EM & Medicine - Plans to take today

[cyanide12345678]

I've been reading this now ever since you posted it and honestly it looks promising. I need to do some more DD, but I'm wondering why you haven't already put money into this?

15 percent doesn’t get me that excited, but i probably will put some money in now that the minimum is lowered to 5k. I might do 10k. But im playing defense since ewz has dropped 10 percent or so in 1 month and that position in my options account is worth a lot more. So just keeping dry powder in case ewz keeps going south. I mean it touched it’s 52 week low 3 days ago. I have 800 contracts on $24 strike with 3 months to expiration and 79k premium in that position. That’s worth more to me than anything else at this point.

Im keeping liquidity and dry powder.

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[HemorrhagicShock]

Wow!! 800 contracts. I remember reading some of your options posts on EWZ and your strategy so I'm excited that it's working out for you!

 

[cyanide12345678]

Wow!! 800 contracts. I remember reading some of your options posts on EWZ and your strategy so I'm excited that it's working out for you!

Ytd ewz has made me 43k. This is after a 30k loss in this 1 month on ewz which has resulted in several rolls resulting in dropping strike prices, decreasing number of contracts (had 1000 contracts 1 month ago), all the while increasing total premium amount.

If ewz reverses, which it should at some point given very strong fundamentals, then ewz should add another 80k to my net worth in 85 days.

 

[emergentmd]

Appreciate the explanation. One other question. How does one unwind this strategy when one is ready to move on, or retire, or just sit on the cash flow from these houses without worrying about too much additional expense and tax burden?

I have no idea about the ones you find online, funds of funds, or funds buying a large array of sites because the waterfalls just do not look as good as operators who buy 1 or a handful of apt complex syndications. Also some other reasons I will not go into bc I could be mistaken about them.

1. You put money in, get your distribution in about 2-3 months. This is 1st way to get a return. I always do Value Add Type B/C into A/B and never Type A/new builds. Just makes sense for a good operator to add value to a project which is essentially what I do with my single properties.
2. You wait the stated 3-5 yrs but the 7 I have been involved in closed between 18 month-3 yrs exiting for a 2-2.5x IRR. This is 2nd way to get a return.
3. The syndication can finance assuming value increased similar to refinancing any property. This is the 3rd way to get your return.

Exits
1. Site sells and you can do a 1031 into another property within 90 days. It just has to be a like investment. 6/7 did this. 1/7 could not find a suitable investment
2. 6/7 1031 into another group of syndications without tax implications
3. 1/7 has tax implications but I rolled this later into a different operator.
4. There could be a cash call if syndication does poorly. I have never had this happen and this is typically the last resort an operator will take. You can chose to participate or not. Participate and you get better terms/1st money out. Do not, and you risk dilution or you fall farther back in the line when it sells

Positives - Not sure you get this with the online ones
1. Money you put in day #1 takes a large loss/depreciation that you carry over to offset distribution as discussed already.
2. I can and have used IRA money for this. A benefit of using IRA money is you have no tax implications even if you do not do a 1031. You have to find companies that will Hold your IRAs for syndications. I do not believe the major ones like Ameritrade will do syndications through an IRA. Not sure you can do this with
3. Totally passive. You get monthly updates on each syndication progress, occupancy, headwinds, etc.

 

[HemorrhagicShock]

Very helpful post emergentmd, I really appreciate that breakdown. I'm trying to learn the syndicate game as I have about 250k of liquid capital that I want to deploy, and want to do it judiciously!

 

[emergentmd]

15 percent doesn’t get me that excited,

15% although good, also doesn't get me too excited.

 

[cyanide12345678]

Very helpful post emergentmd, I really appreciate that breakdown. I'm trying to learn the syndicate game as I have about 250k of liquid capital that I want to deploy, and want to do it judiciously!

Here. See first attachment. 3 percent return. 37 days. Has to be done with a marginaccount though. Leaves A LOT of excess margin maintenance for safety.

$23 is pandemic low. Low likelihood.

