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  • Is it a good idea to switch from internal medicine to radiology in order to work from home

    Posted by christopher.walker_148 on August 11, 2023 at 11:37 am

    Im a current pgy3 internal medicine resident. I wanted to get your thoughts on whether it would be a good idea for me to switch from internal medicine to radiology at this point in order to
     
    Pros:
    1) work from home [no need to wear pants, straight from bed to work, no commute]
    2) get large amounts of vacation
    3) pay minimal taxes from Puerto Rico [I have some distant family/friends there, I speak Spanish, I have been there several times and would love living there over living in continental USA. In fact I strongly dislike living in the continental USA.]
    4) additional location flexibility as telerad [no need to move to flyover country, which is a prerequisite for making large salaries as an IM subspecialist]
    5) Radiologist lifestyle is much more amenable to travel/living as a bachelor; I am single, I have no plans to have children until age 45 at the earliest
    6) Perhaps prelim from overseas one day and geographic arbitrage. I would love to live in Colombia one day and read prelims part time for $20/RVU after reaching FI for a few hours a week. This Geographic arbitrage is not possible in any other medical specialty except maybe telepsychiatry with cash clients, but this requires maintaining a business which I wouldn’t want to do after hitting FIRE numbers.
    7) Easy license transfer and working in Australia/NZ/Canada, again not possible with other medical specialties.
    8) I think I would enjoy this life journey as a radiologist more, than say a gastroenterologist living in a place I don’t like in order to hit FIRE numbers earlier so I can have the option to leave a job I don’t necessarily like but can tolerate. 
     
    Negatives:
    1) I would lose 2 years of time investment in internal medicine residency.
    2) I would also eventually be a radiology attending between ages 33-35 depending on if I can secure a spot for next year and if I were to do fellowship (vs. being IM attending at 29/subspecialist at 32). This comes with the psychological impact of not making a decent salary until 33 – 35.
    3) I wanted to hit 5M liquid net worth by the time I am 40; this is possible as an IM subspecialist/gastroenterologist and living without children in flyover country with a 90% savings rate on post tax income, but due to the time value of money and even with tax benefits in puerto rico (assuming they stay static) I may need to push this back to age 42-43 in radiology.
     
    Variables out of my control:
    1) Puerto Rico tax incentives remaining static
    2) Fluctuations in Radiology Job Market
    3) Application, all of my stats from medical school are solid but static, 250s steps, PDs have told me that funding does not necessarily matter at big programs and to apply any way because I can’t control if a program cares about funding
     
    Working from home as a radiologist, eventually part time when I hit my fire numbers is something I could see myself doing for the rest of my life. I don’t necessarily like the job of an internist/gastroenterologist but can tolerate it in order to reach FIRE.

    What would you do in this situation?

    jeevonbenning_648 replied 11 months, 1 week ago 19 Members · 51 Replies
  • 51 Replies
  • btomba_77

    Member
    August 11, 2023 at 11:42 am

    Yes. Yes it is.
     
    If you have some connection to PR (family, etc) practicing radiology is probably a great option.
     
     
    Even without WFH, just switching from IM to rads is a good idea

    • Unknown Member

      Deleted User
      August 11, 2023 at 11:56 am

      yes

      • william.wang_997

        Member
        August 11, 2023 at 12:07 pm

        Do it !!
         
        You will be an asset to radiology with your background.

      • Chris7549

        Member
        August 11, 2023 at 12:11 pm

        Do you like radiology and interpreting images more than practicing clinical medicine?
        Do you have decent Step scores?

        • afazio.uk_887

          Member
          August 11, 2023 at 12:14 pm

          LOL, is this a real question?  Rads >>>>>>> IM any field of it

          • afazio.uk_887

            Member
            August 11, 2023 at 12:15 pm

            As an aside – I am curious why more Rads are not entertaining the thought of Telerad from PR?  What is required, 6 months there to get the tax break?  You can then take the next 6 months off easily. 

            • smfst7_929

              Member
              August 11, 2023 at 12:24 pm

              you can find a rad spot anywhere most likely if you have successfully completed IM. I wouldn’t worry about step scores too much unless you are hoping for a top tier rad program.  At the end of the day if you’re just looking to do telerad any podunk community radiology program will be fine.

            • btomba_77

              Member
              August 11, 2023 at 12:32 pm

              Quote from Waduh Dong

              As an aside – I am curious why more Rads are not entertaining the thought of Telerad from PR?  What is required, 6 months there to get the tax break?  You can then take the next 6 months off easily. 

