Is Medicine/Psychiatry A Calling?

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That's quite an idealistic perspective. Sure, for some people, medicine may indeed be a calling and they get a spiritual satisfaction that negates the pains of personal sacrifice. Kudos to them. For most of us, medicine is a profession that demanded rigorous training and specific sacrifice in return for a certain level of compensation. Most of us did not go into medicine to be martyrs. I'd change my career without a second thought if I thought it was causing irreparable damage to my family or anything else I truly value.

Fwiw, the people I know who spoke the most about medicine being a "calling" are the ones I've seen burn out and crash the hardest. Nor have I ever seen a correlation between how much of a "calling" medicine is and competence as a physician. You don't need to have a "calling" to have a strong work ethic, provide top clinical care, and stay abreast of your field.
 
Whether or not it's considered a calling or vocation is a deeply personal experience. For me, it's been very meaningful. It started with a childhood curiosity about science and neuroscience, and as I've grown, it's evolved into a profound sense of humanism. Lately, as I approach mid-life, I've been reflecting on this path. There’s no crisis here! I'm very grateful I prioritized curiosity/intellectual fulfillment over money. I also believe this attitude helps patients. It's hard to inspire hope when you don't like your work.
 
Atreides said:
That's quite an idealistic perspective. Sure, for some people, medicine may indeed be a calling and they get a spiritual satisfaction that negates the pains of personal sacrifice. Kudos to them. For most of us, medicine is a profession that demanded rigorous training and specific sacrifice in return for a certain level of compensation. Most of us did not go into medicine to be martyrs. I'd change my career without a second thought if I thought it was causing irreparable damage to my family or anything else I truly value.

Fwiw, the people I know who spoke the most about medicine being a "calling" are the ones I've seen burn out and crash the hardest. Nor have I ever seen a correlation between how much of a "calling" medicine is and competence as a physician. You don't need to have a "calling" to have a strong work ethic, provide top clinical care, and stay abreast of your field.
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While I can appreciate your perspective, I find it deeply offensive that “idealism” has become something of a dirty word in medicine. Whether it is a calling or not, medicine is an inherently idealistic profession. There are many jobs you can do where there is little or no moral valence to the particular work itself (other than perhaps some philosophical position on the personal value of work in and of itself). If you stock vending machines, I imagine there is very little consideration given to who is buying the soda, whether one has bettered lives through their work, or what professional obligations one has to society.

Nobody is forced to be a martyr, but I do believe that being a doctor involves putting others first. When somebody is sick, you should help them to the best of your ability. Your personal gain from the interaction should be secondary to your obligation as a physician to help. If there is a serious wreck on the highway, I will stop. If an acquaintance is calling me because they are struggling to figure out how to best care for their mentally ill family member, I will listen and offer the best advice I can. It would be one thing if physicians were starving in the streets, but they are not. I think that it is more important to make sure people are getting the care they need regardless of their circumstances than it is to figure out how to make $400K rather than $300K.

Early in medical school, I had more of a mercenary perspective. Like you, I thought that medicine was essentially a good job with certain social responsibilities. As I interacted with more patients and realized the degree to which medicine touches people’s lives, my perspective flipped to viewing medicine more as a social role that happens to generally be a good job. The COVID pandemic also launched into full swing during my final years of residency, and it really changed how I viewed my role as a doctor.

Having said this, I am effectively a civil servant in a public institution. Everybody here gets cared for regardless of ability to pay. Frankly, I don’t even understand how we bill for things here. My job is frustrating in a lot of ways, but thinking about payment/compensation simply isn’t one of them. Perhaps my thoughts would be different if I was a private practice psychiatrist.
 
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I think we have this false dichotomy going. Is it just a job, or is it a calling? I think in our society as currently structured it should be both at once.

If we take a "calling" to mean that we focus only on values of the profession and ignore or heavily minimize self-interest, lots of problems follow. It is easy for employers to exploit us. We can drive ourselves into the ground giving and ignoring our, and even more importantly our family's, needs. We need to recognize that we are highly trained professionals doing something that generates huge economic value, and we need to hold firm boundaries with employers that recognize we will not be forced to practice below our own standards of care, or in a way that leaves us feeling exploited.

I always remember that if my toilet breaks the plumber isn't going to come out for $10/hour because I'm such an awesome, generous dude. As long as I don't get a "doctor discount" on everything in society, I am going to make sure I am getting fairly compensated for my own family's wellbeing.

