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Training to become a physician can be intense!

I find myself thinking this quite often, but I can’t truly understand or relate because I don’t have any first hand experience. Fortunately, I found someone gracious enough to share his experience.. someone that does understand. If you are a young medical professional in training, this should be great information for you.

Dr. James “Morgan” Tucker recently transitioned into practice (this month) as a generalist OBGYN working in Georgetown, KY. He attended the University of Southern Alabama in Mobile for medical school where he met his wife, Lauren (also a medical student at the time – now a Hospitalist in Lexington, KY). They both matched at the University of Kentucky and have lived in the area since.

A Career in Medicine

DW: Morgan, thanks for doing this! First off, can you share why you decided to go into medicine?

MT: You’re welcome! Well, early on I knew I really liked science… specifically medical sciences. I was interested in learning how the body worked… and I like solving problems. I really enjoy helping people, too! I felt that practicing medicine would allow me to combine all of these things and have a satisfying and rewarding career.

DW: How has this panned out for you?

MT: Very well!

DW: Looking back, what about residency and training was the most stressful for you?

MT: The amount of information you have to learn in a limited amount of time AND effectively translate that into patient care is stressful. And you almost never get a chance to switch off… you’re almost always “ON” or in “work mode” because the hours are so intense. Even when you do have time off, it’s difficult to actually turn that switch “off”.

Your life is consumed by your training, and it becomes difficult to keep up with the other important aspects of your life.. family, friends and health. Planning for the future is difficult.

Finances & Student Loans in Residency

DW: How do finances play into the residency and training experience?

MT: It’s kind of up to you… they mention it in a cursory manner in the beginning of your training. The good news is if you are single, often times you’re too busy to spend much money. But if you are already married and have a family, it’s a completely different story.

I would think… am I going to be able to afforded the basics? Housing, groceries, gas and eating out occasionally when I am way too tired to cook? Will I be able to pay my student loans or will I be forced into deferment? I would say paying on the loans – even the least amount – is better than going into deferment.

And then after all that… do I have enough for an emergency? Maybe the basement floods or the car needs major repairs… these things happen. I wanted to make sure we had cash on the spot to cover these things.

I guess you can say we winged it a bit… we had a general idea in mind to cover the basics and have enough left over for an emergency – plus providing for the emotional break from work (vacation or eat out from time to time) and that was about it.

My point of view – I did not study finance at all – was to focus on the basics. I wanted to avoid spending the entire paycheck. I wanted to see my bank account grow. As long as our accounts were growing and we weren’t having to be too restrictive, I was relatively happy.

DW: How do you think most young doctors deal with (and feel about) their student debt load?

MT: I think people learn to cope with it. If you thought about it every day, it would paralyze you. My wife and I were confident that we could handle it in the future. It’s very rare for a resident to have no student loan debt. Most have significant debt just from medical school. We were fortunate not to have debt from undergrad… but most do. If you take it too seriously, it would likely be unhealthy.

DW: Do you ever talk about money with your peers?

MT: Sometimes. Everybody generally assumes you are cash-strapped in residency. We occasionally commiserate about how we have debt and old cars breaking down. My wife’s car basically fell apart in residency and we had to decide what to do. We were planning to start a family and wanted a safe car. I wanted her to have a nicer and safer car than mine, so we purchased a newer used SUV. If I had to do it over again I probably would have spent less, but really it’s worked out well and hasn’t been much of a strain.

We really tried to balance frugality and living life. We were careful about not adding too much stress from being really frugal on top of an already stressful life. It probably would have been better to rent instead of buy, but it was nice to own a home. It does come with work and responsibility, but looking back, it’s been worth the cost to us. We were able to find a great house in the right area. It was a modest house… a nice and quiet neighborhood… and very close to the hospital. When I was home it felt like home and that was nice.

DW: Was it hectic finding a house during the transition from medical school to residency?

MT: Kind of – we matched.. then got married.. and then 2 days later drove to Lexington to look for houses. We found one in three days of looking at a ton of places. We had a great realtor named MaryAnn Morris – she drove us all over town looking. We knew nothing and she held our hands through the entire process and helped us find what we wanted. We were approved for a much larger loan, but ended up taking the modest route.

The Transition into Practice

DW: Which part of the transition into practice was most intimidating? Why? And how did you manage these?

MT: I knew we were going to have 50% income for 1-2 months and I was worried about our cash flow during this gap. I also thought the transition into practice would involve hidden expenses (expenses in addition to the normal monthly expenses). I wanted to make sure none of this hurt us financially.

Part of my practice involves taking relatively frequent home calls, and knowing that, it was almost a necessity to be closer to my practice in Georgetown. So we decided we needed to move sooner rather than later… and we only wanted to move one time… so the home transition became the “hidden expense”. It was important to move closer to my work so I could be home more often.

DW: Were you tempted to make a big purchase at the completion of training?

MT: Yea, we hadn’t gone on a real vacation in 4 – 5 yrs… so there was definitely a vacation temptation. We ended up saving up and went on vacation to the west coast – Napa, Carmel, and San Francisco in California. We tried to hit the middle ground between frugal and extravagant.

