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  • Dreamgiver Dreamgiver 
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    Status: Physician
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    Joined: 03/09/2017

    Considering that for high earners traditional IRAs are not tax deductible, your question becomes a moot point.

    in reply to: To Roth or not to Roth- that is the question #248204 Reply
    Dreamgiver Dreamgiver 
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    Growth and value are two specific subsections of the market and would not consider them a substitute of a total market fund in any shape. Those are some high fees, yikes

    in reply to: Question about Two Vanguard Funds #248200 Reply
    Dreamgiver Dreamgiver 
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    Chances are either job will not turn out to be what you think it is and your priorities will change. I’d take the money and kill it for a few years. Find a partner (if you wish) and then move where both of you wish to establish a family. At that point you will be loan free, with a solid foundation for retirement savings. Would pslf be worth it for you? I’d definitely run the numbers

    Dreamgiver Dreamgiver 
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    Sorry, did not see what specific questions you have. If it is just the title, low ER, low turnover, passive index funds (‘total stock market’) Split domestic/international according to your plan. Can add munis if you wish but would not do bond funds due to tax drag.

    in reply to: Optimal investments for taxable account #248193 Reply
    Dreamgiver Dreamgiver 
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    You won’t get direct answers because your timeline falls in a grey area. If it were me, >5 yrs I’d do equities in the form of a total stock market fund. But I got no other debt and can cashflow if the market tanked right before I needed the money. Not sure a target retirement fund would be the best option, especially for tax implications, but I guess, if you choose the appropriate target date, might limit a possible downturn.

    in reply to: Another house down payment question #247986 Reply
    Liked by jfoxcpacfp
    Dreamgiver Dreamgiver 
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    Status: Physician
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    Joined: 03/09/2017

    It is actually really easy to bring people on with the 3+1 yr model where the extra year you are an ‘attending’. It is routinely done by other specialties (CCM, anes, GSurg). You are hired as a clinical instructor or a visiting instructor. Scheduled to cover shifts as an attending twice a week or such (at attending’s pay) and fellow the other days. The best part is that GME is out of this. Fellow days are unpaid but the attending salary for the other days still means a take home pay 2 or 3 times what GME pay would be. Again easy to do and it is done routinely at several institutions.

    in reply to: Just submitted EM residency application. #247941 Reply
    Liked by snowcanyon
    Dreamgiver Dreamgiver 
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    In our big democratic group everybody shares call equally. If you do not want call anymore, you enter a specific retirement track, which requires you to be phased out of the call schedule over 4 years, at which point you must retire. Can stay on as a PRN moonlighter after that with no guaranteed shifts.

    Dreamgiver Dreamgiver 
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    If you are bruised up and such I’d certainly get it checked out. Soft tissue injuries can be sneaky and a pita to deal with in the future.

    Dreamgiver Dreamgiver 
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    If you put it through your insurance it is a claim on your history, rates would not go up but it counts as a claim. If you go through the other person’s insurance no claims on your history. Same thing for uninsured scambags. In that case you have to go through your insurance. Rates won’t go up but it is a claim on your history.

    Click to expand…

    Your rates would go up and I know this for two reasons:

    1. Having immediate family working for auto-insurance companies.

    2. Having personal experience with my rates going up after letting my insurance know of the accident (even though the other party’s insurance accepted responsibility and paid for damages).

    Click to expand…

    You got gipped. Never had that issue and in the past I talked to my local insurance agent who confirmed it. Maybe it’s a state by state thing?

    Dreamgiver Dreamgiver 
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    Joined: 03/09/2017

    If you put it through your insurance it is a claim on your history, rates would not go up but it counts as a claim. If you go through the other person’s insurance no claims on your history. Same thing for uninsured scambags. In that case you have to go through your insurance. Rates won’t go up but it is a claim on your history.

    Dreamgiver Dreamgiver 
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    Go the program with the strongest clinical training. That’s the best financial move. It will make you a stronger doctor, which will open doors to desirable jobs and decrease bad outcomes. It might mean matching in a so so area or in a program where you work more hours. No substitute for hours behind the wheel.

    in reply to: Just submitted EM residency application. #246520 Reply
    Dreamgiver Dreamgiver 
    Participant
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    All my accidents (so far) have been caused by the other driver. First thing you call your insurance
    Company and let them know you were in an accident, what happened. They will ask you if you want to file a claim. I personally have always gone through the other party’s insurance and never had any issues getting a fair settlement. This means I declined to file a claim with my company but can always change your mind later if You feel the other insurer is not being reasonable. Process is usually easy peasy and you might get a little morenthat your car was worth. If you feel your car is reparable, you can also buy it back from the insurance company and get it fixed yourself. Insirance will still cut you a check, just a little less than what it would otherwise be. Car
    Gets issued a salvage title. I have done this before when I knew car was otherwise in good shape and was easy to fix. Got 4 more years out of it, until I got hit again.

    Dreamgiver Dreamgiver 
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    Nope. If you are an average test taker I see no reason. If taking tests has always been a major hurdle, then I’d splurge.

    in reply to: Do you take board review courses? #245593 Reply
    Dreamgiver Dreamgiver 
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    Out of my class of 16 in residency, 3 did a chronic pain fellowship. One does OR anesthesia only full time in PP, one does half and half at academic medical center, one does pain part time in PP. Just a couple of observations you might already be familiar with. If the goal is 50/50 pain/OR anesthesia, an academic medical center might be your only viable option. That will come with a lower salary. Strictly speaking about income, the pain folks who do well are those who built their own practice and employ other people. Many of them, not all, are block jockeys. That’s how you make money. Unfortunately, a comprehensive pain practice is much more than blocks. PT, psych, behavioral specialists and such are needed. They cost money and don’t really bring much money in. That is why, in general, academic centers tend to have better chronic pain centers. I know many folks who do OR anesthesia and make more than chronic pain folks. Yes, that comes with nights, holidays, weekends, high acuity, deaths, and such. Payor mix, group structure, geographical arbitrage all play a role in the economics.

    in reply to: Pain fellowship #245454 Reply
    Liked by akmd
    Dreamgiver Dreamgiver 
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    How much would internal moonlighting pay compared to this other job?

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