From Resident to Attending: 7 Critical Life Decisions for New Physicians
Transitioning from residency into your first full-time physician role is one of the most pivotal moments in your career—and your life. After years of intense training, long hours, and delayed gratification, the shift into an attending role brings newfound freedom, responsibility, and (finally!) a real paycheck.
But with that comes a flood of life decisions surrounded by huge financial implications—some obvious, others less so. Here are 7 key choices that can shape your financial future, career satisfaction, and personal well-being as you step into this new chapter.
1. 🩺 Choosing the Right Job Offer
It’s tempting to jump at the highest salary, but take a breath. Consider:
Practice setting: Academic vs. private practice vs. hospital-employed vs. locums
Work-life balance: What’s the real call schedule? Vacation time?
Support: Is there mentorship? Are APPs or staff well-supported?
Culture: Do the physicians like working there?
Student Loan Implications: Is this a non-profit organization that allows you to qualify for PSLF?
🧠 Tip: Don’t be afraid to negotiate your contract—and consider hiring a healthcare attorney to review it. Certain career positions and location will pay a signing bonus and moving bonus.
2. 🏡 Where Will You Live?
This decision is more than a zip code. Think about:
Proximity to family or support systems
Cost of living vs. salary (that $300K goes further in Ohio than in San Francisco)
Long-term lifestyle: Schools? Commute? Outdoor activities?
💡 Renting is often smarter in your first 1–2 years until you're sure you want to settle. The cost of purchasing and maintenance on a house adds up quickly and you need to be in good financial position.
3. 💰 Tackling Student Loans
You’re finally making real money—so what now?
Consider Refinancing to look for lower interest to a private lender
Consider doing Public Service Loan Forgiveness (PSLF) if staying a non-profit organization
Consider lump-sum payments or aggressive payoff after building an emergency fund
⚠️ Don't rush to refinance before confirming your long-term job path.
4. 🛡️ Getting Proper Insurance
Residents are usually underinsured. As an attending, it’s time to level up:
Disability Insurance: Critical for protecting future income—get it while you’re young and healthy
Malpractice Insurance: Know what your employer covers (claims-made vs. occurrence)
Life Insurance: If you have dependents, term life is a must
📈 This is risk management 101—you now have income worth protecting.
5. 💳 Lifestyle Inflation vs. Lifestyle Design
It’s SO tempting to upgrade everything. After years of grinding, you deserve a win. But make it intentional.
Build in treats (vacations, a car upgrade, nicer living space) without overcommitting
Avoid high-interest debt (and car loans you don’t need)
Automate savings and investing before the spending kicks in
🧠 “Live like a resident” doesn’t mean being miserable. It means being mindful.
6. 🧑⚕️ Setting Career Goals Early
Where do you want to be in 5 years?
Leadership? Academic promotion? Medical entrepreneurship?
Will this job give you room to grow—or will you hit a ceiling?
Burnout prevention: Can you set boundaries from the start?
🌱 Don’t wait for burnout to force a change. Be proactive in designing your ideal career path.
7. 📈 Building Wealth and Investing
Now that you’re earning, the clock on wealth-building starts ticking.
Open a Solo 401(k) or 403(b)/401(k) and contribute early
Learn the basics of index investing—or hire a fiduciary financial advisor
Max out Roth IRA (backdoor if needed) and HSA if available
💡 Investing in your 30s can make you a millionaire by 50—without working harder.
Final Thoughts: It’s Your Time Now
You’ve earned this moment. The attending transition is about more than medicine—it’s about reclaiming control over your time, finances, and future.
Yes, there are big decisions ahead. But you’re not alone—and you’re more equipped than you think.
Whether you're a new hospitalist, surgeon, psychiatrist, or pediatrician—this chapter is the one where you finally get to write the story. I ask you become intentional and focused on what you want of this career and your life.
Author:
James Hargrave, MBA, CFPⓇ, CLUⓇ