Through a combination of creativity, budgeting, investing, and adopting a minimalist mindset, she is now in a place where work is optional and she can travel extensively with her children.
Although her husband chooses to continue working as a teacher, Eliza the dermatologist was clearly the main breadwinner of the family. Although she didn’t work more than a few years, the income she earned and the choices they made set them up for a sustainable lifestyle for many years to come.
If you’d like to live vicariously as she lives out her dream, read her blog Minimal MD, find her as Eliza on Twitter, and follow Minimal MD’s Facebook community.
Why I Left
You hear quite a bit about stress in medicine. I pushed myself quite hard to get into med school and then to match in a competitive specialty. I spent 100 plus hours a week at the hospital as a student. Then, I became pregnant three weeks into my intern year at Yale.
Somehow, I found joy through the sleep deprivation. One day I had to abruptly stop a patient presentation on rounds during a 30-hour call. I was vomiting in the bathroom when my pager went off again. I laughed even then at the absurdity of the situation.
The tipping point came in residency (not at Yale). I completed all of my program’s requirements, and then they arbitrarily added many more. I begged; I cried, and the part of me that loved medicine died that day.
I would have walked away then, but I was saddled with substantial debt. One resident at my institution killed himself that year. I just pressed on while feeling like an empty shell.
Choices Along the Way
When I finished training, I signed up to work just 2.5 days a week at a private practice because I knew that it was more sustainable than working full-time. I was still bound by my debt, but I needed breathing room.
I made lots of financial mistakes, like putting my 3-year old in a $9,000 a year half-day Montessori program, and living in a different state from my husband for 4.5 years. Handy hint: paying for two households is not the way to build wealth.
We survived, and then we watched the Dave Ramsey DVDs. My whole life, I thought being on a budget was just choosing to spend wisely on the “important” things. Oops. We got on track quickly after that (see tips below).
The Breakthrough
In 2017, after years of true financial discipline, I discovered that my retirement accounts were enough to cover my now minimalist habits; I was financially independent. A few months later, I went in to resign from my practice because my husband wanted to move to a new area.
Retiring early isn’t for everyone. My husband loves his job as a teacher and plans to continue for many more years. I incorporate this as income flow in our budget the same way I approach draws on our liquid assets.
Here’s how:
Tip 1: Make a budget with your spouse.
Don’t decide in the moment if you can afford something. Write down your income for the month, subtract the essentials like rent/utilities, and then make a plan TOGETHER for every single dollar. Every. Single. One.
So when you pay down debt or save to invest, don’t take the leftover money at the end of the month. That was our mistake for years. Remove that money at the beginning along with your rent.
Cut up/hide the credit cards and pay cash. Do it. I have had to put items back on the shelves at the grocery store because I didn’t have enough cash, and that is how it should work. Otherwise, you will cheat. You. Will. Cheat.
Tip 2: Minimize expenses.
This is what will ultimately get you to financial independence and early retirement. It works by freeing your income to pay down debt. After finally making that budget, my husband and I paid down our debt aggressively. We paid off our home in 2016 and our student loans in early 2017.
I now own my cars and my house. I drive a Prius (really great for gas mileage) and live with my husband and two kids in a modest 3 bedroom, 2 bath house on 5 acres. The taxes/insurance on these are minimal. I don’t have cable tv, and when I want wifi at home, I use my phone as a hotspot.
As far as utilities go, I pay for electricity right now, but I plan to switch out for solar panels later this summer. I pay for trash pick up now but hope to eventually be zero waste. My focus is on reducing recurring payments to free up more of the budget for other things.
Minimizing expenses also works by reducing the amount of income and size of the nest egg you will need for retirement. I can’t draw $100,000 a year from my retirement accounts, but I don’t need to. I can withdraw at the 4% a year rate and fully support our minimalist lifestyle.
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Tip 3: Prioritize retirement funding.
You need time for your investments to grow, so the early years are important. We were maxing out our Roth IRAs and my husband’s 403b even back in medical school. Start today, even if you still have student loans.
People often also want to fund the 529 plans. If you can do everything, that’s great, but if it comes down to it, I would rather make my kids take on student loans than make them support me later in life.
Tip 4: Make a plan to cover your expenses.
Your lifestyle will change when you retire. I pay more now for my cell phone bill each month but save a ton on disability premiums. You may save on parking fees, gas, or daycare expenses.
Make sure you can get health care coverage. If you are healthy, you can get medical and dental coverage through the AMA at excellent rates. We have also used the Christian health care sharing plans in the past to provide catastrophic coverage.
Tip 5: Give yourself flexibility.
