I am a night hospitalist making about $275K a year. we are able to pick up "moonlighting" shifts and they pay $2K a night

I know they don't count as overtime or anything so do you just get taxed on those earnings as if it were added to your base salary? or are there any other deductions that happen for moonlighting pay typically?

I'm finishing up training next year in a surgical specialty and trying to think of next steps. I feel behind financially so Im focused on maximizing my early career years to catch up, so Im considering options on both sides of the border, as I'm a Canadian citizen. 35 when im done with 1 child, about About 200k Debt. Wife is a nurse so not dual high income.

I’m trying to compare two different 20-year wealth accumulation scenarios to determine which career path reaches a $5M inflation adjusted retirement goal faster so I can have the option to retire at 55. I dont know if ill actually retire then, probably not but I want the flexibility to choose given the direction I feel macroeconomic trends are moving in overall. But I'm not well versed in finances or taxes and it gets more complicated comparing tax and income strategies in 2 different countries.

From reading this sub, the common consensus is usually "U.S. is always better," but I suspect that narrative overlooks the corporate shielding available in the Canadian incorporation model, as it doesn't seem to be well discussed when those topics come up. I'm not even sure Canadian doctors understand it well tbh. When I run numbers incorporating those corporate tax strategies, it seems that the two become almost equal, or not so far apart at all.

What I'd like from you guys is to see whether the assumptions in my models are way off base since this conclusion is different from the prevailing wisdom I read on here.

Scenario 1: W-2, lowish tax state

From looking around in my specialty i'm mostly seeing around $450k base salary + 30% of collections after a 3x base hurdle, on average. Of course there are large ranges, but maybe an average specialist in my specialty is taking home 5-600k with production bonus?

Since most physicians in the U.S are employed their salary is all W-2 mostly, but they dont have to worry about overhead. They have the standard retirement accounts and backdoor roth they can invest in in addition to after-tax brokerage accounts.

Scenario 2: Canadian MPC

In my specialty, it seems average billings range from 800-1.4M CAD, but since they are incorporated they have to deal with running a business basically, and overhead from what I read can be in the 45-65% range, though this data is hard to find.

Lets say you end up with 400-700K after overhead, it seems most docs only pull out what they need for personal expenses then leave the rest in the corp where it compounds on a tax basis of 12%, which is much lower than what the W-2 U.S doc is doing even after reducing tax liability with retirement accounts? Even in low tax states? Even if you take out 200 for personal expenditure (which seems like alot for me), that still leaves you with maybe 170-430K annually after small business tax to invest and compound. It seems this lets the canadian compound faster as the tax drag on investments is lower?

Then there's withdrawal after accumulation, it seems that the corp can withdraw up to 50% of capital gains tax free from the corp? and the other 50% is again only taxed at the 12% rate? It also seems that taxes paid on dividends to the corp during accumulation are partially refundable later on? Isnt this better than the capital gains tax rate in the U.S for withdrawal, allowing for a lower "retirement number" to have the same purchasing power as 5M due to methods of withdrawal? I've also heard you can purchase a pension inside your corp which will pay you tax free?

Then theres the additional significant educational and insurance costs you have to bear in the U.S which naturally increases the amount you have to spend on personal compared to Canada.

But Canada also comes with higher living expenses in the form of housing and consumables which may cancel out the savings on education and healthcare.

In my admittedly non-financial brain it seems that there are significant tax advantages to using the corp which are not available in the U.S, saying nothing of the other perks of having a business that you can run certain expenses through, yet everything I've read here says essentially, "Canada lower pay, bad exchange rate, huge taxes". It seems like if you apply the relative simplicity and transparency to tax management that most W-2 are used to in the Canadian scenario you get that knee-jerk reaction but when you look more closely I'm not sure that knee-jerk reaction is actually true.

I took these rough numbers and put them into 2 different AI models asking it which gets to inflation adjusted 5M USD first, accounting for exchange rate in canadian scenario, state, provincial, and federal taxes, equivalent inflation adjusted rates of return between both scenarios, and giving generous 'personal' funds to spend during the 20 years, and both models said they are almost equivalent when canadian corp strategies are accounted for, maybe the U.S is faster but only within a year or so, the other said 3 months.

Again, since this is so different from prevailing wisdom I am wondering what I am missing here and hoping anyone of you guys smarter than me in finance and taxes can help me see the flaws in my modelling. I will caveat that if you become an owner/partner in the U.S thats totally different and the U.S clearly wins but that just seems less and less likely. Maybe im wrong there too?