But that doesn't mean dropping off relevant values. Even if you are a janitor in the hospital, viewing your job through a lens of purpose means a lot. You can see yourself as an important member of the team, making patient stays more pleasant, helping prevent infection, helping staff work in a pleasant environment, etc. The person who truly internalizes that will likely get deeper satisfaction from that job than they would just clocking in and clocking out. That person can also show up feeling good about pushing to do the best job they can rather than seething with resentment at being forced to sell away the hours of their life for money. In the same way we need to connect with the purpose in the deeply human enterprise of helping another suffering human being get well, or at least decrease their suffering. While we are being paid for what we do, it doesn't negate the meaning of it.

I also think the two feed on each other. A purpose-driven, passionate doctor is going to be worth more to employers and patients. A financially intelligent doctor with good boundaries is going to be less burned out, feel less taken advantage of, and feel more emotionally charged to show up and do a good job.

I think once we view the job/calling debate as a false dichotomy we can start looking at how we maximize our work as psychiatrists viewing this as a job and a calling.
 
slowthai said:
Inspired by this comment.
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Psychiatry IS medicine. I might argue that anyone strong in medicine has the potential to be an excellent psychiatrist, but Psychiatry itself selects for people who excel at connecting with patients and arguably knows when *not* to prescribe something. When *not* to hold someone. When *not* to talk.
 
Yes, it is. There's far more efficient ways to chase money and profit xD. I'm not saying that many physicians enter the field for money, but many over time are burned out and feeling underpaid. And if you break down the student loans, time in school, hours worked and take home pay, imho the pay is not great. So it is ultimately a labor of love.

It is possible to make a reasonable and comfortable living. But it calls for being a physician with healthy boundaries, internal motivation, principles, interpersonal skills and some financial literacy. But nothing one gets rich off of. It's a decent life though. I will put it that way. And the nature of the work, it does call for a fit of personality or else people will get emotionally burned out.
 
futureapppsy2 said:
Maybe I'm just burnt out from academia work, but IME, when people keep calling something "a calling, not a job", that's often code for "you should work for free, because it's a calling, after all."
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During our union negotiations, one of the boss MDs reportedly argued he likes to offer line staff low salaries because that helps them recruit doctors who are in it to help people™ and not primarily for $
 
My favorite mentor once told me all professionals should be compensated fairly, otherwise a calling can turn into calling out. You don't need to work for free to answer a calling, because that's just unsustainable.

But I would gladly do my job for less if the expenses I had in life were moot.
 
Bartelby said:
I think we have this false dichotomy going. Is it just a job, or is it a calling? I think in our society as currently structured it should be both at once.

If we take a "calling" to mean that we focus only on values of the profession and ignore or heavily minimize self-interest, lots of problems follow. It is easy for employers to exploit us. We can drive ourselves into the ground giving and ignoring our, and even more importantly our family's, needs. We need to recognize that we are highly trained professionals doing something that generates huge economic value, and we need to hold firm boundaries with employers that recognize we will not be forced to practice below our own standards of care, or in a way that leaves us feeling exploited.

I always remember that if my toilet breaks the plumber isn't going to come out for $10/hour because I'm such an awesome, generous dude. As long as I don't get a "doctor discount" on everything in society, I am going to make sure I am getting fairly compensated for my own family's wellbeing.

But that doesn't mean dropping off relevant values. Even if you are a janitor in the hospital, viewing your job through a lens of purpose means a lot. You can see yourself as an important member of the team, making patient stays more pleasant, helping prevent infection, helping staff work in a pleasant environment, etc. The person who truly internalizes that will likely get deeper satisfaction from that job than they would just clocking in and clocking out. That person can also show up feeling good about pushing to do the best job they can rather than seething with resentment at being forced to sell away the hours of their life for money. In the same way we need to connect with the purpose in the deeply human enterprise of helping another suffering human being get well, or at least decrease their suffering. While we are being paid for what we do, it doesn't negate the meaning of it.

I also think the two feed on each other. A purpose-driven, passionate doctor is going to be worth more to employers and patients. A financially intelligent doctor with good boundaries is going to be less burned out, feel less taken advantage of, and feel more emotionally charged to show up and do a good job.

