I love my job

[Celexa]

Started as an attending at the beginning of the month. There were any number of admin cluster****s that made the week harder than it should have been, but everything clinical went great. I feel like I am really able to help patients and my colleagues (I am CL after all, and a happy primary team who listened to my recs makes me as happy as an improved patient) and I'm so so glad I chose psychiatry.

Online forums by their nature skew negative sometimes and just wanted to throw this out there. For both those considering psychiatry and those in residency going through the many trying times.

Now if only that first attending paycheck would get here....

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[TheRightMedication]

Congratulations! Enjoy that first attending paycheck. And what could be more fun than a mutual fund? Or an index fund if you're feeling really wild!

 

[shoomer]

Started as an attending at the beginning of the month. There were any number of admin cluster****s that made the week harder than it should have been, but everything clinical went great. I feel like I am really able to help patients and my colleagues (I am CL after all, and a happy primary team who listened to my recs makes me as happy as an improved patient) and I'm so so glad I chose psychiatry.

Online forums by their nature skew negative sometimes and just wanted to throw this out there. For both those considering psychiatry and those in residency going through the many trying times.

Now if only that first attending paycheck would get here....

Any advice on picking out a good CL job right out of training?

 

[Celexa]

Any advice on picking out a good CL job right out of training?

Honestly, my pursuit of CL was wound completely around my pursuit of a clinical teaching position so I did not cast a very wide net as I knew I would be staying in an academic dept. The main advice is not particularly CL-specific, just the same questions about schedule, volumes, teaching time, call, APPs, as with any other job. CL is not a money maker, and often a money loser, so being careful about any productivity targets or compensation tied to metrics in your contract is important.

I did get the non compete removed from my contract so I could do private practice on the side. Making a CL psychiatrist sign a non compete is particularly ludicrous given that the overlap between who we are consulted on and the types of patients you'd want in a small, selective private pracrice is almost nil. There aren't many boarded CL docs around so I had decent amount of negotiating power and multiple departments showing interest. I chose to use that negotiating power on the noncompete issue and schedule/exact clinical responsibilities, and did not bother to try and negotiate salary once I had confirmed what I was offered was in line with what what other people had gotten recently.

 

[Celexa]

Congratulations! Enjoy that first attending paycheck. And what could be more fun than a mutual fund? Or an index fund if you're feeling really wild!

Hahaha I was thinking of splurging on a new set of sheets

 

[Sushirolls]

f) Buy farm land for future farming goals

 

[comp1]

Glad you killed the non-compete clause. They harm the profession as a whole and should never be allowed by any physician. I'm glad you're happy. Sounds like you learned the major CL rule that the primary team IS the patient. Definitely concur with tightly monitoring anything like productivity targets. That should not be the focus of an academic institution and you're already taking a paycut working in academia.

 

[Celexa]

Glad you killed the non-compete clause. They harm the profession as a whole and should never be allowed by any physician. I'm glad you're happy. Sounds like you learned the major CL rule that the primary team IS the patient. Definitely concur with tightly monitoring anything like productivity targets. That should not be the focus of an academic institution and you're already taking a paycut working in academia.

The number of people who asked me "why do you care so much about the noncompete? They don't enforce it" was truly mind-boggling.

In addition to knowing my bargaining position was strong in general due to need, it helped to start negotiations pretty early in the year and also be stubborn as a mule .

 

[clozareal]

It won't always be roses unless you landed a unicorn gig with all the main players sticking around for the next several years.

Hmm so what to do with it that is the question: " enter that who wants to be a millionaire theme song"

a) spend it all on sheets, pillows and blankets
b) save it all in the bank
c) invest it in index funds/mutual funds
d) invest it in stocks esp in tech
e) crypto

Why not a bit of all of them? It's all about asset allocation.

 

[Merovinge]

Why not a bit of all of them? It's all about asset allocation.

No reason to complicate things for the average doctor making doctor money. You do not need to make 100%+ returns on anything (e.g. collectibles, options, crypto etc). You just need to make market or even slightly below market returns to have a great life financially. That's the advantage of a high salary.

1-3 fund portfolio is plenty of diversification for the average doctor, keep it easy, consistent, and you are almost guaranteed to win the game.

 

[clozareal]

No reason to complicate things for the average doctor making doctor money. You do not need to make 100%+ returns on anything (e.g. collectibles, options, crypto etc). You just need to make market or even slightly below market returns to have a great life financially. That's the advantage of a high salary.

1-3 fund portfolio is plenty of diversification for the average doctor, keep it easy, consistent, and you are almost guaranteed to win the game.

I think a 1 fund target date portfolio is fine for the average doctor who saves 20% of gross income. Let them do all the work with rebalancing your portfolio for a low expense ratio.

 

[Merovinge]

Yes, for the average doc who wants a set it and forgot it approach and plans to work a full career 30 year career than this is a fool proof method.

However, for those wanting a chance to be FI in half the time some additional investment in time towards learning about investing is a must. Once that is achieved then early in career a small percent of your money could be diversified into things with the potential for higher returns.

I only want to be in medicine post 2030 if i truly keep enjoying it but want the ability to walk away and do other things.

There can be a real hubris to thinking that learning about investing to generate alpha is a thing and one that is more commonly found in doctors. I assure you the finance marketplace make the top medicine folks look like ogres, the best of MIT/Harvard/Stanford PhD programs are all working for funds with virtually unlimitedly more knowledge, data, and computer power than you will dream of.

