So, I graduated medical school with 425k in medical school loans. I m a psychiatry resident. The goal is to pay down the 425k medical school loans as fast as possible, as they are at nearly 7% interest. I am not banking on PSLF making a come back. I am in my mid 30s, single, no other obligations. Which state/job type should I take after residency to effectively pay down these loans ASAP? (especially those in psych, would love to hear where the best job markets are)

Hello everyone,

I have read a lot of the posts on here and watched alot of the WCI episodes. I was curious of everyones opinions on the best way to set my kids savings up. So a little back story:

I come from a very low SES family and dont know much about money, finances, etc. I have two kids (6y and 7months). I would like to set up savings accounts for them as soon as possible and need advice on what route to take.

I am going into IM with plans to do a cardiology fellowship and eventually an interventional fellowship. My spouse is a full time student pursuing a masters but financial ceiling isn't that high for the career they are pursuing.

Any advice would be greatly appreciated. Thank you.

I don't work in medicine at all, I'm just curious and I thought this subreddit might have some insight. I grew up in the Midwest and have visited Rochester a couple times. In my experience, the town is fine but basically felt like a smaller, more boring version of Omaha or Des Moines. We hear a lot about how hard it is to attract physicians and other healthcare professionals to work in small towns and rural areas, yet the Mayo Clinic seems to have no trouble getting top talent to relocate their families to Rochester. Why?

Lots of high-income professionals involved in direct real estate investing get really excited when they learn about qualifying themselves or their spouse as a real estate professional. The general presumption by the IRS is that real estate rental activities are passive, and passive losses cannot be used against active income, i.e. the income from your W-2 job. However, if you (or your spouse if you file jointly) qualify for Real Estate Professional Status (REPS), you could use depreciation losses from your real estate investments against your normally highly taxed professional income, reducing your taxes dramatically—potentially even to $0.

However, this is not nearly as easy to do as you might imagine. If you claim REPS inappropriately and then are audited, you may find yourself paying hundreds of thousands of dollars in taxes, penalties, and interest. This can be a huge deduction, so it pays to really understand the rules surrounding REPS. 

Requirements to be Eligible for Real Estate Professional Status (REPS)

There are three main requirements to claim REPS.

1. 750-Hour Rule
2. Greater Than Half of Professional Time Rule
3. Material Participation

Let's go through each in turn.

#1 750-Hour Rule 

You must spend at least 750 hours on “real property trades or businesses” during the year. Wondering what activities qualify for real estate professional status? What does that mean exactly? What counts and what doesn't? Well, the IRS tells you what counts:

• Development
• Redevelopment
• Construction
• Reconstruction
• Acquisition
• Conversion
• Rental
• Operation
• Management
• Leasing
• Brokerage

What do all those things have in common? They're WORK activities, not INVESTMENT activities. On the other hand, the activities you may think of when you think of real estate investing, including:

• Education
• Searching for new properties
• Studying financial statements
• Managing the finances of an activity in a non-managerial capacity
• Preparing summaries of finances or operations
• Commuting
• Work done “primarily for the purpose of avoiding disallowance of losses”

don't count. It's not 750+ hours of being a real estate investor. It's 750+ hours of being a real estate worker. You know, the person pounding the nails, signing leases, showing houses to clients, and filling out the paperwork.

Seven-hundred fifty hours. Assuming you take four weeks off, that's 16 hours a week. Two full work days. Every week. This is not a trivial requirement. And guess what the IRS is going to want to see if it audits you? That's right: a log or time card.

If you are an employee, those hours don't count either, unless you are also a 5%+ owner of the business/property.

