Author: Joel Schofer, MD, MBA, CPE
Written Summary of 3 Financial Tips Every Young Doctor Needs to Know
The video podcast for the original post was a beast (> 500 MB) and unwieldy for those deployed with suboptimal internet speeds, so I added a written summary, which can now be seen here:
3 Financial Tips Every Young Doctor Needs to Know
1. You can’t control the investment markets, so focus on the two things you can control – investment costs and your asset allocation.
No one, and I mean no one, knows what is going to happen in the investment markets. Study after study have shown that the overwhelming majority of people who try to beat the markets fail. Because of this, you should forget about trying to predict the markets, and focus on things you can control – investment costs and your asset allocation.
All investments have costs, and the impact of these costs on your investment return compounds over time, taking a larger and larger bite out of your investment returns. If you invest $100K for 25 years and earn 6% per year, without costs you’d have $430K. With just a 2% annual cost you wind up with only $260K. That 2% annual cost consumed $170K, almost 40% of your potential investment! (Source: Vanguard.com)
In addition, because they have to overcome higher costs, investments with higher costs lag the performance of similar investments with lower costs. If you look at stock and bond mutual funds in the highest and lowest cost quartiles, you’ll see what I mean:
| Type of Fund | Highest Quartile of Cost | Lowest Quartile of Cost |
| Stock | 6.9% | 7.8% |
| Bond | 4.0% | 4.4% |
Average yearly return from 2004-2014. (Source: Vanguard.com)
If you want to take one step that will guarantee that your costs are among the lowest in the industry no matter what you invest it, you should invest with Vanguard or the Thrift Savings Plan (TSP). Vanguard is actually owned by its own investors (you), and they leverage this corporate structure to provide the lowest investment costs across the board with the exception of the TSP, which has even lower expenses.
If you can’t invest with Vanguard outside of your TSP, perhaps because your have access to a retirement plan that doesn’t offer Vanguard investments, then you need to get into the weeds on your investment costs. While there are many different potential investment costs, the easiest one to look at is the expense ratio of your potential investments.
According to Morningstar.com, the expense ratio is “the annual fee that all funds or ETFs charge their shareholders. It expresses the percentage of assets deducted each fiscal year for fund expenses, including 12b-1 fees, management fees, administrative fees, operating costs, and all other asset-based costs incurred by the fund.”
Wow. That was a mouthful. Bottom line…high expense ratio bad, low expense ratio good.
You should be able to find your investments’ expense ratios on your investment website or Morningstar.com.
In addition to investment costs, the other things that you can control is your asset allocation. While there are many asset classes you can invest in, the two most basic are stocks and bonds. Here are some of the returns for stocks and bonds from 1926-2013 in commonly utilized portfolios:
| Annual Return | 50% Stocks & 50% Bonds | 60% Stocks & 40% Bonds | 80% Stocks & 20% Bonds | 100% Stocks & 0% Bonds |
| Highest | 32.3% | 36.7% | 45.4% | 54.2% |
| Average | 8.3% | 8.8% | 9.6% | 10.2% |
| Lowest | -22.5% | -26.6% | -34.9% | -43.1% |
(Source: Vanguard.com)
As you can see, the higher your allocation to stocks over bonds, the more risk you are taking and the bumpier the ride. Along the way, though, you have historically been rewarded for this bumpy ride with a higher average annual return. Just like the extra 2% cost that was previously discussed compounds to make a huge difference, so will a small difference in your returns. In other words, the more risk you can take, the more money you will probably end up with.
The application of these principles is that you should take as much risk as you can. In other words, you should invest as much of your portfolio in stocks as you can while still sleeping at night and not lying awake worrying about the stock market’s ups and downs. There will be another market downturn, and when that occurs you need to keep buying stocks because they are on sale, not sell out because you can’t handle seeing your net worth and portfolio value decrease.