              Life on the island has gotten a bit rougher over the last decade.
               
                 That said…. yeah. Certainly doable. A lot more tolerable if you just *love* island life and/or have a family connection and can truly consider it ‘home”

            • Unknown Member

              Deleted User
              August 11, 2023 at 12:38 pm

              Quote from Waduh Dong

              As an aside – I am curious why more Rads are not entertaining the thought of Telerad from PR?  What is required, 6 months there to get the tax break?  You can then take the next 6 months off easily. 

              I take it you have never been to Puerto Rico. 

              • namaalamry_845

                Member
                August 11, 2023 at 1:15 pm

                No one knows what the job market will be in 6-7 years, Radiology may be bust or still really busy. This is a risk you have to accept. If you like practicing IM, that is the safe bet.

                • Unknown Member

                  Deleted User
                  August 11, 2023 at 4:53 pm

                  Visit first.  I visited pre Hurricane,  I could not be a permanent resident.  Remember any tax break can be reversed with the stroke of a pen.

                  • JohnnyFever

                    Member
                    August 11, 2023 at 8:12 pm

                    Not much point in viewing the time investment as a factor in your 20s. If you think you’d be happier in Radiology, do it. It’s a great field, but not for everyone.

                    Either field could be better than the other in 10 years, considering how quickly medicine is changing. That said, I can’t imagine someone quitting radiology for IM

                    • ruszja

                      Member
                      August 11, 2023 at 9:04 pm

                      One thing you may run into is a wrinkle in the GME funding formula. As your ‘initial residency period’ was defined by IM, the funding attached to your SSN rolls off after 3 years instead of 5.
                      There are two parts to the GME funding, the smaller ‘direct’ and the larger ‘indirect’. The time limit is on the smaller ‘direct’ part of the funding stream. So just for round numbers, instead of 120k, they only get $100k. In some programs hospital or university administration wont allow residency directors to hire candidates who have exceeded their funding.

                    • y.rajshekar

                      Member
                      August 11, 2023 at 9:35 pm

                      Your IM background will make you a better rad. But it still going to be a lot of effort beyond residency years because radiology is so different. Hopefully you don’t have small children or other major time commitment.

                    • nasosmunfc_332

                      Member
                      August 12, 2023 at 3:54 am

                      Tangentially, this is also what I am seeing from new rad grads and residents. They are largely going into radiology or a specific group in order to become remote. Changing world. Perception of radiology by administration is going to be far different a few years from now, and likely how we practice. Consolidation, outsourcing, etc. No free lunch imo.

                    • btomba_77

                      Member
                      August 12, 2023 at 4:28 am

                      I’m hoping to transition into full WFH plain film reader old guy at some point. (I figure I’ll do it when my current Chair steps down and before the next one takes over.  Hopefully I can be outside of the building before the new chair even get oriented and they’ll never even know my face ….. just let the paychecks keep coming to some anonymous rad they don’t know 😉   )
                       
                       

                    • nasosmunfc_332

                      Member
                      August 12, 2023 at 5:26 am

                      Dergon, that’s my dream also, ideally reading completely remote, part time from Florida in a few years.
                       
                      My concern is when something swings far one way, it often swings back to an equilibrium, which may apply to both the job market and remote reading. I wouldnt be surprised to see a minor shift back to in house based on negative feedback from hospitals. The job market has swung wildly throughout my career so could be completely different in 5-7 years, especially with remote reading increasing supply and lack of retirements from ease of WFH. The best position will be those already established in groups.

                    • btomba_77

                      Member
                      August 12, 2023 at 5:29 am

                      Yeah.  Agree.
                       
                      I did 25 years of full in house to get to this point.
                       
                      If I’m the part timer in my 60s who still has good relations with referrers who can call me or me them (it’s almost all by phone now anyway because we’re spread over a huge far flung system) I hope nobody will really mind.
                       
                       

                    • khodadadi_babak89

                      Member
                      August 12, 2023 at 7:59 am

                      OP: It seems the only reasons you are interested in Radiology are mercantile reasons. No love of the specialty evident. 
                      So – perhaps you should think of investment banking, or day trading.  