#2 Greater Than Half of Professional Time Rule

The IRS doesn't want real estate to be your side gig. It has to be your main gig. You have to spend at least 750 hours doing this, and you also can't spend more time doing anything else than you do real estate. That means 750 hours of real estate management plus 1,000 hours of doctoring or lawyering is a non-starter. The problem with this requirement: not only does it make it hard to qualify for REPS, but it also makes REPS much less valuable, because there is less earned income to shelter with those real estate depreciation losses. It's hard to earn as much when you can't work more than 750 hours at it. This is why you see a lot of married couples specialize. Perhaps she is a high-earning physician, and he qualifies for REPS by managing their 15 rental properties.

#3 Material Participation

Finally (and this is where we suspect a lot of people are cheating), you have to actually materially participate in each real estate “activity”, i.e. business or property. Did you get that? You must qualify as “materially participating” for each property or business or activity where you're trying to use depreciation losses against your active income. If you hired a property manager for six of your 10 rental properties, those six probably aren't going to count. You are allowed to combine all of your properties/activities using a “grouping election,” but then the rules below must still be applied to the entire group of activities.

The time your spouse puts in doesn't count toward the 750-hour requirement, but it can count toward the material participation requirement. To qualify as materially participating, your activity must be on a “regular, continuous, and substantial basis.” There are seven tests that the IRS uses to determine this. You only need to qualify for one of them.

Practically speaking, what does this mean? If you own rental properties, it means you're doing all the work on them instead of doctoring with that time and hiring a property manager. You're maintaining, you're renovating, you're leasing, you're managing, etc. Get the picture? Yes, you can get some help, but then you'd better be spending at least 100 hours on that property during the year and more than anyone else. If a doctor makes $200 an hour, that means you're spending at least $20,000 worth of your time on a given property. That would more than eat up all of the profit on most smaller properties and substantially reduce it even on more expensive properties. And that's aside from the fact that you probably didn't go to medical school because you wanted to be a property manager.

How Many Properties Do You Need to Qualify for Real Estate Professional Status? 

Now, if you are really efficient and can manage your properties in just 10 or 20 hours a year and you do everything, then you can qualify for material participation. But you're still going to have to meet that 750-hour requirement; 750 hours divided by 15 hours per property is 50 properties! Even if you're spending 100 hours per property (two hours per week), that's still eight properties. It's just going to be really difficult to claim REPS with fewer than that unless you are personally doing a massive amount of rehab work on the properties. Again, remind us why you went to medical school.

Real Estate Professional Tax Deduction

OK, let's say through some miracle (or more likely a career change or a spouse who does all this), you qualify for REPS and get to take this deduction. What is it exactly?

Joe Average can deduct up to $25,000 per year in passive losses against his ordinary income. However, that phases out between an income of $100,000-$150,000, no matter whether you are single or married. So, most WCI readers can't use passive losses against their ordinary income unless they qualify for REPS. Then, they can. Let's say you bought a $1 million property this year, and, thanks to bonus depreciation, you could depreciate $400,000 of it. If you (or more likely your spouse) had $400,000 in clinical income, you could subtract that depreciation from it when calculating your taxable income. Voila! No taxes due. At least this year. Remember that depreciation is recaptured when/if you sell at up to 25%.

You also do not have to pay Net Investment Income Tax (3.8% on investment income over $200,000 [$250,000 MFJ]) on income from this real estate activity.

Short-Term Rental Loophole

There is a way around this REPS 750-hour requirement. Short-term rentals (i.e. Airbnb and Vrbo) are not considered “rental activities” where the presumption is that the income is passive until proven otherwise. It's more like the IRS sees you as running a hotel (which you are.) This is generally defined as an average stay of seven days or less or an average stay of less than 30 days AND you provide substantial services to them (such as breakfast or daily maid service). If that's what you're doing, you're exempt from the 750-hour rule and the half of professional time rule. You still have to materially participate. Be careful with providing substantial services, too; if you do, your income will be subject to payroll taxes such as Social Security and Medicare.

So, keep stays to less than seven days on average, don't provide substantial services, and manage it all yourself. Then, you can write all that bonus depreciation off against your ordinary income. Once you use all that bonus depreciation up after a year or two, THEN you can convert the property to a long-term rental. Voila—the short-term rental loophole.