If the argument is I can afford high risk because I can just work longer, sure that's fine if you want to introduce a higher standard deviation. You can also go to Vegas and play on the 1:1000 odds bet tables on craps and take a 49.995% coin flip for 100K if you want to introduce variance.

If the argument is I want to work a second job in real estate, sure that can work as well (although I would typically just say moonlight with your extra time).

If the argument is I want to learn about how to maximize the revenue from my day job or get into owning ancillary services/surgery centers etc. and find a way to do this legally, that is very likely to generate above market returns.

Most other arguments about seeking alpha are just hubris mixed with chance and there is just no reason for folks with MDs/DOs to go down that rabbit hole.

 

[FlowRate]

I think a 1 fund target date portfolio is fine for the average doctor who saves 20% of gross income. Let them do all the work with rebalancing your portfolio for a low expense ratio.

Higher expense ratio than if you instead hold the underlying funds and you can often set up accounts to automatically rebalance, as well.

Edit: But I agree that many can do much, much, much worse than just set+forget a vanguard target date fund. (Vanguard or any other low expense TD fund. Some smaller companies offer much higher expense TD funds.)

 

[Merovinge]

Higher expense ratio than if you instead hold the underlying funds and you can often set up accounts to automatically rebalance, as well.

Very minimal on most though, 10-15 bps certainly not going to wreck a retirement. Bigger concern is the tax implications, it would be fine in a 401k or other tax protected account but they be an issue in taxable.

 

[Celexa]

As the originator of the thread I'm gonna declare retirement advice off-topic... My plan is to be prudent with my money and keep working jobs I enjoy until I very literally cannot physically do it, or until no such job (including self-employment) can be found. One of the benefits of our field is longevity if you stay healthy.

 

[smalltownpsych]

As the originator of the thread I'm gonna declare retirement advice off-topic... My plan is to be prudent with my money and keep working jobs I enjoy until I very literally cannot physically do it, or until no such job (including self-employment) can be found. One of the benefits of our field is longevity if you stay healthy.

Way to set a clear and reasonable boundary, you’re going to do well in this field if you keep doing that. 😉
It is a little funny to talk much about retirement planning in a thread celebrating your enjoyment of your first position as an attending. The psychologist path is a little different in some ways, but I well remember how I felt about my first job as a licensed psychologist after many years of supervised training and how exciting that was. Enjoy the ride! t
The nice thing about both of our jobs is that there are so many new things to try and ability to be flexible, why retire until I am so damn old I can’t really do much else with my free time.

 

[Mad Jack]

Higher expense ratio than if you instead hold the underlying funds and you can often set up accounts to automatically rebalance, as well.

Edit: But I agree that many can do much, much, much worse than just set+forget a vanguard target date fund. (Vanguard or any other low expense TD fund. Some smaller companies offer much higher expense TD funds.)

TD funds often hide poorly performing assets within them to buffer losses that would otherwise occur due to lack of interest by investors. I recommend just using index funds, personally

 

[untapped]

Celexa what are you gonna splurge on with that first paycheck besides sheets? There's gotta be more

 

[Celexa]

Celexa what are you gonna splurge on with that first paycheck besides sheets? There's gotta be more

OK I did also schedule monthly 90 minute massages

 

[MedMan80]

Celexa what are you gonna splurge on with that first paycheck besides sheets? There's gotta be more

Dad joke but, Escitalopram?

 

[clausewitz2]

TD funds often hide poorly performing assets within them to buffer losses that would otherwise occur due to lack of interest by investors. I recommend just using index funds, personally

May I suggest y'all make a new thread to continue this retirement account conversation? We...do not lack for other investment discussions.

 

[Stagg737]

Dad joke but, Escitalopram?

C'mon man, we're docs. Splurge on some Viibryd.

 

[clozareal]

C'mon man, we're docs. Splurge on some Viibryd.

Psh. Gotta splurge the newest: Auvelity! Or you know, make it yourself cheaper...

 

[MedMan80]

C'mon man, we're docs. Splurge on some Viibryd.

Ive been using more trintillex lately, haven't Rx Viibryd much..but heard it's better for anxiety?

 

[G Sheb]

I appreciate this thread.
Too much here goes around pay. Having a good quality of life, being engaged in what you do feeling fulfilled at the end of the day, looking forward to work with friendly and competent colleagues sometimes counts a lot more than than even one or 200K you bring in additionally.
These positions exist, mostly at quality academic programs that provide good care (though not all of the 'top' programs are not malignant). These places generally invest in keeping their faculty on board. Their well being matters.

 

[Merovinge]

I appreciate this thread.
Too much here goes around pay. Having a good quality of life, being engaged in what you do feeling fulfilled at the end of the day, looking forward to work with friendly and competent colleagues sometimes counts a lot more than than even one or 200K you bring in additionally.
These positions exist, mostly at quality academic programs that provide good care (though not all of the 'top' programs are not malignant). These places generally invest in keeping their faculty on board. Their well being matters.

I work with awesome colleagues at a PHP/IOP, we have amazing speakers for grand rounds, I have fellows coming out year round for learning and I make above market salary working 40 hours week with no call (and honestly a bit under 40 most weeks). One does not need to be at an academic institute for what you describe.

 

[Monocles]

Congratulations! Enjoy that first attending paycheck. And what could be more fun than a mutual fund? Or an index fund if you're feeling really wild!

Go hard on VTSAX.