                    • christopher.walker_148

                      Member
                      August 12, 2023 at 8:09 am

                      Frankly I don’t really have love of internal medicine or gastroenterology either. But I do really enjoy the diagnostic aspect of radiology, in that sense it almost feels like an extension of Internal Medicine in a way, especially now that the CT scan has become the new physical exam.
                       
                      I do really enjoy studying and learning though, I would love to learn radiology in depth, which is something I feel like I haven’t had much time or motivation to do in internal medicine residency. 

            • jeevonbenning_648

              Member
              August 12, 2023 at 9:35 am

              As I mentioned above, you are still in the Western Hemisphere so you will be expected to work nights. Which I wouldn’t do for any amount of money. Not even $80/wRVU. That is why I made sure to reach FI first, that that I can choose exactly the type of lifestyle and work I wanted without compromising and personal beliefs or values. I know one guy 25+ years as a radiologist, who moved to PR to do telerads part time for the tax breaks. He wakes up at 3:30AM to do his shifts.

              • 22002469

                Member
                August 12, 2023 at 10:12 am

                Groups don’t care where you live, they just want to get the work done, particularly in this market. If you are going to be a faceless telerad anyway, they won’t care if you are in living Florida or Puerto Rico.
                 
                Now if you are living somewhere you can only do prelims, that’s of course going to affect which shifts you are able to do for many groups.
                 
                But generally speaking there are a lot of daytime full tele jobs available right now (paying less per wRVU than nights of course). Just because you or a couple friends didn’t find anything when you looked doesn’t make it so. 

                • jeevonbenning_648

                  Member
                  August 12, 2023 at 10:27 am

                  Think about what you just said. “They just want the work done”. Yeah and what work during what times do you think they need external telerad coverage for?

                  Their own employees are working the days (duh) and the work that nobody wants to do is evenings and nights, particularly nights. There is no free lunch.

                  They have plenty of coverage for day shifts they don’t need you out of Puerto Rico working the shifts that their employees and partners are already doing.

                  • 22002469

                    Member
                    August 12, 2023 at 10:33 am

                    If any particular group has plenty of coverage for day shifts already, then of course that group isn’t going to hire you (or anyone else) for a remote tele day job. And they won’t be advertising for such a job.
                     
                    But if a group is advertising for a remote daytime reader (as many are), then that means they are understaffed for days and you can do it from anyplace that allows you to read the cases. I admittedly don’t know all the logistics issues a rad might have reading from PR, but if you are credentialed and can sign off on the case the group won’t care.
                     
                    If you are willing to only do days and they have an opening, they won’t say “well since you are in Puerto Rico so you have to do nights or nothing”. That makes no sense. 
                     
                     

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 11:35 am

                      Just ask yourself if a group is understaffed for day positions, what would be the most likely scenario. Would they tell the group in so many words to just tough it out and help out more to cover it / hire an extra radiologist OR would they hire teleradiologists? If teleradiologists were cheaper or provided better reads and continuity of care then groups would not add new daytime employees or partners, they would just hire a few people and then next 30 hires would be teleradiologists if it was more economical or useful to the group. Just imo and in keeping with most groups saying “solely day time positions not offered”

                    • 22002469

                      Member
                      August 12, 2023 at 11:53 am

                      This is a confusing discussion as you are arguing against the existence of something that factually exists all over the place right now.

                      Check out the ACR job board or call around, plenty of places are understaffed and currently hiring daytime only work from anywhere Telerads.

                    • Unknown Member

                      Deleted User
                      August 12, 2023 at 12:02 pm

                      Yes bro

                    • afazio.uk_887

                      Member
                      August 12, 2023 at 12:41 pm

                       
                      Yeah I was having difficulty understanding the thread as daytime Tele is widely available. 
                       
                      That’s why you see all these Telerads pulling $1M+ a year right now. 
                      They do insane volume and volume is easily available right now. 
                       
                      Imagine pulling that income but effectively no income tax.  But yes, they can change the PR tax break easily someday. 
                       
                      I would actually consider setting up shop in PR as a Tele half the year and take the other half off, if I didn’t have wife and kids etc.  
                       
                       
                       
                       

                    • 22002469

                      Member
                      August 12, 2023 at 12:51 pm

                      It was a conversation between someone living in 2023 and someone living in 2013.

                      Strange indeed.

