds bananas, but when you have a kid, you make time for things. Every person is different and we can’t judge or nay-say when we don’t know how someone else might handle a situation!

    I would suggest, before getting pregnant, to sign up for short and long-term disability and life insurance (like another poster said), because childbirth is an extremely life-changing event, and as a mom who was on hospital bedrest during the last 5 weeks of my pregnancy, craaazy stuff can happen. I’m so glad I had my kid and I will definitely be having another (with hormonal butt injections to boot, lol), but I strongly suggest that moms-to-be don’t just prepare for after the kid is born… be sure you’re prepared for anything that can happen in the pregnancy or during birth. I continue to volunteer with bed-rest moms and I see so many different crazy types of health issues, that are completely without fault from the mom, that can cause serious complications/death for mom/baby. Anyone who says childbirth is super safe now have not seen maternal death rates for women in the US, particularly women of color. So it’s good to be prepared, especially since you’re putting so much time/effort and money into your desired career.

    Lastly, I am so curious what type of education program your husband went into and what types of jobs result? I know he doesn’t love his job, but it sounds like something my husband would be great at.

    • Melissa says:

      Hi Tara!

      Thank you for the words of encouragement! Yes, each person is different and will handle life’s challenges in their own unique way.

      It’s amazing that you now volunteer with moms on bed rest! On the note of maternal health in the US, did you see the pieces NPR recently did on the subject? It’s a special series called “Lost Mothers: Maternal Mortality In The U.S.” and it has a specific segment on women of color.

      After doing this case study we’re definitely looking into insurance. On that note, FW nation- any recommendations for where to get life/disability insurance?

      I’m afraid I might have painted Gabe’s job in a slightly negative light- he actually really enjoys his work, it’s just that his current employer is a bit disorganized and lacking in the benefits department. That being said, he’s very happy with his career change overall and plans to keep working in the field (long-term in a different setting, but still in the same industry). He went through a startup “bootcamp” called General Assembly in Boston about 5 years or so ago, but they’re all over now. It’s been a great journey for him. Previously he worked in finance, and likes being a software engineer much more. It’s also been a great financial boost for us. When he first started in the industry in 2014, his very first job offered him $60k a year (or so, we can’t quite remember) and now he makes $180k plus guaranteed 10% bonus. That being said, it does take some work to get where he’s at, but it can be a great career option.

      • Deezee says:

        This is what I was going to ask you about, thank you for the detail! How did he find his first job out of the bootcamp? Did the school have career assistance? My hubby and I are both engineers and this is an appealing career path for us. I am a female engr and new mom to a 5 month old. I understand your frustration about would these comments be made if I were a man. After having a baby I do understand why people say it more, having my son has rocked my world in the best ways possible. But I have put a ton of pressure on myself to keep up pre and post partum- it’s been very difficult to make that a reality. I’m in the process of outsourcing everything I can so theres a financial impact I wasnt expecting, but it will all work out 🙂

  37. Louise says:

    If they want to keep the Chase Sapphire Preferred card for the travel benefits, then they should convert one of the cards to the Chase Freedom Unlimited (no yearly fee). The cashback percentage is higher than the Preferred AND the points earned can be transferred over to the Preferred to redeem at 1.25. We’ve done this for a few years. It is really easy to switch-just call Chase customer service. We did this after earning the signup bonus (although we had to wait until the anniversary to switch). Hope this helps!

  38. Me says:

    I did not read all of the comments yet, so I apologize if this has been mentioned.
    I too felt that the potential downsides to student loan repayment programs (whether NHSC, military, etc) were not worth it when I was in med school. Looking back, it was probably the biggest mistake I have made in my career.
    Can you shed more light into why this would not be worth it? Graduating debt free is a wonderful thing!!!
    All the best to you in the future!

  39. totoro says:

    I had kids in law school and it was great. We had access to subsidized great daycare on campus and lived in family housing with lots of others in our situation. I’m not sure what your university is like for this where you are, but I’m sure glad I didn’t wait until I had finished school and there were financial advantages in the forms of grants and subsidies for those with families (Canada not sure about the US). If you are 32 and want three or four kids you could start now if you feel like you could manage it. Alternatively, and maybe a bit more controversially, think about freezing your eggs right now. I wish I had done that as I would have loved to have more than two.