If it touches $24, then you do a rollover. See second attachment. Essentially, drop strike to $22, extend 3 weeks forward, and get another $1000 for the next 3 weeks.

Keep rolling until you win.

 

[Mount Asclepius]

I love the money. Some of you guys remind me though why I initially picked medicine instead of finance. There’s no heart and no passion for most of us in puts, syndications and alphabet soup term rentals. Glad some of you have found something for yourselves, but it’s not the answer for most. I want to be a part of the cool kids club, but then realize it’s probably FOMO and index funds are just fine.

Assuming I keep working, I’m conservatively on track for $7M by 50 just with saving and index funds. That probably works for me. I’m not sure what I’d do by utilizing more leverage. Second home, yacht, Bali? Can practically have any of those and anything I want, even if not everything I want (not really sure I want everything - what does that even look like?). I have all of the important things. Health, family, and contentment playing with some rough textured rocks while sitting beside a mountain stream observing my dogs pant beside me after a mountain trail run.

Gave someone with severe spinal stenosis, radiculopathy and borderline cauda equina syndrome pain relief, diagnosed hyperaldosteronism in someone else with a K less than 2 after years of no diagnosis (definitely beyond my scope), and picked up a massive liver mass in a 20ish year old solely on exam despite presenting with clear food poisoning within the last few days. Sure, sprinkle in all the other worthless stuff, but admidst all of the doom and gloom of EM, I’m just not convinced all of the finance magic bullets are the key to my happiness.

$10M though tomorrow and I’d be awfully tempted to hang it up…

Today though I’m off work and life isn’t bad.

 

[bravotwozero]

$7 mil on a EP salary just by saving an investing in index funds? That seems unrealistic for most EPs. If you don’t mind me asking, what kind of savings rate would you have over how long a time horizon?

 

[Mount Asclepius]

$7 mil on a EP salary just by saving an investing in index funds? That seems unrealistic for most EPs. If you don’t mind me asking, what kind of savings rate would you have over how long a time horizon?

SDG partnership with better income than average EP. Prefer not to share exact specifics and don’t want to turn into earnings contest (average $450-550K annual range working average EP hours).

Living frugally and probably saving more than most ($90K-ish in tax deferred retirement - 401K/CBP - plus additional backdoor roth and around $150K in post-tax savings/investment per year currently).

Timeline would be 20 years from when I made partner at age 30 until I hit 50. The real kicker is if I decide to walk away or cut back hours before 20 years.

Correct, might be unrealistic for many EPs. Very practically doable though. I think I have a quasi-unicorn job in a pretty good location (think mountains or ocean). They are out there. So many people are location inflexible though.

 

[emergentmd]

$7 mil on a EP salary just by saving an investing in index funds? That seems unrealistic for most EPs. If you don’t mind me asking, what kind of savings rate would you have over how long a time horizon?

Start at 30. Save 100K your first year. Put only 50K into the S&P every year, spend the rest which is 200K+ yearly for many EM docs. When you are 60 you will have 10M. Retire at 60, spend 300K/yr and when you are 70 you would still have well over 20M. At these levels, it is really difficult to overspend.

Its not really that difficult being high earners and having time to compound. Most people can't seem to do this. They get jittery, take it out, try to time the market, try to pick Teslas and apple, etv.

 

[miacomet]

Start at 30. Save 100K your first year. Put only 50K into the S&P every year, spend the rest which is 200K+ yearly for many EM docs. When you are 60 you will have 10M. Retire at 60, spend 300K/yr and when you are 70 you would still have well over 20M. At these levels, it is really difficult to overspend.

Its not really that difficult being high earners and having time to compound. Most people can't seem to do this. They get jittery, take it out, try to time the market, try to pick Teslas and apple, etv.

Except most EM docs will be crispy by their mid forties, sixty is an impossibility for many.

