Merely a PGY-1 going into a procedural specialty. Recently spoke to a resident who signed as a PGY-2 in the Midwest for a guaranteed salary north of 600k starting with a hospital system. Plan is a short term aggressive saving plan prior to relocating closer to family after a couple of years. I was calculating this to be nearly 700-800k post tax savings for 2-3 years which would be a sizable amount of retirement fund eventually even if nothing more was added to it.

Has anyone done something like this? Any regrets?

debating where to get my haircut - how much will $10 more on my loans cost in the end if my loans are 6% interest and I’ll pay it back in 10 years?

edit: “don’t live this way” - noted! thanks folks!

I feel like a lot of new attendings plan to live like a resident for a few extra years to save or pay down student loans. But when you have upwards of 10 grand hitting your bank account every other Friday it’s hard to ignore the thought of treating yourself just a bit.

Incoming US-DO student here. I will be starting medical school with somewhat of a shaky financial foundation. I am not sure if it’s a good idea to use federal loans to pay for my car note, insurance, phone bill, and living expenses. I am a little worried about the debt. I would prefer to work during my pre-clinical years but I have been told its not possible.

Any advice on how to efficiently manage my personal finances and minimize the debt would be much appreciated.

Looking at physician employment contract, and the leave notice period is 6 months (both ways for termination of contract). Any idea what is standard? I was under the impression it is usually 60-90 days. Any disadvantages for 6 months (aside from the obvious of having to wait 6 months before taking another position)? Is this period typically negotiable? Thanks in advance!

So I’m signing with a group a couple years before graduating residency and I’m getting part of my signing bonus now. But I’m not sure how to fill out the W4 for this signing bonus alone. There’s a multiple jobs section but technically i don’t have two jobs, it’s just a signing bonus so I’m having trouble figuring out how to fill this out. If anyone could help that would be great!

Hi everyone, currently new attending. Feels sort of settled, need to buy a home. I am trying to live like a resident and I am trying to fill my retirement accounts and same some money for a house down payment. I have been able to put away $5-10k/mo into a HYSA and have about 20% of a the cost of the house we would buy. So I am right on the brink of being ready to start looking (just a few i’s to dot with cc FICO score and a couple other things).

However, I don’t feel in a hurry. I don’t have a good reason but with the uncertainty and the shit show that has been the trump presidency so far, I just don’t have a good feeling in my gut.

We are renting. It’s not cheap by my guess is that rent now is about a 1/3 of what I will pay for mortgage. Yes, it’s money wasted but when I buy a home, a big chunk of the payment goes to interest anyway. So I can just keep growing my retirement and down payment and just maybe pay 30-40% down instead of 20%. Slim down my mortgage.

Am I thinking about this right? I know there is a lot of speculation in my post but I am not asking you to speculate. Just poke holes in my line-of-thinking.

Looking at doctor loans and Alliant Credit Union seems to have competitive rates for their ARM and fixed mortgages. I’ve been talking with Ken and wondered if anyone else has done a doctor loan through them and how the experience was at closing and afterwards with them servicing it?

Hi! I receive a stipend monthly for my attending contract (lasts until June of next year). I owed in taxes this year for the 24k I received in stipend, which is fair and makes sense. I received a 1099-MISC with the income listed as medical payments under box 6.

This year.. do I need to pay quarterly taxes like I am self-employed or as long as I pay them in full at the end of the year I am okay? I guess I am confused since I know this is considered schedule C/business income technically but very confusing for me. I am used to my taxes just being a couple W2s and my retirement accounts so this form is new for me lol.

Renovated our home in a VLCOL area to be our dream home with plans to stay for at least 10y. Purchase price 165k, 350k to basically take it to the studs and redo it. Rough area to get comps (not a lot of high quality homes in the area with a chefs kitchen and high quality 4 seasons rooms, new builds with similar sqft and BR/bath count sell anywhere from 350-450k without chefs kitchens 4 seasons or fenced in yard). It’s an old home on the oldest and nicest street in town where most homes have been passed down for generations. Several have been redone in the past 5 years but not to be resold.

