The first attending paycheck changes everything, and this episode gives it an order. Ryan walks the new attending money waterfall, starting with the double up rule: live on twice your resident salary, cap it there, and let every dollar above that line flow down in a fixed order. The match, reserves, insurance, student loans, retirement accounts, then goals. Get the order right and the attending years get much simpler.

This podcast is for education and entertainment purposes only. Nothing mentioned is individualized financial, medical, or legal advice.

Diane has $4.3 million, zero debt, a paid-off house, and a 95 out of 100 on her Financial Health Assessment. It is the highest score we have ever given on this show.

Her question is the one that comes after you win: can she stop maxing out her retirement accounts and be done working in three years?

In this episode I walk through her full assessment: what she nailed, the few points still on the table, and the moves that protect a plan this strong through the gap decade before retirement money unlocks.

Want yours? financialfellowship.com/submit

This podcast is for education and entertainment purposes only. Nothing mentioned is individualized financial, medical, or legal advice.

Pay the mortgage off early, or keep it and invest the difference? Daniel Wrenne's first warning is about the advice itself: anyone who tells you to always pay it off is giving bad advice.

A 3 percent mortgage from 2020 is one conversation. A 7 percent mortgage from last year is the exact opposite. We run the numbers, and the feelings, on both, after looking at the whole picture: tax shelters maxed, savings rate, the rate on the debt, and cash flow.

Have a question? Send it to financialfellowship.com/submit and I'll answer it on air.

This podcast is for education only. Nothing mentioned is individualized financial, medical, or legal advice.

Sean and Kate have $7.5 million, zero debt, and a 90 out of 100 on their Financial Health Assessment. They are the couple everyone wants to be.

And I still found the holes. The kind that only show up when you have something worth protecting.

In this episode I walk through their full assessment: what they nailed, where the gaps are, and the four moves that take a 90 to a 95.

Want yours? financialfellowship.com/submit

This podcast is for education and entertainment purposes only. Nothing mentioned is individualized financial, medical, or legal advice.

Mid-career physicians often accumulate a messy collection of accounts — old 401(k)s, multiple IRAs, taxable accounts, and employer plans. In this episode, Ryan and Daniel Wrenne walk through how to clean it up: consolidating accounts, simplifying your portfolio, and making sure your investments actually match your plan.

Topics covered:

- Why mid-career physicians end up with scattered accounts

- How to decide what to consolidate vs keep separate

- Simplifying your investment lineup without losing diversification

- Common mistakes when cleaning up a portfolio

Full show notes at financialfellowship.com.

Episode 17: The 401(k) Was an Accident

A physician sits down to pick her 401(k) investments. 27 fund options. Zero training for this decision. Nobody ever designed this system. It grew out of a 1978 tax provision about executive bonuses that one consultant read differently than everyone else.

Ryan traces how a narrow law became America's retirement system, why pensions actually died in the 2000s (not 1981), and what the three real risks are for physicians building their retirement on this accident.

The 401(k) holds $10.8 trillion in assets (Investment Company Institute, 401(k) assets as of June 30, 2026: https://www.ici.org/statistical-report/ret_25_q2). Almost nobody chose it on purpose.

You tell yourself you're saving 40%. Then we open the spreadsheet and find the mortgage, the student loans, the car payment, and that 40% gets a lot smaller.

This week Daniel Wrenne joins me to strip the savings rate down to what's real: what actually goes into investable assets. We cover what counts as savings (and what doesn't), why maxing out your 403(b) isn't enough at a physician income, and the one test every attending household should run, cut one clinical day on paper and see if your plan survives.

We also get into building margin into your plan, Monte Carlo versus linear projections, and why the "just pick up an extra shift" button is a slippery slope.

Have a question? Send it to financialfellowship.com/submit and I'll answer it on air.

This podcast is for education and entertainment purposes only. Nothing mentioned is individualized financial, medical, or legal advice.

You were trained to be bad with money. In 1910, the Flexner Report rebuilt American medical education around expensive lab science. It accidentally built a financial training system that teaches doctors to ignore money for 15,000 hours, then graduates them into their highest-stakes financial decade with zero preparation.

Ryan traces the building: how curriculum hours, board exams, and the tuition-funded model standardized an education that contains germ theory but left out how income works, how debt behaves, and how to protect a family.

The reframe is simple. It's not a you problem or a doctor problem. It's a building problem, and buildings can be remodeled.

This podcast is for education and entertainment purposes only. Nothing mentioned is individualized financial, medical, or legal advice.