Going Back for Fellowship after Being in Practice

[QofQuimica]

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I'm a second year academic attending who will be applying for fellowship this summer to start July 2017. Anybody here who has gone back into training after a few years in general practice and would be willing to let me bounce my financial logistics plans off you? (I guess anyone who has taken a planned 75% paycut from one year to the next in a non-medical career should also feel free to chime in. 😛)

 

[mvenus929]

I have no advice, just wanted to tag the thread as I intend to apply to fellowship after graduation as well.

 

[ThoracicGuy]

I haven't gone back to training, but I'd be open to discussing issues or questions if you want.

 

[QofQuimica]

I have no advice, just wanted to tag the thread as I intend to apply to fellowship after graduation as well.

Sure, feel free to add any questions you have. I am also happy to provide any insight to you that I can.

I haven't gone back to training, but I'd be open to discussing issues or questions if you want.

Hmm, as I ponder this situation more, I realize that I actually feel like I have the logistics of the next 3-4 years pretty well figured out. But I do still have some uncertainties, such as these:

1) Feasibility/desirability of moonlighting in your primary specialty as a fellow. What is the optimal way to balance this? If you don't have to moonlight for financial reasons, is it still worth doing for secondary reasons like keeping up your skills in your primary specialty or to achieve secondary financial goals more quickly than you would be able to do otherwise?

2) Optional research year/MS degree. At least one of the programs I'm interested in offers this. I am already an MD/PhD with two MSes and definitely don't need a third, but I would like the protected research time. Thoughts about doing this?

I should add the caveat that I am *not* interested in opportunity cost arguments regarding financial losses due to not continuing to work as an attending in my primary specialty. That is not an option on the table; if I didn't do a fellowship, I'd either be dropping to PT work or doing something else altogether. From my perspective, a major reason for working toward FI before fellowship is to avoid the need for making these decisions based upon what makes the most sense financially. I also should point out that, besides the loss of income due to the fellowship itself, I will almost certainly earn less money in my subspecialty than I would earn if I continued working FT in my primary specialty. Again, for me, earning more money is not a motivation for doing the fellowship.

 

[dpmd]

Sure, feel free to add any questions you have. I am also happy to provide any insight to you that I can.


Hmm, as I ponder this situation more, I realize that I actually feel like I have the logistics of the next 3-4 years pretty well figured out. But I do still have some uncertainties, such as these:

1) Feasibility/desirability of moonlighting in your primary specialty as a fellow. What is the optimal way to balance this? If you don't have to moonlight for financial reasons, is it still worth doing for secondary reasons like keeping up your skills in your primary specialty or to achieve secondary financial goals more quickly than you would be able to do otherwise?

2) Optional research year/MS degree. At least one of the programs I'm interested in offers this. I am already an MD/PhD with two MSes and definitely don't need a third, but I would like the protected research time. Thoughts about doing this?

I should add the caveat that I am *not* interested in opportunity cost arguments regarding financial losses due to not continuing to work as an attending in my primary specialty. That is not an option on the table; if I didn't do a fellowship, I'd either be dropping to PT work or doing something else altogether. From my perspective, a major reason for working toward FI before fellowship is to avoid the need for making these decisions based upon what makes the most sense financially. I also should point out that, besides the loss of income due to the fellowship itself, I will almost certainly earn less money in my subspecialty than I would earn if I continued working FT in my primary specialty. Again, for me, earning more money is not a motivation for doing the fellowship.

If you don't enjoy your primary specialty i don't see a good reason for you to moonlight in it if you will enjoy your subspecialty. The earlier attainment of financial independence should be weighed against your current (well soon to be current) happiness. Same principle should apply to the research thing. You live frugally so the pay cut shouldn't affect you excessively even with the extra lost year of attending income. You know this though or you would be staying in your higher paid specialty

 

[tartesos]

If you don't enjoy your primary specialty i don't see a good reason for you to moonlight in it if you will enjoy your subspecialty. The earlier attainment of financial independence should be weighed against your current (well soon to be current) happiness. Same principle should apply to the research thing. You live frugally so the pay cut shouldn't affect you excessively even with the extra lost year of attending income. You know this though or you would be staying in your higher paid specialty

great advise! only thing to add is to save as much as possible on top of your emergency fund for your time in fellowship.

Doing what makes you happy will make all your struggles bearable, even if you eat ramen soup for dinner 5x a week.

Good luck!

 

[Mman]

I'm a second year academic attending who will be applying for fellowship this summer to start July 2017. Anybody here who has gone back into training after a few years in general practice and would be willing to let me bounce my financial logistics plans off you? (I guess anyone who has taken a planned 75% paycut from one year to the next in a non-medical career should also feel free to chime in. 😛)

My financial advice would be to make sure you are not living on a pricy lifestyle right now. As part of your savings during that, I'd build up a big enough liquid asset pile to supplement your fellowship paycheck. That combination will ensure that you don't have to drastically alter your lifestyle in terms of cost of living as you make the transition.

 

[QofQuimica]

My financial advice would be to make sure you are not living on a pricy lifestyle right now. As part of your savings during that, I'd build up a big enough liquid asset pile to supplement your fellowship paycheck. That combination will ensure that you don't have to drastically alter your lifestyle in terms of cost of living as you make the transition.