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 2:10 pm

                      “Are you a clinical teleradiologist looking for an exciting opportunity to work in Hawaii? The [link=https://protect-us.mimecast.com/s/qG9uC68pp7HGrLNOhpZSMH?domain=medicine.utah.edu][b]University of Utah Department of Radiology and Imaging Sciences[/b][/link][b] [/b]is seeking a talented individual to join our Teleradiology Section. As part of this role, youll have the flexibility to provide clinical services from the comfort of your own residence using our cutting-edge home PACS technology, primarily from 5 pm to 1 am Hawaii Standard Time (9 pm to 5 am Mountain Standard Time). Youll enjoy a rewarding work-life balance with one week (7 days) on clinical service followed by two weeks (14 days) off clinical service, which includes academic time.”
                       
                      Those are the hours in Hawaii. Featured ACR job listing. Wanna guess what the hours will be if you live on the mainland? Hint: Add 3-6 hours into the night.

                    • afazio.uk_887

                      Member
                      August 12, 2023 at 2:13 pm

                      Look, I’m not saying Telerad is some great gig. 
                       
                      It is obviously hard work, high volume and probably not that satisfying from a “being a physician” point of view. 
                       
                      All I am saying that we had at least 3-4 people come on this forum and quote (directly or indirectly) $1M annual salaries.   By itself, that can be compelling. 
                       
                       

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 2:20 pm

                      I stand corrected (somewhat). I scanned ACR job listings and there are some daytime positions available, but admittedly the minority at roughly 1:10 in quantity relative to the nighttime positions. With less favorable terms of course. But they are out there like you said.
                       
                      [b]Description[/b]
                      [b]Teleradiology Body/General/ED Work Anytime from Home, Ability to earn in excess of $840K, Benefits Eligibility [/b]
                      [b]ABOUT THE POSITION[/b]
                      Radia seeks a board certified or board eligible radiologist to work from home, anywhere in the United States.  Work at your own pace, whenever and as much as you choose.  Work is available at all times, and compensation is productivity based, with rates based on time of day.  Read a wide variety of general,  body and ED radiology exams, based on your individual skill set.  [b]Annual minimum of approx. 500 hours per year required. [/b]
                      This is an employed position with [b]completely flexible hours[/b].
                       
                      This sounds too good to be true. We have talked about the theoretically “log on anytime and read as much as you want” telerads gig, with no set hours. Didn’t think it was a possibility but here it seems to be the case.
                       
                      Has anyone heard of these positions popping up? I wonder what they pay per study.

                    • 22002469

                      Member
                      August 12, 2023 at 2:24 pm

                      They are all over the place, but generally low 30s/wRVU at best (often in the 20s). That’s the market right now, could always change.
                       
                      But no one has to be an overnight telerad if they don’t want to and are OK with mediocre rates. 

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 2:28 pm

                      I am okay with those rates for the flexibility to live anywhere in the world. Geoarb the same or better lifestyle as in the US at ~40% the cost of living. If I was paying US prices to live in the US and making only $25/wRVU I would understandably be pissed. I guess there are people out there that are happy to do it.

                    • mwakamiya

                      Member
                      August 13, 2023 at 2:06 am

                      “Are you a clinical teleradiologist looking for an exciting opportunity to work in Hawaii?
                       
                      Only a few issues — very high cost of living, limited everything in terms of options to go eat/shopping/activities/etc., tsunamis, hurricanes, fires, volcanic eruptions, travel to anywhere is a nightmare, 3rd world infrastructure, unreliable internet/electricity, etc. etc. 
                      These are part and parcel of ANY island in the world. 
                      I am sure someone will come up with some exception saying they lived there and it was the best thing since slice bread, but anecdotal exceptions do not negate the above truths. 

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 2:02 pm

                      Those are the outliers reading faster than the bottom 98-99%. Who told you they are reading during the day? There is one person I know (they are on this forum occasionally) that works 8 PM – 2 AM, and that early shift is not even available for new hires because its the least busy / least coverage needed shift. New hires are expected to work nights. Because nights are when regular employees don’t work. This isn’t rocket science. If it was so easy to make $1M from the comfort of your own home, more people wouldn’t be complaining about $400-500K day time PP salaries. > $1M is an outlier for a partner, its even more an outlier for a telerad contractor.

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 2:07 pm

                      Have you been to PR? I went in Sept 2022, so hot that even the locals were inside their air conditioned car 10 – 5 pm every day. I escaped the incoming hurricaine by a few hours, I took the last flight on Friday. Sat – Mon all flights were cancelled. I heard of the brown outs as well. The climate is a non-starter for me, and this is coming from an adventurous person.

