Anesthesiology ranking near the bottom for both burnout and job satisfaction

[<(^_^)>]

I am in my mid 40s and have been an attending (hospitalist) for over 2 yrs now. Salaries have been 400k.

I got what you are saying regarding the housing market. I purchased a townhome in 2005 for 225k and it's only worth 335k now. I also purchased a house in 2011 after the crash for 150k, and it's worth 500k.

That’s an awesome hospitalist salary. My friends said it was more like 300k, at least for days.

It is astonishing how good stocks have been over the last 15 years. I think a lot of people might be in for an extremely rude awakening…although maybe we are entering an area where companies will be bailed out if stocks go down for a year or two. I still have some YOLO TQQQ from back in the day and it’s becoming an alarming amount of money.

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[qwerty89]

I like how the study has Radiology and Neuroradiology as separate categories and both have completely different results. Study looks like BS.

 

[Splenda88]

That’s an awesome hospitalist salary. My friends said it was more like 300k, at least for days.

It is astonishing how good stocks have been over the last 15 years. I think a lot of people might be in for an extremely rude awakening…although maybe we are entering an area where companies will be bailed out if stocks go down for a year or two. I still have some YOLO TQQQ from back in the day and it’s becoming an alarming amount of money.

Base salary is 350k/yr for 15 days/month, but I work on average ~17 days.

I missed the gain in the stock market, but I have made a little bit of $$$ in the housing market. The property that I bought for 150k in 2011 worths 500k now and it's paid off 2 yrs ago. I used the rent proceed to pay it quickly. It cashflows ~$1600/month.

 

[qwerty89]

Your specific situation is atypical.
And even still, you're looking at 27 instead of 35 years. So retire with 7-8M instead of 10M or put an extra 1-2k a month and make up for lost time.

But my example was for a family maxing out one retirement account and one roth for 35 years. The vast majority of doctors with a spouse can, should, and generally do max at least 2 retirement accounts, or at the very least- one retirement and 2 roths. My example was super conservative and still got you to a 10M nw.

Yet stats show a vast minority of docs retire with a NW >5M. It's baffling, and a real shame.

Gotta keep in mind that those docs that have retired are in their 60s+. That generation didn't have the advantage of white coat investor, YouTube, forums, etc. They typically got sold some high annual fee investments. Back in the days where you didn't have instant online access to your investment portfolio or even real time stock updates. No free trades either. Everything was done by mail or phone which made it more opaque compared to today.

Roth IRA was introduced in 1998.

No excuse for the younger generation though. Plenty of great free resources to use.
It's also going to be more and more important for the younger generation though since they are more likely to be employed and squeezed by their employers for maximal productivity.

 

[anbuitachi]

$24.3M to retire? WTF? I guess I should plan on living in a homeless shelter when I retire. The numbers quoted in these forums are insane sometimes.

You also didn’t account for pay increases (well maybe not for you). I’ve been in practice less than 10 years and I am making more than double what I was making when I first came out. My expenses have increased, but they haven’t doubled…not even close. If your projections for inflation are correct, but anesthesia salaries don’t keep up with inflation then you are going to hear a lot of crickets in the OR instead of the pulse ox. If you increase your spending proportionally with every pay increase then you will have a hard time saving.

It is absolutely within the ability of every physician to save $10M or much more in 30 years (whether you need that much is another topic). If priority #1 is saving $10M by X age, it is doable, so long as you make certain other choices. If you CHOOSE to live in a VHCOL area or collect Ferraris then you are making a very specific choice where accumulating wealth has no longer become a top priority for you.

i dont think i have ever said you need 24.3M to retire. i am simply accounting for the 10M number that gets thrown out on these forums. and i only used 3% inflation. And its pretty well known physician wages do NOT keep up with inflation. obviously doesnt apply to everyone, but no one i know in nyc had a salary bump that matched inflation in the past 4 years.

 

[anbuitachi]

Me: you can have a normal BMI. All you need to do is literally just exercise regularly and burn more calories than you consume.

You: most Americans are obese. And if they can't be in shape, then I can't do it either. You're underestimating the difficulty of 20 mins of exercise and my inability not to snack before bed.

Yup, it sounds that ridiculous. You can stick to your victim mentality, or you can just max out one retirement account and one Roth for 30 years, and retire a multimillionaire.

this post is kind of offensive and clearly doesn't understand the difficulty of maintaining a normal BMI. all my life i lived at around 17-18 BMI which is not normal range. I eat twice as much as my friends/colleagues with normal BMI. I eat breakfast, 2 full plates for lunch, and a large dinner, and i snack during the day. It is expensive and time consuming to eat so much, especially on top of the busy work schedule. To say it's just victim mentality is ridiculous and does not recognize the difficulties. I see the guys in my office who are normal bmi around 23 and they barely eat. its ridiculously different for everyone.

 

[anbuitachi]

Me: you can have a normal BMI. All you need to do is literally just exercise regularly and burn more calories than you consume.

You: most Americans are obese. And if they can't be in shape, then I can't do it either. You're underestimating the difficulty of 20 mins of exercise and my inability not to snack before bed.

Yup, it sounds that ridiculous. You can stick to your victim mentality, or you can just max out one retirement account and one Roth for 30 years, and retire a multimillionaire.