Invest is as high a percentage of stocks as you can without making the critical mistake of selling stocks during the next market downturn. For me, that has been 100% stocks for the majority of my career, but for some people they’ll panic even at a much lower percentage of stocks. If a 50% stock and 50% bond portfolio is the only one that will keep you from selling during the next market downturn, then that is the right portfolio for you.
If you have been investing for long enough, look at your actual behavior during the 2007-2008 market downturn and what your asset allocation was at the time. Mine was 100% stocks and I kept on buying. Your allocation and actions will tell you a lot about your own risk tolerance.
2. Your savings rate is the most important factor determining your eventual net worth, and it should be at least 20-30% of your gross income.
The most common recommendation you’ll find or hear when it comes to saving for retirement is to save 15% of your gross or pre-tax income for retirement. There is nothing wrong with this recommendation, but built into it is the standard mentality of working until age 65 and then retiring. If you want the freedom to retire early, work as much or as little as you want, and achieve financial freedom/independence, then you will need to save much more than 15%. I’ve saved 30% over most of my adult life, and that’s why I’m writing a personal finance blog post.
If you want to take a look at various saving rates and how they impact your financial life, you’ll want to check out the blog post “The Shockingly Simple Math Behind Early Retirement” at MrMoneyMustache.com. There you will find a chart that shows you how many years you will have to work until you can retire based on your savings rate. If you go with the standard 15% savings rate, you’ll have to work 43 years before you can retire. If you go with my 30% rate, you’ll work 28 years. If you manage to save 50%, you can retire in 17 years! The more you save, the earlier you reach financial independence and can work as much or as little as you want.
The other standard advice you’ll hear and read is that you’ll spend approximately 80% of your pre-retirement income during retirement. For a physician with a typical high income, that can be a lot of money!
You have to realize that 80% is probably high for a physician because after you retire you’ll have greatly reduced expenses. This is because:
- You’ll be in a lower tax bracket.
- You’re no longer saving for retirement.
- You no longer need life or disability insurance.
- You’ve hopefully paid off your mortgage.
- Your kids are out of the house (if you had any).
- You have no more job-related expenses.
- You can give less to charity if you need to.
In the end, you can probably live off of 25-50% of your pre-retirement income, not the standard 80%. This fact can multiply the effect of a higher than normal savings rate.
3. You are your own financial worst enemy.
Unfortunately for us, we engage in self-defeating behaviors all the time, including:
- Assuming too much debt.
- Living above our means in order to keep up with the doctor lifestyle.
- Purchasing too large and expensive a house.
- Purchasing too expensive a car.
- Not maxing out our tax-advantaged retirement account contributions.
Luckily there are some simple rules that, if followed, can keep young physicians and medical students out of trouble.
First, realize that anytime you assume debt you are simply borrowing from your future self for current gain. Sometimes that is a good idea, like when you borrow to pay for medical school, but pausing before you assume debt to purchase something can help you out greatly.
Getting down to brass tacks, no one really cares what medical school you went to, so you should probably go to the cheapest one you can get into.
In addition, no one really cares how large your house is or what kind of car you drive. You think they care, but they really don’t. Don’t try to impress other people.
If you have student debt, you need to get smart about ways to refinance it or get it forgiven with the Public Service Loan Forgiveness Program. Thanks to the HPSP program, I never had student debt, so I’m not going to pretend to be the expert on it. If you have student debt, go to WhiteCoatInvestor.com and learn about options to refinance or get your loans forgiven.
When it comes to houses and cars, if you can’t afford the house you are purchasing on a 15-year fixed mortgage then you are probably buying too expensive of a house. Rent until you can put down a larger down payment or look at less expensive houses.
When it comes to cars, you should realize that you can buy a very reasonable used car that is 5-10 years old, plenty nice, and very reliable for much less than a new car will cost. You should make it your goal to pay cash for cars. If you can’t pay cash, then you should purchase a cheaper car.
Low or no interest loans are tempting because people think they are getting “free money,” but using “free money” to pay for a depreciating asset (one that declines in value) is not a smart financial move. Your goal should be only to borrow money for appreciating assets (ones that increase in value), like businesses or real estate.
