By Francis Bayes, WCI Columnist

According to a Medscape survey of more than 15,000 physicians in 2020, about 80% are married, and only 4% have never married. Another question in the same survey asked whether the physician is married to another physician, and only 16% and 25% of male and female physicians, respectively, responded yes.

This would mean that many physicians had more income potential and/or less net worth than their spouse when they married. Various medical specialties make up more than half of almost every top 10 list of highest-paying jobs, but at the same time, 73% of medical school graduates have student loans. A current or future physician could be in a tricky situation where they bring to their marriage a negative net worth in the present though still would have a high likelihood of earning millions of dollars in their lifetime. (Readers who are in a relationship with a future attending physician should check out this thank-you letter.)

You cannot enter matrimony without saying the word, “money.” That is, you cannot avoid conversations about money when you are married. In this column, I share how my wife and I have handled finances in our nascent marriage. My wife works as a consultant, while I am an MD/Ph.D student. Every marriage is unique, so rather than specific advice, I focus on general insights from our experience.

Before I share our story, I have two big disclaimers. First, I have received economic outpatient care, which is William Danko’s term for economic gifts that parents give to their adult children. Second, my wife and I come from similar socioeconomic and cultural backgrounds, and that’s made it easier for us to initiate conversations about money and to reach resolutions.


Step 0 –  Talking About Money Before Marriage

Before a couple is ready to discuss marriage, a conversation that many medical students in debt might have with their significant others (SOs) is about splitting bills and receipts. Some of my medical school friends and their SOs who work were in a quagmire because every dollar that a medical student spends costs more than the dollar out of the SO’s paycheck.

Because my MD/Ph.D program has been providing me a stipend to cover living expenses, this was not a major issue for me, but I was still open about what I couldn’t afford when my wife and I were dating. Here are my two cents. If financial responsibility is important for a medical student, then they need to let their SO know that they cannot keep up with them on discretionary spending—that is, they cannot go on that three-day vacation or eat at the new three-dollar-sign restaurant—because they are taking out $X in loans for A, B, and C. They will have to disclose their loan amount if they marry their SO anyway, so I think they should be upfront about it. If their SO cares about them, they should be understanding of their financial situation and would be wise to look at their future income instead of their loan amount or their “measly” income for the first few years after medical school.

Still, if the med student cares about the relationship, they also should not be cheap with showing their appreciation either: buy the SO a nice birthday dinner and gift!

Besides talking about spending, we had better uses for our time than talking about investing and paying off loans. My wife did not care whether my stipend was enough to save money for the long-term as long as I paid for our date-night dinners (I gladly did!). I was aware my wife had student loans, but I did not know (or care) enough about it at the time to ask for details. We only had vague ideas about each other’s financial situation, but I sought to answer these questions before one of us brought up getting married:

  • Is she generous when it comes to hospitality, giving gifts to friends, family, and charity?
  • Does she pay off the credit card balance in full in the absence of unforeseen circumstances?

If the answer was no to either of the questions, I would not have wanted to marry my wife because these questions reflect my values. I considered financial chemistry to be just as important as other dealbreakers. Once I was confident about the answer to these two financial and other nonfinancial questions, I trusted that our partnership would work in parenting, volunteering, or financial planning. After all, the best financial planning in marriage is the commitment to be married until death.

Read more from Francis Bayes:


Step 1 – Setting Money Goals as a Couple

When we were dating, we discussed some goals that we wanted to have as a family, but after we said our marriage vows, we wanted such abstract ideas to become a reality. We no longer could be indifferent about creating a financial plan that would help us pursue our goals. I wanted us to talk about money early so that we would think about it as seldom as possible down the road.

We merged our bank accounts, shared passwords, and created joint email and Mint accounts. Every couple is different, but for us, doing so was the easiest way to assess our financial health and remove any unnecessary friction. We learned that my wife had squirreled away cash in a low-yield savings account, while I invested most of my meager savings in index ETFs. Neither of us shamed the other, because getting married meant having a fresh start with our combined strengths. Before we reallocated our excess cash, we monitored our spending as a new couple for the first few months so that we would know how much we need in our checking account on a monthly basis and in our emergency savings account.