Few notes:
- I'm not underestimating the expenses, I live in a HCOL area myself. I'm not frugal by any means.
-I have kids
-i had loans, paid them off moonlighting through residency.
- Inflation historically is 2.4% in last 20 years and 2.2% in last 100 years. If you're going to use a 3% inflation rate over the next 30 years, I'm going to use a 10% historical s&p return rate and blow your numbers out of the water.
-nobody uses after tax money when calculating or talking about NW. First its not practical, because everyone's tax rate varies widely. Second, capital gains taxes are a bargain compared to income taxes.
-I don't really need to enter the top 1% wealth or care where it's at. It skewed by the likes of pro athletes, hollywood stars, entrepreneurs, billionaires, trust fund babies etc. I just need to accumulate enough to provide me steady returns that allow me to replace my income so I can maintain my QOL indefinitely.
-the contribution limits of retirement accounts are increased proportionally with inflation by the IRS, specifically to account for erosion of purchasing power by your retirement age. So just continue maxing your retirement account and inflation is accounted for.

I'm just a hospitalist, all you anesthesiologists supposedly have a much higher earning potential than me. I'm on track to have a NW of 5M around age 40. I don't think there's anything special about me. If I don't contribute another penny and just don't touch my nest egg, I'll have over 25M by retirement age. If I can do it, you can do it.

i think you are drastically overestimating anesthesiologists earning potential. we have a higher average than hospitalist and work more work hours. we do make more. many IM hospitalists are also working 7 on 7 off and get half the year off. our average rate a hr is higher, but probably not as high as you think. i think the more rural you go, the less difference there is IMO.

and you paid off loans in RESIDENCY thru moonlighting? you mustve graduated a long time ago. average debt after med school is 250k. i cant see any resident moonlighting to pay that off in residency. i dont think thats even possible today. I covered mostly the interest payment in residency because it was at close to 7%. (about 15k a year) i was very frugal in residency.


sure net worth can be calculated in different means. but you have to admit, having 10m in real estate paid off, is very different than 10m in your 401k. 401k is NOT capital gains. it is INCOME TAX. For me thats a effective tax rate of 38%, not insignificant at all.

Also please post your source for inflation is 2.2% for last 100 years. Since 1929, inflation on average was 3.2% per year. Fromm 1960 onwards, inflation was 3.8%. Saying I am overstating inflation with an annual 3% is ridiculous.

Inflation rates in the United States of America

Inflation developments of the past 63 years in the United States of America incl. a comparison to the European Union

www.worlddata.info

U.S. Inflation Rate by Year: 1929 to 2024

By looking at the inflation rate each year, you can gain insight into how prices changed and how events around the globe impacted the average U.S. consumer.

www.investopedia.com

how about you post your expenditures in categories?

 

[anbuitachi]

Base salary is 350k/yr for 15 days/month, but I work on average ~17 days.

I missed the gain in the stock market, but I have made a little bit of $$$ in the housing market. The property that I bought for 150k in 2011 worths 500k now and it's paid off 2 yrs ago. I used the rent proceed to pay it quickly. It cashflows ~$1600/month.

i referred to same thing to nocturnist post. people overestimate anesthesiology salary, and forget that we work one of the highest work hours of all specialties. (61 avg according to aamc.org). your salary for 15 days/month is the same as mine for on average 25 days per month (i get about 5 days totally off on avg - no inhouse or backup call). i get total 20 vacation days and 10 cme days a year and our department is pretty much fully staffed, so we dont have issues recruiting

but also based on those costs, you live in a pretty low cost area. that salary is amazing for the 17 days!

 

[anbuitachi]

from 2020 on 400k salary (so they get 4k tax credit). looks reasonable back then. Major difference i would say other than increase in cost from inflation etc, the biggest difference between now and this, is the interest rate on home. Today at interest rate of 6%, they would pay extra 41% on their home cost compared to 3 years ago. But overall this looks pretty reasonable.

 

[aneftp]

i dont think i have ever said you need 24.3M to retire. i am simply accounting for the 10M number that gets thrown out on these forums. and i only used 3% inflation. And its pretty well known physician wages do NOT keep up with inflation. obviously doesnt apply to everyone, but no one i know in nyc had a salary bump that matched inflation in the past 4 years.

Get out of nyc. And I’ve lived in nyc before. The actual city. Not some suburb.

Teachers make 100– 120k in nyc plus other generous benefits. Other professions do well in nyc relative to what other parts of the country pay. Not doctors.

It’s all supply and demand. If more doctors leave the city. Demand surges.

I got out of that type of rat race up north 15 plus years ago. Not worth it (for physicians) anyplace from dc to Boston. Get out.

 

[triggermaster]

from 2020 on 400k salary (so they get 4k tax credit). looks reasonable back then. Major difference i would say other than increase in cost from inflation etc, the biggest difference between now and this, is the interest rate on home. Today at interest rate of 6%, they would pay extra 41% on their home cost compared to 3 years ago. But overall this looks pretty reasonable.

View attachment 381796

The property insurance here would be 10-50k and the utilities would be 12k. 🤯

 

[aneftp]

from 2020 on 400k salary (so they get 4k tax credit). looks reasonable back then. Major difference i would say other than increase in cost from inflation etc, the biggest difference between now and this, is the interest rate on home. Today at interest rate of 6%, they would pay extra 41% on their home cost compared to 3 years ago. But overall this looks pretty reasonable.

View attachment 381796

$8700 a month (even on 3% interest) a month for a home is insane for 97% of people. ($6700 plus $2000 a month property taxes)

Daycare and pre k 60k. Might as well stay at home for the lower wage spouse (new York is very stay at home wives friendly for divorces so don’t leave the stay at home mom for a mistress) that will cost you even more.

 

[anbuitachi]

The property insurance here would be 10-50k and the utilities would be 12k. 🤯

insurance and utilities have gone up a lot in the past few years so its not reflected here. i live in a coop and they sent a letter saying insurance cost went up 400% last year (how is this possible?! but i have asked other co ops and same happened for them), and utilities is up 220%

 

[Nocturnist]

Again. You have not felt the pain of a crash stock market or housing crash.