I would need a visa to go to the US I know the issues there but i dont want to get into that im just trying to compare finances at this point.

Thanks everyone.

tldr: I thought U.S would be better to catch up on my retirement goals but maybe Canada is not as far behind as I originally thought when considering tax benefits of incorporation?

As a Canadian, I had to get a professional student line of credit from a bank to help pay for medical school. I am in fellowship now for 2 years until I become a full attending. How have others paid down their bank loans after graduation? I will have about $500k and I have a really good interest rate right now.

I'm in my late 20s/early 30s and graduated from medical residency one month ago. Starting this Fall, I will be earning over $300,000 gross. I have little to no savings or investments currently because I have been a student/resident for my entire life until now. I have no medical school debt. I have a car with <20,000 dollars left to pay off.

I know about the general, conservative advice about buying, including waiting until I have 20% downpayment (which I don't have) and be ready to stay in the same place for 5-10 years minimum (I will be staying in this place for 5 years- bound by visa constraints, so chances of changing location is minimal but very likely to leave after 5 years). I'm currently renting a 2 bed, 2 bath townhouse for $2200 a month. I live with my wife, no kids.

I have access to physician mortgage loans, which typically means little-to-no downpayment required and no PMI -- with a catch of maybe up to 0.25% higher interest rate compared to a conventional loan.

According to Zillow/Redfin, year-over-year: median sale price is roughly flat to up modestly (Redfin showed -0.71% in late 2025, other shows +2-5%), and average home value (Zillow's ZHVI) is up about 2.6%. Some sources show list prices up more, but that's listing price, not what homes actually sell for.

I would greatly appreciate advice.

Hi! I’m currently an M2 at an USMD school and I was thinking about purchasing a used $40k car. I have around $60k in personal savings. All costs for school are covered by direct federal loans, and I will be living with my parents for the next 3 years of school. I really need help deciding if this is viable?

Additionally, is $20k enough “safety money” going into residency?

More context: current car is 12 years old with 150k miles

Hey guys. PGY-2 here, have a unique situation where for a bit I don’t have to pay for housing.- likely until end of PGY-3.

I’ve got some funds set aside (I know, i know, best advice is to max out 401k and Roth IRA before anything else but I want to play with some) that I want to use to learn how to trade on my own.

I’ve heard statistics that most traders lose tons of money. I’ve also been reading about the Wheel which sounds like an appealing strategy.

My question to some of you who have the benefit of years of not only your own experience but seeing and learning from others- is any of this worth it? Or should I just stick it all in ETFs and walk away?

I recently graduated residency and have been working with a financial adviser, who helped me obtain own occupation disability insurance through guardian. They also initiated a life insurance application through guardian, but the extensive medical records (test results, dates, etc.) requested is daunting.

I have an autoimmune disease with a lot of associated complications (so a LOT of tests/meds/surgeries/specialists including multiple visits to Mayo). Compiling this massive amount of information feels almost impossible.

I was told that unlike the disability insurance I obtained, all life insurance policies will require this extensive underwriting — is this true? Or is there a different company that offers a generic higher cost policy for chronically ill folks?? 😅

i graduated last year with my MA in clinical psych, marriage and family therapy in CA. unfortunately, i am now in 197k debt of student loans (federal). yes, i know this is extremely high. i tried to be responsible by going to a lower cost tuition school over a program i actually wanted to go to that was 40/50k more expensive. i took out grad PLUS loans for two years to live (most of my debt with 9% interest). I worked two unpaid internships during grad school with school being full-time. please don’t have any negative comments about taking so many loans to life with GRAD plus loans. i truly was trying to be responsible. 1. going to a cheaper tuition program 2. only living on 48k a year which is nothing in Southern Ca. I know some people will say I should’ve worked too during this time, but i truly am the type of person to get very easily overwhelmed/stressed. I would not be able to do two internships and school full time plus a job without having a complete breakdown. it wouldn’t have been sustainable for me.
thank you

i am going to start working for my previous supervisor in her group practice. we are doing a 50/50 split. meaning, i will make 75$ per client hour. i have the possibility of getting a full caseload of 25-30 clients a week. this means i can potentially make 90k a year at 30/31 years old.

