Wednesday, May 18, 2022

by Miriam Sweeney 

The stratification starts in medical school. Before anyone has matched into their residency — long before attention has shifted from Step One and Two to writing a round of personal statements and preparing for interviews — conversations have already started about who is pursuing what specialty.

And in schools that emphasize class rank, pitting students against each other in preparation for a career where collaboration is key, medical students may already be making assumptions about their peers’ future specialties based on their class ranking or rumored scores. “There’s no way Sahil will match into ortho with a ranking like that.” “Emily may say she wants to be a pediatrician, but with a step score like that and the way she’s been buddying up to the attendings, she’d be a shoo-in for derm.”

In a field that requires immense financial and time commitment from its newest members, medicine shakes out to have very different compensations on the other side of residency depending on a physician’s specialty. There are ways of ensuring stability for everyone, especially the majority of medical students who graduate with medical debt. Having a solid understanding of investing, loan repayment options, and intentional spending can lay the path to success for someone making $150k or $500k. Tools like ScrubMoney — a free mobile app — that help support physician financial education and planning can be key in this process. But just understanding the nuances of why we spend the way we do can also go a long way in making sure we’re using what we have to build the life we want.

I'd recommend two basic focuses to achieving the lifestyle you want, no matter your income or specialty.

Focus I: The bold and swaggering decision to define what you want

We all grew up with motivational posters inviting us to go for our dreams, right? Those posters never took the time to help us understand how to know what our dream is, or how to form a dream in the first place.

You can’t get to where you’re going without knowing where you’re going, and too few of us take the time to really pinpoint where we want to be. I’m not talking about knowing our own tastes; it’s one thing to see something interesting, be it a style of a home or a fashion choice or a job description, and know if it’s for us or not. It’s an entirely different arrow in your quiver to visualize that home or outfit or job before any options are presented to you.

I’ve adapted a few different researchers’ and influencers’ ideas^[1] of what this process can look like and simplified it for this column.

1. Sit with the idea of what a successful life looks like. We don’t like talking about it, but physicians know it better than most: our lives are finite, and we don’t get endless opportunities for course correction. When you think of a successful, happy life, what does that look like for you?
   
   Focus on what you can control. You have less control, for instance, over whether you live to a ripe old age or are a casualty of irresponsible driving next month. Nevertheless, your life was a life, legitimate in spite of its abbreviated length. What will have made it successful?
2. Now that you’ve pictured your own brand of success, consider: in order to get to that success, what are the non-negotiables involved? What is irreplaceable in your picture of a life that leaves you happy and proud of what you’ve done and how you’ve spent your time?
3. Now, it’s a simple (or not) matter of defining how to go about shaping your decisions around those non-negotiables. How will you prioritize what’s most important? If your self-defined success has anything to do with an existing life partner, this process of planning for priorities might be one of deciding how to encourage habits that keep that relationship strong. If success requires something that must be checked off as a binary, it may be worth your time to think through what it’s going to take to mark that box.
   
   Many people who get this far stop there. That would still be a productive exercise. But without the next step, it’s still not necessarily going to help with making your resources — time and money — work for you.
4. Decide what to cut out. Do you have goals you’re actively working towards that aren’t reflected in your life success rubric? Are you spending your precious time or your hard-earned money on something that’s unattached to your idea of a successful, happy existence? This step requires confidence in yourself. Are you bold enough to cut out something that may matter greatly to other people, but isn’t central to your own life success?
   
   A big part of this step is understanding how to use your money in a way that will make you happy. Money can’t buy happiness, but according to researchers at the University of British Columbia, Harvard, and the University of Virginia^[2], the way you spend your money can lead to happiness.
   
   Don’t take it from me. Listen to the experts, as described in Chapter II of our effort to use money intentionally to get the life we want regardless of specialty or circumstance.

Focus II: “If Money Doesn't Make You Happy Then You Probably Aren't Spending It Right”

When aligning your actions with your definition of personal life success, the decision of how to allocate your resources can make a considerable difference in your progress. The question of how to spend your time belongs in another column. But the question of how to spend your money, happily, has been answered and peer-reviewed for us. Let’s break down the researchers’ findings.