As anything in life. Some luck. Some good timing

Image being a pretty new grad in 2004/5. The wife wants a new home. You become a big attending making “real money” aka 220k on a partnership track in 2005. Partners make 500k. 3 year partnership track.

You buy that fancy new home for say 700k stretch your budget a little knowing you will make big money in 2006.

That home value goes down to 450k by 2010. The bank won’t let you short sale because you are a physician. You don’t become partner in 2008. They string you along.

Oh. The 401k tanked in 2008. All those gains you made 2005-2008 wiped out in a matter of months.

This my friend is a set back many doctors face. Both the housing crash and stock market crash.

Than guess what? The anesthesia market tanked with mega mergers in your market. Further depressing salaries. Many salaries are in the low 300s range for another 5-7 more years due to amc squeezing everything

That’s what I mean by anyone who’s been out less than 10-12 years hasn’t felt the true pain of how capital markets work.

Yes. That doc still survived. But a setback of 200k plus on a home and depressed salaries for over a decade is painful.

Their net worth after almost 20 years in the real world is probably less than 2-3 million and they are approaching or past age 50 now. Kids get more expensive as well and now they are having to pay for college.

So since you are only 40 or less. You haven’t felt real pain.

Any idiot who’s been in stock market since 2010 should have double or triplet their profolio. Same with housing prices up a staggering 50% in the past 5 years

Oh. Hospitalist salaries have more than doubled in the past 15 years. My sister in law is a hospitalist. She was making a lowly 130k a year with 10 weeks off in a very high cost of living area. Now she makes 270k with 26 weeks off. Big difference.

Not sure what pain you're referring to? You mean the pain of the longest bull market in history from 2009 onward? Anyone who's been an attending since 2004/5 had the fortune of very lucky sequence of returns, having had very little in their retirement by 2008, then to benefit from 15 years of an unprecedented bull run.

The s&p was down 22% in 2022, so yes I have felt pain. It was down 38% in 2008, and anybody that held made their money back entirely in 2 short years, by 2010.

I would kill for a prolonged stock market crash.
You feel wealthy in a bull market, you become wealthy in a bear market.

I haven't gotten a raise in 8 years. How's your sister in law's 270k salary compared to ya'll income potential?

Again, youre making all the excuses in the world, the one thing i havent heard yet is why you can't max a single retirement and one Roth on one of the best salaried professions on this planet?

 

[sevo00]

The s&p was down 22% in 2022, so yes I have felt pain.

Lmao
22% down that’s cute

 

[aneftp]

Not sure what pain you're referring to? You mean the pain of the longest bull market in history from 2009 onward? Anyone who's been an attending since 2004/5 had the fortune of very lucky sequence of returns, having had very little in their retirement by 2008, then to benefit from 15 years of an unprecedented bull run.

The s&p was down 22% in 2022, so yes I have felt pain. It was down 38% in 2008, and anybody that held made their money back entirely in 2 short years, by 2010.

I would kill for a prolonged stock market crash.
You feel wealthy in a bull market, you become wealthy in a bear market.

I haven't gotten a raise in 8 years. How's your sister in law's 270k salary compared to ya'll income potential?

Again, youre making all the excuses in the world, the one thing i havent heard yet is why you can't max a single retirement and one Roth on one of the best salaried professions on this planet?

You fail to account the housing crash. Very few people who purchased in 2005/2006 as new attending. That was their first major purchase and the home values went down 35-40%.

Very few people stay in those homes to see it recover which took well over 14 years.

Some able to short sell. Some not able to short sell. My buddy got hit with a whopping 290k deficiency judgements after letting home go into foreclosure. The bank went after him. He ended up “settling” for 170k to be paid over 10 years.

That’s pain. For a home he didn’t own or live in. And he had 3 kids in a period of 2 year (twins). During that time.

You forgot about the housing crash. It just not the stock market.
Two big things in a row. While the stock market roared back. Some had to pull money out at the worst time to pay for the homes under water.

 

[Nocturnist]

Again. Judging by 88 name. You are under age 40.

You have not felt pain. And no. That 700k home is worth around 1 million now. Because the real value was around 500k for over 12 years since the crash. So people purchased from 450-500k from 2010-2019.

Anyone who says it’s easy to save 5k a month in a high cost of living area is either single no kids or married and duo income.

Not many people can contribute 20k into retirement plus another 5k a month post tax into sp 500.

When I had no kids. I saved 10k a month easy. And I was only making 390k at the time. Plus putting 20k plus into retirement.

Kids and their activities and savings for 529 etc. cost at least $1500 pe

Car insurance for new driver age 16 can ran from $300-500 extra per kid per. It all add up.

I made 450k plus whatever I make on my side gig (it can vary year by year). Almost 250k last year.

Depends if I find the right gig to do extra work.

so you bought a house for 700k in 2005, you put 140k down. You made 300k on your 140k investment, or roughly 14% per year- even accounting for the worst real estate market in history? Ok, ya- you had to pay some interest and property taxes, but I'm roughly assuming those were outweighed by the rent you didn't have to pay (we can argue on a couple percents return based on your location, but I hope we don't).

As I said, I live in a HCOL area. I pay two 15 year mortgages, spouse became stay at home when we had kids. I am not frugal at all, ironically I'm writing this from the ocean front gym on our Caribbean vacation. We have no issue maxing out three retirement accounts and still plenty left over for the after tax account each month. If you can't save 6-7% of your pre tax income, you have a serious spending problem.

 

[aneftp]

so you bought a house for 700k in 2005, you put 140k down. You made 300k on your 140k investment, or roughly 14% per year- even accounting for the worst real estate market in history? Ok, ya- you had to pay some interest and property taxes, but I'm roughly assuming those were outweighed by the rent you didn't have to pay (we can argue on a couple percents return based on your location, but I hope we don't).