Anyways, my wife and I want to move to a different state where I’d take a 15-20% pay cut and we’d be going to a MCOL location.

At what point to we just decide to go underwater on the home and sell it? What loss is “too much” to sell. I am have it appraised from an independent nonbank affiliated assessor. We owe about 90k on a 2.2% 15 year mortgage. I am not super interested in being a long distant land lord for Airbnb or something. We’d probably fetch $2000-2500 a month for rent on a year lease if we listed it for rent.

Any advice or insight is appreciated. We have no other debt 34M and 36F. My w2 income where we are is 350k plus my wife does some part time nursing and brings in 20-30k a year.

Been mentally struggling with current situation and wanted some outside perspective.

35yo subspecialist at large employed position for 5 years now, comp around 800 for about 4 days work. Do some teaching/mentorship/research but that's not mandatory and I do it mostly to give back and not get bored. Work environment is tolerable.

HHI around 1mil. Current NW about 2.5mil, goal NW around 10mil without accounting house. Not sure if I'd actually quit afterwards since I like what I do, maybe go part time.

We live in a L-MCOL area, major intl airport about 2 hours away. I've become fairly well known in the area, think constant stream of patients. Think big fish in lake vs small fish in ocean situation. I have a typical type A competitive personality.

The issue:

Financially, the position has fairly limited upward income potential with no productivity bonus, think couple percent bump every year. Statistically I'm overworking for how much I'm paid.

My wife and I have always had this idea of moving closer to a major city with more access and our young kids in top private schools but the more I interview at these type of jobs and objectively look at the numbers it seems the less it makes sense to jump. These positions in HCOL areas almost all have a lower base (400-650) but include a productivity component. All else being equal my income if I hit similar productivity as current would be around 1.2 in these systems.

Assume the extended family, friends, social support is about same regardless of location.

Options:

1. Stay put at least until we hit NW goal and kids move for college. I estimate it'll take about 10-15 years to get to 10mil invested. Basically stop hustling and quiet quit at current position by cutting back productivity to just meet cutoffs, increasing free time to do hobbies and business ventures. Currently our kids are in the best private school in the area, but maybe only top 30 in the state. Overall less competition professionally and for the kids in current environment.

2. Move to HCOL job and "chase the dream". Start again with lower pay but productivity potential, probably worse lifestyle with 5 day work week. With more competition, I also may not be as productive or busy. I would estimate COL would go up by 10-15% at least, and adjusting for the (potential and eventual) pay bump, our net invested every month may remain similar as currently. Kids would also be in a more competitive environment but more access to big city amenities.

Thoughts much appreciated.

We are looking to buy in LA. What banks have given you the best rates for either a Physician or fha loan?

This is my first year stepping into 1099. Expect to clear about 240 K with 1099, +75K from W-2 and probably 100 to 150 K from spouse W-2. Planning to do LLC with S corp election for 1099. I have been looking for CPA for tax strategy/planning, and to help prepare our tax in 2026.

Came across the recommendation page for CPA, and just wondering if anyone has had any experience using the Taxstra company. And how was your experience? Another one that I’m looking into from the same recommendation page on WCI is SFC CPA. But it seems like this company specializes only in tech preparation, not so much the strategy part of things.

Thank you so much in advance!

All this investing and retirement stuff is hard to understand. I'm trying to learn and save as much as possible for a comfortable retirement.

36M with maxed 403b for 2024. Employer is matching this as well. The account is through TIAA and we don't have many fund choices (high ER, little growth opportunity), so I want to open a Fidelity or Vanguard for a backdoor Roth.

Can I open the IRA and convert the account without funding? I don't understand the point of funding before converting, though it'll be after-tax dollars anyway so my assumption is that it won't get taxed.

On the other hand, if I'm able to have a mega backdoor roth, it seems like I can save much more which can eventually lead to bigger yields.

Too many options. I appreciate your suggestions and comments. Thanks in advance

Good afternoon! I'm about to graduate my psychiatry residency and have an interesting opportunity in front of me. Its a 7 on 7 off position that has some extra time off added where I could potentially work some extra elsewhere if desired.