1. Buy more experiences and fewer material goods. This notion is backed up by many studies, as cited in the paper itself. The gist is that we become accustomed to material possessions, but we never dull a happy memory when recalling it; on the contrary, a happy memory may become even happier when mentally reliving it. A treat yo’self day might be better spent on a visit to a spa or a chocolate tasting night instead of a new bathrobe or quality dark chocolate.
2. Use your money to benefit others rather than yourself. In a study that asked Americans to report about how much they spend on bills and expenses, gifts for themselves, gifts for others, and donations to charity, there was no significant correlation between spending money on the self (the first two categories) and happiness. There was, however, a strong relationship between people who spent money on others and self-reported happiness, even after controlling for income.
3. Buy many small pleasures rather than fewer large ones. I’ll admit, this one caught me off guard. Lots of little things instead of bigger, more significant things? It almost seems to contradict #1 on this list. But the research holds out, and it’s worth diving into the article itself to review the citations. The line that resonated most with me: “Eating two 6 ounce cookies on different days may be better than eating a 12 ounce cookie at a single sitting.”
4. Eschew extended warranties and other forms of overpriced insurance. This piece of advice feels remarkably specific for a list that otherwise boasts great general applicability. But this principle has less to do with specific retail tactics and more to do with human resilience.
   
   There is insurance that makes a lot of sense, and this article isn’t talking about it. This article is talking about the kind of insurance you get when you’re over concerned about losing something material, like the integrity of your new TV. Interestingly enough, the research suggests that, while the prospect of inconvenient loss is devastating, the experience of inconvenient loss tends to be one people recover from reliably and quickly.
5. Delay consumption. This principle essentially suggests that, if you plan a getaway to the tropics, plan it for nine months away, not two weeks. You will enjoy the experience more because you spent so much longer anticipating it.
6. Consider how peripheral features of your purchases may affect your day-to-day life. In other words, it’s easy to picture a dream of ours and only see the positives. Filtering out the negative effects of a decision may lead to disappointment when the time comes to enjoy a wish come true. Both the past and the wished-for future can be distorted with rose-colored glasses.
7. Beware of comparison shopping. Comparison shopping — looking for things based on how they measure up to each other instead of based on what you want in the first place — is designed to distract us from what we really want and make us make purchase decisions based on the best deal, not whatever is right for us.
   
   This holds true whether in a literal shopping situation or a more metaphorical situation that involves searching and decisions. (Dating and home browsing apps wouldn’t have anything to say about this, would they?)
8. Pay close attention to the happiness of others. Not to encourage a herd mentality, but, according to this article, “Research suggests that the best way to predict how much we will enjoy an experience is to see how much someone else enjoyed it.” It may be a good exercise to think about someone who you would define as successful or happy in your circle, then have a frank, humble conversation with them about what they think has made them happy and what might help you reach some of your intangible goals. We are all unique, but this research makes it look like we wax and wane in our satisfaction with things and experiences in concert with our peers.

It can be easy to assume that people with x will be guaranteed success in life, but success is a personal, arbitrary measurement.

If we can first a) define success for ourselves, along with a healthy foundational education of the elements that influence our success (like financial, mental, and social wellbeing, for instance), then b) follow best practices when spending our resources (our time and money), we’re more likely to reach our goals and be proud of our lives than if our personal rubric for success remains undefined or suffers from moving goalposts. 

Find out what resources your institution and community offer to support you in designing an intentional, satisfied life.

About the Author

Miriam Bay Sweeney is a co-founder and Head of Product of ScrubMoney, an app designed to help physicians lay the foundation for financial independence. She’s been fascinated by personal finance ever since learning as a young adult that sticking her paychecks and babysitting money she made as a teenager in a savings account was a crummy idea. She researches personal productivity and the foundational aspects — including financial confidence — that enable a person to innovate and thrive creatively. ScrubMoney is her way of giving back to the community of physicians that so many of her friends are part of, because we ought to think about taking care of the people who dedicate their lives to taking care of us.

Sources

1. Thanks to Clayton Christsensen, Ramit Sethi, Eric Barker, Dave Burnet, Bill Evans, James Clear, and likely a handful of others whose writing influences my perspective subconsciously

2. https://scholar.harvard.edu/files/danielgilbert/files/if-money-doesnt-make-you-happy.nov-12-20101.pdf