I think once we view the job/calling debate as a false dichotomy we can start looking at how we maximize our work as psychiatrists viewing this as a job and a calling.
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This is absolutely spot-on and very well written. I was/am an idealist and do find medicine is my calling, but there is no way I would let it get in the way of my family which certainly has been the playback of the practice of medicine in the past. I also prioritize a job with average pay but great workflow/hours/flexibility to both enjoy my job and place my family first.

I really enjoy a week long vacation but am fairly excited to get back to work after a week. I know it's different for some of my colleagues and there is nothing wrong with that as long as they provide great care. My partner finds medicine to be far less of a calling than I do, but provides excellent care and goes above and beyond her colleagues in diligence on a daily basis. I love her for it and would not have married her if that wasn't the case, but I am under no illusion that she finds the same level of intellectual or human fulfillment as I do. My next hurdle is supporting her stepping back from full-time work in her early 40's or moving away from medicine entirely once we can easily afford for her to do so.
 
Merovinge said:
This is absolutely spot-on and very well written. I was/am an idealist and do find medicine is my calling, but there is no way I would let it get in the way of my family which certainly has been the playback of the practice of medicine in the past. I also prioritize a job with average pay but great workflow/hours/flexibility to both enjoy my job and place my family first.

I really enjoy a week long vacation but am fairly excited to get back to work after a week. I know it's different for some of my colleagues and there is nothing wrong with that as long as they provide great care. My partner finds medicine to be far less of a calling than I do, but provides excellent care and goes above and beyond her colleagues in diligence on a daily basis. I love her for it and would not have married her if that wasn't the case, but I am under no illusion that she finds the same level of intellectual or human fulfillment as I do. My next hurdle is supporting her stepping back from full-time work in her early 40's or moving away from medicine entirely once we can easily afford for her to do so.
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What specialty is she in, out of curiosity?
 
Would totally agree with the idea that ideally it needs to be a balance of both and to be very aware that others will try to exploit your ideals of this as a "calling" to get you to do more with less. "Professionalism" is also another weasel word that ends up getting tossed around a bunch to get doctors to do more or work more for less.

For instance, take a look at how it worked out for these poor "professionals" who got bullied into continuing to show up for work after their group stopped making payroll:
EctopicFetus

Thread 'NES healthcare'

Mostly or all in California, but apparently sent an email to their doctors that they are not going to make payroll for them this month and they will catch up in the next few months. Worth the discussion and light of what happened to a PP, envision bankruptcy, etc. Can’t imagine how bad your finances have to be that you miss payroll makes you wonder if you missed or stop paying your rent or other mandatory expenses as I would imagine missing payroll will be the last thing you wanna do because if I was a physician there, I certainly would not show up to work another shift and expose myself...
  • Wow
  • Like
 
calvnandhobbs68 said:
Would totally agree with the idea that ideally it needs to be a balance of both and to be very aware that others will try to exploit your ideals of this as a "calling" to get you to do more with less. "Professionalism" is also another weasel word that ends up getting tossed around a bunch to get doctors to do more or work more for less.

For instance, take a look at how it worked out for these poor "professionals" who got bullied into continuing to show up for work after their group stopped making payroll:
EctopicFetus

Thread 'NES healthcare'

Mostly or all in California, but apparently sent an email to their doctors that they are not going to make payroll for them this month and they will catch up in the next few months. Worth the discussion and light of what happened to a PP, envision bankruptcy, etc. Can’t imagine how bad your finances have to be that you miss payroll makes you wonder if you missed or stop paying your rent or other mandatory expenses as I would imagine missing payroll will be the last thing you wanna do because if I was a physician there, I certainly would not show up to work another shift and expose myself...
  • Wow
  • Like
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I do have views about medicine as a craft and avocation, something that in order to be virtuous we must all constantly seek to get better at and learn how to do with more excellence.

But also if you want me to work, f**k you, pay me.
 
futureapppsy2 said:
Was just wondering if she might be in a higher burnout specialty!
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Yes she certainly is. She also is well reimbursed for it and knew what she was getting into. The tax system doesn't exactly reward making 2x money for y years versus 1x money for 2y years, but we don't have expensive tastes and I make a solid salary. Weill see when she hits the decade mark of attendinghood in 3 years what she decides to do as we should be at chubbyFIRE by that point.
 