We then set SMART goals (specific, measurable, attainable, relevant, time-based) and prioritized them. My wife wants to spend as much time as possible with our future child(ren), so our most immediate goal is maximizing flexibility for her. In case she would want to work part-time or stop working altogether, we prioritize paying off her student loans so that our liabilities would not be a burden with one or one-and-a-half sources of income. We refinanced her student loans before the federal forbearance ended, and based on our current savings rate, we will have zero student loans no more than three years after I finish my medical training.

talking about finances before marriage

We are content with the possibility that we might achieve financial independence later than we would with two incomes. But I do not know how much I would enjoy practicing medicine 20-30 years in the future. My choice of career path also depends on whether my wife discovers a new field in which she wants to work full-time. Despite these uncertainties, if my wife and I could be better and happier parents, we believe any potential financial trade-off would be worthwhile.

Medical students, as well as residents and fellows to a lesser extent, have a clean slate on which they can sketch a financial picture for their families. They can erase and edit some parts of their sketch as they go through their training. As rigid as medical training can be, future attending physicians can add flexibility to their family’s financial plan. Do not be afraid, and take heart with the WCI’s words: “A physician income covers a multitude of mistakes.”


Step 2 – Dividing Financial Responsibilities

Each of us gravitates toward what we do better, hate less, or enjoy more than the other person. I do the laundry because I have lived in our apartment longer, while my wife likes to vacuum and dust. I eagerly clean the bathroom and the kitchen knowing my wife would handle any cockroaches that appear (dead or alive). I enjoy planning trips outside our city, but my wife manages our social calendar.

I manage our household finances because I regard it as a hobby or “second job.” I do not take my wife’s trust for granted, especially because her paycheck currently funds most of our monthly budget and retirement portfolio. If we ever need to change our financial plan, we would do it together. I do not inundate my wife with every financial transaction I make, but I ensure that she is aware of these three things: (1) we pay off our loans aggressively (see above); (2) we have an aggressive asset allocation; and (3) we automate everything (more later).

All of the above would hold true even when my paycheck is bigger than hers because our regular financial check-ups remind us that we are a team in whatever we do. I also do not want her to be clueless if something happens to me and she has to manage our household finances by herself. In addition to the regular financial check-ups and a written contingency plan, I have been recommending her to read two personal finance books that are engaging and not too technical: The Psychology of Money by Morgan Housel and I Will Teach You to Be Rich by Ramit Sethi. One day, she will read them!


Step 3 – Investing in the Relationship First

While we give and save a set percentage of our net income, our focus is on investing the remainder of our income in our relationship by automating our donations, contributions, and payments. Because we already know where our money is going and how much we can spend every month, we can (1) encourage one another to buy something that one needs, (2) eat somewhere new and interesting regardless of the cost, and (3) understand that “not now” does not mean “never.”

Here are some examples:

  1. When we were dating, I hated seeing my wife (then-girlfriend) buy cheap boots that would fall apart after she wore them for the winter months. Once we were married, she felt secure buying whatever was the most comfortable and stylish because she knew we could afford it.
  2. We enjoy trying a variety of dishes across cuisines, so we have explored both hole-in-the-wall and Michelin-starred establishments. On special occasions and vacations, we order what we want because some dishes might become cherished memories that connect us to that time and place.
  3. My wife wants to eventually drive a more comfortable car, but she understands that driving our current car for as long as possible helps us achieve our financial goal (she actually wouldn't mind driving a Lexus). Choosing delayed gratification is easier because we know that we are making progress and that we can reevaluate our big financial decisions when we achieve our goals and milestones.

We want the other to feel valued in the present and in the future, and our conversations about money have helped us grow in our understanding of how the ways we save and spend show that we care about our wants and needs. As I am about to finish my Ph.D and prepare to go back to my third year of medical school, my wife and I are thankful that we have gone through each step because building a good financial plan and financial habits would have been challenging while I am going through an Anki deck and UWorld questions.

No matter how inconvenient, not doing so would have been costly. If you have not, the best time to talk about money with your spouse was yesterday. The second best time is today.

Did you talk to your significant other before you were married about your respective financial history and your goals? If so, how much did it help your future relationship? If not, how much did it affect your finances? Comment below!