Looking back, I am glad we went because we would look back and regret not doing something. It was also great for our relationship. I didn’t realize during residency… the toll it took on our relationship- I didn’t realize how much we weren’t together. We were almost in a holding pattern. And now that we are out it’s like, oh hey… we have some time! And it’s been great. Each day I have an extra 4 hours to spend with my wife and daughter, and that’s a significant improvement. You don’t realize what you are missing until you look back on things. And now I realize it’s getting better. Residency is just hard!

DW: Any suggestions for others still in training?

MT: You kind of just have to deal with it. We specifically made time for each other. When we were home, we spent time together. When we weren’t working, we spent time together. It was kind of an unwritten rule with us. We would hang with other couples sometimes, but the majority of time not doing medicine was 100% family.

We started dating in medical school… it was hard then, but we had tons of time compared to residency – then we had very little or none! When you get home, you have to decide between working out, hanging with friends at a bar, or being at home with the family… for me it was an easy decision.

Financial Planning as a Physician

DW: What prompted you to reach out to a financial planner?

MT: If you looked at my background… I grew up very self sufficient. As a physician, you want to do everything on your own. If I look at what caused us to reach out for financial planning help… I guess it was my parents. They have a family trust and they were big on financial guidance from attorneys and financial planners, and I originally thought it was simple enough to do on my own.

But, the more I self-educated, the more I realized it was out of my league. The more I learned, the more I realized what I didn’t know. And time is very precious. I didn’t really have the time to spend educating myself more, and there is somebody out there who went to school for this that I can hire. And the lightbulb just went off one day and I decided I should find this person.

And so I was spending some time looking for someone, but hadn’t really found anyone. One of my closer co-workers and I were on rotation together and talking about life… and I mentioned I didn’t quite trust the financial guys I had found so far. They were just trying to sell products. And I was spending time trying to pick one. And my co-worker said “hey, I got this guy you should call and see what you think – he’s a good guy but you can decide for yourself.” And that’s when I reached out.

DW: What has been your experience dealing with financial service people in general?

MT: My wife was approached by a financial person when she ended her residency… with a pretty well known company. He was very nice and advised on life & disability and it seemed great, but the motive was still to sell product – not necessarily to provide services in our best interest.

I got the sense – or warning: “you are going to be a physician soon and there are a lot of people that know you will be making a good income and they will seek you out and offer products that seem like a great deal, but aren’t as good as they seem.” And I took that to heart. I have always been wary of people that seek me out that offer products or services.

The finance guy approached us… we agreed with the general premise… but we didn’t really have time to make a super informed decision. And we felt like we had to make a quick decision. I would have preferred not to do it that way and take some time.

If I had to do one thing differently, I would have sought out an advisor at the very beginning. Someone independent – one with no products to sell – one that only provides advice.

DW: What if you cannot find an advisor that only provides advice – one that doesn’t sell any products? Sometimes these types of advisors are hard to find!

MT: I feel like some is better than none. I would definitely put in the effort to find an independent one, though. But if you just cannot find one, find one that is affiliated with major company. Some is better than none.

It’s kind of a catch 22… the hard thing was that I had no financial knowledge. I didn’t really know what to be looking out for at first. I thought financial planning was what super rich people offered to manage assets. I didn’t realize there was a market for advice for people like me, and that it was a necessary thing. I thought everyone like me just fiddled around until they made enough money to hire one.

And looking back on the price and the cost… I wouldn’t have shied away during residency. I didn’t realize the cost/benefit at the time. What you charge is very affordable – and we could have afforded it from the get go (during training). Even as far back as medical school it would have been helpful. I mean, the fees we pay are less than our cable bill and vastly more valuable. There are lots of things we would give up before this. But I didn’t really understand this before.

What they tell us in medical school… they give us this financial lecture early on… they try to scare the mess out of you. Every time you get a latte – it’s going to cost you this over the life of the loan. But they don’t look at the lifestyle and stress factor. Sometimes it’s just easier to get a latte. And sometimes it’s worth it.

But they don’t give much helpful, real world advice. They don’t say seek a financial planner. They don’t say do this basic plan. They basically say you will have a ton of debt. Don’t spend any money. Be a miser and hopefully you will be ok in the end.

DW: How do you distinguish between salesmen and advisors?

MT: An advisor is someone I have to look for. Sales people come at you. And they sometimes come at you at your most vulnerable point. They always seem to approach when I am at a weak point. And they usually have some sort of catch.

Then, advisors are almost invisible until you look for them. Advisors are often more transparent, and even if you don’t ask a question, they would volunteer the answer you need. Salespeople often never offer it, and then when asked, the answer is not straight-forward.

Advice for Other Young Doctors

DW: What one specific action would you suggest to young docs that they could start doing today to help them prepare for the coming transition into practice?

MT: Hire a financial planner… an independent one. That’s probably the one thing I would do… because it’s a simple action… but it affects every other aspect.

You don’t have to do crazy stuff… you’re not talking about outlandish things… you’re talking about setting up the basics. Figuring out your benefits. Making sure we’re making the best decisions. Instead of saying no… no… no you can say “hey, let me run this by my financial guy.“

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