Maybe I should give you guys some specifics then, since this advice, while generally sound, is not particularly helpful in my specific situation. Currently I spend ~$36,000/year, and I don't see myself cutting back my expenses a whole heck of a lot more. I spend ~$2500/month on myself. This includes my pricey individual DI policy, which I will probably keep during fellowship. I also spend ~$500/month on my niece's prepaid college fund. I will still owe the state ~$15,000 for that in July 2017 when I start fellowship. I had considered paying this off early, but decided against it since the state does not deduct any interest for early payments. Instead, I plan to keep the money set aside in a savings account, although I fully anticipate being able to pay for it out of my fellowship stipend, which would be ~$60,000/year.

The main "secondary goals" I was talking about include purchasing a similar prepaid college fund for my nephew. The cost of this is about $30,000 for four years of prepaid tuition to any of our state universities. I cannot prepay this amount unless I do it early next year right before starting fellowship, as he will not be born for another month and the state has a yearly window of enrollment. Even if I could, I also do not want to pay it all in one year, as this will cause him to owe a gift tax since it is over $14,000, and I wish to also fund a 529 for him on a monthly basis like I am for his sister (so I would not be able to squeeze five years of gifts into one year). If I moonlighted during fellowship, I could easily afford to fund both of their college programs at the same time. If not, I would fund their college programs sequentially. (I will be done paying for hers in October 2019, which will either be during or right after I finish the fellowship, depending on whether I take an extra year for research.)

 

[bc65]

There's no reason why you have to follow such a strict schedule.
So, either moonlight for the extra money, or just take it out of savings, perhaps from your emergency fund. Or just wait a year or two to fund the nephew's account.

I also try to have different buckets of money for different needs or projects, but the money itself doesn't care where it comes from or where it goes. If the pleasure of funding all the accounts from earnings right now exceeds the pain of moonlighting, then moonlight. If you're rather enjoy your fellowship year, then the kid can wait a couple of years for his tuition. It's not like he's missing anything, you know. He hasn't even been born yet! 😉

 

[PhysicianOnFIRE]

It looks like you've got the finanancial part figured out, living well, well below your means and understanding the concept of FI. How long is the fellowship? Depending on specialty / subspecialty, we could be talking 1,2 or 3 years.
I see that you don't love your primary specialty, but moonlighting on occasion might be a good way to provide a financial buffer if you get into fellowship and fail to find fulfillment there. If you decide none of it is making you happy, you might be in a better position to finish funding the niece & nephew college funds, and RE completely, doing whatever it is that you love every day.

 

[QofQuimica]

There's no reason why you have to follow such a strict schedule.
So, either moonlight for the extra money, or just take it out of savings, perhaps from your emergency fund. Or just wait a year or two to fund the nephew's account.

I also try to have different buckets of money for different needs or projects, but the money itself doesn't care where it comes from or where it goes. If the pleasure of funding all the accounts from earnings right now exceeds the pain of moonlighting, then moonlight. If you're rather enjoy your fellowship year, then the kid can wait a couple of years for his tuition. It's not like he's missing anything, you know. He hasn't even been born yet! 😉

True. Even if I wait until I'm completely done funding hers to fund his, he'll only be nine when I'm done funding his. Not that he won't be a perfect genius, of course, but probably he won't be ready for college just yet at that point. 🙂

It looks like you've got the finanancial part figured out, living well, well below your means and understanding the concept of FI. How long is the fellowship? Depending on specialty / subspecialty, we could be talking 1,2 or 3 years.
I see that you don't love your primary specialty, but moonlighting on occasion might be a good way to provide a financial buffer if you get into fellowship and fail to find fulfillment there. If you decide none of it is making you happy, you might be in a better position to finish funding the niece & nephew college funds, and RE completely, doing whatever it is that you love every day.

The fellowship is 2-3 years.

The problem is, I don't see myself completely doing nothing. The more I read about early retirement, the more I realize that the only way to get to the point where you can retire early, is to be too Type A to even WANT to retire early. Look at people like MMM, ERE, etc, and you see that they all go back to working PT, albeit at different things than what they had been doing previously. And it's not that I want to do nothing all day. I just don't want to HAVE to work, and particularly not when it involves jumping to someone else's demands on how high. Other options I have considered are working PT or working abroad again. If I wind up not liking the fellowship, I would probably do one of those options.

 

[PhysicianOnFIRE]

True. Even if I wait until I'm completely done funding hers to fund his, he'll only be nine when I'm done funding his. Not that he won't be a perfect genius, of course, but probably he won't be ready for college just yet at that point. 🙂


The fellowship is 2-3 years.

The problem is, I don't see myself completely doing nothing. The more I read about early retirement, the more I realize that the only way to get to the point where you can retire early, is to be too Type A to even WANT to retire early. Look at people like MMM, ERE, etc, and you see that they all go back to working PT, albeit at different things than what they had been doing previously. And it's not that I want to do nothing all day. I just don't want to HAVE to work, and particularly not when it involves jumping to someone else's demands on how high. Other options I have considered are working PT or working abroad again. If I wind up not liking the fellowship, I would probably do one of those options.

Getting to that magical 25x expenses does take some Type A behavior. It's hard to imagine anyone with the drive to complete medical school in residency retiring extremely early to do nothing. As they say, you should retire to something.

If I follow through with an early retirement at some point in my forties (I'm 40 now), I will have plenty to do. 2 kids at home / in school, hobbies that I wish I had more time for, lots of travel (particularly when the nest is empty). OTOH, I've known a number of physicians who have "failed retirement" and returned to work. I would recommend hanging onto the license and board certification for at least a couple years after leaving medicine for retirement or another career path.

You are wise to have already contemplated a couple options if you wind up not liking the fellowship.