This post is inspired by Boglehead author Michael LeBoeuf. In 2014, he gave a talk to a room full of college students at Arizona State University called “If I knew what I know now.”

It was epic.

Read it for yourself here: If I Knew Then What I Know Now

I’m here to share with you my version of “If I knew what I know now” and the financial mistakes I have made during the medical journey so far.

May my life be a lesson for you.

Experience is a very tough, expensive teacher because you get the test first and then you get the lesson. It’s always cheaper and easier to learn from the experiences of others.”
-Michael LaBoeuf


First, I need to go over some terminology here for those who are new to this blog or to the medical journey.

MS = medical school, so MS1 means first year of medical school

PGY = post graduate year, so PGY1 means intern year (think: first season of Scrubs)

I also need to tell you that finances are very personal. YMMV (your mileage may vary). This is our authentic journey. While we will have a ton of similarities, yours will be different.

This post is list-heavy because it was the best way to deliver my information. There’s a reason why I love grocery checklists.

So get ready to be hit in the face with one hundred bullets.

Let’s begin.


You may know the story of how my husband and I met, which was before medical school.

If you missed it, see here: How I met my husband

My husband was a non-traditional pre-med. In a previous life, both of us worked and earned two tech salaries as engineers.

Family situation:

  • We were dating/engaged.
  • *No kids — yet.


  • Compared to medical training years, we were “rolling in it” and maxed out all accounts available to us.

What we did well:

  • Not freak out in 2008 during the recession and sell. Had we pulled out our money, we would have missed out on the bull market that came after.

What we wish we knew:

  • *What the heck did we do with so much free time before kids!?!?

My advice:

  • Keep the course. Stick to the plan. Ignore the noise.
  • Choose the cheapest medical school your DrSpouse can get into.


When my husband became a medical student, he made zero income. Not only was he not bringing anything in, but he was also accruing tuition debt.

Family situation:

  • We got married during the first year of medical school. At the end of medical school, we had Kid #1.
  • We owned our home. #nontraditionalpremed #weareolder
First day of intern year (left), Last day of intern year (right)


  • I worked to support him and funded all accounts available to me.
  • He no longer had a 401k he could fund.
  • *We stopped funding his IRA.
  • **We opened a 529 for Kid #1.
  • We wrote a will when Kid #1 was born.

What we did well:

  • Discovered Boglehead and FIRE culture. Binged White Coat Investor, Boglehead Guide to Investing, and other great resources. Repeat, lather, and rinse with other books.
  • Switched from “big name brokerage” with high-fee funds to Vanguard low-cost, well-diversified index funds. (Shout out to Vanguard, btw, for being awesome. There’s no affiliate link because they don’t offer it, but I would recommend them to everyone even without one.)
  • Lived well below our means.

What we wish we knew:

*I should have continued to fund his spousal IRA while he was a medical student. I thought he had to have earned income to do so, but I was wrong.

**We didn’t have to wait to have a kid to open a 529. We could have had a head start and opened one up for me, then transferred it to Kid #1 when he was born.

My advice:

  • Don’t carry a balance on credit cards. If you are, cut up your cards and go cash-only.
  • Once you have dependents, get a will. While using an estate planning attorney is the way to go, you can use a FREE one from LegalZoom for now.
  • Read one financial book a year. I suggest starting with Boglehead’s Guide to Investing book.


Internal Medicine Residency was 3 years long and a big change to our cash flow with both of us working again. We were moving up in the world and adulting!

Family situation:

  • Kid #2 was born during PGY2.


  • We both worked and funded all accounts available to us.
  • He now had a HSA, which he previously didn’t have before, and funded that.
  • We got into a income-driven repayment plan for his student loans.
  • *We submitted paperwork for Public Service Loan Forgiveness (PSLF) every year.
  • **We bought term life insurance for both of us in PGY1.
  • ***For his student loan payments, we waited until Kid #2 was born to increase (+1) the number in our household.
  • We bought own-occupation (“own-occ” for short) disability insurance for my husband in PGY1.
  • We opened a 529 for Kid #2.
  • He moonlighted as soon as he was allowed.

What I wish I knew:

*Because we were planning to do PSLF, we could have gotten out of the 6-month $0 grace period to have a head start on having more low payments count towards PSLF. We didn’t because we thought the grace period was mandatory.

**We should have bought term life insurance as soon as Kid #1 was born in MS4. Instead, we waited until PGY1.

***Because Uncle Sam counts unborn children when calculating student loan payments, we should have increased (+1) the number in our household when I became pregnant and not waited until I gave birth. We missed out on 8 months of lower IDR payments.

What we did well:

  • Lived below our means.

My advice:

  • Buy term life insurance as soon as you have dependents. Stay away from whole life and its cousin variable life.
  • As soon as intern year starts, get disability insurance quotes from an independent agent for ALL six own-occ companies. If you or your DrSpouse are a female physician, most definitely get it before the first pregnancy.
  • Handle those student loans and get into the right IDR payment plan (your only good options are IBR, PAYE, or REPAYE) the moment he graduates. If his residency program is #1) not a 501(c)3 or #2) you know 100% that he wants to go into private practice, refinance.
  • For the vast majority of families, renting will come out ahead over buying a home.
  • Save more aggressively than your friends who didn’t go to medical school because of unique expenses. Related: 10 Expenses Unique to Medical Families.
  • Learn to DIY your finances and begin saving for retirement.


Towards the very end of residency, my husband became interested in subspecializing in GI. By the time he decided to go into it, he hadn’t published enough research that’s needed to match into GI.

We decided to go for his dream and meet that requirement by doing a Clinical Nutrition Fellowship aka “First Fellowship.”

Family situation:

  • Baby #3 was born 10 days after he started fellowship. With three kids who were three and under, our cash flow was the tightest it ever was in our lives.


  • Baby #3’s birth was a tipping point between SAHM vs. working mom. I could choose either. I chose to work part-time.
  • We lowered or stopped our contributions to our accounts.
  • We opened a new 529 for Baby #3.
  • *Learning that my husband is more interested in private practice and highly unlikely to go academic, we might abandon PSLF. But we’re still filling out paperwork for PSLF just in case.

What we did well:

  • Lived below our means.

What I wish I knew:

*I wish we have a crystal ball to tell us whether he’s going into private practice or not, so I would know what to do with student loans. Time will tell.

Advice for myself:

Living paycheck to paycheck is OK…for now. We would have more money if I change careers or work more hours. But right now we’re consciously “slowing down” to grow and raise our family.

I typically like to mathematically optimize all our decisions, but the truth about finances is that sometimes not all decisions are based on money. If kids are a part of your dream, too, you get me.

I write this post while our three carefully budgeted, dream babies are asleep. #blessedmom


We’re not there yet. This blog will grow with us as we continue the medical journey.

We’re at negative net worth right now. We plan to take the first 2-5 years after training to aggressively pay off his student loans and catch up on retirement savings. #backtobroke

I can’t wait for the day to have positive net worth. At that point, I will break the bubbly and celebrate with him saying:

“Yes!! We are now worthless!”

To continue to see how we progress towards worthlessness along our medical journey, subscribe to my emails and follow me on Facebook and Pinterest.

Your Turn

Imagine yourself going back in time. What would you tell your younger self, colleagues, or co-residents? Share below in the comments. It may help a lot of people.