I have been offered the position as a W2 however I am pretty unimpressed with the benefits (paying your own health insurance premiums, 2% retirement match, etc). Another physician with the same position is employed as a 1099. I do not know many details about if his pay is structured differently. It seems 1099 would allow significantly more opportunities to save for retirement. Does anybody know of other benefits or have general advice on this?

None of my mentors in residency know anything about this and nobody in my family is in medicine.

This is one of the most common questions we get. Should you pay off debt or use your money to invest? Over and over again it is asked, always with slightly different details. Ninety-five percent of the time, the answer is simple: “It depends.”

Now, let's talk about what it depends on. Until you become debt-free, you're going to struggle with this question just like everybody else does, especially if you owe student loans. Whatever you choose, make sure you're thinking about debt the right way.

Avoid the Extremes When Choosing Paying Off Debt or Investing

Perhaps the best advice is to avoid extreme positions. Most of the time, there is no right answer, but maybe 5% of the time, there is. If you're giving up an employer match to pay off debt, you're making a mistake and basically leaving part of your salary on the table. If you're carrying credit card debt with a 30% interest rate in hopes that your investments will outperform it, you're making a mistake. But for just about everything else in between, there is a situation where it might make sense to invest but where it could also make sense to pay off debt—no matter what kind of debt that might be.

Paying Off Debt and Investing Are Both Good Things

Here's the other thing to keep in mind. Paying off debt is a good thing to do. It builds your net worth. Investing is also a good thing to do. In general, it also builds your net worth. They're both good things to do. At its worst, one is a little more right than the other. If you can't tell which one is better for you, it probably doesn't matter much. If you're really paralyzed about it, just split the difference and put half of your extra money toward debt and half toward your investments.

In the end, this decision isn't the one that is going to determine whether you are financially successful. The important decision is probably what percentage of your income is going toward building wealth rather than consumption.

7 Principles That Determine Whether You Should Pay Off Debt or Invest

#1 Attitude Toward Debt

Some people hate debt. The more you dislike being in debt, the more likely you are to want to pay it off instead of investing. Some people love debt. There are even people who think you should stay in debt your entire life. There is a significant behavioral aspect to this. Even though the math would sometimes indicate you should carry debt and invest, behavioral and cash-flow considerations often argue for just paying it off.

#2 Risk Tolerance

If you aren't going to invest aggressively, then you might as well get the guaranteed return available from paying off debt.

#3 Available Investment Accounts

This should have a major effect on debt vs. investing choices. If there is a sweet tax deal being offered for investing, you should probably take it instead of paying off debt. Yes, you can pay off your mortgage, but don't put an extra dime toward it until you've first maxed out your retirement accounts, HSAs, and as much as you want to give to your kids (529s, UTMAs).

#4 Anticipated Investment

This is where the math comes in. If you're expecting to earn 10% on investments and your debt is at 2%—even if it is 2% variable—it seems kind of dumb, at least from a mathematical perspective, to pay off the debt. In this respect, perhaps investments with high expected returns get purchased before paying off debt and vice versa. Bear in mind that the only returns that count are the after-expense, after-tax, after-inflation returns. Market valuations might play into this, as well. The higher the valuations, the lower the expected returns may be. Eight years into a bull market? Maybe you should pay off your mortgage. Market just dropped 40%? Maybe it's time to invest. Is it market timing? Sure. But if there is no right answer to the question anyway, why not?

#5 Interest Rate of the Debt

On the other side of the mathematical equation is the interest rate of the debt. High interest-rate debt should, in general, be paid off before low interest-rate debt and making investments. Bear in mind the only interest rate that counts is the after-expense, after-tax, after-inflation rate. So, a tax-deductible debt (like many mortgages) is less of a priority than one with an equal interest rate that is not deductible. Likewise, if you have a low, fixed-interest rate debt and inflation is high, well, you're going to be paying off that debt with less valuable dollars the longer you drag it out.

#6 Level of Wealth

Your level of wealth can affect whether you should pay off debt. You've heard the phrase before, “When you win the game, stop playing.” When it starts seeming kind of silly to still be carrying that little old mortgage debt around, pay it off. But if you have a four-figure portfolio and you are decades away from financial independence, paying off your 2.5% mortgage early probably shouldn't be your priority.