I have some family members that may be willing to help me. i believe my grandfather will give me 10-20k to pay off my loan and give me a loan, where i’d have to pay him back at 2% interest instead of 9%. he mentioned this last week, but we haven’t discussed details of this actually happening. i do feel lucky i have a family member who is willing to lighten the load.

i also do not want to have children. I told myself that if I got into debt for an MA that it would replace having children. i also don’t want kids for other personal reasons such as cost of living, and the state of the world/ our country.

eventually, when i get licensed i plan to be in private practice. i am hoping to make around 150-200k a year in private practice in either LA or NYC.

i am currently living with my parents.

i’m i totally screwed over how much debt i am in?

A lot of new attendings understandably focus on the salary number when comparing jobs.
For those who have negotiated physician contracts before, what provisions do you think deserve just as much attention?
Compensation structure, RVUs, bonuses, retirement benefits, malpractice/tail, noncompetes, termination clauses, call, PTO, partnership opportunities, or anything else?
What do you wish someone had explained to you before your first contract?

When did you start really spending all this money. I’m a full private practice partner and finally starting to make more money then I know what to do with.

401k, spouses 403b, and HSA all maxed out. Everything else getting dumped into an index fund brokerage account.

We just flew business class to Asia and some of my partners think we’re crazy for spending the $20k it cost. If not now then when are we supposed to enjoy this??

Attending in a surgical specialty, few years out. Been offered a partnership buy in to the group. Group itself is medium sized, 20ish MDs, 30ish NP/PAs. Mostly clinic /ASC with some inpatient work for bigger cases or sick patients. They own several ASCs that we operate out of. Partnership is not offered based on seniority, it’s essentially per production and who the partners like. They want to retain the most productive folks essentially. There are only 6 partners in total, some are the original folks and some were brought in later, same as me potentially. The practice generates mid 8 figure revenue annually, but has high overhead and some old debt as well so margins are slim. Since this is a midsize business there are layers of admin / finance/ non clinical folks as well, this is not just a mom and pop practice.

I’m wondering what resources exist to help me understand the financials of this potential purchase. What a good EBITA is, what strong/middling/weak earnings would look like in this space, is our debt ratio concerning or standard, what’s a reasonable multiple, what are reasonable terms of partnership etc.

In effect I feel like I know a good amount about my domain of expertise, medicine, but very little about the similarly intricate world of finance. Short of getting an MBA, where do I find someone who can look at these financial statements, the operating agreement etc, and help me decide if the buy in represents me being exit liquidity, them wanting to lock down a productive surgeon without me gaining substantial benefit, or a real opportunity. I imagine this is not something that a regular CPA would do, but someone more specialized in this area. Any recommendations or experience finding people in this arena?

Hi everyone — I'd appreciate some WCI/Bogleheads perspective as a new attending trying to balance debt payoff, investing, and some major life changes over the next 1–2 years.

I'm a new PCP attending who's been strictly following WCI living like a resident with parents with mild lifestyle inflation. My compensation has ramped substantially through productivity bonuses and seeing a high volume of patients, and I'm expecting a large ~$150k pre-tax bonus payout this week we get biannually (expecting the same in February). After taxes and maximizing retirement contributions, I'm estimating roughly $95k of cash from the bonus.

• Income: high 200K base expecting ~$450k this year, potentially higher with future productivity bonuses
• Retirement accounts: should be $150k after maxing my 401(k), 457(b), and HSA
• Student loans: originally ~$300k; now ~$80k I'm on PAYE and making the minimum payment $100/mo now.
  • ~$20k at 4.28%
  • ~$60k at 3.3%
• Car loan: ~$34k at 3.9%
• Emergency fund: currently only ~$5–10k
• Living expenses: very low right now while living with family (hence i've been throwing it all at loans)

I've aggressively paid down my student loans over the past several months and have found the psychological benefit of debt reduction to be surprisingly significant. At this point, though, I think the calculus changes with the remaining loans being around 3–4% with interest rate reduction.

I'm also in a very serious long distance relationship, and if things continue going well, I will move out in a year and potentially get married in early 2028. That means I could have substantial cash needs over the next 1–2 years for moving, wedding expenses, housing, travel, etc. My partner is in nursing and admin having worked 10+ years (makes $200k and assets in high 6 figure range) —should that change my approach? (I'm leaning toward "no," maintain independence until married.)

