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Welcome to the latest episode of the Physician Cents Podcast, where we explore complex financial topics tailored specifically for physicians. Whether you're a medical student, resident, fellow, or attending physician, you're going to find valuable insights that can help you increase your financial IQ, further your financial journey, and improve your overall well-being. Hosted by Chad Chubb and Tyler Olson, let’s dive in!
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You finish training, your attending paycheck finally hits, and suddenly the numbers in your bank account look completely different.
This is the moment where a lot of physicians accidentally choose between two very different futures:
This post is Part 1 of a three-part series based on a wildly popular tweet thread from financial planner Tyler Olson, co-host of the Physician Cents podcast. The idea is simple: if you want freedom on your terms, your first few years out of training matter a lot more than you think.
Here, we are walking through Steps 1–4 of his 12-step framework so you can build a rock-solid foundation without feeling like you have to live like a resident forever.
Let’s start with why this whole thing blew up in the first place.
On July 27, Tyler posted a thread that started like this:
“Docs, you want to be financially independent 15 to 20 years into attendinghood. It starts the moment you finish training with these following 12 steps.”
The response was huge:
When the bookmarks beat the likes by that much, that tells you something. People are not just casually liking it, they are saving it because it hurts a little and feels very real.
So why did this particular thread hit so hard?
Over the past year, Tyler has talked about meeting more physicians in their 50s who are coming in with big incomes, big houses, big cars, and very small financial freedom. Some of them:
All because the early years after training were spent in “I earned it” mode instead of “I’m building my future” mode.
One of the most memorable lines from that thread was this:
“You can build generational wealth in these next three years or wake up at 40 with a boat, two BMWs, a million-dollar mortgage, and zero freedom.”
So, how do you pick the first option? You start with Step 1.
Here is the heart of Step 1:
“Don’t fall for the I earned it trap. Yes, you did earn it, but upgrading to the $1.2 million house, the G Wagon, the country club right now is like eating dessert before you’ve had dinner. Freedom is greater than flexing. We’ll build the fun stuff after we build your foundation.”
That last line is the key: freedom > flexing.
Think about what is happening when you first become an attending:
You finally have attending-level income, and emotionally it feels like:
“I’ve waited long enough. I deserve the house I want. I deserve the car I want. I deserve to feel like I’ve made it.”
So instead of easing into this new money, a lot of physicians sprint straight into:
On paper, the payment “fits.” The paycheck is there. The bank pre-approves the mortgage. The dealer approves the loan. Everything looks fine.
Except it is not fine when:
Big fixed expenses crush flexibility. You can change a streaming subscription in 30 seconds. You do not casually unwind a $1.2 million mortgage.
You have probably seen some version of this at your hospital:
Now, to be clear, those things are not automatically bad. Tyler mentioned he has clients with incomes close to $2 million who can own high-end cars without it wrecking their plan.
The problem is when people copy the look without the numbers.
From the outside, all you see is “physician car, physician house, physician lifestyle.” You do not see whether that person is on track for retirement, drowning silently, or working until 75.
And for anyone in a high-cost area like Southern California or New York City, the sticker prices are different, but the math is the same. A $1.2 million house might be “normal,” but you still have to build a plan around your income and your spending. Location does not cancel reality.
Think about building a house. Nobody shows up on day one and installs the chef’s kitchen, pool, and built-in sound system. They pour the footings. They build the structure. The pretty stuff comes after.
Your financial life works the same way.
The “pretty stuff”:
Those are not off the table. The message is not “never have nice things.” The message is “build your foundation first, then add the fun things on purpose.”
The deeper question is: what do you actually value?
A few examples:
There is always a tradeoff. You can have almost anything, but you cannot have everything at once.
Step 1 is about protecting future you from early, emotional “I earned it” decisions that quietly lock you in.
Once that mental trap is clear, you are ready for the most unsexy but powerful step in this whole plan.
Here is Step 2 in one shot:
“Know your number. Before you buy anything, track your cash flow for three months. Not just a rough guess. Actual numbers. Fixed expenses, discretionary burn, savings rate. Most docs think they’re saving. They’re not. Numbers don’t lie.”
Nobody loves this step. You can almost see the energy drop when someone hears “cash flow meeting.” But it is the difference between thinking you are fine and knowing you are fine.
You do not have to create some color-coded, 400-line spreadsheet if that is not your style. You have options:
Monarch is especially helpful if you work with a planner, because you can share the data directly. Many of Tyler’s physician clients do exactly that with Olson Consulting LLC, and Chad’s clients do the same through WealthKeel LLC.
The goal is not a perfect system. The goal is awareness.
Money in, money out, and what is left over.
There is a weird zone a lot of physicians fall into. Chad once paraphrased something he heard as:
“Income that is high enough that you do not budget, but not high enough that you can afford not to care.”
For many physicians, that is somewhere in the 300,000 to 600,000 dollar household income range.
What happens in that range:
So cash flow tracking feels optional. You might think, “We are maxing the 403(b), maybe the 457(b). We are fine.”
But Tyler has seen households earning more than 500,000 dollars per year that are in trouble:
This is why Step 2 comes before you set your savings rate. You cannot decide what to save if you do not know where money is actually going.
Most physicians do not want to sit down every month and categorize every purchase. That is fair.