Merovinge said:
Yes she certainly is. She also is well reimbursed for it and knew what she was getting into. The tax system doesn't exactly reward making 2x money for y years versus 1x money for 2y years, but we don't have expensive tastes and I make a solid salary. Weill see when she hits the decade mark of attendinghood in 3 years what she decides to do as we should be at chubbyFIRE by that point.
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Lol, chubbyFIRE :hilarious:
 
Stagg737 said:
Lol, chubbyFIRE :hilarious:
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Oh man, let me tell you a story when I started discussing chubby travel with my partner. She was very confused and a bit concerned even though she understand that she was involved with it. When the explanation starts with "you see Fat means, so chubby...".
 
Merovinge said:
This is absolutely spot-on and very well written. I was/am an idealist and do find medicine is my calling, but there is no way I would let it get in the way of my family which certainly has been the playback of the practice of medicine in the past. I also prioritize a job with average pay but great workflow/hours/flexibility to both enjoy my job and place my family first.

I really enjoy a week long vacation but am fairly excited to get back to work after a week. I know it's different for some of my colleagues and there is nothing wrong with that as long as they provide great care. My partner finds medicine to be far less of a calling than I do, but provides excellent care and goes above and beyond her colleagues in diligence on a daily basis. I love her for it and would not have married her if that wasn't the case, but I am under no illusion that she finds the same level of intellectual or human fulfillment as I do. My next hurdle is supporting her stepping back from full-time work in her early 40's or moving away from medicine entirely once we can easily afford for her to do so.
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Wow now I realized why I *like* so many of your posts - I think you're me. Similar age, spouse in a surgical field (well, IM but the most surgical / procedural subspecialty of it) with similar feelings about medicine, enjoying vacations but excited to come back to work etc. My wife already cut back to 80% and will probably cut back more. I think we can FatFIRE or maybe even chubby it in the next five years if she pushes hard at work, but with kids growing and all that, better for us to slow things down for a while so we can spend more time with them now.
 
FatherPsychiatry said:
Wow now I realized why I *like* so many of your posts - I think you're me. Similar age, spouse in a surgical field (well, IM but the most surgical / procedural subspecialty of it) with similar feelings about medicine, enjoying vacations but excited to come back to work etc. My wife already cut back to 80% and will probably cut back more. I think we can FatFIRE or maybe even chubby it in the next five years if she pushes hard at work, but with kids growing and all that, better for us to slow things down for a while so we can spend more time with them now.
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I have long since come to the realization that a $4million dollar home on the beach in Hawaii is not going to buy the same happiness that my spouse would get having more time with our child. I've heard enough people tell you to enjoy the time (even though it can be awfully challenging at times) to know that we need to savor these years. We will be just fine with less income, but it's certainly coming from a place of significant financial diligence to have this flexibility in the first place.

Glad there are other's like me out there, I tend to be pretty different than the average bear....
 
Merovinge said:
Yes she certainly is. She also is well reimbursed for it and knew what she was getting into. The tax system doesn't exactly reward making 2x money for y years versus 1x money for 2y years, but we don't have expensive tastes and I make a solid salary. Weill see when she hits the decade mark of attendinghood in 3 years what she decides to do as we should be at chubbyFIRE by that point.
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Congrats! 2-3M NW?
 
sloh said:
Congrats! 2-3M NW?
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Just under 4 now, 6M (5m liquid) would be a chubbyfire number for us. With an expected 40+ years of retirement would expect around 3% withdrawal rate. Of course I would keep working and that number would then grow, but who knows what the future will bring.
 
Merovinge said:
Just under 4 now, 6M (5m liquid) would be a chubbyfire number for us. With an expected 40+ years of retirement would expect around 3% withdrawal rate. Of course I would keep working and that number would then grow, but who knows what the future will bring.
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Impressive, do you mind me asking how old you are? How many years it took for you guys to hit 4M?
 
sloh said:
Impressive, do you mind me asking how old you are? How many years it took for you guys to hit 4M?
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I hate talking about it, but I'm officially losing my youth this year and turning 40. I am just hitting 8 years of being an attending, 7 for my SO. Net worth was approx -200k coming out of training. Her income did a lot of the heavy lifting as does living a modest life (although I feel I live pretty large on around 125k year spending in a MCoL area).
 
