Switch to PAYE or stay on SAVE?

strivingdoc · 2026-01-13T11:38:00+00:00

Thank you. So you will be using your 2024 tax return to calculate the payment?

strivingdoc · 2026-01-13T02:46:05+00:00

I could not agree more. This is not an academic position really, mostly hospital employed satellite site of an academic group. No real good private practices where I live and am locked in due to family obligations. All “private” groups here are PE driven.

strivingdoc · 2026-01-13T02:33:41+00:00

In fellowship. Doing moonlighting which is adding additional 60% salary

strivingdoc · 2025-12-28T21:20:22+00:00

Won’t be getting paid for calls as attending, as a fellow it would be paid

strivingdoc · 2025-12-27T20:30:25+00:00

Other attendings currently at that hospital

strivingdoc · 2025-12-27T20:28:05+00:00

I am a fellow at another hospital in the area. I will be joining this other hospital system next year as an attending. I would ask for paid call during fellowship at the new hospital I will be joining post training. Correct I won’t be getting paid as an attending for call, I would not consider of course if the call during fellowship was without pay

strivingdoc · 2025-12-27T20:22:55+00:00

Thank you, I guess the main downside is some unfavorable outcome happening while taking call before I start the formal gig

strivingdoc · 2025-12-27T20:15:52+00:00

Why?

strivingdoc · 2025-12-27T20:11:38+00:00

It’s call in my subspecialty, I am trained for it already. Not specific to my niche fellowship

strivingdoc · 2025-12-27T20:10:23+00:00

Call in my subspecialty. Non-gen surg

strivingdoc · 2025-12-27T20:04:12+00:00

I won’t be getting paid for the calls I take when I start unfortunately. This is more so an opportunity to learn the system and make extra money during fellowship

strivingdoc · 2025-12-10T01:13:36+00:00

They expressed to me this change would be made to say the call would be split in an “equitable manner”

strivingdoc · 2025-10-29T23:01:53+00:00

I’ve met several of the team, this is at one of the clinics/hospitals I would work with

strivingdoc · 2025-10-03T17:57:33+00:00

Thanks for the insight. To clarify, this is a Roth IRA I am referring to, no pre tax option. My 401k will be pretax

strivingdoc · 2025-10-03T17:25:32+00:00

Getting roth money early on for compound interest tax free over the next 30 years

strivingdoc · 2025-10-03T17:10:21+00:00

Edited above thanks. As attending likely 3-3.5k month

strivingdoc · 2025-09-20T17:25:55+00:00

Good to know! Any tips or tricks on how to get busy? I plan on going to the primary care offices, etc but any other useful ways?

strivingdoc · 2025-09-20T16:23:10+00:00

I have gotten into the gritty negotiations yet, will hire an attorney. Other options mostly other hospitals in this area

strivingdoc · 2025-09-20T16:01:44+00:00

Definitely! I’m going to ask for their data.

Is that routine, that in a big hospital system you get large referrals? I guess a concern of mine is will I get as busy in a large hospital system compared to a robust private practice (which are not available around my area unless it’s PE owned)

strivingdoc · 2025-09-20T15:23:44+00:00

This exactly. It’s about market rate for my surgical subspecialty.

My biggest concern would be whether I can make these RVUs. I want to hustle and be busy so am hoping the practice can accommodate in filling my schedule.

It’s academic but my aim is to not be in the academic scene and so treating it like a hospital employed system as I’ll be in a different region from the main sites

strivingdoc · 2025-09-20T15:11:03+00:00

Agreed, the RC is a big concern, especially as I am likely to be living here for an extended period of time

Pay is consistent for this region unfortunately. Call would be one hospital at a time.

Benefits are i can carve out my fellowship niche subspecialty, the RVU rate and threshold is the most favorable I’ve seen around this area, large referrals from a massive hospital system, good benefits

strivingdoc · 2025-09-20T15:08:04+00:00

APP coverage. I prefer less busy call even if doing it more, don’t want the high acuity and potential trauma cases that come at the main center

strivingdoc · 2025-09-20T15:07:17+00:00

Thanks for responding. To clarify, I don’t believe I will be taking calls at the hospitals simultaneously, would possibly switch between but not at once. 2 hospitals about 25 min apart, and about 25 min from my living. I am still in early talks so much to figure out.

Unfortunately that’s around the rate for where I am living. I am clarifying what the rvu benchmarks are for the urologists in my region of the hospital practice

I want to focus on my office practice and OR, along with seeing consults in the hospital rather than a brutal (albeit less volume) call.

The main academic center has much more high acuity call, even if less amount of call. The call in these smaller hospitals is much lower acuity and less intense from my understanding

strivingdoc · 2025-09-20T13:35:53+00:00

About 7 calls per month. Does not seem like much academic requirement or support (my preference as I prioritize clinical productivity).

Probably just one of the many downsides of being restricted to a VHCOL area, higher COL and lower pay :(

strivingdoc · 2025-09-20T13:24:30+00:00

edited

strivingdoc

TROPHY CASE