Q. What happens if you miss the 2-5 year post-residency window but still want to “get on board?”

A. This question refers to the easiest, most sure, nearly guaranteed method of becoming a wealthy doctor, also known as “Live Like A Resident.” When using this technique, you do the following.


How to Live Like a Resident and Get Rich

  1. Finish residency
  2. Get an attending job
  3. Work hard at said attending job and make good money
  4. Continue to live the same lifestyle you lived as a resident (i.e. spend something like $50K per year)
  5. Take the difference between what you earn as an attending and what you spend as a “resident” and use it to build wealth – paying off student loans, saving up a down payment on the dream home, and maxing out retirement accounts

Typically, if you will do this for 2-5 years after you finish residency/fellowship/dental school, you will no longer have student loans, be living in your dream house, and have a six-figure nest egg beginning to compound. Do it for a decade and you'll likely be financially independent at that “resident” lifestyle.


I Didn't Get the Memo

Unfortunately, many of my readers didn't get the memo. They didn't get it in med school. They didn't get it in residency. They didn't get it within the first few years out of residency. But somewhere in their late 30s or even their 40s, they realized they didn't know anything about money, still had student loans, and were on track to be one of the 12% of doctors in their 60s with a net worth under $500K. What now?

Well, the truth of the matter is that “Live Like a Resident” will work at any time. It works better right out of residency for two reasons – # 1 You haven't become used to having more than $40-50K a year to spend and # 2 You have more time for your savings to compound. But it certainly works better at 35, 40, or 45 than it does at 70 or 75 when you're forced to live like a resident on Social Security.


The Minor Stuff

So what's the big issue? Well, there are probably some minor things you'll need to fix.


The Main Thing

But honestly, all of that pales in comparison to the main thing. The main thing is you're going to have to spend less money. And while that may be simple, it's not easy, and it is much harder to cut spending five years out of residency than it is to never grow into that income in the first place. The only question is really how much you are willing to cut. The more you cut, the more quickly you build wealth. You don't get a pass on math.

At a minimum, you need to carve out 20% of your gross income for retirement. Even if you spend a decade or two paying off your student loans and mortgage, you're eventually going to need some kind of a nest egg to supplement Social Security.

Better yet, you'll carve out that 20% plus enough to pay off your student loans (and heaven forbid any credit card or auto loans) within the next five years. Perhaps that's 30% of your gross income.

And perhaps, if you're really serious, you will actually go back to a resident average American level of spending while earning like a doctor.

So how do you get there from here?

There's no magic formula. Well, there is, but you missed it. (Live Like a Resident right out of residency.) So now it's a Choose Your Own Adventure Book. I can tell you this–the most successful people who do this begin with the big rocks. The more of those you're willing to take a step back with, the better this is going to go. Let's take a look at some of them. I'm sure I missed a few (be sure to read the comments!)


16 Ways to Build Wealth and Be Financially Successful If You're Behind in the Game


#1 Move

This one is pretty drastic, but done well, can solve three, four, or even five of the big rocks all at once. Few are willing, but I wish more would at least consider it. I had a sad email not long ago, from a doc who moved from NYC to SF and felt desperate due to her debt. Newsflash! Moving from one coast to the other does not constitute geographic arbitrage. I'm not going to get into all the ways moving helps here, but you'll see that it facilitates the next 5 big rocks.


#2 Get a Job That Pays More 

Back in 2009, Katie and I were on track to become financially independent at 52. Then I took a partnership job and when I made partner, I started getting paid a lot more than the $225K/year our original plan called for. Then I started a blog that started making lots of money. End result? We hit our “number” at 42 instead of 52. Despite the increased taxes and increased temptation to spend, there's no doubt that making more money speeds up the process. I'm amazed how many doctors are working for less than half the average in their specialty while struggling financially. A “job you love that pays crummy” is a luxury you cannot yet afford.


#3 Lower Housing Costs

The big problem with this one is that it requires moving, at least a short distance. A major part of most budgets is housing. This includes rent, mortgages, maintenance, upgrades, insurance, landscaping, and property taxes. It should be no surprise that the smaller the house and the less prestigious the neighborhood, the less you spend on all of that. Only you can decide if your situation calls for something this drastic, but there's no doubt you can dramatically decrease spending by concentrating on housing, especially if you're willing to leave a High Cost of Living Area for a Low Cost of Living Area.


#4 Lower Your Taxes

This one might sound like another variation of screw your whole life up by moving somewhere else. But did you know there are states that don't have a state income tax? And that some states have lower property tax and sales tax rates than others? It's true.

There are other methods of lowering your taxes too, like investing more efficiently, maxing out retirement accounts, and becoming an S Corp that you should give serious consideration to.


#5 Stop Paying for Private K-12 Schools

I know. The schools in your town are terrible. Just last week half the sophomore class was wiped out by zombies and the average ACT score coming out of there is only 28. That's why Little Joey and Baby Sue are in the best private schools money can buy. You make $140K. There's no reason you can' t put them both in $30K/year elementary schools is there?

