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Attending Anesthesiologist Returns to Training with Huge Debt

Home Personal Finance and Budgeting Attending Anesthesiologist Returns to Training with Huge Debt

  • fatlittlepig fatlittlepig 
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    U should have changed jobs not go to fellowship. U don’t have the luxury of being unhappy, Fatlittlepig would be begging for your job back then applying for a new job in the interim. Fatlittlepig’s brain is hurting thinking of the interest accumulating on that debt while you are a fellow. Good luck buddy.

    Avatar billy 
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    1- sell the RV for sure

    2- does your fellowship (im assuming at a university hospital) offer free or cheap daycare?- if so, utilize it and sorry but wife will have to go back to work.

    3- your student loan rates are still high (4.9%)- after you sell the rv/house/etc use the proceeds to pay down that debt and refinance to a cheaper rate (may still be able to before you start fellowship, otherwise you’ll likely have to wait until after fellowship for a better rate). The 30 grand inheritance should go straight to your highest interest loans.

    4- Are you sure you want to do critical care?  It can also be that your current job is making you unhappy but anesthesia elsewhere can be better (was for me).  what particularly do you dislike about the current job? how will critical care be better? (is it you want more interaction with patients and their families? want to write notes and round? dont like the OR itself? prefer more control?).  Every specialty has its flaws and perks.  If personally you think CC is more your personality, then great and you are making the right move.  But if you are just switching because your current job stinks, then you wont be happy afterwards either.  Make sure you can live with the WORST part of critical care before switching.

    Im sorry if I come across as blunt, but you really need to know that you will like ALL the parts of CC before switching, otherwise you are just digging your financial hole deeper

    #227701 Reply
    Liked by Kamban, Anne
    Avatar Anne 
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    Agree with the recs above. It’s hard to read into what’s written, but you don’t seem too anxious about the situation. I feel like my hair is on fire just reading about it. While I like to preach about the importance of optimizing life satisfaction over absolute wealth once one’s finances and financial future are in order, you *have* to prioritize getting those finances in order first before you focus on things like career satisfaction, because the firestorm that this debt could cause will ruin the satisfaction of even a dream job.

    Everyone I know, doctor and non-doctor says they like the core aspects of their job but don’t like all the garbage that comes with it. Eventually over the years you learn to either ignore or accept the garbage so that it doesn’t bother you, or with seniority or playing the game of politics you get to peel back or delegate the stuff you don’t like. Saying no to that stuff is a lot easier when you’re not worried about finances. Do you want to do critical care because you need more end of life family discussions, weaning trials, and sepsis protocols in your life? If so (and I’m not being sarcastic, I can completely see loving that stuff), then the fellowship is not a bad decision. But if you are doing the fellowship because you are hoping to escape all the junk that floats around the periphery of your anesthesia job, don’t be surprised if that follows you everywhere you go.

    Sell the RV, sell the house, sell the cars and get cheaper ones (or one–agree with switching to one car if you can). You need program director permission to moonlight, pursue that. Agree your wife should return to work in some capacity. In my area structural engineers can do quite well, one of my friends set up his business working from home (going out for site visits obviously), was also able to control his schedule this way. Can also work as an architect from home, maybe look into consulting jobs. At least keep her feet wet and increase her experience.

    I really wish you had sought advice earlier, this all would have been more actionable and useful 6-12 months ago.  Good luck.  You are young and can recover, but it’s not going to be quick.

    #227702 Reply
    fatlittlepig fatlittlepig 
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    In 3 years that student loan debt gonna be higher especially as a single income family. I would stick with your day job so to speak.
    FLP

    #227703 Reply
    Liked by Tangler
    Avatar BCBiker 
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    OP, my spouse is also an engineer, and I’m the same age as you. Through simple good habits (no lottery winnings, inheritances, nor anything of that sort), we’re on track to hit >$1M net worth before I finish fellowship. You, on the other hand, are on track to hit NEGATIVE $1M. There may be situational differences, but I bet 99% of this discrepancy is attributable to making good decisions.