As I said, I live in a HCOL area. I pay two 15 year mortgages, spouse became stay at home when we had kids. I am not frugal at all, ironically I'm writing this from the ocean front gym on our Caribbean vacation. We have no issue maxing out three retirement accounts and still plenty left over for the after tax account each month. If you can't save 6-7% of your pre tax income, you have a serious spending problem.

What the heck at you talking about.

I moved a long time ago. And took a 200k lost which I paid out of pocket. No short sale.

That home value didn’t recover until 2020.

I sold it 14 years ago after renting it out for a year at a lost of $1800 a month. Does it make sense or keep renting losing $1800 a month?

 

[Nocturnist]

from 2020 on 400k salary (so they get 4k tax credit). looks reasonable back then. Major difference i would say other than increase in cost from inflation etc, the biggest difference between now and this, is the interest rate on home. Today at interest rate of 6%, they would pay extra 41% on their home cost compared to 3 years ago. But overall this looks pretty reasonable.

View attachment 381796

I actually think those numbers are pretty accurate. I take a little issue with a mortgage on a 2M house. Financial Samurai is from SF so i think he's really generalizing to the rest of the country. Maybe in SF, but in 2020 Boston, seattle, 2M bought you damn near a mansion in one of the nicest suburbs. For a 4 person family, 1-1.2M bought you more than enough house back then. 60k a year for child care is also objectively a little on the high side. And yet, behold- they managed to put 10% into their retirement and still have a couple bucks left on a 400k salary..

 

[nimbus]

Makes you wonder about the poor schleps who have to live on 300k/yr

 

[Nocturnist]

What the heck at you talking about.

I moved a long time ago. And took a 200k lost which I paid out of pocket. No short sale.

That home value didn’t recover until 2020.

I sold it 14 years ago after renting it out for a year at a lost of $1800 a month. Does it make sense or keep renting losing $1800 a month?

That 700k home is worth around 1 million now.

Dude, I'm not a mind reader. You said your house is worth 1M now so I assume you held on to it.

So you bought a house at the top (presumably 2006ish) and sold it at the bottom (2010).

The median amount of time homeowners stay in their home is over 13 years. I'd venture to say it's probably higher for physician because they're less likely to buy a starter home with their new attending salary.

Sounds like you had terrible luck.
But yes I would have held on to the asset personally.
I say that as someone who owns a rental that was cash flow negative for 5 years until finally this year when rents caught up.
I personally care more about my equity and nw than cash flow.

 

[Splenda88]

i referred to same thing to nocturnist post. people overestimate anesthesiology salary, and forget that we work one of the highest work hours of all specialties. (61 avg according to aamc.org). your salary for 15 days/month is the same as mine for on average 25 days per month (i get about 5 days totally off on avg - no inhouse or backup call). i get total 20 vacation days and 10 cme days a year and our department is pretty much fully staffed, so we dont have issues recruiting

but also based on those costs, you live in a pretty low cost area. that salary is amazing for the 17 days!

I don't live in these home. They are investment properties.

I indeed live in LCOL area when it comes to housing. I purchased my home (4BR/2BA) in 2022 for 280k. My mortgage payment is akin to a luxury car payment.

I feel bad for people who live in HCOL areas. Can't imagine having a mortgage payment >4k/month.

 

[nimbus]

I don't live in these home. They are investment properties.

I indeed live in LCOL area when it comes to housing. I purchased my home (4BR/2BA) in 2022 for 280k. My mortgage payment is akin to a luxury car payment.

I feel bad for people who live in HCOL areas. Can't imagine having a mortgage payment >4k/month.

A lot of HCOL areas were less than $4k/mo just a few years ago. Rising home prices and interest rates really screwed affordability. Current mortgage payments are about 2.5x what they were in 2020 for the exact same house. A 4K/mo house in 2020 is now $10k/mo. People who bought before 2020 and refinanced during the 2-3% fixed rate mortgage era pay even less for the same house.

 

[anbuitachi]

I actually think those numbers are pretty accurate. I take a little issue with a mortgage on a 2M house. Financial Samurai is from SF so i think he's really generalizing to the rest of the country. Maybe in SF, but in 2020 Boston, seattle, 2M bought you damn near a mansion in one of the nicest suburbs. For a 4 person family, 1-1.2M bought you more than enough house back then. 60k a year for child care is also objectively a little on the high side. And yet, behold- they managed to put 10% into their retirement and still have a couple bucks left on a 400k salary..

Makes you wonder about the poor schleps who have to live on 300k/yr

It assumes family of 4. My colleague had a kid in 2021. We are in NYC. Daycare is 3300 per month. A couple hundred discount for the 2nd child per month. And that doesn't include babysitters etc bc daycares don't open at 6am... But even without anything else that's almost 80k for 2 kids for daycare

of course you can't really afford that on our NYC salary. So she moved out shortly after. This was in addition to paying 5k rent for a 1 bedroom. And 3.5k a month on student loans. (Minimum payment for pslf)

 

[ambiturner]

A lot of HCOL areas were less than $4k/mo just a few years ago. Rising home prices and interest rates really screwed affordability. Current mortgage payments are about 2.5x what they were in 2020 for the exact same house. A 4K/mo house in 2020 is now $10k/mo. People who bought before 2020 and refinanced during the 2-3% fixed rate mortgage era pay even less for the same house.

I don’t think most people fully comprehend how huge of a problem this is. It has the potential to create a feudal-style renter and owner class in high cost areas where the only way to afford property will be to inherit it. On the other hand, maybe something happens in the next 5 years to break the trend (lower interest rates, deflation, recession causing people to move for work, who knows). I expect my housing costs to double on my next move unfortunately.