#7 Asset Protection and Estate Planning

Just when you thought it couldn't get more complicated, let's bring asset protection and estate planning considerations into the equation. In some states, your homestead is 100% protected from creditors. If you live in one of those states, perhaps you should prioritize paying off the mortgage a little faster. If you're in a state where it isn't protected, perhaps it is less of a priority. Likewise for paying off debt prior to maxing out retirement accounts with their awesome asset protection and estate planning benefits. What about an ill 85-year-old with some debt but also some taxable assets with low basis? In that scenario, it would make sense NOT to liquidate the taxable assets to get the step up in basis at death. It might even be wiser to borrow against them rather than sell them.

Financial Order of Priorities

OK, despite reading those seven principles, some of you still can't decide whether you should pay off your debt or invest. You want an algorithm that will tell you exactly what to do. If you just follow this list, you're not going to do anything stupid. Reasonable people are going to disagree with the placement of some items on this list. They may even argue about it for weeks in the comments section. That's fine. But no reasonable, knowledgeable person is going to move something from the bottom of the list to the top of the list. This algorithm is good enough to lead you to financial success.

#1 Get Any Employer Match

Not getting this money is leaving part of your salary on the table. It would be very unusual for you to have a better investment or debt pay down option than this. 

#2 Pay Off High-Interest Rate Debt (8%+)

This “investment” comes with a high rate of return, and it's also guaranteed.

#3 Max Out Available Retirement Accounts

• 3(b) — Tax-deferred accounts first in peak earnings years
• 3(c) — Tax-free first in non-peak earnings years
• 3(d) — Include non-retirement tax-protected accounts in accordance with your goals—HSAs, 529s, UTMAs, etc.

This is where most of the arguments are going to be made. The Dahle family funds tax-protected accounts (Roth IRAs, HSA, (401(k)s, and Defined Benefit/Cash Balance Plan) before investing in a taxable account (and before paying off debt.) 529 and UTMA contributions may also be prioritized.

But if you're in a situation where you can't max out everything and have to choose, well, there are no right answers. HSAs are triple tax-free, but you can't stretch them or use them very tax-efficiently except for healthcare. 529s are good, but the tax break pales in comparison to a 401(k). Supersavers might benefit more from a Roth than someone who started saving late. Lots of little subtleties there, but the general principle remains—tax protected accounts are great places to invest, and if you don't max them out in any given year, you can't go back and do it later.

#4 Invest in Assets with High Expected Returns

Some more room for argument here. What is a high expected return? Are stocks going to have a high expected return in the near future? What about over your entire investing horizon? What about real estate? Hard to say. But if you're expecting to make 15%-20% on an investment, it can make sense to not pay off 5% debt and invest instead. Heck, if you're expecting 20%, it might make sense not to max out the retirement accounts first (or figure out a way to put the investment inside the retirement account).

#5 Pay Off Moderate-Interest Rate Debt (4%–8%)

It's amazing how many people are willing to carry around debt like this. A 5%–8% guaranteed return is a very attractive use for your dollars. That investment better be very compelling if you're not paying off this sucker ASAP. Even in 2023 when cash paid just over 5%, paying off moderate interest rate debt was an attractive option.

#6 Invest in Assets with Moderate Expected Returns

OK, that makes sense. If you expect to make 5% or 6% on something, it can make sense to carry a 2% loan. 

#7 Pay Off Low-Interest Rate Debt (1%–3%)

You may avoid paying it off when the interest rate is really, really low, but certainly pay it off before dumping a ton of money into a bond fund paying 2% or a savings account paying 1%. Not much arbitrage there.

#8 Invest in Assets with Low Expected Returns

Hopefully nobody is surprised to find this one at the bottom of the list. In fact, some people might even put “buy a wakeboat” ahead of this one.

So pay off debt or invest? Truly, it depends. Not only is the answer different for different people, but it can be different for you as you progress from one stage of life to the next.