 

[emergentmd]

If you save 100K/yr x 10 yrs starting your first year at age 30, you can be crisply retired at 40 working just to pay the bills having 12M at 60. Not a bad deal

 

[miacomet]

Also, research places that might be cheaper to retire (Costa Rica, Spain, Panama, Thailand, Mexico) and consider learning a language or two...much cheaper to retire in many other places, with a high quality of life and longer lifespans

 

[emergentmd]

Also, research places that might be cheaper to retire (Costa Rica, Spain, Panama, Thailand, Mexico) and consider learning a language or two...much cheaper to retire in many other places, with a high quality of life and longer lifespa

Sounds like a great plan for a single ER doc but with Kids then grandkids, the rib would never go for it.

Now, if I were single unattached, I would for sure live in LCOL. Don't even need to learn a language, I hear lots of cheap Xpat places

 

[miacomet]

Sounds like a great plan for a single ER doc but with Kids then grandkids, the rib would never go for it.

Now, if I were single unattached, I would for sure live in LCOL. Don't even need to learn a language, I hear lots of cheap Xpat places

Plenty of US families are moving to Portugal, Spain and Greece, esp if they can work remotely. LCOL, decent schools, high quality of life. Not everyone's cup of tea, but it's becoming more popular. The US isn't known for being particularly child-friendly, after all.

 

[bravotwozero]

Plenty of US families are moving to Portugal, Spain and Greece, esp if they can work remotely. LCOL, decent schools, high quality of life. Not everyone's cup of tea, but it's becoming more popular. The US isn't known for being particularly child-friendly, after all.

I've seriously thought about moving to Turkey once retired. Cheap cost of living and great food. Terrible place to work though, so not worth moving if not retired.

 

[cyanide12345678]

I've seriously thought about moving to Turkey once retired. Cheap cost of living and great food. Terrible place to work though, so not worth moving if not retired.

I don’t know how safe Turkey is now. A lot of recent political turmoil as well.

 

[JacobMcCandles]

I've seriously thought about moving to Turkey once retired. Cheap cost of living and great food. Terrible place to work though, so not worth moving if not retired.

Are you from Turkey or have family there? Turkey would probably rank just below Russia and Ukraine for me right about now.

 

[cyanide12345678]

Are you from Turkey or have family there? Turkey would probably rank just below Russia and Ukraine for me right about now.

Yeah, id pick spain, panama, costa rica, bahamas, portugal, malaysia, indonesia all above turkey.

I would pick dubai or abu dhabi if it wasnt so damn expensive.

 

[miacomet]

I'm still really surprised more EM docs don't consider moving abroad with kids after reaching coastFire. Many other countries have longer parental leave, safer schools, higher educational standards, longer lifespans, safer roads, safer streets, opportunity for bilingualism and a higher QOL for much less money than most of the US- Portugal, Spain, Italy, France and Greece would top my list for families, along with Costa Rica and maybe Panama. I would think families would be jumping at these opportunities, esp if one parent can get some kind of digital nomad job. There would be more than ample time to see family- probably more than working in the US in many situations.

It's not just for young singles- in fact, quite the opposite, moving to these countries seems like it would be even more attractive to families.

 

[GonnaBeADoc2222]

I think I'm too dumb to play options.

I did throw 10k into FSKAX and FTIHX today though.

 

[cyanide12345678]

I'm still really surprised more EM docs don't consider moving abroad with kids after reaching coastFire. Many other countries have longer parental leave, safer schools, higher educational standards, longer lifespans, safer roads, safer streets, opportunity for bilingualism and a higher QOL for much less money than most of the US- Portugal, Spain, Italy, France and Greece would top my list for families, along with Costa Rica and maybe Panama. I would think families would be jumping at these opportunities, esp if one parent can get some kind of digital nomad job. There would be more than ample time to see family- probably more than working in the US in many situations.

It's not just for young singles- in fact, quite the opposite, moving to these countries seems like it would be even more attractive to families.

I’m considering it. My wife is the road block. We could do 2 more years in the US and then call it a day and do some online thing to make 40-50k to cover expenses while we coast fire.

She just don’t want to move, like the forever home we’ve bought, and didn’t understand my philosophy of wanting to just retire early -_-

 

[cyanide12345678]

I've been reading this now ever since you posted it and honestly it looks promising. I need to do some more DD, but I'm wondering why you haven't already put money into this?