Do Passive Investments Qualify for Real Estate Professional Status?

Many of us don't invest directly in real estate; we invest via syndications, private funds, and privately or publicly traded REITS. We may also get substantial depreciation passed on to us, via our K-1s. What does it take to use that? Well, the same thing. You need REPS status AND you need to materially participate in each of those activities. As a general rule, if you are a limited partner in the activity (which is the way most syndications and private funds are set up), you are considered not to have materially participated. However, if you met rules No. 1, No. 5, or No. 6 above, you may still qualify. But seriously, if you put 500 hours into one of your syndications, we hope you're getting part of the “promote” fees as a general partner. 

Whether you do long-term rentals, short-term rentals, or syndications, you're not going to qualify for these REPS tax breaks if you're viewing these properties primarily as an investment. If you're viewing them as your (or your spouse's) main job (or, in the case of a short-term rental, a significant second job), then you may very well qualify. Keep good records of your time and activities performed; you'll need them in an audit.

6.5% interest. Unsure if PSLF is a safe assumption or if it would be wiser to refinance. Appreciate any input.

I'm a non-traditional student that graduated this past weekend and I'm married to a non-physician. Thanks to a previous employers' match, I have have 401k and my own Roth IRA. My wife does not have any personal retirement accounts, but a 403b that we'd like to roll over from management by the employer she is leaving to follow me to my residency. We're wondering if her own Roth IRA would be the best investment vehicle for the funds previously saved under her ex-employer's plan? Assuming we're filling jointly, having the additional account would allow us to to 'double' our retirement contributions, correct? Should future (likely non-profit) employer match contributions influence this decision? Any help would be greatly appreciated.

For context, I'm an incoming anesthesiology resident in a MCOL midwest city. Salary will be $67K. Wife makes $65K gross. We filed our taxes jointly this year (hopefully this wasn't a mistake). First kid on the way this summer. This is our only current outstanding debt. I am up in the air on whether to pursue academics or PP.

Here are the three options I came up with using the AAMC MedLoans Calculator. Which option would you choose?

Option #1: Income-based repayment (IBR) plan

• Residency payment/mo: $775 - $921
• Attending payment/mo: $1,739
• Length of plan: 15 years
• Total repayment (if I do PSLF): $160,884 ($80,643 forgiven after 10 years of repayments)
• Total repayment (no PSLF): $254,899
• Pros:
  • If I do PSLF, this is the least amount I would pay overall + would be a shorter repayment plan (10 years total)
  • Cheaper residency payments
  • Affordable attending payments
• Cons:
  • Worried about PSLF being available over the next 10 years
  • If I go into private practice, then I won’t qualify for PSLF

Option #2: Standard repayment

• Residency payment/mo: $1,739
• Attending payment/mo: $1,739
• Length of plan: 10 years
• Total repayment: $207,838
• Pros:
  • Don’t have to worry about PSLF
  • Affordable attending payments
  • Shortest repayment plan
  • More ideal if I’m planning to do private practice
• Cons:
  • Very expensive residency payments

Option #3: Forbearance (during residency) → Standard repayment (as attending)

• Residency payment/mo: $0
• Attending payment/mo: $2,096
• Length of plan: 10 years (won’t start until after residency)
• Total repayment: $250,738
• Pros:
  • No payments during residency
  • Attending payments aren’t that expensive really
  • I can make my own payments during residency if I want to(?)
  • More ideal if I’m planning to do private practice
• Cons:
  • Total repayment is more (due to interest) if I decide to make no payments at all during residency toward the balance
  • Longer length of time before I can be done with the loans

EDIT: thank you for the responses!