I will be starting dental school in August and am currently looking into my options regarding housing. I will be moving from my hometown of nyc to Buffalo with a NW ~ 92k of which 12k is my Roth IRA and brokerage. No debt (yet). I’m torn between buying a house and renting out the other rooms or renting a small apartment and paying for a chunk of my D1 year in cash. Homes I like are around 180-230k which I would be able to afford if I had the extra bedrooms occupied. Rentals are around 900-1400 depending on amenities. I would also be splitting the rent with my partner. I’m having trouble deciding as everyone I talk to seems to have a different opinion regarding the feasibility of actually buying a house and how fiscally responsible it would be. I want to minimize my student loans and live a frugal life while in school, not sure which is the best way to do it. I should mention that Buffalo real estate is currently having a “moment” and has been on an extreme upward curve for the last few years. Many houses bought for 100k 5 years ago are on the market again for 200k+.

My wife is Pediatrician and is currently undergoing contract negations. Company is wanting to switch what system they use to benchmark productivity and wRVUs. There is a fairly significant difference between what the two systems benchmark the 25th, 50th, and 75th percentiles, so was curious what other pediatricians are doing and which seems closer. So, what do your monthly, quarterly, or yearly wRVUs look like and at what amount are you getting paid out per wRVU? Thanks!

Looking at a new job that supposedly offers a salary guarantee for 3 years. I have heard horror stories where people are required to repay salary, despite guarantee, if they don’t make a certain amount of RVUs. How do I tease this out and figure out if this is the case? I asked and was given a vague response, with we can usually avoid having to make doctors repay anything. What do I need to look into to make sure this is not the case?

Hello recently I came across the Expert witness course which is recommended by WCI. However while applying I am confused whether it’s for Dental Specialist also or only Medical . Thanks

Hi,

Just had a kid recently (almost 8 weeks old)! Took a month off initially full pay. Back at work and my wife is off till he is 5 months. I have an additional 3 months I can take; however it is unpaid. I want to take it off but it’s a significant amount of money. We’ll be fine if I do it’s just hard to mentally forgo that much. What did you do/ worked you do?

Hey Folks, Need to bring on a CPA this year as we incorporated an S-Corp.

• California
• 1 x Single member S-Corp, split income as reasonable wage + distribution
• 1 x W2 income
• No other tax complications such as mortage, investment properties, complicated investments, etc

Interviewed a few CPAs, and here are the costs we are seeing:

~$5K a year for the S-Corp annual return, ongoing bookkeeping and payroll (inclusive of quickbooks and Gusto fees)

~$1K for the personal return

Is this in line with what folks are paying? If not, any CPA recommendations?

Hello everyone,

I 27F am graduating medical school and starting a military residency in pediatrics this May. My husband 27M wants to go back to school and is considering either becoming an NP/PA or anything in the healthcare field due to years in a career with no self satisfaction. I am okay with living off one salary for the time being, and he will take care of all school fees with cash he has saved up for as long as he can (looking like 2 years of tuition so far). We have put off buying a house and having children. I guess what I am wondering is if there is any other route that he has not considered yet (I have talked to him about PT, OT, anesthesiology assistants, radiology tech), and if this is a route that is worth pursuing. But he is attracted to the idea of being able to switch around specialties and the accelerated time to achieve these degrees compared to medical school. I know there is a need for midlevels in healthcare, but over the years the talk surrounding midlevels has not been pleasant and I don't know if that's bias coming from the physicians I am surrounded by or if this really is not a career worth pursuing.

Also any advice on budgeting over the next few years and what type of accounts we should be funding, especially school tuition specific savings accounts. TIA

I’ll be finishing Anesthesiology residency this upcoming June. I currently live in a state (we’ll call it Kentucky) with approximately 5% state income tax as well as a local tax of approximately 1.5%. I have accepted my first attending job in a state with no state income tax (we’ll call it New Hampshire). I’ll (obviously) finish residency on June 30, 2025 and technically won’t start my new job until early August 2025, though I’ll become a citizen of New Hampshire sometime in July 2025.

