The money checklist for your first attending year

Protect the income before you optimize it

Your ability to earn is the largest asset on your balance sheet, and it is the one nobody thinks to insure first. Own-occupation disability coverage is the specific thing to ask about, because it pays if you cannot perform your own specialty rather than any work at all. For a proceduralist, the distinction is the entire point of the policy.

If you have people who depend on your income, term life belongs in the same conversation. Both are cheaper to secure while you are young and healthy, and both get harder to obtain after a diagnosis that has not happened yet.

Decide the loan strategy on purpose

Student loans deserve an actual decision rather than a default. The right answer depends on the interest rates, whether you may qualify for a forgiveness program, whether your employer is a qualifying institution, and how the numbers interact with your tax situation.

The reason this cannot be answered with a slogan is that the paths diverge sharply. Aggressively paying down loans and pursuing forgiveness can be close to opposite strategies, and switching between them late can waste years of progress. Model it once, properly, then follow the plan.

Let lifestyle rise, but on a schedule

The advice to "live like a resident" is well-intentioned and rarely survives contact with a real life that has been deferred for a decade. A more durable version: decide in advance what share of the raise goes to saving before any of it reaches your checking account.

If saving happens automatically at the top, the rest can be spent without guilt or tracking. That is the whole idea behind reverse budgeting, and it works precisely because it does not depend on willpower at the end of the month.

• 01Own-occupation disability coverage in place
• 02Term life if anyone depends on your income
• 03A modeled decision on loans, not a default one
• 04Retirement accounts funded automatically from the first paycheck
• 05An emergency fund sized to your actual fixed costs
• 06Beneficiaries updated on every account

Fill the accounts in a sensible order

Capture any employer match first, since declining it is turning down part of your compensation. If you have access to an HSA through a high-deductible plan, it is worth understanding: contributions, growth, and qualified withdrawals each receive favorable tax treatment under current rules, which is unusual.

After that, the order depends on your bracket now versus what you expect later, which is exactly the kind of thing worth modeling rather than guessing. Practice buy-ins, if one is on the horizon, change the calculation again and are worth planning for early.