After I quit my day job, I was invited to continue with some occasional consulting for a pharmaceutical company. I have logged 10-15 hours a week for them over the past year and loved every minute of it. I was also approached by an acquaintance to do some locum work averaging one to two days a month.
Given my recent move, these have been a creative way to make new contacts and spend time with peers. They are helping me adjust to a new area and a huge amount of free time.
I would encourage any young retiree to keep an active license for the first few years. You may want to volunteer at a free clinic, teach residents, or do medical missions.
Keep your options open, and try lots of new things. I may start another degree this fall; I may move abroad for a few months to finally learn a language through immersion.
I get to live again and dream again, and it is perfect.
-Minimal MD
Have you ever felt like she did? Looking for a veer away from the career path you chose? Would a frugal, minimalist lifestyle appeal to your more if it meant never having to go to work again?
Congrats on your accomplishments. From school, career, family, and doing what it takes to support your life’s new direction. I wish I had been more financially aware at a younger age as you did. It took me a bit longer. I pulled the plug on an engineering career at the age of 51 and debt elimination was certainly the main issue that made it possible.
I am a 65 year old physician doing locums work. I still love medicine but miss being home. I wish I learned about fire earlier in life. We concentrated on cash flow rather than paying off debt. WE had great fun but did not save as much as we could have . Everyone has a different story and I enjoyed reading Eliza’s and the responses. Thank you.
Can you expand more on what sounds like the tipping point in this— you were ‘arbitrarily’ assigned what sounds like extra months of residency? That is certainly uncommon and unlikely to be arbitrary in my experience, but would be interested to hear more… esp since it sounds like it was the final straw
Sure. Our chair, after promising that we were finished with call for the remainder of our residency, decided to overhaul the call structure. He announced 4-5 more weeks of call for each upper level resident and then several weeks later added more call on top of that. Perhaps unexpectedly would have been a better description. As a physician, I am designed for delayed gratification, but I don’t like it when expectations repeatedly change halfway through.
Do you think you would have ended up at the same place in your life anyway? I’m legitimately curious. It seems strange that a few more weeks of call during residency, however unfair they may have seemed at the time, would have led to a career-altering path that led to only a few years of actual work. I know residents in certain cities are treated fairly roughly so I’m sure it was the straw that broke the camel’s back, and there were a lot of other issues with the program … but residency is 10% of your career. There are a ton of wonderful derm attending opportunities across the country with good work-life balance.
With that said, I guess everyone is different. I love my field. I suspect I’ll be more like PoF and simply cut back hours when I become financially independent rather than walk away completely.
Thank you sincerely for your reply. My plan prior to that moment in residency was to be a full time academic dermatopathologist.
I’ve spoken to multiple people who have left medicine and have heard many other stories of a defined “tipping point” that changed their trajectory. For example, one interventional radiologist said that she gave up her clinical career quite suddenly after receiving a needle stick from a HIV positive patient with a high viral load. In moments like that, we sometimes feel that we have to make a choice (and perhaps this isn’t a fair dichotomy, but it is felt by the individual at the tipping point moment) between our practice of medicine and our health. For me, it was, at least in an emotional sense on that day in residency, a choice between my job and my family. The fact that I had a three week old baby (that I had delayed having until I finished my call obligations) made the situation more stark for me.
I’m thankful for my career. I’ve paid my debt. I’ve become financially independent. I’ve provided well for my family. Along the way, I’ve taught residents and had fun with coworkers and helped tens of thousands of patients. You are so correct that there are many practices with great work/life balance and wonderful support.
I’ll note that I am really young, so it is impossible to predict what will happen in the next 20-60 years of my life. I’m keeping my license active by doing occasional locum work averaging two days per month. Ten years ago, I would have said my clinic/hospital time was to help patients. Three years ago, I would have said it was to pay off my debt. When I am in clinic now, I see it as a great way for me to make connections with colleagues/peers and engage my brain in a unique way. Perhaps I will seek more of that in the future, perhaps not.
We home schooled our kids also using a great books curriculum. One daughter went straight through to college. Once in college she was so happy with her experience. Her great books curriculum transferred 24 credits toward her degree. The other daughter wanted “high school experience” and the chance to walk to get her diploma, so she spent her senior year in HS. Once she got there she was less than impressed at the learning experience compared to great books. I always called our life style Parsimonious not Minimalist in that our choices revolved around the best value as opposed to the least amount.
Value is certainly the important factor. I’d rather spend $10,000 on six weeks in Europe than spend $15 on a cheap shirt. It isn’t about the dollar amount but the joy returned.