Merovinge said:
I hate talking about it, but I'm officially losing my youth this year and turning 40. I am just hitting 8 years of being an attending, 7 for my SO. Net worth was approx -200k coming out of training. Her income did a lot of the heavy lifting as does living a modest life (although I feel I live pretty large on around 125k year spending in a MCoL area).
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Damn, makes me jealous of the dual physician households. Our net worth was probably -$50k when I came out of training and I was non-trad, so got a later start on attending salary than a lot of people. My goal was to have net worth of >$1m by 40yo, but probably won't hit that with an academic salary and a single income household, even in our relatively LCoL area.
 
Merovinge said:
Yes she certainly is. She also is well reimbursed for it and knew what she was getting into. The tax system doesn't exactly reward making 2x money for y years versus 1x money for 2y years, but we don't have expensive tastes and I make a solid salary. Weill see when she hits the decade mark of attendinghood in 3 years what she decides to do as we should be at chubbyFIRE by that point.
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To give some hope to those single income doc households , do u think had ur wife been a sahm with 1 kiddo, would you be close to 1m nw by age 40 or is that not realistic unless u were single without a family?
 
finalpsychyear said:
To give some hope to those single income doc households , do u think had ur wife been a sahm with 1 kiddo, would you be close to 1m nw by age 40 or is that not realistic unless u were single without a family?
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As someone that fits that description currently (actually worse because wife went back to school and we paid tuition) it is 100% possible. I’m 3 years out of residency and went from a negative net worth to over $300k a few months ago with about 3/4 of that in accounts while working in academia (<$300k/yr). I expect my net worth to be around $700k by the time I hit 40.

So can it be done? Definitely. It does depend on your situation and career choices though. If you want to work in academia in NYC or LA, buy a big, expensive house (or a house at all in those locations), drive a nice car and take regular vacations, its not going to happen. If you take a job making $350k+ and live modestly in a moderate or low CoL area where you can save $80k+ per year, it should be very possible. It really just depends on your choices and how you want to balance work with lifestyle.
 
Merovinge said:
I hate talking about it, but I'm officially losing my youth this year and turning 40. I am just hitting 8 years of being an attending, 7 for my SO. Net worth was approx -200k coming out of training. Her income did a lot of the heavy lifting as does living a modest life (although I feel I live pretty large on around 125k year spending in a MCoL area).
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Thanks for sharing. It’s really inspiring to read this
 
finalpsychyear said:
To give some hope to those single income doc households , do u think had ur wife been a sahm with 1 kiddo, would you be close to 1m nw by age 40 or is that not realistic unless u were single without a family?
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I'll be honest, if I had a SAH partner with a kid, I would have been out there grinding. I was a dog when I was 30 and would have worked 60 hours/week and cleared 500k for sure. I actually saved all my time off from the 2nd year of fellowship to graduate training 3 weeks early and start my attending job to get 3 weeks of a double paycheck (I really wanted to pay off my loans, I have a very debt adverse mindset). I could do 24 hour shifts with a lot less bother than my peers in residency (this would be now wildly untenable for me with a child that has chronic sleep issues now).

So yes for me it would not have been hard to be at 1 mill NW at 40 in the area I live in now. My friend is just turning 40 as a hospitalist, so 2 years less of training but slightly lower salary and with 1 child (the 2nd was recently born) I believe the 1 mil NW is still quite a ways off. They spend about as much as we do though despite us earning triple their take home.
 
Stagg737 said:
As someone that fits that description currently (actually worse because wife went back to school and we paid tuition) it is 100% possible. I’m 3 years out of residency and went from a negative net worth to over $300k a few months ago with about 3/4 of that in accounts while working in academia (<$300k/yr). I expect my net worth to be around $700k by the time I hit 40.

So can it be done? Definitely. It does depend on your situation and career choices though. If you want to work in academia in NYC or LA, buy a big, expensive house (or a house at all in those locations), drive a nice car and take regular vacations, its not going to happen. If you take a job making $350k+ and live modestly in a moderate or low CoL area where you can save $80k+ per year, it should be very possible. It really just depends on your choices and how you want to balance work with lifestyle.
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Those first 5 years of attendinghood may be the most important financially of your life. The doctor house, nice cars, vacations/trips are all in high demand after a 12 year mostly delayed gratification.

Wish it was taught more in residency but the system really wants you in the game as long as possible. I think we'd be seeing a lot of sub 50 part timers if people really knew the importance of those first 5 years of attendhood and investing.
 