Finally, make sure you maximize your tax advantaged retirement contributions every year, like the TSP. It is one of the few legal ways to hide money from the IRS, and the compound growth year after year is an opportunity you don’t want to miss.
In summary, here are the three things every young physician or medical student needs to know:
- You can’t control the investment markets, so focus on the two things you can control – investment costs and your asset allocation.
- Your savings rate is the most important factor determining your eventual net worth, and it should be at least 20-30% of your gross income.
- You are your own financial worst enemy.
Somebody out there is going to take this advice to heart and get rich. Is it going to be you?
FY18 Enlisted to Medical Degree Prep Program
If you know of an enlisted member interested in attending medical school, make sure you tell them about this program:
UNCLASSIFIED
ROUTINE
R 121431Z JUL 17
FM CNO WASHINGTON DC
TO NAVADMIN
INFO CNO WASHINGTON DC
BT
UNCLAS
PASS TO OFFICE CODES:
FM CNO WASHINGTON DC//N1//
INFO CNO WASHINGTON DC//N1//
NAVADMIN 172/17
MSGID/GENADMIN/CNO WASHINGTON DC/N1/JUL//
SUBJ/FY-18 ENLISTED TO MEDICAL DEGREE PREPARATORY PROGRAM ANNOUNCEMENT//
REF/A/DOC/BUMED/7MAY15//
AMPN/REF A IS BUMEDINST 1500.31, UNIFORMED SERVICES UNIVERSITY OF THE HEALTH
SCIENCES ENLISTED TO MEDICAL DEGREE PREPARATORY PROGRAM.//
RMKS/1. This NAVADMIN solicits applications and provides guidance for the
FY-18 Enlisted to Medical Degree Preparatory Program (EMDP2).
2. The EMDP2 is a 2-year undergraduate education program open to enlisted
personnel of all ratings who meet eligibility requirements in line with
reference (a). The EMDP2 is a partnership between the Uniformed Services
University of the Health Sciences (USUHS) and the armed services to provide
an opportunity for highly-motivated, academically promising enlisted service
members. The EMDP2 consists of intensive coursework, preparation and
mentoring to prepare students for application to medical school. Upon
completion of the program, successful students will be competitive for
acceptance to U.S. Medical schools.
3. Selectees are assigned to the Uniformed Services University in Bethesda,
MD for a 24-month period. Individuals selected for the EMDP2 program will
remain on active duty while completing coursework and will receive pay,
allowances, benefits, and privileges of current paygrade. Selectees will
receive permanent change of station orders to USUHS for the entire length of
the course. All school expenses (i.e., books, tuition, labs, etc.) will be
paid by USUHS for the entire length of the course.
4. Deadline for submission of applications for FY-18 enrollment is
1 November 2017. Application packages must be postmarked on or before the
deadline date. No additional documents or packages will be accepted after
this date. The selection board will convene in December 2017. All
application requirements are specified in reference (a) which can be found at
https://www.usuhs.edu/emdp2,
http://www.med.navy.mil/ or http://www.public.navy.mil/.
5. Strict adherence to package submission requirements will be a primary
factor for selection. The application is a reflection of the applicant.
Applicants must review their package in its entirety before submitting. A
minimum score of good on the latest physical fitness assessment and
qualifying Scholastic Assessment Test/American College Test scores are
required.
6. This NAVADMIN does not modify any previous guidance contained in
reference (a) regarding selective reenlistment bonus.
7. Applicants assigned to a nuclear training command or who hold a nuclear
navy enlisted classification (335x, 336x, 338x 339x) and are applying for the
FY-18 EMDP2 selection board must obtain conditional release from nuclear
field duty prior to submitting an application for consideration for the FY-18
board in line with NAVADMIN 070/13. To obtain a conditional release,
applicants must submit an Enlisted Personnel Action Request (NAVPERS 1306/7)
to Nuclear Propulsion Program Management (OPNAV N133) via the detailer at
Enlisted Nuclear/Submarine Assignment (PERS-403). The FY-18 EMDP2 selection
board will only consider nuclear enlisted candidates who have conditional
release included in their EMDP2 application.