    • Get rid of the RV. Why on earth did you buy a *new* RV without a plan for something so fundamental as parking?
    • Sell the house. You don’t want to be an absentee landlord.
    • Wife goes back to work. Many big companies have “Career re-entry” programs especially for women who’ve taken time out for childcare. Cost of childcare will be less than what she can make as an engineer.
    • Moonlight like crazy
    • Reconsider your fellowship. I hope you will take a long, deep look at the fact that you essentially quit a high-paying job, while $1M in debt, because you were “unhappy”. At the very least, consider how you will ensure you have the ability/stamina to work in crit care and not be unhappy in that situation, as well.
    • Live like a resident.

     

    Click to expand…

    Good advice @octopus85.

    However, I am a bit skeptical on >$1M NW before completing training without some significant tailwinds (e.g. parents paying for school, spouse with high income, speculative investing). Your lifetime earnings after 6 years of training on the high end would be (6 years * $60K training stipend) + (3 years * $100K moonlighting) << $1M. As you know there is this headwind vs. tailwind bias, where when you have always had these advantages you forget that not everyone has them.

    This does not negate the significant headwinds that OP has generated for oneself. What I see from the OP posting is that there are 2-3 fairly major bad decisions that were not well-considered.

    Going back to training is a major financial decision that should be avoided at almost all costs. If one is burned out so early in career, you can pay for a lot of vacation and therapy plus relocate to a more desirable employer plus etc., etc., before one should even think for two seconds about doing additional training.  There is a lot more variation between jobs in same sub-specialty than between sub-specialties and I don’t see this particular change to be a major income enhancer. Maybe this is incorrect assumption? Moving from an attending salary to a trainee salary and from an attending schedule to a trainee schedule does not seem to be a great solution to job dissatisfaction and burn out in my opinion. As someone who is familiar with LCOL places, maybe it is the area (and the people<-I’m making broad generalization here.) that sucks, not the job. Moving to higher COL location might be a better solution to be in a better environment.

    The RV fiasco seems to be in a similar spirit to decision on training albeit less consequential. The shared theme being that a major decision was made without thinking through to how that decision will play out over the relevant time horizon. Whenever making big decisions, it is worth putting in the time to consider all possible decisions even ones that seem implausible.  When you were thinking about housing, in addition to RV (which is quite out of the box: can you really not find someone’s back alley to park this thing?), you could have evaluated what costs of apartments across the street with 1, 2, or zero cars, apartments across town with 1 vs. 2 cars, buying a cheap property, etc., etc. Once you know the range of possibilities you can weigh feasibility, costs, varying degrees of inconveniences, etc and only then pulling the trigger.

    In spirit of making the forum a more friendly oasis for newcomers, I will also say that I sympathize with your feelings of burn out and when you are tired, depressed, feeling less valuable; one is more likely to make poor decisions.

    I hope that the advice here highlights the likely wrong directions you have made so far and perhaps there is an opportunity to reverse course on the fellowship in particular. I would drop this position now.  The sooner you let the program know, the better. Also, as people have said you are not sunk but if you keep making bad decisions you could be sunk quickly. The savings you mention is good but you might want to consider removing debt over holding >$100K in idle cash. You do want a liquidity cushion but that has significant cost.

    #227704 Reply
    Avatar Dilaudidopenia 
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    I thought OPs post was a joke when I first read it.  It gave me angina.

    I would forget about fellowship. You’re definitely not going to be happier in CC than anesthesia.  I would work in anesthesia for another 3-4 yrs at least and kill off your loan.  Beg for old job back or find another.  Attending anesthesiologists should easily be able to make 350-500K depending on the set up and how much you work.  Take more night call.  Take more weekend call.  Sell the house and RV.  How was this debt not cleared already after working for several years as an attending?

    #227706 Reply
    Liked by Tangler, MPMD, Peds, CM
    CM CM 
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    I would forget about fellowship. You’re definitely not going to be happier in CC than anesthesia.

    Click to expand…

    In my opinion, this is the most important advice.

    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried bags for Cyd Charisse (gracious). Hosted epic company parties after Friday night rehearsals.

    #227708 Reply
    Avatar Peds 
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    Any thoughts/ideas/suggestions/questions are most welcome. Thanks!

    Click to expand…

    Michael Jackson Popcorn eating - Sorry I'm late popcorn line was really long

    #227709 Reply
    Avatar octopus85 
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    Click to expand…

    Good advice @octopus85.