 

[nimbus]

I don’t think most people fully comprehend how huge of a problem this is. It has the potential to create a feudal-style renter and owner class in high cost areas where the only way to afford property will be to inherit it. On the other hand, maybe something happens in the next 5 years to break the trend (lower interest rates, deflation, recession causing people to move for work, who knows). I expect my housing costs to double on my next move unfortunately.

The realtors and mortgage brokers hate it. Owners are also reluctant to sell because they cannot replace their property. The only folks selling are investors who are looking to sell real estate and move the proceeds to another asset class. I agree a recession and job losses could stimulate the RE market.

 

[Nocturnist]

i think you are drastically overestimating anesthesiologists earning potential. we have a higher average than hospitalist and work more work hours. we do make more. many IM hospitalists are also working 7 on 7 off and get half the year off. our average rate a hr is higher, but probably not as high as you think. i think the more rural you go, the less difference there is IMO.

and you paid off loans in RESIDENCY thru moonlighting? you mustve graduated a long time ago. average debt after med school is 250k. i cant see any resident moonlighting to pay that off in residency. i dont think thats even possible today. I covered mostly the interest payment in residency because it was at close to 7%. (about 15k a year) i was very frugal in residency.


sure net worth can be calculated in different means. but you have to admit, having 10m in real estate paid off, is very different than 10m in your 401k. 401k is NOT capital gains. it is INCOME TAX. For me thats a effective tax rate of 38%, not insignificant at all.

Also please post your source for inflation is 2.2% for last 100 years. Since 1929, inflation on average was 3.2% per year. Fromm 1960 onwards, inflation was 3.8%. Saying I am overstating inflation with an annual 3% is ridiculous.

Inflation rates in the United States of America

Inflation developments of the past 63 years in the United States of America incl. a comparison to the European Union

www.worlddata.info

U.S. Inflation Rate by Year: 1929 to 2024

By looking at the inflation rate each year, you can gain insight into how prices changed and how events around the globe impacted the average U.S. consumer.

www.investopedia.com

how about you post your expenditures in categories?

Missed your post earlier. These are the inflation numbers I was going by attached.

I'm 8 years out of residency. I moonlit my butt off, made more than my attendings, and paid my loans off in full a couple months after residency. My loans weren't 250k, though if they were I still would've paid them off my first year as an attending.

Here are my expenditures from another recent thread. I dont bother to subcategorize my credit card bills.

For simplicity,

My mortgage payments are around 13k/month (8500 for my primary with 6 years left and 4500 for my vacation home with 12 years left)
Utilities lets say are another 1k.
College savings $800 per kid.
Credit card bills are 6-7k on average.
10k vacations 3 times a year for another 2.5k/month.
Cars are paid off, student debt long paid off.
No debt other than mortgages.

I max out 2 retirement accounts and spouse maxes out a 3rd. My job contributes another 20k a year, spouse's job stopped contributing since went per diem. This is a total of around 85k a year, plus 13k for each of our Roth's so call it 100k.

Whatever is left, generally around 8k a month goes to our brokerage account. My goal has been 100k a year towards the taxable account.
So I'm investing around 200k a year, plus the 100k a year or so that comes back to my net worth as equity.

So our spending is broadly around 25k/month on average. That's a gross oversimplification. For example, we put a 15k generator last year, and 10k in finish carpentry work to spruce up our vacation house.

But once my primary home is paid off, my monthly spending will go down by 6-7k a month, and another 3-4k a month when 2nd home is paid off. College saving contributions go away too when the kids turn 18. The wild card will be health spendings, which no one can predict.
Inflation and rise in property taxes is impossible to predict as well...

But broadly I'm assuming my spendings would be down to 10-15k a month with paid off homes and kids in college. 200k a year seem like a reasonable target to aim for. I dont hate working and 2 shifts a month can make me 60k, 4 shifts a month 120k etc...so I'm not too worried about my ability to course correct if I'm a little off.

 

[ucsfgaspain]

So as an old fart (relatively) that has been through many real market downturns since the late 1990's. Everyone likes to think they have the mental and fiscal discipline not to make emotional decisions. Kind of like how many of us think they can cut the neck if they have a real Can't intubate Can't ventilate. But until you actually face the situation, you come to the very sobering realization that it is the minority that actually can...But it is the beauty of youth..irrational exuberance and all that stuff. I get it, I was there once. Wisdom comes from the humbling experience of time and mistakes...

 

[IIMC]

The s&p was down 22% in 2022, so yes I have felt pain. It was down 38% in 2008, and anybody that held made their money back entirely in 2 short years, by 2010.

How did you come up with 2010? Looking at the S&P500 it looks like this market didn’t recover until around October 2013.

 

[nimbus]

So as an old fart (relatively) that has been through many real market downturns since the late 1990's. Everyone likes to think they have the mental and fiscal discipline not to make emotional decisions. Kind of like how many of us think they can cut the neck if they have a real Can't intubate Can't ventilate. But until you actually face the situation, you come to the very sobering realization that it is the minority that actually can...But it is the beauty of youth..irrational exuberance and all that stuff. I get it, I was there once. Wisdom comes from the humbling experience of time and mistakes...

And we make enough and can save enough that even with mistakes, we can still build a nice nest egg.

 

[ucsfgaspain]

And we make enough and can save enough that even with mistakes, we can still build a nice nest egg.

Absolutely!

 

[Nocturnist]

How did you come up with 2010? Looking at the S&P500 it looks like this market didn’t recover until around October 2013.

Nasdaq was 2600s at the end of 2007/beginning of 2008, and was back to the same level by the end of 2010. Dow Jones was back to its pre 2008 level by Q1 of 2011. You're right, s&p did take a year or two longer.