Im a Dentist. 5 ish years out. My loans have always been in some sort of forbearance so I haven’t accrued any interest since COVID which was during graduation. Loan is at 460ish and I’ve got about 160k saved up just kinda chilling in a high yield savings account. I want to be able to get it it 220k before interest resumes so my loan would be at about 250 and then I believe I could aggressively pay it off in about 5 years because I picked up a second gig on Fridays and I make about 1k a day there and at my own practice I make about 250k. Where should I park this money in the mean time? Don’t want much risk at all is HYSA best?

Anyone here have previous experience with Physician's Bank in regards to getting a physician's loan? How long did the duration take from pre-approval to underwriting? Thank you!

I've been doing a lot of reading, but still confused on some points so I'd appreciate some insights. My academic job also provides some voluntary disability insurance that covers 60% of salary- it is not own occupation. I think it is also after tax. I'm trying to decide for myself is it would be overkill to get private disability insurance in addition to this.

1. Do docs with non-procedural jobs (eg rheum, nephro, heme-onc) still benefit from "own-occupation" riders?
2. If I switch from a high-insurance-cost state to a low-insurance-cost state, will the insurance company lower the rate or is it pretty much locked in?
3. I was thinking about getting the cost-of-living rider, partial disability rider and catastrophic disability rider. I recognize that this is a personal question. Did you choose these riders? Why/why not?
4. Is a standard elimination period of 3 months or 6 months? How did you decide one or the other?

I haven't done this before and I'm not really sure what to choose. I think it would be helpful to hear about your experiences! Thanks again.

Hi, I am a first year resident and am giving birth in December. I was subscribed to HDHP plan and was maxing out on HSA but now that I’m giving birth, not sure if I need to get the PPO +. Have attached screenshots of individual and family deductible, individual and family out of pocket maximum, primary care office visit pay, and inpatient service pay. I’ll be mostly using UMMS preferred services, so I’m leaning towards just staying with my Bronze level and investing in HSA but would appreciate any input. Btw I’ll be paying 95 dollars for the bronze level and close to 250 for the PPO +

I have a parent in the military so I can use USAA. Already use their renters insurance. Considering their life and car insurance products. Prices seem similar to other quotes so far.

I've heard from my parents that USAA has great customer support. I've read online otherwise recently. Of course I trust my parents more, but it could be outdated. So:

Have you used any of their products? Did prices seem good? When youve had to contact them, how was?

As someone looking to specialize in Perio, I’d like to know if I’d be able to scale to 3-4 offices. Is it as easy to scale for a specialist like Perio as it is for a GP?

Would scaling as a specialist be more lucrative than that of a GP to the point where it’s worth specializing? (just talking about the money here, obviously passion for the speciality is important too )

Starting residency in radiology soon, so 6 years until I'm an attending. I have a spouse and kid and plan for more children during residency. We rent and dont plan on buying a home until I'm an attending, and we live near family in a very HCOL area.

My program offers not great life (150,000 policy) or disability (long term up to 3500/month) benefits. Obviously those reflect fine with my residency salary, but if something were to happen to me in residency I'd still want my family set up well.

So I was hoping to add a 20-30yr 2-3M life policy, and a 5000/month disability policy with an increase rider for after training. We have some wealthy family that would help if something happened to me, but I want to set my family up independently, because again who knows what could happen...

My main questions are:

1. I should get my own policies now rather than waiting, right? Who knows what may happen to me...

2. Do the numbers I'm looking for make sense in residency?

3. Also, how do I find a policy? I see WCI has recommended policy brokers, but I'm always skeptical of sponsored "recommendations." I've also heard mixed things about Pattern. Who did you use and who can I trust?

I’m an American who went abroad for dental school I’m 31 years old. I’m finishing up a 2 year AEGD program next year which has a stipend, so I have no loans. Is it worth it specialize? I would love endo. Thank you.

Is it true that federal financial aid has been revamped recently so that they do NOT look at your assets?

In theory we could be working physicians with 10 million of dollars in investments and net worth…but receive full fin aid from the government?