Congrats on finding the right educational setting. We have homeschooled for 2 years (not consecutively) and continue to explore our options.
https://minimalmd.com/homeschool-transitions/
Eliza
getting burned out and having to quit at 34 is inspiring? i would disagree. i’m financially independent, but don’t see this story as inspiring.
If you haven’t faced burnout as she has and don’t share the same dreams, I wouldn’t expect you to be inspired. You may find the story of the physician earning $1.8M a year more compelling.
Best,
-PoF
I’ll be honest I found that guest post to be pretty depressing not inspiring. To be that disillusioned with medicine, having to quit at that age, and then having to watch every dollar to the point of not having WiFi at home? Sorry this is not an example of a success but rather a failure. Just my opinion.
FLP,
Thank you for your compassionate response.
I apologize if I gave the impression that we couldn’t afford WiFi. Our family finances are minimized by choice. While we do sit around considering solar panels so that we can eliminate our electric bill, we are also pretty quick to book flights to Europe on a whim.
Regarding connectivity, I actually find it peaceful/liberating to put away my computer for weeks at a time while I spend time traveling/hiking/etc. We went several months this year without a TV as well and have never had cable. Our family life centers more around reading, being outside to swim/hike/play baseball/bike, and things of that nature. I do realize that many people love screen time; they are free to do as they please.
I also regret your impressive that I had to quit medicine. I am a very capable physician. I do not exaggerate when I say that if I wanted to work 5 days a week starting next week, I could.
It is reasonable for you to have different dreams for your own life. I can think of many dream jobs or dream retirements that would be my own personal nightmare. Retiring on a boat, for example, would put me in a permanent state of nausea though I respect that it would be the ideal set up for some. I shared my story here and on my blog so that other people in debt could be encouraged. As POF mentioned, burnout exists. Showing young physicians that they have options with their careers is important.
I LOVE my current life. I wake up thrilled with who I am and what I’m doing.
All the best,
Eliza
Please don’t give up your medical license. It may be harder to retrieve than you think. A friend of mine gave his up at retirement and decided later that he wanted to do a couple of half days a week providing physicals for the military inductees. Due to his age of 78 the State Medical Board forced him to go back and take his original board exams all over again. To his credit after much study he actually took the exam and passed it again. I’m not sure I could. He educated me that it’s always easier to continue to pay a few hundred dollars a year to renew your license than to go through what he did.
That is excellent advice, John. I will always keep the license. I worked hard for my MD and for my board certification, and I have no plans to put myself through training again. I do, however, want the option to volunteer or do locums as I desire over the next few decades. Young retirees should be especially careful with this as desires and needs change drastically over time.
Minimal MD, very awesome story. A frugal, minimalist, zerowaste lifestyle does appeal to me and my wife. In fact, other than our house and trips, we pretty much live a frugal, minimal, zerowaste, vegan lifestyle.
There are times that we fantasize about living a similar lifestyle as you where we are completely early retired and free. I am about the same age. I paid off my medical student loans at a similar rapid rate. We could totally pull the trigger and live a similar lifestyle right now if we sold our house in California and continued to live the frugal/minimal way we are currently living. A vast majority of our expenses outside of income tax come from our mortgage and property tax. Without those components, we can comfortably live off of $30-35k a year if we lived somewhere else.
While we do fantasize about that life. We also love our current life now and I like my current job. Fortunately, our jobs are somewhat flexible. When our kids are a little bit older, we may be able to find a middle ground in which we take a few mini-retirements and sabbaticals here and there before full semi-early retirement. It may allow us to get our feet wet a bit without diving too deep :).
What a great story. Thanks for sharing! Now, I have another blog to catch up on. Great job paying off your home and student loans so young. How did you do that? I’ll have to go over and find out.
Joe,
We tried to live on my husband’s salary alone and put mine to debt payoff. There were certainly times when we chose to make exceptions, but that was part of the strategy, along with serious budgeting and frugality. Now that we are past that stage of debt payoff, we are indulging quite a bit more. Thanks for your comment.
https://minimalmd.com/i-paid-cash-for-a-house-today/
I applaud MinimalMD for making tough decisions and adapting to find a combination of income and expenses that works for her life situation. Thank you for sharing, as you provide a great case study of what is possible if one doesn’t get hung up on sink costs. At the same time, I can imagine many who work in other service fields with long hours and occasionally difficult situations, but at a much lower hourly rate (teachers, retail, construction, military, to name a few), reading an article like this and rolling their eyes. The same goes for physicians in specialties where ending the day before 6pm, having no call, and working less than 5-6 days a week are not considered the norm. I am extremely grateful for the fact that I am in one of the “ROAD” specialties, where I can choose to drop down to part time, work locums, find jobs with minimal patient follow-up, and be able to support a family, with or without minimalism. I constantly find it amazing that I can make more than most families spend by working 1 day a week. Minimalism is fine, especially if it aligns with your lifestyle and goals, but, in my opinion, a high hourly rate and demand for your services is even better.