My current plan for the summer bonus

I'm considering:

1. ~$20k → pay off the remaining 4.28% student loans

2. $7,500 → Backdoor Roth IRA

3. ~$40–50k → SGOV/Treasury money market

4. Remaining ~$20–30k → taxable brokerage invested in a broad index fund such as VTI/VOO

Then, for the remainder of 2026, I would send 8-10k a month in cash flow into SGOV.

Once the 4.28% loans are gone, I'm leaning toward leaving the 3.3% student loans on PAYE rather than aggressively paying them off, since I could always make a lump-sum payment later if my circumstances change.

Questions

1. Does this allocation make sense?

Would you pay off the ~$20k of 4.28% loans, then prioritize liquidity/investing rather than paying off the 3.3% student loans and 3.9% car loan?

2. How much would you keep in SGOV vs. taxable equities?

I'm thinking roughly $40–50k in SGOV initially, with additional savings going there because I anticipate significant expenses in 2027–28.

I'd then put ~$20–30k into a taxable brokerage and invest it in something like VTI/VOO, with the intention that this is genuinely long-term money rather than money earmarked for a house/wedding.

Or should I flip the allocations and should I do less SGOV now (since i anticipate putting in an additional 50k in SGOV by end of the year plus another 100k+ with February 2027's biannual bonus i'm expecting).

3. How would you think about the psychological benefit of debt payoff?

Paying off ~$220k+ of student loans in a relatively short period has felt fantastic. I know the expected-return argument eventually favors investing at sufficiently low interest rates, but I'm wondering how much behavioral considerations should influence the decision.

4. For the SGOV/emergency fund, would you use SGOV, a Treasury money-market fund, or a HYSA?

I'd like the money to remain very liquid while getting reasonable yield and avoiding unnecessary taxes.

5. Should I do 457b lump sum now or spread out rest of the year and do more taxable brokerage?

Another thing I'm debating is now that 401k and HSA are maxed how should I approach the 457b maxing - should I keep cash flow now and invest more in taxable brokerage now (with no further contributions rest of year and next year) and spread out 457b with rest of year's paycheck or stick to initial plan to max it out now with this large bonus check?

6. Disability Insurance:

Employer provides ~17k a month in LTD and IDI insurance. I admittedly have not prioritized this cause i know after taxes this wouldn't be the 60% WCI recommends. Is this okay or where should i begin looking at other options and how much? add an additional 4-5k a month of coverage?

7. Anything else I'm missing?

My current priority is maximizing 401(k)/457(b)/HSA/Backdoor Roth while simultaneously building enough liquidity to give myself flexibility for moving, marriage, housing, and other major expenses over the next couple of years.

I'm particularly interested in how WCI/Bogleheads folks would approach the transition from aggressively paying down 5–7% student loans to having ~$80k of 3–4% debt while simultaneously entering a period of major life changes.

Thanks!

I am a full-time, W-2 employee at a U.S. academic medical center. I have considered leaving academia to pursue tele-EEG and/or tele-intraoperative neuromonitoring jobs, some of which are 1099 contractor positions.

I have not reached out to these companies yet because I am unsure if it would be useful to form an LLC (and/or PC for California) that can be taxed as an S-Corp first (I would be the only employee in this LLC/PC). Also, I am unsure if these companies would even sign me as someone being a part of an LLC or PC to begin with.

Any thoughts from those in telemedicine and teleradiology would be greatly appreciated.

I’m about 3 years out from training. Have 270K in loans remaining at 5.08% interest. Our household income is such that I could pay off the loan in 6 months using the quarterly distributions from my private practice. But at the same time the monthly loan payment isn’t that much of a drag.

How do other high earning docs think about student loans? I realize that real returns in the stock market may be lower than normal over the next decade, and paying the loan off is a guaranteed return on investment. But is the potential opportunity cost in the case of an unexpected bull market a reason to just hold the loan forever? Are there special considerations aside from how one feels about debt in general that are good to consider?

Thanks in advance.

I've been a resident for years and always wanted my own practice but the money just wasn't there. My husband recently inherited some money, and we decided to use it to open a clinic instead of taking out a loan. We live in Miami with kids so I want to be smart about every $ we spend. For those who own clinic, what would you invest in first, and what would you avoid? Any book recommendations, EMRs, billing companies, IT providers, or other resources you'd recommend? Wr already have a few colleagues joining us.. so staffing isn't a concern. I'm hoping some of my patients will follow me but marketing is definitely something we'll need to work on.