When I’m done, I’ll have around $45,000 in a 403(b) that both my employer and I contributed to while I was in residency in Kentucky. I also maxed out my Roth IRA all 4 years. I’m trying to figure out the best strategy for handling by 403(b) when I finish residency. I know that if I were to convert it to my Roth IRA, that ~$45,000 in the 403(b) would be subject to federal tax when I file for 2025 – a year that will have ½ residency salary and ½ attending salary.

Question: is there any strategy to consider regarding WHEN exactly I convert to a Roth IRA? For example, if I converted it to my Roth IRA in late July right before I start my new job (after I’ve already become a New Hampshire citizen), would this conversion be exempt from state and local income tax from Kentucky?

I just spent thousands of dollars on an unsuccessful fellowship application. I am currently spending thousands of more dollars on a hopefully successful re-application. This has completely wiped out my savings outside of retirement accounts. I additionally am now starting to look for a job for the year significantly later than others. In addition to various fellowship related expenses (rotations, conferrences, registration fees, hopefully interviews), I will need to pay for a full license, board exam registration, study materials, and moving expenses. All told I'm estimating around $10 thousand in expenses above my budget over the next few months before I have an attending salary. Ideally, I will have a job secured soon, but I of course have limited control over that.

So assuming no signing bonus is forthcoming, what would be a good way to handle this?

I asked ChatGPT, and the main useful recommendations were personal loan, 0% intro APR credit card, and borrowing from my 403(b). I assume that the 403(b) idea would be bad, because I would have to pay it back right after graduation. Between a loan and 0% credit card for 12ish months, the latter seems like a better option, but I'm a bit confused about how they work. I have never carried a balance on a credit card before, so do you just pay the minimum requirement for the 12 months and then pay it off at the end? Is there some better idea that I'm not thinking of?

My father (70M) has worked masonry self employed for over 40 years. He still does mostly field work carrying concrete, building/walking on scaffolding, laying block with one other older mason. It’s dangerous and he has pretty bad wrist pain and is getting more back pain. In the summer he gets heat cramps and really can’t work more than 2 or 3 days a week. He used to do a lot of subcontracting/office work but he hasn’t pursued this lately. He made good money at subcontracting construction jobs previously but he admits he can’t stand this kind of work.

I (34M) and my wife (34F) are just about 2 years out of residency and saving to build a house. At the start of 2024 we made a 2 year plan to pay off student debt then build a home for us and our two toddlers. We have outgrown our current house and want a 3rd child. We are able to max out retirement as we save and pay off loans but really can’t do much more.

My father did save for retirement however he was in business with my brother (36M) in roofing several years ago that ultimately failed. My father revealed to me just recently that he lost his $180,000 in retirement savings in the business. Actually worse. My brother stole it. He has only saved up about $60,000 since then and gets about $2,000 per month in SS.

His minimum needs for supplemental Medicare, car payment, car insurance and home insurance is $2,000 per month. His home is paid off and worth about $250,000-$300,000 on 1 acre and is getting to be too much. If he moved and downsized I see all of that equity easily needed for a new home. No financial plan for other needs like gas, electric, internet, groceries, and other needs.

Growing up father was wonderful and honestly provided the stability and support to go to medical school. Kind of a “You can live here for free as long as you are going to college” type of deal.

I can’t afford a building a house and maxing out retirement PLUS financial support going to him for his financial needs. My brother won’t help him. My fear is that one day he will get hurt working and he will have to retire or worse be debilitated.

Thoughts? Retire now and sacrifice family needs or wait and see if what house payment is and if he decides to do more subcontracting work and less field work?

EDIT: a lot of one sided comments about helping my father. I’m not a cold hearted person. Obviously any reasonable person would help their parent but the math doesn’t math that easily.

I have another post about building a home and maxing retirement on WCI. yes I have a successful 50yo brother. He has retired our mom and his wife’s parents but frankly my father is not ‘his’ father, so not his responsibility.

If I took the advice of both posts I would build my house now and retire my dad. That would leave $zero retirement savings for the foreseeable future. So that leaves the conundrum…

If you read this thru the end post a random number like 1 or 12,000 so I know you did just read half and comment off emotion. I’ll know your comment is more meaningful this way. Thanks.

I am seeking advice on saving for retirement as a resident.

