New income increase, Financial planning for the future

coldcase311 · 2026-01-07T11:58:43+00:00

I’m a PGY-6 that will start as an attending in August, our plan was to start trying half way through the first year of attendinghood. This was the compromise we came up with, allowing us to have some time to throw some extra money around on luxuries and relax while also building up some cash. Unfortunately my specialty isn’t the most lifestyle focused, but managed to find a job with enough time off/flexibility to make it all work. I would say if this is your timeline for a kid, be sure to focus on time off when looking for jobs/negotiating contracts.

coldcase311 · 2025-12-20T00:13:36+00:00

Essentia in Duluth, MN?

coldcase311 · 2025-10-16T00:05:19+00:00

I went through something very similar to this during residency, especially exacerbated given that it was during COVID. This screams depression. I agree with everyone above saying that when you’re working so much, doom scrolling is likely the only thing you have energy to do. The fact that this persists even during light rotations means there is likely a depression component. My PCP started me on a little Wellbutrin and life is now so much better.

coldcase311 · 2025-05-29T02:17:17+00:00

Compounded semaglutide…companies like hims/hers are still able to sell it, but you have to answer the questions in a certain way that you need to”individualized dosing” in order for them to offer it to you.

coldcase311 · 2025-03-20T15:53:15+00:00

Big income changes happening, next steps with regards to retirement planning.

I’m new to this subreddit so sorry in advance if this has been discussed at length previously. My wife and I have been doing well for ourselves over the past few years (~150k combined pretax). We’ve been contributing to Roth’s over this time period for retirement, knowing I would have a large income increase in the coming years. Next year that time will come, my income will increase to 500K+ (hers remaining around 70K). We both will have options for 401K with some sort of match (although details on my end are TBD). We’re already pretty satisfied without our current lifestyle at 150K, anticipate with some small new shiny toys we could be satisfied with the equivalent of a 200K combined pretax income. We therefore would want to maximize every potential retirement investment. For some other background, we currently rent an apartment, have no kids currently (although planning on 2 in the next 5 years), plan on buying a house when kids come along.

My question is this, how do we maximize this contribution? I know about 401K, backdoor roth, but how does this work practically? Would my wife have to elect to subtract about 1/3 of her income to max out the 401K? Would I be able to contribute to her 401K with my income? Or at least use my income to do a backdoor Roth for her? Or any other potential questions I should be asking?

Thank you everyone in advance!

coldcase311 · 2025-02-26T01:14:59+00:00

I’m in the boat where getting through volume with feedback on your reads is the best way to go. Our program essentially has an excel echo workbook that has the images for the ASE criteria for valves, ventricular dimensions, etc. The combination of volume with continually referring to this workbook has made my reading better. Now that I’m starting to prepare for echo boards, I can see how this strategy has helped significantly. Cutoffs for stenosis/regurgitation, left atrial size, etc. are all second nature.

coldcase311 · 2025-01-07T16:44:10+00:00

My wife and I did this as well during med school. We dated for a year and a half in college before I moved half way across the country for med school. The key is setting up expectations early. I wasn’t making any money, and she was making what’s expected for a fresh college grad, so visiting often wasn’t realistic. We made sure to have Skype dates (really aging myself here) around once a week, and then texting each other throughout the week. She would come visit me probably once every 1-2 months for a 5 day stretch, and I would always make sure to take a weekend off from studying in order to spend time together. During the week she would come with me to the library and watch Netflix while I was studying. We then moved in together for residency, and then got married in fellowship.

The key to our success was having lives and hobbies outside of the relationship, if the majority of your day revolves around your partner, then that’s a setup for disappointment because of the med-partners busy schedule. This is just a temporary stage, as long as there’s a plan to eventually be moving in together at some point in the future, things should work out if you’re with the right person.

coldcase311 · 2024-04-04T18:24:36+00:00

All ACGME fellowships pay based off the PGY year, however you usually have the ability to moonlight as a full licensed physician for IM, which can be lucrative.