Seriously though, this one combines well with moving too. Guess what's crazy? You can actually move somewhere that pays you more, that charges you less in malpractice, that offers better housing at 1/4 the price, offers better public schools, and lowers your taxes all at once. You don't have to go from San Francisco to Chelsea, South Dakota either. San Bernardino and Las Vegas aren't very far apart but have dramatically different tax and housing burdens. [Please don't send hate mail if you love San Bernardino or San Francisco or hate Las Vegas. If you live in Chelsea though, feel free. I can handle all 27 of those emails.]


#6 Start Budgeting

I get lots of emails from doctor families struggling on an income of over $300K. They usually have two things in common. The first is a lot of debt. The second is they don't live on any sort of a written budget. They often have no idea what they spend. Guess what? That which is measured, improves. You'd be surprised how much money you're hemorrhaging on stuff you don't even value that much.


#7 Quit Paying an Advisor

This one is usually a big rock, just because even good financial advice tends to be expensive stuff. I met with a doctor who wanted to start managing your own investments, which was good because not only was her advisor charging her 1.5% on her $500K portfolio ($7,500/year) but was giving her bad advice. There are definitely ways to lower the costs if you really need financial advice, but if you're going to get serious about this finance stuff, you might as well learn how to do it yourself. It isn't that hard if you have enough interest. And an extra $7,500 a year goes a long way for most of us.


#8 Downsize the Cars

how to get rich

Not your car if you're living like a resident

Another common scenario – Two $30K+ cars with $20K+ notes on them. This is far less hassle than moving, but if you sell both of those cars and buy two $10K cars, you'll eliminate both car notes and after a few weeks, probably won't even care that much about the change. And every time you see that beater, you'll be motivated to get ahead financially so you no longer have to drive it.


#9 Sell the Boat

I use “boat” here, but this may be something else in your financial life. Perhaps it's the sports car, the snowmobiles, or the 4 wheelers. Maybe the lake home or ski condo. These are the things that doctors who got their ducks in a row in their 30s bought in their 40s. You will be able to afford them eventually, but not right now and not all at once. The cool thing about selling them is you get some cash to use for paying debt or building the nest egg AND you reduce your ongoing expenses.


#10 Take Fewer, Less Expensive Vacations

Katie and I went nuts on vacations in 2018. For example, from mid-June to Mid-November (5 months) we went to Zion twice, Lake Powell three times, Moab, Wyoming, Arizona, Oregon, California, Florida, Hawaii, Denmark, Sweden, and Norway. However, we're financially-independent, multi-millionaires who are still working and making a great income. If you're trying to vacation like that and struggling financially let me introduce you to my friend “Go Camping at the State Park Twice a Year.” I haven't seen her in a while, but we go way back.


#11 Quit Eating Out

Did you know that some people eat out a half dozen or more meals a week? Mr. Money Mustache suggests you compare eating in a restaurant to renting out a restaurant and all its staff to celebrate a special occasion rather than to making food at home. You can stuff a lot of money down your esophagus in a hurry, especially when you're on vacation. Better to go to the State Park and eat hot dogs and s'mores. “But that's not healthy!?” Yea, well, neither is working 7 days a week up to 48 hours at a time until you're 75 in a dysfunctional hospital.


#12 Send Partner to Work

You're not where you want to be financially and you have someone with the ability to earn $50-100K+ per year playing video games in the basement or sitting around between dropping the kids off at school and picking them up? A stay at home parent may be a luxury you cannot yet afford.


#13 Get the Kids Out of Daycare

Diapers and baby food are expensive but other than private school tuition, few child-related expenses compare to the cost of daycare. You can save a lot of money by finding a way not to pay that. Maybe it's a family member or friend. Maybe it's just giving it time until those kids are in school. I don't know, be creative; it might be easier for you than downsizing the cars or moving to Vegas.


#14 Dump the Help

It's not going to have the same financial impact as managing your own investments, but you may be able to save a lot by doing your own lawn care, cleaning your own house, working on your own sprinklers, and fixing your own car. (Amazing what you can learn on Youtube.)


#15 Pull the Kids Out of Their Activities

I said there would be sacrifice involved, didn't I? You might be surprised to find out your kid doesn't care that much about that traveling basketball team, viola lessons, or cub scout camp. (Have I offended everyone reading this post yet by attacking their favorite pet expense?) This is another great reason to live like a resident early on, before those kids get old enough to start caring about this stuff.


#16 Be More Frugal

Use it up, wear it out, make it do, or do without. All of us can be more frugal. Maybe it's keeping your furniture for one more year. Maybe it's washing and reusing ziploc bags. I don't know. But surely there is some money you can squeeze out of that budget with a little effort. Everyone thinks they are frugal, but guess what, if you have a six-figure salary and you're struggling to build wealth (or even just make ends meet), by definition, you are not frugal. Go read some frugality blogs and you'll see what I mean.

This list could go on and on, but I think you get the point. You've got to find something you're spending money on that you value less than financial independence. Then quit buying it and invest the difference.

What do you think? What should someone who has already grown into their income do to become financially successful? Were you in this situation? What did you do? Comment below!