Learned I have a likely fatal medical condition (IM intern) - help me leave family secure

[ActinRocker]

Title pretty much has the gist of it. I am a categorical medicine intern at a generally well regarded program. I just found out I have a serious medical condition and while I had initially planned to try for a cards or GI fellowship, I don't know if I'll have the time to do that. I have a wife pregnant with twins who teaches high school. We have a lot of loans from my medical school and very little savings. I'm afraid I will die and leave her with nothing so I'm thinking about just getting out of IM residency in 3 years and trying to work as hard as I can to save up as much as possible for my family.

I've never really thought about salary before, but this is now a big concern and I'm hoping you guys could help me out. I've heard IM starting salaries are like $150k in my area (northeast). Are there certain jobs or certain places I could look move to that would help me to make more than this? I'm willing to work as hard as I can through treatments, etc.

I know asking for advice about money sounds callous and I apologize. I am simply very concerned about my family's future. I don't want to leave my wife and kids with nothing, especially after her support throughout medical school.

Edit: I don't actually know how accurate those starting salaries are. I don't want to be a douche my 2nd month of intern year and ask around too much about this.

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[Anri of Astora]

Hey, sorry I don't know any useful information for you, but I did want to say good luck with your endeavours. I hope you find the job that you are looking for and make a killer earning for your family!!

 

[chessknt]

Unless you have another background in something your residency job is probably going to be the highest salary you get. Don't pay a cent back in any federal loans as they are forgiven in the event of death (could even consider not paying them at all and letting it wreck your credit and trying to file for forbearance but this could have an impact on your wifes credit). No independent life insurance company will insure you with a fatal diagnosis so get whatever your job currently offers and get the highest amount possible without requiring a health insurance physical. Even with all this, best case scenario, you get a 100-150k life insurance payout and all your loans forgiven + whatever you save with the time you have left.

In the long run that isnt that much and your wife has to be able to make it during those early years without you. It might be a better idea to have some kind of plan in place to help support her when/if this happens--ie moving back to your or her family so that everyone can help raise the kids and comfort her. Spending as much time as you have is also really important. I'd encourage you to take some time to process this--take a week off work and go back home or do something besides work that lets you clear your mind and grip what is happening. This is going to be much more valuable than an extra 100k somewhere.

 

[deleted547339]

If you really have limited time to live, why would you ever finish residency? If I knew I had something that would end my life prematurely, I wouldn't be taking q4 call, I'd be spending time with my wife.

 

[Merely]

I cannot express in words how sorry I am for your situation. What was the diagnosis of and can it possibly be treated and cured?

 

[Instatewaiter]

Title pretty much has the gist of it. I am a categorical medicine intern at a generally well regarded program. I just found out I have a serious medical condition and while I had initially planned to try for a cards or GI fellowship, I don't know if I'll have the time to do that. I have a wife pregnant with twins who teaches high school. We have a lot of loans from my medical school and very little savings. I'm afraid I will die and leave her with nothing so I'm thinking about just getting out of IM residency in 3 years and trying to work as hard as I can to save up as much as possible for my family.

I've never really thought about salary before, but this is now a big concern and I'm hoping you guys could help me out. I've heard IM starting salaries are like $150k in my area (northeast). Are there certain jobs or certain places I could look move to that would help me to make more than this? I'm willing to work as hard as I can through treatments, etc.

I know asking for advice about money sounds callous and I apologize. I am simply very concerned about my family's future. I don't want to leave my wife and kids with nothing, especially after her support throughout medical school.

Edit: I don't actually know how accurate those starting salaries are. I don't want to be a douche my 2nd month of intern year and ask around too much about this.

How long are we talking in terms of life expectancy? Is there hope you can beat this? These facts alone will help determine what you should do. I agree with the above, get as mucch life insurance as you possibly can.

One option could be to do general practice after internship.

Another serious question- do you want to work like a dog for the remaining time you have?

 

[HelpPleaseMD]

in the northeast hospitalist is about 160k. night hospitalist is 200k. Locums is about 300k i believe.

 

[quickshot]

I think there are two ways to look at this:

1. If you really want to make as much money as you can, you are going to have to leave the Northeast. Places in the South for a hospitalist gig will be able to easily give you $250K +, even 300K+. And I actually have friends in the Northeast that are comfortably making over $200K in a Hospitalist gig.

2. You have to balance that with spending time with your family. If you truly have a fatal condition and you don't have long, then perhaps having those extra moments with your children/wife is worth more than extra cash (priceless). Medium intensity job, making 120-150K and weekends with the family might suit you better.

I'm sorry to hear you in such dire straits. You are in my prayers.

 

[Onefellswoop87]

Sorry for everything you are going through.
Have you considered doing intern year, getting state license, then finding "urgent care center R us" that only requires a license without BE/BC? It might not pay typical internist salary but it should be more than resident salary.
You wouldn't be the first person to work with those sort of credentials and your situation in definitely unique.
You'd also only have one year of grueling hours then have more time with loved ones. Just a thought.

 

[deleted547339]

Sounds cool and all, but with a wife and kids on the way, the finances are important.

Probably as/more important than life insurance is HEALTH insurance. An end of life illness can wrack up major expenses. Say what you will about resident salaries, they usually come with a pretty good health insurance plan. Maintaining gainful employment at a large medical center is probably one of the best preventive steps OP can take. Maybe their residency would let them take medical LOA while maintaining their employment/benefits?

I get what you're saying. I'm married and have a baby on the way and I can promise you my wife would rather be broke and have more time with me than have me spend time at work and have less time together. Even though I'm healthy (to my knowledge), she still hates me moonlighting because she'd rather have the time than the money.