                    • Unknown Member

                      Deleted User
                      August 12, 2023 at 3:17 pm

                      It is true. Plenty of day tele jobs advertised. Pay worse than night jobs and/or they want you to work 40+ weeks per year. On the other hand I do not see any jobs advertising “prelim reads” from a different country.

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 3:37 pm

                      You might not see them in the advertising, but there are plenty of them from word of mouth. That’s how I found it and now I’m licensed in 10 more states and will be starting my work from the Basque region of Spain or Malaga in a couple of months. Go East to Tuscany after a few months etc.

                      Payment rates of prelim studies are about 85% of those of final reads, and you can read them more than 15% quicker. So do the math.

                    • Unknown Member

                      Deleted User
                      August 12, 2023 at 5:58 pm

                      That’s interesting so one of those companies similar to vrad just filters your list for hospitals that accept prelims. I am curious what you would do with taxes? I’d be ok if taxes were the same as in the u.s. since usa would collect taxes abroad anyway. But most euro countries actually charge more than usa, certainly including Spain. Even those with “20% flat income tax” have a 35% social security tax or similar. I understand if you stay less than 6month you are not a tax resident on worldwide income, but dont u still have to report taxes that are made while on their soil? And I suppose you register a corporation in some foreign country and a company like vrad pays to that corporation? How does that work?

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 6:10 pm

                      Most countries don’t require you to file or pay any income taxes unless you’ve lived there for 12 months. Even after you hit that 12-month threshold, there are tax treaties and if you are working for an American company being taxed by the US, it would be a reciprocal treaty where you would only get taxed once.

                      Not to mention if you have an LLC taxed as an S corp technically you are not working in said country. Since you are not making any money in the country. Your company (LLC) is being paid by the telerad firm, then your accountant will determine how much you pay yourself when the time comes.

                      When what you’re talking about comes into play is let’s say you’re living in Spain and working for a Spanish company, the United States would tax your overseas income above the 110K threshold. After that, the tax treaty would kick in. Either way, you never would be double taxed.

                      You are putting the cart way before the horse my friend.

                    • jeevonbenning_648

                      Member
                      August 12, 2023 at 6:12 pm

                      If you want to start a corporation you would file the LLC in the US since you are working for US company. It would be idiotic not to mention not make any sense to start an overseas company when you’re working for a US firm.

                      Even having to file taxes in that country would only start after you live at least one year in that country, and as I said there are reciprocal tax treaties where you would file the taxes but you would only pay the taxes once.

                    • toumeray

                      Member
                      August 13, 2023 at 12:03 am

                      My understanding is that reciprocity agreements can get you out of double taxation but you will always have to pay the higher of the two taxes, ie if you live in a Nordic country which generally has higher tax rates, you have to pay them according to their tax laws minus whatever you pay to the US. Is this not correct? Obviously only after living for 12 months in country.

                      I also believe certainly state/regional taxes and locality taxes may have their own janky tax laws and be non reciprocal, ie the town in Spain in which you live might not have reciprocity and wants their cut of your total worldwide income. Probably varies on region/locality basis. Even within the US, some cities do this such as Philadelphia (if working in or for a company in Philadelphia you always have to pay their locality tax regardless of what other state or local taxes you pay).

                    • ruszja

                      Member
                      August 13, 2023 at 7:00 am

                      Quote from Alwaysbereading

                      My understanding is that reciprocity agreements can get you out of double taxation but you will always have to pay the higher of the two taxes, ie if you live in a Nordic country which generally has higher tax rates, you have to pay them according to their tax laws minus whatever you pay to the US. Is this not correct? Obviously only after living for 12 months in country.

                      There are a few moving parts to this:
                      – the applicable double taxation treaty
                      – the local tax laws
                      – having the right to either work in their country or the right to operate a business

                      When overseas tele was a business, the companies who did this in Israel, Switzerland and Australia spent a lot of effort to structure it in a way that made it legal and somewhat tax effective. As a solo actor you just have to hope that you get it right or that you are able to fly below the radar without attracting the attention of local tax authorities. Doable if you do the digital nomad thing. 3mo in Portugal, 3 mon in Spain, 3mo in Prague etc. Probably fun for a year, not sure it’s a career plan. Of course, if you have ties to an area, you can live a pretty nice life doing a few hours of scheduled overnight prelims for a US based customer and enjoying local life with the income it provides. That may be my retirement gig, who knows.