 

[pgg]

I don’t think most people fully comprehend how huge of a problem this is. It has the potential to create a feudal-style renter and owner class in high cost areas where the only way to afford property will be to inherit it.

That potential was recognized a long time ago. Private equity has been buying up MASSIVE quantities of single family homes for the last decade.

They're not going to banks asking for mortgages; their capital costs are far, far less than ordinary buyers. Investors are shoveling money in - there aren't any loan fees, points, interest to pay. No monthlong waits for mortgage applications. Consequently they've been able to offer market or even over market prices while actually paying less in the end than ordinary people. Much of the runup in residential real estate is because of PE.

Housing market corrections or crashes help PE more than individuals. I don't know how our society fixes this trend. There's no way it stops or reverses, absent government intervention, which carries its own issues and legal hurdles.

It's a ****ty time to be a young person who wants to buy a house.

 

[aneftp]

Nasdaq was 2600s at the end of 2007/beginning of 2008, and was back to the same level by the end of 2010. Dow Jones was back to its pre 2008 level by Q1 of 2011. You're right, s&p did take a year or two longer.

That was the major mistake I made with "new" money I put into the market in 2009-2011, I kept most of it in cash instead of the standard market.

While waiting for the "old" money I had in pre mid 2008 crash to recover, the "new" money wasn't doing anything.

It's very hard to time the market.

My friends pulled as much as 40% out of their portfolio in April 2020 with covid, missed out on a huge rally that happened quickly.

Even in early year 2022 many people were thinking they were the smartest guy/gal in the room by pulling a lot of their money at or near the "peak". as the market went down throughout 2022. Many kept their money in cash/treasury yields at a 5% rate patting themselves in the back only to miss the market coming back. There were literally trillions (5.84 trillion) parked in money market funds in November 2023. They missed out big time as the market closed out the year strong.

Moral of the story, if you don't need the money in the next 5 years AND anticipate earning the same or more income, just keep rolling the dice. Your earning potential will continue to makeup for whatever losses you could incur as a worst case situation.

 

[<(^_^)>]

If you’re a Nocturnist you can make about as much as anesthesiologists by working the same hours. It’s not like you’re M-F peds outpatient. A Nocturnist buddy made 680k last year working 18 nights a month. Thats obviously a lot of nights but it’s the equivalent of 43 weeks M-F and 9 weeks vacation. He never switched, which as I understand it is the main thing damaging from a health standpoint. Not for everyone, but the money is out there.

 

[Nocturnist]

Lmao
22% down that’s cute

Ok, boomer?

The 4th largest single daily drop was in 2020 at 12%. The top 3? All 100 years ago. 2008 wasn't even in the top 5. 3 of the top 20 were in 2020, only 2 were in 2008. We watched the dow go down 38% from 30k to 19k in 3 weeks.

Cute enough for you?

So as an old fart (relatively) that has been through many real market downturns since the late 1990's. Everyone likes to think they have the mental and fiscal discipline not to make emotional decisions. Kind of like how many of us think they can cut the neck if they have a real Can't intubate Can't ventilate. But until you actually face the situation, you come to the very sobering realization that it is the minority that actually can...But it is the beauty of youth..irrational exuberance and all that stuff. I get it, I was there once. Wisdom comes from the humbling experience of time and mistakes...

If you can't afford to watch your investments take a 50% cut and not buy more (or at least, not sell), you've either invested more than you can afford or haven't adjusted your investments to reflect your risk tolerance as you get closer to retirement. Everyone should be asking themselves at every given point- can I watch my investments/retirement take a 50% haircut and not care? If the answer is no, you have to rethink your strategy...or better yet, give up that 1% AUM and let somebody else manage your portfolio for you. The gain drag would suck, but they'll at least talk you out of being your own worse enemy.

 

[Nocturnist]

If you’re a Nocturnist you can make about as much as anesthesiologists by working the same hours. It’s not like you’re M-F peds outpatient. A Nocturnist buddy made 680k last year working 18 nights a month. Thats obviously a lot of nights but it’s the equivalent of 43 weeks M-F and 9 weeks vacation. He never switched, which as I understand it is the main thing damaging from a health standpoint. Not for everyone, but the money is out there.

I really wish you'd float over to the hospitalist forums and tell them that. I only average 550k and I'm consistently accused of having the most unicorn nocturnist job known to man. I keep telling them there's nothing special about it. Still, not out of line with non academic anesthesia salaries?

 

[Splenda88]

Ok, boomer?

The 4th largest single daily drop was in 2020 at 12%. The top 3? All 100 years ago. 2008 wasn't even in the top 5. 3 of the top 20 were in 2020, only 2 were in 2008. We watched the dow go down 38% from 30k to 19k in 3 weeks.

Cute enough for you?



If you can't afford to watch your investments take a 50% cut and not buy more (or at least, not sell), you've either invested more than you can afford or haven't adjusted your investments to reflect your risk tolerance as you get closer to retirement. Everyone should be asking themselves at every given point- can I watch my investments/retirement take a 50% haircut and not care? If the answer is no, you have to rethink your strategy...or better yet, give up that 1% AUM and let somebody else manage your portfolio for you. The gain drag would suck, but they'll at least talk you out of being your own worse enemy.

People should have at least 12-18 months emergency fund when they retire in the event of market downturn so you don't have to withdraw money while the market is tanking.

 

[BLADEMDA]

So, if you want to retire with a $25,000 monthly budget you need about $14 million dollars saved up by age 65. This assumes a 6-7 percent annual return and 3% inflation. $25,000 per month represents roughly 60% of the annual salary of $500,000. I humbly submit to you that $14 million is the new number for an attending starting out in 2023.