8. Applications should be mailed to:
Bureau of Medicine and Surgery
Office of the Hospital Corps (M00C5)
7700 Arlington Blvd
Arlington VA 22042-5113
9. Point of contact is HMCS John Hendrick, Office of the Hospital Corps,
Bureau of Medicine and Surgery, who can be reached at (703) 681-9241, or via
e-mail at john.hendrick.mil(at)mail.mil.
10. Released by Vice Admiral R. P. Burke, N1.//
BT
#0001
NNNN
UNCLASSIFIED//
FY18 O5 Medical Corps Promotion Stats by Specialty
| FY18 MEDICAL CORPS COMMANDER SELECTION BY SUBSPECIALTY | |||||||||
| SELECTION OPPORTUNITY 75 % | |||||||||
| # IZ | #SEL IZ | % SELECT IZ | # AZ | #SEL AZ | % SELECT AZ | # BZ | #SEL BZ | % SEL BZ | |
| FLT SRG | 1 | 0 | 0.00% | 8 | 1 | 12.50% | 12 | 0 | 0.00% |
| RAM | 4 | 0 | 0.00% | 8 | 3 | 37.50% | 6 | 0 | 0.00% |
| ANESTH | 11 | 3 | 27.27% | 5 | 2 | 40.00% | 28 | 0 | 0.00% |
| SURG | 14 | 2 | 14.29% | 12 | 6 | 50.00% | 40 | 0 | 0.00% |
| NEURO SURG | 1 | 0 | 0.00% | 1 | 1 | 100.00% | 10 | 0 | 0.00% |
| OB GYN | 5 | 1 | 20.00% | 8 | 1 | 12.50% | 21 | 0 | 0.00% |
| GMO | 0 | 0 | N/A | 2 | 0 | 0.00% | 6 | 0 | 0.00% |
| OPHTH | 2 | 2 | 100.00% | 3 | 2 | 66.67% | 5 | 0 | 0.00% |
| ORTHO | 7 | 2 | 28.57% | 7 | 2 | 28.57% | 28 | 0 | 0.00% |
| OTO | 4 | 2 | 50.00% | 4 | 1 | 25.00% | 11 | 1 | 9.09% |
| URO | 2 | 2 | 100.00% | 3 | 1 | 33.33% | 6 | 0 | 0.00% |
| PREV MED | 5 | 3 | 60.00% | 7 | 1 | 14.29% | 4 | 0 | 0.00% |
| OCC MED | 3 | 1 | 33.33% | 3 | 0 | 0.00% | 8 | 1 | 12.50% |
| PHYS MED | 1 | 1 | 100.00% | 1 | 0 | 0.00% | 3 | 0 | 0.00% |
| PATH | 7 | 3 | 42.86% | 4 | 1 | 25.00% | 6 | 0 | 0.00% |
| DERM | 5 | 4 | 80.00% | 2 | 1 | 50.00% | 11 | 0 | 0.00% |
| EMERG | 10 | 4 | 40.00% | 14 | 4 | 28.57% | 29 | 0 | 0.00% |
| FAM PRAC | 15 | 5 | 33.33% | 20 | 9 | 45.00% | 40 | 1 | 2.50% |
| INT MED | 21 | 10 | 47.62% | 15 | 3 | 20.00% | 41 | 0 | 0.00% |
| NEURO | 1 | 1 | 100.00% | 1 | 0 | 0.00% | 2 | 0 | 0.00% |
| UMO | 2 | 0 | 0.00% | 2 | 0 | 0.00% | 2 | 0 | 0.00% |
| PEDS | 4 | 3 | 75.00% | 7 | 1 | 14.29% | 22 | 0 | 0.00% |
| NUC MED | 0 | 0 | N/A | 0 | 0 | N/A | 0 | 0 | N/A |
| PSYCH | 4 | 2 | 50.00% | 3 | 0 | 0.00% | 24 | 0 | 0.00% |
| DIAG RAD | 13 | 6 | 46.15% | 13 | 6 | 46.15% | 30 | 0 | 0.00% |
| RAD ONC | 1 | 0 | 0.00% | 2 | 1 | 50.00% | 4 | 0 | 0.00% |
| TOTAL | 143 | 57 | 39.86% | 155 | 47 | 30.32% | 399 | 3 | 0.75% |
| FY18 MC CDR SELECTIONS BY ZONE | |||
| # OF PEOPLE | # SELECTED | % SELECTED | |
| ABOVE ZONE | 155 | 47 | 30.32% |
| IN ZONE | 143 | 57 | 39.86% |
| BELOW ZONE | 399 | 3 | 0.75% |
FY18 Medical Corps O5 Promotion Board Stats and Math Explained
Overall stats are here (and in PDF form – FY18 AO5S STATS):
The promotion opportunity was 75%. The number of people in zone was 143. In order to find the total number of officers they could select for promotion, you take the promotion opportunity x the size of the zone:
(75% promotion opportunity) x (143 officer zone size) = 107 officers could be selected for promotion, which is how many they selected…