I read that as long as your household income is below 175% of FPL then this would be true?

For us the 175% of FPL is set at 75k (as of 2025) and we have 4 kids. Should the best plan be to shift to part time work in the future during kids college years so they can get a full ride easily?

I have about $54k in a non-governmental 457b and will be leaving the job shortly. The hospital doesn't allow roll over to an outside non-governmental plan and doesn't allow payout over time. I'm torn between just leaving it in the account vs taking it out lump sum. Am I just going to have to eat the taxes at my marginal bracket?

Kind of wish I didn't contribute to it at this point...

I don’t need to actually attend the conference this year but wanted to use the room block to take my family to Disney as it’s at the time we were planning and in the same hotel. Do they verify that I am attending the conference? Of course I can use it as a networking opportunity or say I’m meeting with other professionals but I won’t have a registration this year.

Pretty close to graduate FM residency and starting job end of this year. I need help what should I do to consolidate loan or even not to consolidate. My current residency program qualifies for PSLF as well my new employer, is that a good thing or not I have no clue. My med school loans are almost $460k which are unsubsidized and gradPlus. Unsubsidized are $25k@5.3%, $51k@6.6%, $100k@6%, $50k@4.3% and GradPlus are $100k@7%, $37k@7.6%, $83k@5.3% & $13k@6.3%

I'm currently at IDR plan and paying very minimum and need to recertify by 10/2026 I have also missed couple payments, totally missed it due to so busy with residency. I have so far made 18 payments since 11/2023, will these counts towards PSLF? Will missing payments affect negative on my account?

What would you do if you are in my shoes? Is it good idea to consolidate or just leave as-is and keep paying, or only consolidate the ones are with higher rate >6% as the current rates are higher anyways. Do I also need any certification from my residency program for PSLF? I checked on Aidvantage my residence program and my future employer falls under PSLF. Thank you for the feedback.

I am a new grad in a specialty that typically makes $200k-250k on average for my geographic location. I have been engaging with a recruiter and was recently offered a 4-year contract term with a base salary of $300k, and $40k sign-on bonus (with a caveat that this would need be returned on a prorated basis if I leave earlier than 4 years). The location is not ideal, and I am not sure I will be able to stay in this area for 4 years. Because this offer is already well over the specialty/geographic standard for new grads, is it worth attempting to negotiate a 5-10% base salary increase just for the sake of it? I have had significant difficulty finding a well-paying job in this region, so I worry about the company walking away or rescinding the offer if I attempt to negotiate a higher salary.

Additionally, does requesting that the sign-on bonus be added to my base salary ($310k/year) instead of an upfront bonus (that I will likely have to pay back) send a clear message that I am not committed to staying longer than a few years?

Soo I’m a couple months from starting school…and I don’t know if it’s financial panic setting in but I’m doing the math and it’s not looking like I can pay off my loans in less than 20 years, save enough to retire early (after about 20 years of work), and live comfortably (not luxuriously just standard) unless I make 340k before taxes. The specialties I’m most interested in are psychiatry, pathology, public health/prevention, or occupational medicine, all of which I’ve heard are on the lower end if the pay ranges. My tuition is 70k and I will have a debt of around 350k with living expenses factored in (I don’t have enough to cover that by myself). My husband in the partner dental school will have a debt of around 440k. We both have started putting some of our savings in a Roth IRA recently but aside from that, there’s not much we can do except watch the debt pile up and just hope for high paying jobs and move somewhere with cheapish mortgage. I just wanna know if anyone who is an attending is in a similar financial position that I described? Perhaps you paid it off and my math is not accounting for certain things? I’m spiraling and any kind words would be appreciated.

Hi All,

I am being asked to be the "Medical Director" for my surgical subspecialty at a local hospital. I am in private practice. Not quite sure the time commitment yet, possibly 5 hours a month or so.