Retirement Calculator - NerdWallet

Our retirement calculator estimates your savings based on your current contributions and then calculates how that money will stretch in today's dollars.

www.nerdwallet.com

 

[BLADEMDA]

Doctors Don't Save​

The bigger problem is that doctors, like everyone else, don't accumulate enough money to pay for their desired retirement. Check out this survey from Medscape where doctors were asked about their net worth. Remember that this is everything they have, not just their retirement nest egg. It includes their home(s), car(s), and all of their other stuff. So, their nest egg isn't even this large.



As you can see, one-quarter of doctors in their 60s aren't even millionaires, and only about 1 in 6 have $5 million or more. Doctors might say, “I need $5 million (or $10 million) to retire,” but almost none have it.


White Coat Investor

 

[BLADEMDA]

For a physician who has been making $200,000, $300,000, or even $400,000 per year, the thought of living on only $40,000 per year might be downright depressing. If a physician wanted to replace their entire $200,000 income, they would need a $5 million portfolio. To achieve that over a 30-year career with a 5% annualized return, they would need to put $73,000 per year toward retirement—or nearly 37% of their income! If they wanted to retire early after 20 years of practice, that number rises to 72% of their income—a nearly impossible figure.

This is bad news indeed.


White Coat Investor

 

[aneftp]

Doctors Don't Save​

The bigger problem is that doctors, like everyone else, don't accumulate enough money to pay for their desired retirement. Check out this survey from Medscape where doctors were asked about their net worth. Remember that this is everything they have, not just their retirement nest egg. It includes their home(s), car(s), and all of their other stuff. So, their nest egg isn't even this large.



As you can see, one-quarter of doctors in their 60s aren't even millionaires, and only about 1 in 6 have $5 million or more. Doctors might say, “I need $5 million (or $10 million) to retire,” but almost none have it.


White Coat Investor

The younger ones not married don’t max out their retirement. They only do the bare minimum with the employer match.

At least in my practice. This young doc age 30. Barely out of residency. He took a big vacation before he started. He didn’t even start till the fall. So took 3 months off.

But he owes like 400k student loans. and really doesn’t want to pay it off. Counting on loan forgiveness. Doesn’t put money into tax advantage 403b or 457b.

Basically a millennial who wants the money but doesn’t want to work for it. Just brought a brand new luxury car. Now he’s on an expensive ski trip with the girl friend internationally. And I ain’t talking. Canada. I mean in the Swiss alps. Granted skiing tickets are cheaper in Europe. But still the travel and expense.

And than complains we aren’t making enough

He’s already behind the 8 ball in terms of savings. The best time to save is when you are single and he’s not doing it. But there are many just like him. I try to hook him up with some locums gigs. And the first thing he ask is it easy.

 

[Nocturnist]

For a physician who has been making $200,000, $300,000, or even $400,000 per year, the thought of living on only $40,000 per year might be downright depressing. If a physician wanted to replace their entire $200,000 income, they would need a $5 million portfolio. To achieve that over a 30-year career with a 5% annualized return, they would need to put $73,000 per year toward retirement—or nearly 37% of their income! If they wanted to retire early after 20 years of practice, that number rises to 72% of their income—a nearly impossible figure.

This is bad news indeed.


White Coat Investor

This is just some click bate BS to make high income earners feel needlessly anxious about never being able to retire.

5%? I get a better return in my HYSA or MMF. That's an absurdly conservative calculation.

At an 8% return which is already fairly conservative, you'd need to save 39,600 per year.
At 10% which is closer to the actual historical average, you'd get there with only 26,400 a year.

Mind you that includes your own contributions plus employer match. You're telling me your employer doesnt kick in at least 10k a year? You're telling me you can't set aside 15-30k a year at your income?

which circles back to my original point-
Don't overthink it. Definitely don't think it's out of reach like this article wants you to..

Just max out a single retirement account and a single roth, take advantage of 100% of your employer's match, don't touch your money for 30 years, and I promise you you'll have much more than 5M by retirement. There's no reason any physician with a 30 year career should settle for any less.

 

[mmag]

For a physician who has been making $200,000, $300,000, or even $400,000 per year, the thought of living on only $40,000 per year might be downright depressing. If a physician wanted to replace their entire $200,000 income, they would need a $5 million portfolio. To achieve that over a 30-year career with a 5% annualized return, they would need to put $73,000 per year toward retirement—or nearly 37% of their income! If they wanted to retire early after 20 years of practice, that number rises to 72% of their income—a nearly impossible figure.

This is bad news indeed.


White Coat Investor

I don't get this. Can you really replace your entire income? If you want to have 200k a year in retirement, you have to put away 73k a year. If you make 200k a year, then really you are living off of 127k a year. Since you are saving for retirement, you never have your total income and you don't need save for retirement when you are retired.

 

[Nocturnist]

Doctors Don't Save​

The bigger problem is that doctors, like everyone else, don't accumulate enough money to pay for their desired retirement. Check out this survey from Medscape where doctors were asked about their net worth. Remember that this is everything they have, not just their retirement nest egg. It includes their home(s), car(s), and all of their other stuff. So, their nest egg isn't even this large.



As you can see, one-quarter of doctors in their 60s aren't even millionaires, and only about 1 in 6 have $5 million or more. Doctors might say, “I need $5 million (or $10 million) to retire,” but almost none have it.


White Coat Investor

Thank you for posting this. This is actually the chart that inspired me to aim to have a nw>5M by 40 and a big part of why I'm passionate about it. It should be mandatory reading for all physicians.

The percentage of physicians that have <1M net worth by their 50s and 60s is downright embarrassing. The fact that the vast majority will never get to that 5M mark that is the minimum we should aim for, when the path is so straight forward, is disappointing to me.
We should all strive to part of that purple.