I agree that someone working in a profession such as teaching, retail, etc. might look at this article as not applicable. It is mathematically easier to pay down debt when you have a high salary. My hope is that the teacher/retail employee wouldn’t have hundreds of thousands of dollars in student loans to contend with. Without student loan debt, it is a matter of picking a lifestyle that matches your income/priorities.
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Wow! At 34 years old? I’d like to congratulate you on such a great achievement and inspiring story. Looks like you’ve made the best decision as far as working as a consultant for this particular Pharma company. Totally agree with you on maximizing IRA’s.
Great story! I often think I would be happier had I chosen a more lifestyle-oriented specialty. Thanks for showing that ROAD and its cousins psych and PM&R aren’t a panacea, and that we still deal with outsize expectations, stress, and dysfunction.
It’s also great to hear from a female physician breadwinner as opposed to a non breadwinner who retired early.
And your pictures are beautiful, wherever they are.
Getting rid of debt goes a long way towards funding your financial freedom. It had such a profound effect on my life, it convinced me to write The Doctors Guide to Eliminating Debt. Congratulations on your freedom.
Dr. Cory S. Fawcett
Prescription for Financial Success
Agree that the lifestyle specialties can still suffer burnout. Financially Ophthalmology has not been as rewarding as I hoped. Typical first 2 years start out making 150k. Then have to come up with sizable practice buy in (after tax dollars of course), and also on the hook for buying out partners. For someone wanting to get to FI ASAP that conflicts with the goal. Then factor in large overhead, expensive equipment, and the pressure to offer the latest and greatest technology, that ultimately we have to sell to the patients as insurance will not cover. This is a great recipe for burnout.
That is surprising, SG. I don’t know if there’s a specialty with a wider bell curve of salaries than ophtho. Some make less than the CRNA monitoring the cataract patients; others make seven figures. It’s certainly better to be an owner than an employee in most cases.
Cheers!
-PoF
I think this is an important addition to the discussion of financial independence and its use to help prevent, treat, and otherwise undue burnout.
I think the 529 advice is solid, and I personally struggle with that. We cut back on ours this year because of increased day care costs as my wife went back to work full-time for professional fulfillment. It was better to do this than to slow down our debt pay down plan or retirement savings plan.
Thankful for sites like this where people that have experienced burnout and chosen an alternative path as a physician can be highlighted.
TPP
Congrats MinimalMD! Minimalism is hard and counter to our training as citizens. To be able to cut out so much while paying off even more is incredible.
I’m glad you found the right balance. We are doing our own experiments in frugality and budgeting, it definitely doesn’t come naturally.
The term “lifestyle” specialty always gives me a giggle. Who came up with that? What qualifies something as a lifestyle specialty? Seeing 30+pts a day would be a fast track to madness for me. Is it because their is so much money to be made that you can have the salary of a full timer generalist for a couple of days of work a week?
Good luck!
What an inspiring story.
Medical students often talk of the “lifestyle specialties” with the acronym ROAD (Radiology Ophthalmology, Anesthesiology, and Dermatology) but even if you match into these competitive residencies does not mean you can not experience burnout.
Being in one of the ROAD specialties myself (Radiology) I too have suffered some effects of burnout. I think every specialty has some risk of this. I combatted this burnout by reducing my clinical hours to 4 days a week and paying someone to cover the extra day. That has prolonged my career tremendously by allowing me to recharge my batteries.
Smart advice on funding the 529 plan. People often sacrifice themselves to give their kids a head start but in the end may be more of a financial burden if they can’t support themselves in retirement. It is way easier to get a loan for education than it is to get support for retirement (the only product I can think of is a reverse mortgage).
Xrayvsn,
I agree with you. The practice of medicine is difficult and stressful. Even in the “easy” specialties. The radiologists I know seem to feel the pressure to do more and more reads for more and more imaging centers, to be available, and to do some teleradiology. The work is never done. The anesthesiologists and ophthalmologists can face O.R. conflicts, surgical risks, bad outcomes, malpractice etc. Derm seems to have high pay with minimal risk which is nice. But the ones I know see 35-45 patients when they are in the clinic. I can’t imagine that is easy.
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