I am fortunate to be in a program with a substantial amount of moonlighting (so much so that I will have to complete a backdoor Roth for 2025). Up to this point (PGY-4), for retirement I have only been maxing out my Roth IRA annually and have not contributed to my program's 403b option. The main reason for this is I have been saving moonlighting income for a house down payment post-residency vs possibly paying off all my loans in a lump sum as soon as I am done training (loans have been in forbearance basically all of training, so no reason to make payments on them now). Most of my money is currently in a taxable brokerage and some in a HYSA.

Beginning in 2025, my program is now offering a Roth 403b option. I am strongly considering contributing to this, as they also are now offering a 5% match.

If I have the ability to, it's a no-brainer not to contribute to the Roth 403b option, right? Unless I am missing something, the benefit of this is that when I am done with training in ~1.5 years I can just roll the entire Roth 403b into my existing Roth IRA with zero penalty or taxes, correct? So it's essentially as if my Roth IRA limit is way higher than the 7k annual limit while I contribute to the Roth 403b (with the intention of a rollover)?

From what I understand I will not have to pay taxes on this money when I roll it over since it is already Roth account (as opposed to pre-tax 403b), and it will not affect my ability to complete backdoor Roth conversion in the future.

If I am missing something (such as any downside to this option), or if anyone has done something similar and wants to give input I would appreciate the insight. Thank you.

I'm curious to hear what everyone here is paying for health insurance premiums - our premiums went up 20% last year and sit at an eye-watering $1000/month for spouse+family. Our benefits list that the employer is paying $2500/mo in premiums, making the plan cost around $48,000 in premiums alone. That seems insane - right? How does anyone afford this?

FWIW, this is at an integrated health system. Part of me wonders if there's tiered pricing based on salary, where they charge their high-earning physicians an astronomical rate, because they know they'll be able to pay it.

Many physicians are heavily taxed, so it is no surprise you are looking for ways to invest that do not increase your tax burden. However, it is critical that you pay attention not just to the taxes paid but to the after-tax return on the investments. Sometimes it makes sense to pay more in taxes “now” if it leaves you with more later.

Here are 10 ways to invest without paying any taxes at all. Naturally, with each method there is a way you could owe taxes if you are not careful, but for the most part, these investments are tax-free.

Tax-Free Investment Options

#1 Municipal Bonds

Municipal bonds are a loan to a state or municipality. Municipal bond interest is federal income tax–free (although some bonds do produce interest subject to the Alternative Minimum Tax). A municipal bond from your state is also often state income tax–free. Of course, if you sell a bond or bond mutual fund for a gain, capital gains taxes would apply.

#2 Treasury Bonds

Treasury bonds are a loan to the federal government. While not free from federal income tax, they are free from state income tax. This is one reason their yields are generally lower than those of corporate bonds. Like a municipal bond or bond fund, if sold for a gain, capital gains taxes apply.

#3 Savings Bonds

Savings bonds, whether the standard type EE or inflation-adjusted, are like treasury bonds in that they are always free of state and local income tax. Federal income taxes are deferred until the bond is redeemed, perhaps decades later. If the proceeds are used for education, they are free from federal income tax, too.

#4 Anything in a Roth Account

The dollars you contribute to a Roth IRA, Roth 401(k), Roth 403(b), or Roth 457(b) have already been taxed, but all earnings from these accounts, no matter the investment, are free from federal, state, and local income taxes. There are two notable exceptions: First, income from leveraged real estate in a self-directed Roth IRA may be subject to Unrelated Business Income Tax. Second, if you withdraw money from the account prior to age 59½ and do not have a viable exception such as disability, a first home, or early retirement under the Substantially Equal Periodic Payments Rule, there will be a 10 percent penalty on earnings.

#5 Anything in a 529 Account

529 contributions may provide a state tax credit or deduction at the time of contribution, but if the proceeds are used for approved educational expenses, there are also no federal, state, or local income taxes due on the earnings.

#6 Anything in a Health Savings Account

Contributions to a health savings account (HSA) also provide a federal and state income tax deduction. If used to pay for approved health care expenses, there are no federal, state, or local income taxes due on withdrawals from the account. Note that New Jersey and California do not recognize HSAs, so contributions there are not state income tax deductions and earnings are not free from state income tax.