What was your verdict after the due diligence?

 

[bravotwozero]

Anyone ever thought about owning a franchise?

I always thought it would be cool to own a smoothie king, but have no clue if it would be profitable….

 

[cyanide12345678]

Anyone ever thought about owning a franchise?

I always thought it would be cool to own a smoothie king, but have no clue if it would be profitable….

Sign up for wesellrestaurants.com

I think that’s the website. I was pretty close to buying a marcos pizza until i just chickened out since historically I’m a terrible business operator and have never actually ran a successful business - mostly just several failed ventures.

But yeah…i get their updated listings and have often thought about buying one.

 

[DoctorMD1]

I'm still really surprised more EM docs don't consider moving abroad with kids after reaching coastFire. Many other countries have longer parental leave, safer schools, higher educational standards, longer lifespans, safer roads, safer streets, opportunity for bilingualism and a higher QOL for much less money than most of the US- Portugal, Spain, Italy, France and Greece would top my list for families, along with Costa Rica and maybe Panama. I would think families would be jumping at these opportunities, esp if one parent can get some kind of digital nomad job. There would be more than ample time to see family- probably more than working in the US in many situations.

It's not just for young singles- in fact, quite the opposite, moving to these countries seems like it would be even more attractive to families.

Public schools are not that good in southern europe.

 

[JacobMcCandles]

Anyone ever thought about owning a franchise?

I always thought it would be cool to own a smoothie king, but have no clue if it would be profitable….

I would imagine owning a franchise would likely take much longer hours than you’re doing now. Plus, dealing with unreliable hourly workers wouldn’t be something I would want to deal with right now.

 

[Apollyon]

Anyone ever thought about owning a franchise?

I always thought it would be cool to own a smoothie king, but have no clue if it would be profitable….

The Dairy Queen right near me is owned by a woman who got it from her father. Her husband still works in a separate job. She manages the place. They close from November to February, and stay in business. I asked her about buying another one in the next town over (more rural, but has a tiny town center that actively draws), bit she said she'd have to hire a general manager, and she just doesn't want to deal with that. I don't know how much she makes, but, apparently, it's enough!

Around here, Tim Hortons are EVERYWHERE. They are all franchised. The one here in town (there's actually two) started out with just the two - the franchisee now owns seven. And Tim's is a cash cow.

Some people are just naysayers - no matter what you say, they'll say it's impossible or unsustainable - even when it, demonstrably, is.

 

[HemorrhagicShock]

What was your verdict after the due diligence?

I ended up registering and putting some of my cash into the fund. I watched a series of youtube videos on how to evaluate deals like this, in addition to reading some of your posts. It SEEMED like a reasonable deal, but ultimately this might just be an expensive lesson on how to approach deals like this. If that's all it ends up being, perhaps it will be worth it!

This is also a great example of why doctors are stupid with their money. One thing I know about myself is that I learn mostly by doing, especially when it comes to very complex stuff like this. YOLO I guess!

 

[cyanide12345678]

I ended up registering and putting some of my cash into the fund. I watched a series of youtube videos on how to evaluate deals like this, in addition to reading some of your posts. It SEEMED like a reasonable deal, but ultimately this might just be an expensive lesson on how to approach deals like this. If that's all it ends up being, perhaps it will be worth it!

This is also a great example of why doctors are stupid with their money. One thing I know about myself is that I learn mostly by doing, especially when it comes to very complex stuff like this. YOLO I guess!

It’s a debt deal, low ltv, you’ll be fine. You shouldn’t lose money, plus the fund is liquid and you can take your money out in 6 months if you want.

Debt is much safer than equity. Worst case scenario, you as the bank acquires assets at 60 percent of the cost of the asset. Banks do badly when the leverage is >80 percent and the property can become upside down in a recession.

Good luck. It’s as safe as you can get in a private syndication by holding a portfolio of mortgages.

 

[CajunMedic]

Anyone ever thought about owning a franchise?

I always thought it would be cool to own a smoothie king, but have no clue if it would be profitable….

