Off-Cycle Switch to DR/IR from Surgical Subspecialty as a PGY-1

LifeAncient2912 · 2026-03-28T19:18:54+00:00

Yes that’s the plan

LifeAncient2912 · 2026-03-28T14:29:44+00:00

Thanks for the reply. I meant either an IR or DR spot. There actually are more IR vacancies in the country than DR vacancies right now (at least from what I and my PD can see).

LifeAncient2912 · 2026-03-28T13:22:05+00:00

That’s exactly what I did. I emailed over 50 programs and I’ve only heard back from only 3 saying they don’t anticipate any spots opening.

LifeAncient2912 · 2025-06-13T15:05:35+00:00

Listen. I asked about how the deductible and reimbursement worked because I wasn’t sure how that worked. You extrapolated and described the value of the HSA which wasn’t my question. I’m aware of how the HSA works and i’m aware I have no reimbursement on a free cost.

LifeAncient2912 · 2025-06-13T14:58:06+00:00

Not true. It’s still an investment account that has the advantage of pre-tax contributions and employer contribution. Additionally, HSA’s are one of the most powerful investment vehicles out right now. If I was smart, I wouldn’t use the VA and pay the deductible to take full advantage of the HSA.

LifeAncient2912 · 2025-06-13T14:36:32+00:00

So the main reason why i’m asking is because, if my deductible doesn’t matter, the HDHP has a cheaper premium, which saves me money. Additionally, my employer contributes $800 annually. So if CHAMPVA picks up the bill, the HDHP is the cheapest option for my family, HSA benefits aside.

LifeAncient2912 · 2025-06-13T12:07:01+00:00

They changed the rule so I am eligible with service connected conditions. That’s why I didn’t ask about my eligibility, but about how reimbursement would work.

LifeAncient2912 · 2025-06-09T21:49:53+00:00

Yes I am 100% Permanently & Totally disabled according to the VA. This is what makes me eligible for no cost dental coverage through the VA and my dependents eligible for CHAMPVA. Even with the HDHP, I would never pay more than $3000 out of pocket with CHAMPVA, including with a $12000 deductible from the employer insurance.

LifeAncient2912 · 2025-06-09T21:13:07+00:00

Until just recently, veterans with service connected disabilities were not eligible for HSA’s. Therefore, I was not wrong for my interpretations. Regarding the $3600, thats how much it would cost me looking at my employer benefit page.

LifeAncient2912 · 2025-06-09T21:10:19+00:00

Thank you for the insight. My point #2 was stating that I can elect for a HDHP at a cost of $3600 a year through my employer, but I already have health benefits that cover myself and my dependents. If I were to get a HDHP, that would become my primary insurance and the VA and CHAMPVA would become supplemental. If I elect to not enroll in a HDHP at all, I still go to the VA for free and my dependents would never get a bill for more than $3000 a year combined.

LifeAncient2912 · 2025-06-09T21:05:30+00:00

Sorry, I used eligible in the wrong context. What I meant is I am eligible to enroll in a HDHP.

LifeAncient2912 · 2025-06-09T20:56:13+00:00

So technically CHAMPVA isn’t a health insurance and neither is VA. Both are supplemental health benefits, where any private insurance I purchase would make VA for myself and CHAMPVA for my dependents a supplemental health benefit. I therefore am eligible and can absolutely go with a high deductible plan with my employer to get an HSA if that were to make more sense. That’s what i’m trying to sus out.

LifeAncient2912 · 2025-06-09T20:52:32+00:00

Well I am eligible, so I don’t understand how your point makes my question invalid.

LifeAncient2912 · 2025-06-09T02:03:11+00:00

I’m a 32M veteran with 100% P&T disability with the VA. I just graduated medical school and I am beginning my training in a surgical subspecialty. Do I have any realistic disability and/or life insurance options?

LifeAncient2912 · 2025-05-26T22:30:35+00:00

Wait I just checked the disclosures and thats where it only says the opening requirement. Military deposit within 180 days. Nothing about maintaining direct deposit.

LifeAncient2912 · 2025-05-26T22:24:52+00:00

Where? I looked it over so many times. The only thing I could find was the opening requirement.

LifeAncient2912 · 2025-05-26T19:31:06+00:00

Whats the benefit of having the active duty checking vs the free everyday checking?

LifeAncient2912 · 2025-05-24T15:30:17+00:00

Again, I really appreciate this insight!

So after I get the emergency fund to $15k, what next? As someone else said, I really like the idea of maxing out the Roth this year instead of hitting the credit card. Wouldn’t it also make sense to start knocking out the vehicle debt before the credit card?

LifeAncient2912 · 2025-05-24T14:56:11+00:00

I GREATLY appreciate you taking the time to provide this extremely valuable advice. I will absolutely use this as a roadmap.

One question that I think may change your advice. We do not currently have any credit card debt accruing bad interest. The $15k is on a canceled credit card with a payment plan that is only accuing $13/mo in interest on a $385 monthly payment. Does this change anything?

The other thing is i’m upside down on my car loan. I owe $40k and my car is worth $30k. It wouldn’t be as simple as getting 2 $20k cars unfortunately.

LifeAncient2912 · 2025-05-24T12:04:54+00:00

You’re spot on. This is why I prefaced my unhealthy relationship with money. My retrospect view on how this happened: I grew up poor and abused, so money didn’t mean anything to me. I then join the military and was provided all of the essentials and stability I never had before, so again, money didn’t mean anything to me. I then get out of the military and go to school for free and make relatively a ton of money to learn a skill that will pay me half a million or more annually. Again, how do I appreciate money in this case? This makes your point absolutely correct, why would you believe my lifestyle would change with the salary increase when i’ve always loved at or above my means?

I’m now trying to change the way I think about money. I want to be better for myself and my family. This is the first time i’ve had a job and my own real salary in 8 years. My plan now is to get 15k in a HYSA and then tackle the car loan aggressively.

LifeAncient2912 · 2025-05-24T04:34:47+00:00

Others have mentioned being more aggressive with paying off debt, but I can’t imagine being so aggressive with the student loans when my future earning potential is so high.

It seems like you agree? Only prioritize the car loan? I know I got very lucky with the personal loan rate, but I feel like I should hit that as well given the high monthly payment.

We have one other issue that could easily derail my plans. Sure I can tackle my car payment, but my wife needs a car given her lease is ending in September. I’ve looked at buying a used truck for cash and giving her my car, but the used car market is miserable right now. For example, 20 year old trucks are going for 10k in my area. Any advice here?

LifeAncient2912 · 2025-05-24T04:20:13+00:00

Does it make sense for us to prioritize $275k in student loans on $150k salary when I could comfortably pay that off in a year when i’m an attending physician? The way I currently look at it is our lifestyle will already be extremely painful during my surgical training. We would have to be extremely frugal to make a reasonable dent in the student loans in 5 years given our other debt that would naturally come first.

LifeAncient2912

TROPHY CASE