#7 Basis

Many people forget that you never owe income taxes on your “basis” (ie, the purchase price, excluding commissions and other expenses) since it has already been taxed when you earned it. Basis is the amount the IRS considers you to have paid into an investment. For example, if you paid $10,000 for stock and then sell it when it is worth $15,000, you only owe capital gains taxes on $5,000. The initial basis is income tax–free. This characteristic allows many retirees to dramatically lower their tax bill in retirement. 

#8 Equity Real Estate Covered by Depreciation

Depreciation can be an important tax break, and the bonus depreciation enabled by the Tax Cuts and Jobs Act, which went into effect in 2018, offers significant savings. The income from equity real estate is often completely offset by this deduction, providing tax-free income. If you or your spouse qualifies for real estate professional status, that depreciation can even be used to offset your earned income. While depreciation is recaptured when you sell a house, it is recaptured at a maximum of 25 percent and can be deferred by doing “1031 tax-free exchange” of a property instead of selling it. If you do not sell prior to death, the depreciation recapture is eliminated for your heirs by the step-up in basis at death (ie, when the basis of an appreciated asset is adjusted to current market value when it is inherited).

#9 Non-Dividend-Paying Stocks

Qualified stock dividends are eligible for lower tax rates, but if the stock does not pay dividends at all and you do not sell the stock, then the investment grows tax-free. If left to your heirs, the heirs will also benefit from the step-up in basis at death and receive an income tax–free inheritance. Of course, the risks and lack of diversification with picking individual stocks may outweigh this benefit, but a growth stock index fund with a yield under 1 percent is still tax-efficient.

#10 Whole Life Insurance

Cash-value life insurance policies such as “whole life” grow in a tax-deferred manner. Partial surrenders of the policy allow you to access your basis first, which is tax-free. The death benefit is also always income tax–free. In addition, you can borrow against the value of your policy tax-free (just like you can borrow against your house, car, and investment portfolio tax-free), albeit not interest-free. Even with that tax treatment, it is hard to recommend whole life insurance to someone who doesn’t have the permanent need to have a benefit paid upon their death. The low returns (negative for the first five to 15 years) and high insurance costs make this a niche product that is appropriate for only a few physicians.

Do not be afraid to pay more taxes if it means you come out ahead after tax. For example, if a municipal bond fund yields 1.5 percent and a taxable bond fund yields 2.1 percent and you are in the 24 percent federal tax bracket, you can quickly see that 2.1 percent – (24 percent x 2.1) = 1.6 percent. In that case, you would be better off with the taxable bond fund than the municipal bond fund.

Minimizing taxes is an important part of being an investor, but do not let the tax tail wag the investment dog.

What tax-free investments do you use to lower your tax burden? 

It is common knowledge that the housing market is cyclical - churning between highs and lows and between being a buyer's vs. seller's market. Currently however, housing affordability is at an all time low. So is this time different, or should I expect housing prices to fall at some point in the future (whether it be 5 or 10 or 20 years from now)? Hoping to hear from those of you with more experience, who have been through a few market cycles. Because at the moment, things feel quite hopeless.

In my extremely desirable/VHCOL city with amazing public schools, prices have been skyrocketing with no end in sight for the last two 2-3 that I have been watching the market. I can't really comprehend how things might change here to bring prices down. It's plausible that things might slow, but it's hard to imagine that prices will ever go down significantly here. Because in what scenarios can that even happen? All I can think of is:

-Interest rates explode significantly higher

-Massive recession

-Catastrophic changes to the city causing people to no longer want to live here

But at the moment, demand is ridiculously high - there are probably at least 50 families vying for every house on the market (or I am at least often competing with 50+ offers when I make a bid). Supply will remain low as well - there isn't really anywhere else in the city to build.

Is it possible that this is simply the new normal? That there is no "bubble", that house prices here have 3-5x'ed in the last ten years and that is simply their true value, and the only option is to be willing to pay that price or else rent forever (i.e., housing prices will never come down in my city)?