So use a lighter version:
Then, add one powerful ritual: money dates.
Once a quarter or twice a year:
You can also use your paystub as a secret weapon. A lot of physicians have no idea what is happening under the hood. When you break it down:
You start to see patterns. For example, that “sudden raise” late in the year is often just the moment you stop paying Social Security. Once you see that, you can plan to capture it for something intentional, like funding next year’s backdoor Roth.
For deeper thinking about physician savings and retirement accounts, Tyler did a Q&A with White Coat Investor that is worth a read: Is Over-Contributing to Your 403(b) Ever a Good Idea?.
Once you know your real number, Step 3 gets a lot easier.
Step 3 is where things start to move:
“Set your savings rate now. Your first big pay raise is the easiest time to start saving. Aim for 20–30% of your gross income. Yes, that’s aggressive, but you’re starting late compared to most high earners. Compound growth is your best friend. Every dollar you automate equals less guilt later.”
This is the boundary that protects your future life from your current lifestyle.
If you were a software engineer making six figures at 25, you could maybe save 10 to 15 percent and be fine. As a physician, you start late:
That is why Chad likes 20 percent as the absolute minimum for most physicians who want real flexibility. If you want:
Then 20 to 30 percent of gross income is a very reasonable target.
And remember, this does not all go into a 401(k). That percentage covers:
That brokerage account becomes the “utility player” of your plan. It can:
Here is a simple sequence:
Automation is not just about convenience. It is about behavior. Every automated dollar is one less decision, one less thing to feel guilty about, and one less chance to talk yourself out of saving.
If you get a pay raise, increase your savings rate the same month. If you can live on your old income for a year or two and push the raise straight into savings, you will be way ahead of most of your peers.
Now you have a savings rate. Next step is protecting yourself from the unexpected so you do not have to raid those savings every time life throws a punch.
Step 4 is short and very misunderstood:
“Build your cash moat, aka the emergency fund. Three to six months of expenses in a high-yield savings account. This is not for investing. It’s for sleeping at night when life punches you.”
This is not about math. This is about behavior and sleep.
You will see people online say things like:
That sounds edgy and interesting on social media. It does not match real life for most physicians who already carry a lot of stress.
A solid cash cushion helps you:
Yes, most surprise expenses can be paid with a credit card. But the plan is:
That way you keep your credit clean and your brain calm.
Chad likes an even more conservative take for many early-career physicians: three to six months of after-tax income, not just expenses. That can be very helpful if:
Once your core emergency fund is full, you can create a second layer, what Chad calls the Level 2 emergency fund.
That usually looks like this:
Why bother with this second layer?
Because after a certain point, having a giant pile of cash sitting at low yield starts to hurt you. The Level 2 fund:
Real life example: Chad mentioned a dentist client who went on a water slide with her kids, got kicked in the head, ended up with a concussion and a small brain bleed, and has been out of work for months. That is the kind of weird, unplanned event that breaks people who have no margin.
The emergency fund, disability insurance, and smart planning are what keep that from turning into a full-blown financial crisis.
At some point, you also cap this Level 2 fund and send extra money toward long-term investments so you are not forever sitting half in bonds and half in stocks for money you will not need for decades.
The point of Step 4 is simple: when life swings at you, you want a moat, not a puddle.
These first four steps are intentionally in order:
Once these four pieces are in place, everything else in your plan gets easier. Debt payoff, investing strategy, insurance, college savings, practice ownership, all of it sits on top of this foundation.
If you feel behind, getting help early can change the whole trajectory. Even a one-time plan or short-term engagement with a fee-only planner who understands physicians can save you from some brutal, late-career surprises.
Part 2 of this series walks through Steps 5–8, and Part 3 finishes with Steps 9–12 so you can see the full picture of what Tyler originally laid out.
Those first few attending years are a fork in the road. You can use them to build freedom, or to build a lifestyle that owns you.
If you:
You give yourself choices. More time with family, earlier financial independence, the option to cut back clinically without panic.
If something in here hit a little too close, that is actually good news. It means you see it early enough to change it.
Thanks for reading. If you want more physician-focused money content, you can check out WealthKeel LLC for more from Chad or connect with Tyler through Olson Consulting LLC.
The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don’t expect!) about a sponsor, please let us know. We call it the “best of the best” for a reason, and we will maintain that standard for our listeners & viewers.
This information is for general purposes only. This information is not intended to be a substitute for specific professional financial, tax, or legal advice, as individual circumstances vary. Please see a financial professional, CPA, and/or an attorney in regards to your own individual situation.
Wealthkeel’s Advisory Services and Financial Planning offered through Vicus Capital, Inc., a Federally Registered Investment Advisor. WealthKeel LLC, 615 Channelside Drive, Suite 207, Tampa, FL 33602 -- 267.590.9533.
Olson Consulting LLC, Offering Advisory Services and Financial Planning, is a State-Registered Investment Advisor.
A podcast designed specifically for physicians, offering a breakdown of complex financial topics to help you develop your financial IQ, further your financial journey, and improve your well-being. Whether you're a medical student, resident, fellow, or attending physician, you're sure to learn something new that will benefit your journey.
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Conversations helping graduating medical students to attending physicians build a strong financial foundation