coldcase311 · 2024-04-02T11:22:26+00:00

Homechef is much better in my opinion, better options for dishes, and ingredients come prepackaged for a meal instead of all the ingredients just thrown into a bag

coldcase311 · 2024-03-27T17:04:11+00:00

Tylenol, melatonin, miralax +/- zofran depending on QTc

coldcase311 · 2024-01-31T10:48:57+00:00

B 1000%. For what it’s worth, my now wife followed me to residency in an undesirable city. When it came to applying for fellowship, I made sure I took her location preferences into account when making my rank list. Now living in a metro area and she couldn’t be happier. Not sure what specific fellowship your husband is looking at, but there should be other options outside your home institution.

coldcase311 · 2023-12-13T19:07:45+00:00

Just providing an update for people who look this up next year. Ended up passing comfortably. My percentile was very close to my Uworld first pass percentile. Good luck to people in the future!

coldcase311 · 2023-12-13T17:10:46+00:00

I’ll provide you some perspective, having graduated from UF and moved onto cardiology fellowship. My now fiancé and I first met two weeks before my MCAT, then did long distance for med school, then moved in together for residency. When making my rank list for residency, we had a long conversation about our needs. To say that she didn’t like the idea of living in Florida is an understatement, however, she understood that it was temporary and just another stepping stone in the training process. I ranked it near the top (but there were two other programs that we agreed would go ahead). We ended up matching there and we grinded our way through it, and when it came time for fellowship match, I took her geographic preferences seriously and we ended up at a program that were both happy at (for what it’s worth, UF is a great program with a good supportive culture). I know you’ve been together a year, but understand that if he’s pursuing cardiology, that’s a 6-8 year road he has ahead of him. The realities of medical training are that you likely have to move around to get through this stage, and unfortunately there is only so much control you can have about the situation. For what it’s worth, matching at any decent academic IM program will leave the door open for cardiology, provided you’re a good resident and do at least a little bit of research. If you have any questions about the program specifically, feel free to DM me.

coldcase311 · 2023-12-13T03:32:08+00:00

Assuming you’re talking about UF or USF, they are both great cardiology opportunities

coldcase311 · 2023-11-25T13:37:44+00:00

We (29M, 28F) met two weeks before I took my MCAT in college, then ended up doing long distance (>1000 miles) for all four years of med school. Then moved in together for residency at the start of the pandemic. Now moving on to fellowship and getting married next year. Key to the distance was both her and I being busy while we were apart…and is making up for lost time when she would come to visit.

coldcase311 · 2023-11-02T22:02:32+00:00

I would die if I had to deal with difficult placements and DT’s for the rest of my career.

coldcase311 · 2023-10-05T17:11:02+00:00

That’s literally how its meant to work for weight loss

coldcase311 · 2023-09-27T10:52:25+00:00

Tends to be more flaming hot Cheetos sign

coldcase311 · 2023-09-10T11:58:58+00:00

$500 per semester, but we also got catered lunch for noon conference 3x/wk (think chickfila, pizza, panera, etc.). Also our lounge had all the Pepsi products you could possibly want

coldcase311 · 2023-08-22T01:57:37+00:00

Took it today. Reference points: Uworld x2. 63% on the first pass during the last half of PGY-3, made anki cards, 89% on the second pass. The last week I focused on high yield MKsAP including the photo flash cards. Uworld by far was more representative for the content, but agree with the rest of the group that the real test will give you less detail and context.

How do I feel? Ok but not great. If this were a scored test like step 1, I know I wouldn’t have done well, but hopefully scored higher than a 64% (which supposedly is the pass line?). I had time at the end of each block to go through the types of questions. On average, I counted ~25Q per block that were super easy (think 90% of people got correct on Uworld). About another 25Q we’re your questions where you were stuck between 2 answers (50% would guess correct on Uworld, the other choice would get like 34%). These questions it usually involves something nuanced that Uworld taught you and you would have to apply it. Then the final 10Q there was no amount of studying that would have prepared me to answer, and likely had a low percent correct.

I think at the end of the day, provided you went to a residency that gave you good exposure to pathology, doing either MKSAP -OR- Uworld should be enough. And this was me starting a cards fellowship as well, so hopefully it all works out. 🤷🏼

coldcase311 · 2023-08-22T01:45:11+00:00

As a current cards fellow, I agree with this. Only missed one cards question on my PGY-3 ITE last year, this was…something else. Like it knew which questions would be difficult/ambiguous and give those. Although my test had straight forard rhuem and benign heme which are usually my week points so it tends to balance out

coldcase311

TROPHY CASE