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My (anonymous) podcast episode is 204 if you want to hear a bit more
 
Merovinge said:
I'll be honest, if I had a SAH partner with a kid, I would have been out there grinding. I was a dog when I was 30 and would have worked 60 hours/week and cleared 500k for sure. I actually saved all my time off from the 2nd year of fellowship to graduate training 3 weeks early and start my attending job to get 3 weeks of a double paycheck (I really wanted to pay off my loans, I have a very debt adverse mindset). I could do 24 hour shifts with a lot less bother than my peers in residency (this would be now wildly untenable for me with a child that has chronic sleep issues now).

So yes for me it would not have been hard to be at 1 mill NW at 40 in the area I live in now. My friend is just turning 40 as a hospitalist, so 2 years less of training but slightly lower salary and with 1 child (the 2nd was recently born) I believe the 1 mil NW is still quite a ways off. They spend about as much as we do though despite us earning triple their take home.
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finalpsychyear said:
Those first 5 years of attendinghood may be the most important financially of your life. The doctor house, nice cars, vacations/trips are all in high demand after a 12 year mostly delayed gratification.

Wish it was taught more in residency but the system really wants you in the game as long as possible. I think we'd be seeing a lot of sub 50 part timers if people really knew the importance of those first 5 years of attendhood and investing.
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So true. I grinded hard during residency - we had pretty good moonlighting opportunities starting PGY2 year, so I and many other residents would routinely hit 80+ hours a week (shhh don't tell the GME office) hustling up dough. Most of us residents that did that, were also financially "savvy" (ie, saving a lot and investing, mostly in index funds, paying down student loans etc) so if you can curtail lifestyle spending for a few years, the compounding growth is massive. Granted, the shifts were all night, weekend etc, stringing together multiple shifts so we would be working 30+ hours in a row (again don't tell GME!) but I don't think I could ever do that kind of work now with kids at home and (mostly) wanting to spend time with them on the weekend, despite getting 2-3x the pay now.

I don't think you have to "live like a resident" exactly when you're an attending, and its OK to loosen the belt a bit but not 100% if you want real wealth. We loosened up a good amount when I started doing more moonlighting, and more when my wife became an attending. But we only increased our spending by 1.5x - 2x, even though our income went up like 3-5x. But that spending increase felt huge - simple things like being OK with getting the drinks at a restaurant instead of just water etc whereas we would always skimp before.

Also finding contentment... I still feel like a baller now that I add the guac to my chipotle order without thinking about the cost, and I'm happy with that being my financial goal in a sense. But I know a lot of people that just keep escalating their wants and it leads to never finding contentment,.
 
FatherPsychiatry said:
So true. I grinded hard during residency - we had pretty good moonlighting opportunities starting PGY2 year, so I and many other residents would routinely hit 80+ hours a week (shhh don't tell the GME office) hustling up dough. Most of us residents that did that, were also financially "savvy" (ie, saving a lot and investing, mostly in index funds, paying down student loans etc) so if you can curtail lifestyle spending for a few years, the compounding growth is massive. Granted, the shifts were all night, weekend etc, stringing together multiple shifts so we would be working 30+ hours in a row (again don't tell GME!) but I don't think I could ever do that kind of work now with kids at home and (mostly) wanting to spend time with them on the weekend, despite getting 2-3x the pay now.

I don't think you have to "live like a resident" exactly when you're an attending, and its OK to loosen the belt a bit but not 100% if you want real wealth. We loosened up a good amount when I started doing more moonlighting, and more when my wife became an attending. But we only increased our spending by 1.5x - 2x, even though our income went up like 3-5x. But that spending increase felt huge - simple things like being OK with getting the drinks at a restaurant instead of just water etc whereas we would always skimp before.

Also finding contentment... I still feel like a baller now that I add the guac to my chipotle order without thinking about the cost, and I'm happy with that being my financial goal in a sense. But I know a lot of people that just keep escalating their wants and it leads to never finding contentment,.
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Yeah. I cant and wouldn't do the hours i did in early attendinghood. Covered inpt psych fri 5pm til sun 5pm responsible for rounding 15 pts per day, all ED admits, all hospital consults for 2500-3000 for a 48 hr shift (bad pay), Multiple calls through the night during that shift. I did it to make a name for myself as i was starting a PP so people would know me but only did a handful of shifts. No nights/wknds/holidays since 2017.