As a note to all others, this is the time to get life and disability insurance.

 

[dozitgetchahi]

OP - my goodness, my heart goes out to you and your family. This is literally the doomsday scenario I've always feared throughout the long march of medical training.

I hope your family finds some way to become financially secure and I hope this process is as painless for you and them as it can possibly be. That said, yeah, you're gonna need health insurance.

 

[Mad Jack]

I wish you the best OP, whatever course you take. No one deserves a fate like this, and I'm sorry it is happening to you.

 

[Crayola227]

Please talk to your wife.
Factor in what she wants into your decision.

Maybe what *you* really want is to keep working, and that's fine. If the two of you don't agree on what to do moving forward, get some counseling. Maybe get some counseling anyway.

However, don't just do this for her and assume it's what she wants. If you're doing this for her, ask her what she wants. If it were me, and I was her, I would want every moment possible with you. If you leave her in this world, I bet she'll be thinking more about the time you did/didn't have together than even a hundred thousand dollars. She's going to have to work and go on without you either way. If you're really worried about what you're leaving behind for your family, consider that, memories. Maybe the time you share during her pregnancy, ob visits, not missing those things means more to her than you being a resident and getting money.

I don't know your timetable. You could finish intern year and look at other jobs. If things change for the better with your health it doesn't close the door on finishing a residency especially given your circumstances putting off PGY2 would be understandable to most programs, although I can't lie not going straight through makes it tougher to come back later. And it depends on what your health does, if this can truly resolve then they would have less worries taking you on as a PGY2 later, if it's an ongoing condition that can be harder. If you have an interruption in training I'm not sure what that means for a GI fellowship, but it sounds like you have reason to focus on other things right now.

I am so sorry this is happening to you.

If you have questions on navigating the system and disability, feel free to PM me with questions.

 

[jdh71]

Go west young man. Work as a hospitalist. Find an employed position with life insurance as a basis component of their package. You obviously won't be able to buy anything supplemental.

Sorry to hear about the dx. It's one of my worst nightmares.

 

[IMreshopeful]

I'm so, so unbelievably sorry to hear this. I hope you and your wife are able to work this out. And I hope that whatever condition you were diagnosed with is treated well, whatever the odds are.

 

[Heme_Onc]

My prayers are with you and your family. Is there anything we can do to help? I know we are all limited in terms of the things we can do but we can still try to be there for you and your family.

 

[bronx43]

I must echo that this is one of my worst fears... and I'm certainly at an age where not a small handful of my friends are getting bad diagnoses and prognoses. I'm sorry to hear this about you.

I agree that it really depends on how long you expect to live. If we're talking 5+ years, then it MAY be worth it to finish up residency and just pump out two years as a hospitalist in rural Midwest. Don't pay back any loans like the others said. If you have less than 5 years to live, then I would just quit after intern year. Pass step 3 and get a license. There are jobs out there (clinical or non-clinical) that you can definitely swing being a licensed physician.

 

[Apollyon]

I don't know if the OP will ever come back, but I had an amoral idea. If you are 100% sure you won't make it, instead of doing internship and out, and doing urgent care, you could get the license, then work in a pill mill. As I said, amoral, but, even IF you got busted, no one would send you to jail, and these folks can make $1mil or more per year. It's just the "ick" factor.

 

[Merely]

They might take his money from him when busted...

 

[Apollyon]

They might take his money from him when busted...

Clearly (in my "Johnnie Cochran" voice), you don't know the law. (I'm not ragging on you) Even in black letter violation, it takes time. Forfeiture only happens as a penalty (at the end). Freezing the assets can occur on the front end, but that is generally a financial criminal thing (not medical fraud), when the person can still make fraudulent money. Pill mill guys, once they get arrested, can't make any more money.

If someone dies before sentence is entered, they have not yet been adjudicated "guilty", and the conviction will be vacated (that is what happened with Ken Lay and Enron - he died before sentencing, and his conviction was vacated).

As I said, this takes time. "The wheels of justice turn slowly, but grind exceedingly fine". Unfortunately, what this brother doesn't have is time.

And, in all complete candor, I (thank heavens) am not a lawyer.

 

[NRAI2001]

I must echo that this is one of my worst fears... and I'm certainly at an age where not a small handful of my friends are getting bad diagnoses and prognoses. I'm sorry to hear this about you.

I agree that it really depends on how long you expect to live. If we're talking 5+ years, then it MAY be worth it to finish up residency and just pump out two years as a hospitalist in rural Midwest. Don't pay back any loans like the others said. If you have less than 5 years to live, then I would just quit after intern year. Pass step 3 and get a license. There are jobs out there (clinical or non-clinical) that you can definitely swing being a licensed physician.

I m really sorry about your situation... It actually made me really sad to read this thread... Especially as I m spending my holiday weekend moonlighting right now.. But I agree with the quote above.. I would move to the west coast and depend ding in the amount of time you have left a) work in an urgent care 3-4 days a week and make about $180-200k or if you really want to b) work like a dog as a hospitalist 21-30 shifts a month and pull in anywhere from $500-$700k..

As others have said you should discuss this with your wife.. I would personally try to work 3-4 days. Week and spend as much time with her as possible... Maybe even tAke a final vacation...maybe do the hospitalist one week on and one week off and pull in $300k a year?

 

[NRAI2001]

Since this is an anonymous form and you have only one post on your account... What is your diagnosis and how long do,you have? Like others have said if it's a slow condition that woul be fatal in 5-10 years would be very different than 6 months...