  40. Becky says:

    Hi Melissa,
    I am so impressed with how much you guys have been able to save already despite your huge student loans. I agree with Mrs. Frugalwoods in all her recommendations, except since your emergency fund is so big I think you could also use a little of that to pay off your debts as well. You could still leave 3-4 months worth in there and then top it back up once your debt with interest is paid.

    There have been a lot of comments about how kids are going to effect your calculations, and I would recommend you to consider when would be the best time to take a break from studies/work. I am at home with my 19mo and lucky enough to live in Finland where you can stay at home for a long time, even though the pay is very very low. My husband and I chose to buy a 1 bedroom apartment and live frugally in order to be able to comfortably afford me being at home for a long time and still able to save.

    I would highly recommend trying to work it out financially to stay at home for a year or at least 6 months if you can take a one year break from your studies. You will never regret this time you spend at home. And if your husband can also afford to take unpaid leave to be at home for half a year that is amazing as well. I know it’s not as easy in the states to do this.

    So I guess my recommendation would be to save or budget so that one of you can be at home for the first year with your baby.

    If you really cut your costs and save all that extra money I think you could afford this. It might set you back a bit in your studies and savings plans, but I think it will be totally worth it.

    Also, since daycare is so expensive there and you have some mum friends in your course. Maybe you could try sharing a nanny with one of them when you go back to the course.

    Also, no need to get a bigger place right away. The baby will sleep in your room the first year anyway.

    Good luck
    Becky

  41. Mary in Maryland says:

    First, a check to see if my comment gets posted, as they seem not to.

  42. C says:

    Two personal data points: my sister is an internal med doc who has also ended up doing a lot administrative (she directed the residency program)/teaching work. She had two kids back to back in med school and took only a couple weeks off for each. She would absolutely recommend having kids in school versus residency, because it was much more flexible for her during the school period. She had easy pregnancies (she was in her early 20s) and decent deliveries/recoveries, though my nephew was in the NICU for a couple weeks because he came early. To make it work, her husband, who also works full-time, stepped up a lot in terms of kiddo logistics (taking nights, driving them around, drop offs and pickups) and, evenly more importantly, they outsourced food prep and housework during the early years and made liberal use of in-home help, on-campus, subsidizied!!! day care, and family help . Using $$ and accepting all help to take those chores off their plate saved their brains/time for things only they could do like work, study, bond with kiddos, LIFE, etc. Now that their kids are older, they both have rich social/extracurricular lives and the kids are doing great. Plus, they have lots of plans for flexible work/international travel once the kids are out of the house.

    I had two kiddos starting at 35 and had much tougher pregnancies and recoveries, including stints of PPD, while working full time (I am a consultant, my hubs is a professor) with my 1st. I didn’t have any fertility issues, but that was definitely a concern before my pregnancies. With my 2nd, I dropped down to part-time work and absolutely love the difference it has made. Taking a page out of my sis’s book, we outsourced a lot of basic life chores and focused on the important TO US stuff, including keeping the kids in-home with us and babysitters for years longer than originally expected (they are only starting day care/school now, @ 2 and 4). We’ve put hobbies/extracurriculars mostly on hold for the moment, but plan to make time for them once child-rearing is less physically demanding.

    All of this to say that you are doing GREAT, have a solid plan, and up-front resources to tap when entering the early childhood years is more precious than gold because it represents TIME. You’re already considering flexible work/parenting options and seem to have your eyes wide open. Meaningful work, challenging/time-consuming hobbies, and parenting can go together! It just might not all happen at the exact same time and that’s fine. Pregnancy and child-rearing is different for everyone, so all you can do is prepare as much as you can, be forewarned and fore-armed, and go in with a good attitude like yours, hoping for the best. Best of luck!!!