 

[qwerty89]

The younger ones not married don’t max out their retirement. They only do the bare minimum with the employer match.

At least in my practice. This young doc age 30. Barely out of residency. He took a big vacation before he started. He didn’t even start till the fall. So took 3 months off.

But he owes like 400k student loans. and really doesn’t want to pay it off. Counting on loan forgiveness. Doesn’t put money into tax advantage 403b or 457b.

Basically a millennial who wants the money but doesn’t want to work for it. Just brought a brand new luxury car. Now he’s on an expensive ski trip with the girl friend internationally. And I ain’t talking. Canada. I mean in the Swiss alps. Granted skiing tickets are cheaper in Europe. But still the travel and expense.

And than complains we aren’t making enough

He’s already behind the 8 ball in terms of savings. The best time to save is when you are single and he’s not doing it. But there are many just like him. I try to hook him up with some locums gigs. And the first thing he ask is it easy.

From what I remember you work in Florida so this probably doesn't apply. But many normal private practice jobs in CA and TX now qualify for PSLF through a loophole.

Does Kaiser Permanente Qualify for PSLF? | White Coat Investor

Many doctors have benefitted from PSLF. But another adjustment to the program is coming, meaning many more docs could qualify.

www.whitecoatinvestor.com

Many many docs will get full loan forgiveness easily in those states now. Sounds like your millennial colleague would like CA. Live in coastal CA. Enjoy the lifestyle while still working for a normal private practice rather than the VA or academics. Make modest minimum qualifying payments and then PSLF tax free. Then you can leave after. The longer your training the better since more of the 10 year period happens in your low income training years.

You really are incentivized to take max loans with this kind of deal and start investing sooner.

 

[Splenda88]

Thank you for posting this. This is actually the chart that inspired me to aim to have a nw>5M by 40 and a big part of why I'm passionate about it. It should be mandatory reading for all physicians.

The percentage of physicians that have <1M net worth by their 50s and 60s is downright embarrassing. The fact that the vast majority will never get to that 5M mark that is the minimum we should aim for, when the path is so straight forward, is disappointing to me.
We should all strive to part of that purple.

Your expenses seem to be high. How the heck you already have that kind of net worth?

My mortgage is < $1600 and I think it's too damn high.

 

[Nocturnist]

Your expenses seem to be high. How the heck you already have that kind of net worth?

My mortgage is < $1600 and I think it's too damn high.

Because your net worth includes your home equity. And because 80% of my mortgage (and rising each year as I pay my principal down), returns to me directly in home equity. Only the interest on the mortgage and property taxes are true expenses, the rest is just a transfer of liquid assets to less liquid assets from me to myself.

 

[aneftp]

This is just some click bate BS to make high income earners feel needlessly anxious about never being able to retire.

5%? I get a better return in my HYSA or MMF. That's an absurdly conservative calculation.

At an 8% return which is already fairly conservative, you'd need to save 39,600 per year.
At 10% which is closer to the actual historical average, you'd get there with only 26,400 a year.

Mind you that includes your own contributions plus employer match. You're telling me your employer doesnt kick in at least 10k a year? You're telling me you can't set aside 15-30k a year at your income?

which circles back to my original point-
Don't overthink it. Definitely don't think it's out of reach like this article wants you to..

Just max out a single retirement account and a single roth, take advantage of 100% of your employer's match, don't touch your money for 30 years, and I promise you you'll have much more than 5M by retirement. There's no reason any physician with a 30 year career should settle for any less.

Many people from 2011-2019 worked at AMC as anesthesia salaries collapsed. Many amc like Sheridan (now envision) team health had no matching or tiny $3000 matches.

From what I remember you work in Florida so this probably doesn't apply. But many normal private practice jobs in CA and TX now qualify for PSLF through a loophole.

Does Kaiser Permanente Qualify for PSLF? | White Coat Investor

Many doctors have benefitted from PSLF. But another adjustment to the program is coming, meaning many more docs could qualify.

www.whitecoatinvestor.com

Many many docs will get full loan forgiveness easily in those states now. Sounds like your millennial colleague would like CA. Live in coastal CA. Enjoy the lifestyle while still working for a normal private practice rather than the VA or academics. Make modest minimum qualifying payments and then PSLF tax free. Then you can leave after. The longer your training the better since more of the 10 year period happens in your low income training years.

You really are incentivized to take max loans with this kind of deal and start investing sooner.

He’s getting loan forgiveness (for now) until our savor trump reverses the dept of education directive under Biden. Biden exempted even religious organizations so people working for them get loan forgiveness

Remember. Its guidance the current president directs. Trump may initiate a different guidance when he becomes president again

The rules for loan forgiveness have become way too loose (befor you had to work for the peace corps or like a VA/military style hospital to get loans forgiven).

Or do it the old fashion way like me and pay it ourselves without assistance. And I made $3.80/hr working grocery store during my college years before getting a pay bump to $4.25/hr

And my unsubsidized loans were 8.25% and I think my subsidized loans were 7%. I owed I think 117k. Which in today’s money is worth close to 400k in loans as well. Home mortgage interest rates were 7% as well in the later half of the 1990s.

So people complaining today about how expensive things are today. Don’t know the lean years I had to live through.

 

[Splenda88]

Because your net worth includes your home equity. And because 80% of my mortgage (and rising each year as I pay my principal down), returns to me directly in home equity. Only the interest on the mortgage and property taxes are true expenses, the rest is just a transfer of liquid assets to less liquid assets from me to myself.

I understand. I have 3 homes and I include the equity as part of my net worth.

You have been out of residency for less 10 yrs and it's remarkable your net worth > 3 mil if your spouse does not make as much as you do.

Do you day trade?