                    • jeevonbenning_648

                      Member
                      August 13, 2023 at 7:35 am

                      Keep in mind that different people want different length careers and want to retire at different ages. Some have to means/ability/desire to go part time earlier than others.
                       
                      What you described is simply teleradiology. If you don’t consider it a viable “career plan” you would have to tell that to every rad who is doing teleradiology.
                       
                      I agree with you doing telerads out of residency is not the best, but 5-10 years out I see no issue with it.

                    • ruszja

                      Member
                      August 13, 2023 at 9:45 am

                      Quote from Re3iRtH

                      Keep in mind that different people want different length careers and want to retire at different ages. Some have to means/ability/desire to go part time earlier than others.

                      What you described is simply teleradiology. If you don’t consider it a viable “career plan” you would have to tell that to every rad who is doing teleradiology.

                      I don’t think it’s a viable career plan to move from place to place on 3mon tourist visas while dodging the local tax authority [u]indefinitely[/u]. If you stay longer than a temp stay on a 3 or 6 month tourist visa, you need some type of ‘right of abode’ or permanent reidency.
                      Depends of course where you want to live, but in some of the central european venues, you actually have to show a residency permit in order to execute a lease for an apartment or house. Prob less of an issue if you aim for some developing country or Greece where all this is solved with an ‘envelope’.

                    • jeevonbenning_648

                      Member
                      August 13, 2023 at 9:53 am

                      You know that every country has about a dozen options of temporary/permanent residency? Do a little research and apply. If you want to stay longer you can. You are not dodging any tax authorities. First year you are not responsible for filing taxes in the new country, and after that you educate yourself. You will not pay taxes twice. People move offshore to minimize taxes. I understand people are conservative on this forum, but to the point of just criticizing everything or saying it’s too hard without actually looking into it.

                    • jeevonbenning_648

                      Member
                      August 13, 2023 at 9:55 am

                      That is the beauty of doing this. You don’t have to stay in any place if you don’t like it. If you do end up falling in love with any given place, there are dozens of options to stay there if you’d like. You are smart enough to get into radiology you could find out how to minimize your taxes offshore and get residency permits.

        • christopher.walker_148

          Member
          August 12, 2023 at 8:03 am

          Yes I have good steps and radiology specific research. I can say I enjoy the concept of interpreting imaging more than speaking with patients, although I’ve never actually interpreted imaging so it’s hard to say. 
           
          I can tolerate talking with patients or doing endoscopy all day, but frankly it’s not something that I need to incorporate into my day to day life. In fact I think the efficiency and lack of interaction in teleradiology would be much more enjoyable than the inefficiencies of clinical medicine. 

  • jeevonbenning_648

    Member
    August 12, 2023 at 9:26 am

    I left the US because I no longer saw the value proposition. You have to pay more for lower quality food, not good weather, less safety, and deal with a weird political agenda constantly. I’ve also found that in Latin America and Asia there was more emphasis on family and community.
    That being said, I have a few friends working in Puerto Rico doing teleradiology. You will not get daytime hours right off the bat. You are still in the Western Hemisphere are will be expected to work nights. There are no purely daytime positions in telerads, esp from the comfort of your home and them knowing you are in Puerto Rico. The best you will likely find after a few years is 9 pm to 2 am or 4 am to 10 am shifts from Puerto Rico.
    Respectfully, you are way to obsessed with arbitrary liquid net worth numbers that really mean nothing other than them looking nice on a computer screen. How much passive after tax cash flow is that $5M producing that replaces your day job income, that is the pertinent question to be asking. For one person that number can be $150K, another $750K.

    • jeevonbenning_648

      Member
      August 12, 2023 at 9:31 am

      I just spent a month in Colombia. Lots of preconceived notions and people telling you how great Colombia is. Mexico (and in particular cdmx) was much safer, much cooler climate, more delicious food and better food scene, and people were much nicer (spending 3 months in Mexico and 1 in Colombia).
      I reached FI/RE age 37 and have been traveling the world since. The places you think you will love you may not and vice versa. Have to live in the place first before talking about dreams and where you think you would like.
      I love your goal, I have had the same one and I am living it now in real time. Couldn’t be happier. You have no idea what its like to wake up every day and do the things you want to do the most in that moment. I can’t explain to you how joyful it is.
      I always recommend rads to med students that I meet. I know you are an IM doc but same concept.