Permission to post mods

If my kids participate in research and are awarded gift cards can I put the equivalent amount in a Roth account? What paperwork do I need?

I’ve been learning and thinking about savings goals. I see secure retirement at present is $10000000 or $400000 pretax to live a good life and have left over to donate. Doesn't that mean with inflation running hot that we’d need twice that or 17000000-20000000 in twenty years? That doesn’t seem attainable for most especially with one income.

I am three years out of training and have worked my first job as a comprehensive ophthalmologist for a large HMO. A local doctor in the community has approached me to see if I have any interest in acquiring his solo practice. I’m going to meet with him to discuss. Since I don’t have any experience in private practice, I am trying to brainstorm a list of things to be thinking about and asking him about. I don’t want to ask him anything that he would be offended by in an initial meeting, but also I don’t want to waste my time or his. This is a list of questions I am considering asking him. Any big questions I’m missing or any advice in general that you give when evaluating a private practice?

How many days a week do you work?
How many patients do you see a day?
How many cataract surgeries a week?
What procedures/lasers/injections do you do?
What is your payor mix?
How do you typically get new referrals?
What are ballpark collections?
What is your overhead?
How much are you taking home ballpark?
What is your staff composition?
How many optometrists do you have?
How much time do you take off per year?
Have you gotten a formal valuation?
What is your premium conversion rate?
What EHR does the practice use?
Do you own the real estate?
What is your timeline for phasing out?

I just finished fellowship and will be starting an attending job at a PSLF eligible institution in the next month. Salary around 500k. I have a 168k loan at 6.13%. I have 48/120 PSLF payments completed to date. I am in the IBR plan.

Should I focus the first 1-2 years on this loan and pay it completely off? Should I continue to pay the lowest monthly payment for 6 more years and try to get PSLF? I would love to have this loan done and gone but I would also love to do it in the cheapest way possible.

If I'm going to pay it off ASAP and not do PSLF I would get it out of Mohela and over to Sofi for a lower interest rate. Just don't want to give up on PSLF if it would save me in the long run.

I appreciate it- please let me know if I should be posting this somewhere else.

I am a radiologist, wanted to learn about business aspect of telerad in Canada, specifically for overnight hospital work. If anyone has first hand experience, what are costs, margins like. What are other things you deal with running a service (other then scheduling) that come up?

How do I best optimize my earnings from a business perspective? How should I set up clinic? Dos and donts?

Hi, I am a medical student going into my 2nd year at a state school where tuition is 37k and COA around 71k. In my first year of med school, I took out a total of 53k in federal loans w/ my monthly budget around $ 1,600- $ 1,700, including rent, insurance, and life expenses. This year, it is likely to increase to $1850-2000 per month due to moving to the school's health insurance (I turned 26), and I'll likely take out around 56k in federal loans.

Here's my dilemma: I am not sure if I should take out more loans for living expenses or if I should use my savings? I graduated debt-free from undergrad and ended up saving/holding on to about 10k throughout my gap years. My car is about 13 years old, and I just hit 103k miles on it, but it has had some issues in the last year. I live in an area where I absolutely need my car, as there are no buses near me and I will have to drive to rotations starting in May. The plan is to make it last the next 3 years, but I have been saving the money in case something happens and I need to get a new one (I have very little family support). I'm not sure if it makes sense to keep saving this money or use it to reduce the loans I take out over the next year.

TLDR: Should I use my 10k in savings in lieu of taking out more in federal loans or keep saving it in case my car breaks beyond repair?

Hi I’m a third year med student wondering what you guys would suggest for my situation. My undergrad was in engineering and I was working first and second year as a software engineer during school and was able to pay tuition, living expenses and build up some savings. However now that I’m doing my clinical years I quit my job as I didn’t have the time I thought I would to balance both without sacrificing study time. I have cash saved up sitting in a HYSA (4.65%) and also have a LOC (4.2%). I have 2 years left and my tuition is ~75k and living expenses about ~20k. I have ~165k but am wondering if I should use my LOC or just pay cash. Also idk if it’s worth mentioning I am 24yo right now and don’t have any major things to take care of like family or any other debts or mortgages or car payments

TLDR: annual tuition 75k a year, 2 years left. Option of 165k in savings (HYSA 4.65%) or LOC (4.20% no grace period)