  43. Mary in Maryland says:

    Melissa, I note that you are excited about comments that are optimistic and upbeat and somewhat dismissive of the others. The others are just as apt to reflect reality. I practiced OB for 40 years. It is not a child-friendly life. Women left my residency program for anesthesiology, ER medicine, pathology, and –yes—dermatology, when they noticed that even attendings were always in the hospital rather than tucking their children in at night. As an attending I had a colleague ask for coverage one day because she had to go home and interview a live-in nanny for the children. I asked if her current nanny was leaving—the colleague, said “No, I’m hiring a second one because it seems unfair to have Trina raising three children all by herself.” I laughed, but the colleague couldn’t see what was funny.
    Adding OB to Family Practice usually more than triples your malpractice insurance (8K to 30K in Alabama, 18K to 64 K in West Virginia). Paying this much upfront works against anyone doing OB part-time. Did you know that the AMA definition of part-time for a physician is “less than 60 hours per week”? Requiring OB coverage also triples the amount you would have to pay a locum temens to cover your practice when you wanted to leave town assuming you were in an underserved area.
    The reason most docs elect not to work in underserved areas is because you are always on call—underserved means that you don’t have anyone to cross cover with and must pay for coverage. In my case it also meant not having a glass of wine except when I was on vacation. (I know Mrs. Frugalwoods would appreciate the immensity of this sacrifice).
    You are a first year medical student, and everything looks exciting. It is. However, it wasn’t until the clinical years that I realized there are exactly 168 hours in each week. Children, homestead, underserved area, and family practice with OB would take about 300 hours per week. Only you can decide on your priorities, and time may make them clearer to you. I would advise you to think carefully before committing to any particular piece of your dream.

    • I’m very inclined to agree with this. I am a subspecialist in an academic center, but one of my dear friends from medical school is a family doc who does OB and ED in an underserved area. She did not take a vacation for the first 18 months of her practice. Neither she nor her partners have children — in fact, they have been unable to recruit anyone with kids or planning to have kids — mainly because the school systems in underserved areas tend not to be great, and schools are a major consideration for people with kids. (Unless you homeschool, in which case either you or your husband would need to stay at home to teach the kids.)

      The early years of medical school are all about exploring your options and deciding what fits with your personal priorities! Have fun with it!

  44. tess says:

    Any recommendation for company that offers low-fee index funds?
    My husband has investments that seem to garner rewards for the advisor who administers them.
    How would we go about transferring them?
    Thank you in advance.

  45. Kristy says:

    This is a bit delayed, but I wanted to mention they can up their Roth contributions, $458/month was the cap last year, this year it’s 6k so $500/month each. Every little thing helps!

    I think they’re going to rock it, being as thoughtful as they are!

  46. Kayla says:

    I lump a few of these categories together in our budget for simplicity’s sake. For example, anything I would ever buy at the grocery (i.e. dishwasher powder, toothpaste), I lump into one. Also lump all eating out, all gifts, all entertainment, etc. to get a broad grasp on each category. I am continually disgusted by the cost of owning a paid-for vehicle! I tend to buy most of my clothes second hand, and my husband’s new (men just wear that stuff out!). It sounds like you have a grasp on your priorities and will definitely find clarity on your own.

  47. I’m in academic medicine, just over a year out of training. It sounds from your career goals (research and teaching) that you are also interested in an academic career rather than private practice, so double-check your projected attending salary, as $200k seems quite high for FP. Academic salaries are generally about 60-75% less than their PP counterparts. The AAMC puts out a faculty salary report every year, and you should have access to it through your medical school library. The equivalent salary report for private practice is the MGMA, but you have to pay for access to that, ironically.

    One other thing I wish someone had told me was to save ahead for all the credentialing expenses. The USMLE Steps 1-3 are a couple thousand dollars (and for Step 2 Clinical Skills, you’ll have to travel as it’s only offered in like 5 places nationally). My neurology boards were another couple thousand, then about $1000 for state-level credentialing (including verifications, transcripts, notarization of a million forms, DEA, and state license). Most of this used to be deductible on taxes, but not any more, so you just have to eat the cost.

    Also, you’ll probably be traveling a lot for residency interviews and possibly fellowship interviews as well. Sign up now for every frequent flyer program you can. Buy your interview suit on sale, no one cares how much you spent as long as it’s clean. It’s also very possible to get a professionally-appropriate wardrobe for your clinical rotations from thrift stores and sales.

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