    However, I am a bit skeptical on >$1M NW before completing training without some significant tailwinds

    Click to expand…

    High-earning spouse makes a big difference, which is why I’m surprised the OP is so dead-set against his wife going back to work. Unemployment is at record lows, and even more so in technical fields. My engineer spouse says they can’t find enough bodies to hire, and competition is insane. If there were ever a time for someone with a non-traditional career pathway to try to get back into the labor market, this is it.

    #227712 Reply
    Avatar okayplayer 
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    It kind of makes me nauseous when you guys do this holier than thou act when someone who is in a tough situation comes here asking for help. A lot of us had a lot of debt by the time we were done with med school/residency (more expensive med school, no help from parents, etc). It’s a hard hole to dig out of. Also, people discover the “WCI principles” at various points in their life.

    If you truly love critical care and there is nothing else you’d enjoy doing, do the fellowship. If your goal is becoming financially secure, it is for sure not the right move. Besides the opportunity cost ($400,000+), you are severely limiting your job prospects, especially if you want to do a mix of ICU and anesthesia in private practice. Most of those jobs are in academics and will pay 100-200k less than your average private practice anesthesia partnership job.

    Obviously I agree with most here that you should cut your losses on the RV, old house, etc.

    I also started with a huge hole (2 physician household), so I can relate. We started off -720k net worth on the day we finished residency. Today (5 years later to the day almost), we are +750k. We also had 2 kids in the mean time and my wife took ample time off for each because it was important to us. It can be done. Good luck and feel free to PM me if you would like a sympathetic (non judgemental) ear.

    #227717 Reply
    Avatar okayplayer 
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    I would add that some here would have lived in a 1br apartment, picked up every call possible, ate Top Ramen exclusively and would probably have a 1.2m net worth in my situation at my career juncture. Good for you guys, not my path,

    #227718 Reply
    Vagabond MD Vagabond MD 
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    As I reread this, having your wife as a SAHM is a luxury that you cannot afford. One reason is that you guys are $1M in the hole and require a larger shovel to dig out your way out of debt.

    Another is more emotional. $250k of the debt is her student loan debt, obtained to prepare for a career that she is no longer monetizing. Today, you are young and in love with a new baby and unicorns and rainbows and everything, but there is a chance at some point down the road, when the unicorns and rainbows disappear (they always do) that you will resent her for the $250k encumbrance that she added to your life.

    It might not be tomorrow or next year, but imagine a day when your marriage is as routine as everything else, you are getting pummeled in the ICU, on a 24 hour shift, hating your life, and maybe you have added some extra shifts to continue to work down the debt. You call to check in, and she has just dropped the kids off at pre-school and is on her way to yoga and to meet some other moms for lunch. It will creep into your thoughts, “Why the F am I working like a dog, to pay off my DW’s debt, and my DW is living a life of leisure?”

    It’s a perspective you cannot see now, and it may not come to pass, but there is a decent chance that it will. It’s human nature. In a sense, having her return to work might just save your marriage.

    "Wealth is the slave of the wise man and the master of the fool.” -Seneca the Younger

    Dreamgiver Dreamgiver 
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    How much do you realistically expect this fellowship to increase your salary compared to its cost?

    0 is the answer, in fact, depending on the specific job situation, this fellowship might actually net a lower overall salary than OR anesthesia.

    #227720 Reply
    q-school q-school 
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    How much do you realistically expect this fellowship to increase your salary compared to its cost?

    0 is the answer, in fact, depending on the specific job situation, this fellowship might actually net a lower overall salary than OR anesthesia.

    Click to expand…

    +1

    It’s a professional satisfaction decision, not a financial decision.

     

    #227721 Reply
    Vagabond MD Vagabond MD 
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    I would add that some here would have lived in a 1br apartment, picked up every call possible, ate Top Ramen exclusively and would probably have a 1.2m net worth in my situation at my career juncture. Good for you guys, not my path,

    Click to expand…

    I would argue that this is not a more vs. less frugal scenario. That is, too much Starbuck’s vs. coffee at home, Audi vs. Camry,  and the like. This is about a young doc who is extremely comfortable with high levels of debt and is making career and life choices that are positioning him to continue to have high levels of debt for the foreseeable future.

    "Wealth is the slave of the wise man and the master of the fool.” -Seneca the Younger

    #227722 Reply

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