I looked at Walk On's Sports Bistreaux. Always had good food in Louisiana and stayed packed. Bring a little cajun flair to the OH/WV/PA area and would probably do well in college areas like Morgantown, WV. It would be a LONG while before I met the cash and liquidity requirements without partners

 

[emergentmd]

Sign up for wesellrestaurants.com

I think that’s the website. I was pretty close to buying a marcos pizza until i just chickened out since historically I’m a terrible business operator and have never actually ran a successful business - mostly just several failed ventures.

But yeah…i get their updated listings and have often thought about buying one.

I can't think of a worse business an EM doc would want to go into. Restaurants are high risk, low return, high stress job.

Now, I have thoughts about opening up a Solo salon type set up. But again, dealing with 30 hair stylists makes me want go back to residency.

 

[emperor tamarin]

I ended up registering and putting some of my cash into the fund. I watched a series of youtube videos on how to evaluate deals like this, in addition to reading some of your posts. It SEEMED like a reasonable deal, but ultimately this might just be an expensive lesson on how to approach deals like this. If that's all it ends up being, perhaps it will be worth it!

This is also a great example of why doctors are stupid with their money. One thing I know about myself is that I learn mostly by doing, especially when it comes to very complex stuff like this. YOLO I guess!

I'll be following with interest to see how this goes for you so please do keep us updated

 

[cyanide12345678]

I'll be following with interest to see how this goes for you so please do keep us updated

Y’all make a debt deal sound like a high risk deal.

Not only that, it’s an investment grade fund with dozens of mortgages. So you don’t even have a single asset risk. You literally have 300 million loaned out, average loan size of 10M, with an average loan to value ratio of 58. It’s not as risky as one would think, though i would cash out 1-2 years before their bond becomes due personally which is 2026. But that’s just me being risk averse since the biggest risk to their portfolio is the bonds that become due sep 2016z

 

[bravotwozero]

Concentra is hiring docs for urgent care in Austin. M-F 8-5.

 

[miacomet]

Concentra is hiring docs for urgent care in Austin. M-F 8-5.

Salary?

 

[JacobMcCandles]

Salary?

$1 for every z-pack and prednisone script you write.

 

[bravotwozero]

I can't think of a worse business an EM doc would want to go into. Restaurants are high risk, low return, high stress job.

Now, I have thoughts about opening up a Solo salon type set up. But again, dealing with 30 hair stylists makes me want go back to residency.

Fully automated car wash, perhaps?

 

[cyanide12345678]

Fully automated car wash, perhaps?

I’ve thought about it too but unfortunately owning any business is not as passive. There are funds that buy car washes, those are truly passive.

Other brainless easy things I’ve thought about are atm machines and snacking vending machines.

 

[HemeOncHopeful19]

I'm still really surprised more EM docs don't consider moving abroad with kids after reaching coastFire. Many other countries have longer parental leave, safer schools, higher educational standards, longer lifespans, safer roads, safer streets, opportunity for bilingualism and a higher QOL for much less money than most of the US- Portugal, Spain, Italy, France and Greece would top my list for families, along with Costa Rica and maybe Panama. I would think families would be jumping at these opportunities, esp if one parent can get some kind of digital nomad job. There would be more than ample time to see family- probably more than working in the US in many situations.

It's not just for young singles- in fact, quite the opposite, moving to these countries seems like it would be even more attractive to families.

I realize this is an old post but I really don’t think medicine in Europe is some holy grail where life is great… I think this is part of the whole “European Utopia” myth that a lot of Americans have in their minds for some reason

 

[emergentmd]

Everyone talks about going abroad and how other countries are better until they realize that nothing is perfect. America still is one of the last great countries even with all of its warts.

Look at all the European countries struggling. When Trump won, everyone talked about leaving the country and very few left. Even Markel and the Prince left Europe and chose America.

 

[cyanide12345678]

Everyone talks about going abroad and how other countries are better until they realize that nothing is perfect. America still is one of the last great countries even with all of its warts.

Look at all the European countries struggling. When Trump won, everyone talked about leaving the country and very few left. Even Markel and the Prince left Europe and chose America.