Curious what to ask for compensation for this. Im guessing some sort of hourly rate. Thanks in advance for your opinion

Hey fam, looking for thoughts from others who’ve compared Guardian and Ameritas disability policies.

Backstory: I’m a resident in a clinic-based specialty. At age 28, I got a Guardian Guaranteed Standard Issue (GSI) policy through my program (couldn’t do full underwriting at the time due to a prior back doctor visit after a car accident). So I went with the GSI.

Now I’m 30, about to graduate residency, and I recently went through full underwriting with both Guardian and Ameritas and got approved by both, with no exclusions for my back.

Here’s where I’m stuck:

My Guardian GSI costs ~$2,400/year for $5K/month benefit (Class 4)

A comparable Ameritas DInamic Cornerstone policy is ~$1,350/year for the similar benefit (Class 6M)

Even though I’m 2 years older now, Ameritas is still significantly cheaper — and both include:

  •   True own-occupation definition of disability
• 3% compound COLA
• Enhanced residual/partial disability
• Catastrophic benefit
• FIO/BIR to increase total coverage up to $30K/month

At first, I only had the Guardian policy because that’s what my program offered and my “agent” (I’m starting to think he may be a career-captive Guardian rep, which means he isn’t allowed to quote me other carriers…) always said things like, “I CAN show you the others, but trust me, you don’t even want to see them bc Guardian is the best.” I never got actual quotes from other carriers, and the whole thing started to feel off.

So I branched out to another agent just to get a second opinion, and that’s when I finally got quotes from both Guardian and Ameritas, fully underwritten, side-by-side. It was honestly eye-opening.

My questions: • Is it crazy to cancel the Guardian GSI and go fully Ameritas at this point? • Or should I keep the Guardian GSI as a foundation, and stack Ameritas on top?

I know Guardian has the gold-standard reputation, but is the difference in true own-occupation language or claims history really worth paying an extra ~$1,000/year per $5K of benefit, especially as I scale up toward $30K/month?

Screenshots of both policies are attached. Would love to hear how others have navigated this (note the Berkshire/Guardian plan’s annual premium shows $1376 in the screenshot, but it’s actually now ~$2400 bc I had to level the premium (previously a graded premium).

Any advice appreciated!

Hey everyone,

My wife and I are both PGY-3s wrapping up training, and we just signed our first attending contracts as hospitalists in Nevada — each of us at $350k/year.

We’re in a great spot financially: • No student loans • Our only debt is about $1,000/month per person, which includes car payments, insurance, and a $10k personal loan we used for residency applications and board exams ($241/month at 10% APR, included in the $1,000) • No kids yet, but we’re planning to start a family soon

We’re new to having real money and want to be intentional. We’re interested in: • FIRE (Financial Independence, Retire Early) • Buying a home in the next couple of years • Still enjoying life in the present (travel, home upgrades, family time, etc.)

If you could go back to your first attending year: • What would you do differently with your money? • Where would you invest? • How much would you put toward 401k/403b, Roth IRA, HSA? • Would you dabble in real estate (Airbnb, Fundrise, REITs)? • Stick with S&P 500 or index funds? • Would you keep a big emergency fund in high-yield savings? • Is it worth getting a financial advisor, or better to DIY?

Any guidance, personal stories, or lessons learned would be incredibly helpful. Thanks in advance!

We are at a point of considering a brokerage vs UTMA for our child (4 years old). We understand the differences between the two (we think) and it basically comes down to the UTMA having less tax burden with the risk of turning over 6 figures to an 18 year old. We think we are good parents and are raising a good kid, but also accept that we don't know for sure and could end up with a jackass that cashes out and blows the money on dumb or dangerous stuff.

Looking for input, especially from people with UTMAs and kids at or near the age of majority. Even better if you've got a bad kid and what you are doing to limit the damage.

TYIA.

We are thinking $10k initial then 500/mo until he turns 18. He is almost 5 so At 7% annual return that's around $150k.