Yes, I too find contentment in small things like chipotle with guac but now im considering double meat and large guac at some point but they sorta skimp on portions unless your in person ordering lol.

EIther way i was single and didnt marry till mid 30s but worked pretty hard and saved. I simply first took my residency monthly pay and gave a 50% pay bump and then 1-2 years later doubled my residency monthly take home pay.. Even in residency saved even 400 on a 3k monthly pay but i never compromised going out, food, domestic travel even then.

Now i didnt know crap about investing really so i learned and read WCI and forums. Then covid 2020 came and i entered the market in a big way for the first time. But having savings made a world of difference and learning from forums like this and others.
 
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FatherPsychiatry said:
So true. I grinded hard during residency - we had pretty good moonlighting opportunities starting PGY2 year, so I and many other residents would routinely hit 80+ hours a week (shhh don't tell the GME office) hustling up dough. Most of us residents that did that, were also financially "savvy" (ie, saving a lot and investing, mostly in index funds, paying down student loans etc) so if you can curtail lifestyle spending for a few years, the compounding growth is massive. Granted, the shifts were all night, weekend etc, stringing together multiple shifts so we would be working 30+ hours in a row (again don't tell GME!) but I don't think I could ever do that kind of work now with kids at home and (mostly) wanting to spend time with them on the weekend, despite getting 2-3x the pay now.

I don't think you have to "live like a resident" exactly when you're an attending, and its OK to loosen the belt a bit but not 100% if you want real wealth. We loosened up a good amount when I started doing more moonlighting, and more when my wife became an attending. But we only increased our spending by 1.5x - 2x, even though our income went up like 3-5x. But that spending increase felt huge - simple things like being OK with getting the drinks at a restaurant instead of just water etc whereas we would always skimp before.

Also finding contentment... I still feel like a baller now that I add the guac to my chipotle order without thinking about the cost, and I'm happy with that being my financial goal in a sense. But I know a lot of people that just keep escalating their wants and it leads to never finding contentment,.
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Ah yes, Chipotle rich, the standard for when you’ve finally “made it”. Adam Devine has a great little stand up bit on this. Link below, but warning for f bombs aplenty.

 
I agree, there's nothing wrong with it being both a calling and profession. Saying its one or the other is absolutely a false dichotomy.

Stagg737 said:
As someone that fits that description currently (actually worse because wife went back to school and we paid tuition) it is 100% possible. I’m 3 years out of residency and went from a negative net worth to over $300k a few months ago with about 3/4 of that in accounts while working in academia (<$300k/yr). I expect my net worth to be around $700k by the time I hit 40.

So can it be done? Definitely. It does depend on your situation and career choices though. If you want to work in academia in NYC or LA, buy a big, expensive house (or a house at all in those locations), drive a nice car and take regular vacations, its not going to happen. If you take a job making $350k+ and live modestly in a moderate or low CoL area where you can save $80k+ per year, it should be very possible. It really just depends on your choices and how you want to balance work with lifestyle.
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Good for you man!

Honestly, almost any physicians (save maybe academic Peds) should be able to accomplish this if they are not impractical. Also, I'd bet you're going to be closer to $1 million by 40.

I am 3 years out as well, and I live in a HCOL area, and I did pretty much all the things WCI tells you not to do (bought a big house, bought my wife a new-ish car, etc.). Even with that, I'm comfortable and on a similar track as you, because I really don't spend on that much else and I knew I wanted to spend more on where I spend my time outside of work and my family's safety driving. I'm also just incredibly lucky to have found a place and job I like.

You prioritize what's important to you and realize a lot of the other things just aren't that important to being happy. I talk myself out of a new (gently used) car every 4-6 mos, and I still seem to be fine driving the car I went to med school in.
 
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Stagg737 said:
Ah yes, Chipotle rich, the standard for when you’ve finally “made it”. Adam Devine has a great little stand up bit on this. Link below, but warning for f bombs aplenty.

Click to expand...

LOL love it. I'm gonna start telling people that their financial goal should be to become Chipotle rich. Attainable for most, and once you're there you can/should start focusing on other wholesome stuff like gardening and appreciating art masterpieces like Clair Obscur: Expedition 33.
 
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