The money keeps me here. If i had 3-4 million and found an English speaking country with excellent quality of life, I’ll probably move.

My wife and i have talked about it multiple times now, we are truly starting to think about moving in 4-5 years when We hit 3+M. Really the struggle has been finding a country where English is very commonly spoken with reasonable cost of living - portugal, Spain, Italy are all going to have a massive language barrier. Canada is cold as hell and their major cities have ridiculous priced real estate.

The Arab world is an option like qatar, abu dhabi, not the cheapest places but could actually work tax free and make very decent income - but arabs are racist as hell towards Pakistanis and the cost of living is significant.

There’s places like bahamas, Panama, Belize, gibralter, malta that On paper sounds okay, but will really have to get comfortable with not having much of an income and truly retiring.

Kuala lumpur on paper doesn’t sound bad, cheap, developed, nice beaches nearby, English very commonly spoken. Time will tell.

Honestly if the school/mail shootings stop, or road rage leading to people pulling guns, i would love to just work 8 shifts a month and keep living the life i have here

 

[Splenda88]

I'm still really surprised more EM docs don't consider moving abroad with kids after reaching coastFire. Many other countries have longer parental leave, safer schools, higher educational standards, longer lifespans, safer roads, safer streets, opportunity for bilingualism and a higher QOL for much less money than most of the US- Portugal, Spain, Italy, France and Greece would top my list for families, along with Costa Rica and maybe Panama. I would think families would be jumping at these opportunities, esp if one parent can get some kind of digital nomad job. There would be more than ample time to see family- probably more than working in the US in many situations.

It's not just for young singles- in fact, quite the opposite, moving to these countries seems like it would be even more attractive to families.

I am not EM; therefore, I don't make as much as you guys. Base salary is 330k/yr now; will be 350k in 2 months when we get a 20k raise.

I have cousin who lives in France; he is an engineer and has construction company. Was there last summer and he proposed to me that he can build a 3BR/2BA house free of charge. I will just need to pay for what the house will cost 350-375k. House will be in the a suburb of Lyon close to Switzerland border (about 1hr15mins from Geneva).

Very tempted to take him on his offer in 4-5 yrs and hoping price will not go up.


Picture of a cute house his company build below:

 

[Splenda88]

Everyone talks about going abroad and how other countries are better until they realize that nothing is perfect. America still is one of the last great countries even with all of its warts.

Look at all the European countries struggling. When Trump won, everyone talked about leaving the country and very few left. Even Markel and the Prince left Europe and chose America.

For the money, that is true. But not too sure about quality of life though.

 

[Splenda88]

Anyone ever thought about owning a franchise?

I always thought it would be cool to own a smoothie king, but have no clue if it would be profitable….

The average McDonald's makes 150k/yr net profit. Rather work on extra day per week and make almost as much instead of having the headache of running a business.

 

[CoolDoc1729]

The average McDonald's makes 150k/yr net profit. Rather work on extra day per week and make almost as much instead of having the headache of running a business.

My mom owns an ice cream shop. What a pain. She can’t travel or really be more than half an hour away 6 days a week, can’t find help, every day there is a different hassle, employee calls out so she has to work late, freezer breaks, water heater breaks, these are examples from the last month. Once the power went out for a week and she had to drive around finding dry ice so she would “just” have to remake all the ice cream instead of throwing it all away. Growing up like that I would never ever ever have a restaurant or the like.

 

[JacobMcCandles]

For the money, that is true. But not too sure about quality of life though.

It’s always hilarious when people pretend the quality of life in America isn’t great, especially for someone making a physician income.

 

[Splenda88]

It’s always hilarious when people pretend the quality of life in America isn’t great, especially for someone making a physician income.

It might be a case that the grass is greener...

100k would afford me a couple live-in maids and a driver in Malaysia or Thailand. Lol

 

[JacobMcCandles]

I guess everyone is different but I’d much rather live in the US without live-in maids rather than live in Malaysia or Thailand with live-in maids. I’d also hate to give up driving.