Above zone – 47 of 155 selected – 30.32%
In zone – 57 of 143 selected – 39.86%
Below zone – 3 of 398 selected – 0.75%
FY18 Medical Corps O5 Promotion List
Here’s the list (link to the ALNAV is here):
Ableman Thomas B 0031 Agraz Javier Jr 0021
Atienza Arriel Elarmo 0105 Auten Jonathan David 0013
Ballard Sarah B 0074 Barker Patrick Dean 0079
Barlow Thomas K 0098 Bernhard Jason Robert 0081
Boller William A 0017 Burke Kim Elizabeth 0038
Canuso Amy Arnold 0070 Capra Gregory Gerard 0083
Carbone Peter Neff 0088 Childs John Michael 0025
Choe Anna Y 0068 Chung James 0039
Clark Delbert David 0008 Clark James K 0069
Coffey Debra D 0072 Connolly Randy Wain 0041
Cook Jerald L 0106 Cronyn Patrick Dager 0052
Cross Garfield 0029 Crossman Emily L 0048
Decker Lawrence C 0067 Degrado Justin James 0024
Dierksheide Julie E 0014 Dimmer Brian Matthew 0086
Douglas Mark S 0075 Elliott Adrian 0026
Fechner Kenneth M 0020 Fick Daryl Burton Jr 0087
Fowler Elizabeth Mae 0085 Gentry Shari Lynn 0012
Germana Antonino 0101 Gibson Lisa Kay 0104
Gomezleonardelli Domin 0047 Greene David Erik 0009
Grijalva Steven D 0033 Grossart Richard T 0005
Gudeman Suzanne Rae 0089 Heltzel David Andrew 0010
Hoover Khristina J 0030 Kazlauskas Kristofer A 0003
Kilfoil Terrence M 0043 Ko Charles C 0036
Koren Kelly Gray 0080 Krzyzaniak Michael J 0023
Lamme Jacqueline S 0034 Leibig Jonathan Scott 0046
Lodico Derek N 0061 Love Kathleen M 0076
Lunceford Martin W 0065 Mcadams Douglas C 0056
Mcdivitt Jonathan D 0078 Mcdonald Lucas S 0032
Mcgrath Sean F 0001 Mei Jian Ming 0007
Mentler Ellie Chiwon K 0084 Miletich Derek Matthew 0082
Miller Kyle Eric 0077 Mullins Lynita H 0095
Murphy Thomas J II 0019 Murphy Wayne Thomas 0006
Nassiri Joshua Darius 0064 Nelles Meghann E 0015
Nelson Benjamin E 0055 Nicholas Luke C 0092
Nork Justin J 0100 Owings Alfred John II 0050
Paz David Alexander 0018 Perez Angel J 0107
Peterson Jami Jo 0058 Phillips Christopher R 0071
Phun Huy Q 0060 Potochny Evelyn M 0049
Pryor Howard Irwin II 0004 Quartey Benjamin N 0028
Rappe Jodie Danielle 0090 Reynolds William W Jr 0002
Rice Nelly Kim 0022 Ripple James Randall 0066
Robinson Christa M 0045 Rose Matthew W 0011
Rupp Brianna L 0042 Sangiorgi Michelle J 0073
Schmitz Joseph William 0035 Schuette Albert J Jr 0016
Shah Anil N 0027 Singla Manish 0091
Smith Jason E 0040 Smith Monique E 0096
Spring Leah Kristina 0063 Stclair Kristina J 0093
Steelman Theodore J 0053 Stickle Edward T Jr 0059
Sweet Nicholas N 0062 Teti Virginia Plitt 0054
Uniszkiewicz Robert N 0103 Valentine Johannah K 0037
Vargas Marcel Moses 0044 Viola Shelton A 0094
Ward William Harrell 0102 Whaley John Gregory 0051
Wood Kristi M 0097 Worthley Jeffrey C 0057
Yee Bruce Arnold 0099
USSOCOM Surgeon Position – O6 Only
The USSOCOM Surgeon position is opening in June 2018 and is open to O6 only. Nomination packets are due to BUMED by 17 JUL via your Specialty Leader. The nomination packet must include:
- Flag officer letter of recommendation
- Photo
- CV and BIO
- Last 5 fitreps
- Detailer and Specialty Leader concurrence
MHS Female Leadership Award Deadline Extended to 26 JUL
The deadline for nominations was extended to July 26th. Here is the original info:
Guest Post – Maximizing TSP Contributions During Deployment
[Editor’s Note – The process of contributing to the TSP above the $18K annual limit while deployed can be confusing. Thanks to Dr. Levi Kitchen for giving us a first hand summary of how it works.]
By LCDR Levi Kitchen (Levikk81 < at > gmail.com)
Deployment offers a number of financial benefits, including tax free pay which can be directly contributed to your Thrift Savings Plan (TSP). However, this can be tricky. The following numbers are based on 2017 limits, which can be seen at this link.
Normally, the elective deferral limit is $18,000 annually. A deferral is defined as the money you elect to remove from your paycheck and contribute to the TSP. This includes either Roth or traditional TSP contributions. When deployed to a combat zone and therefore receiving combat zone tax exempt (CZTE) pay, the deferral limit for the current calendar year increases to $54,000. However, even when receiving CZTE pay, you cannot exceed $18,000 in contributions to your Roth TSP. The remaining $36,000 would have to be contributed to the traditional TSP. Also, in order to take advantage of the higher limit, the money has to come from your CZTE pay, which has to come directly from your paycheck. So, you can only take advantage of the higher deferral limits while receiving CZTE pay, not after.
Although the decision between the Roth and traditional TSP can be complicated (a matrix can be seen here), it’s probably smartest to max contributions to the Roth TSP first as, due to the CZTE, this money will never be taxed by the federal government. Once you reach a total contribution of $18,000 to the Roth TSP, DFAS will automatically stop deducting money from your paycheck. At this point, you need to change your contributions to traditional TSP in MyPay, because you’ve reached the limit of allowable Roth TSP contributions. Automatic deductions to the traditional TSP would again stop once you reach the total limit of $54,000 ($18,000 in Roth TSP and $36,000 in traditional TSP) for the calendar year, or you stop receiving CZTE pay.
As far as I know, once you stop receiving CZTE pay, your annual limit returns to $18,000 regardless of either Roth or traditional contributions. If you’ve already contributed over $18,000 while deployed, then you cannot contribute anymore to your TSP for that calendar year.
For any comments or questions, please email Levi at Levikk81 < at > gmail.com.
Resources for LCDR Fitreps
At my command, they just put out the call for LCDRs to start writing their OCT fitreps. Remember that everything you need can be found here: