Hey, it’s Carlos.

Welcome to the first issue of The Wealthy Attending!

Today, I want to give you one simple move that makes the rest of your financial life much easier.

(and most physicians never learn it)

A few years ago, I met a general surgeon who had just started making $325,000 right out of training.

In our very first meeting together, he looked at me and asked: “Why do I still feel broke?”

We laughed, but he wasn’t joking.

Most physicians step into attending life and expect the money to fix things.

And when it doesn’t, they think the solution is to “live like a resident.”

But you don’t need to punish yourself to build wealth.
You simply need to control your burn rate.

Burn rate decides:

Burn rate is the speed at which money leaves your life.

If your take-home pay is $17,000, and you save $3,000, your burn rate is:

$14,000/month

That’s the true cost of your lifestyle.

But here’s what’s so hard to anticipate coming out of training:

When you go from PGY to attending, your burn rate jumps 40–70% overnight.

Even if you don’t consciously “upgrade” anything.

Burn rate doesn’t rise from one big choice,
but from a hundred tiny upgrades you barely notice.

And this is where almost every new attending gets blindsided.

Below are the two most important sentences in this entire newsletter:

Cutting spending reduces what leaves your account.

Controlling the gap reduces what’s available to spend.

The gap is the real engine:
Income – Spending = Savings

The formula never changes.
But how you influence it does.

Most people try to widen the gap by cutting expenses.
That may work for a while, but it relies on discipline.

And discipline collapses when life gets busy 🙃
So top attendings widen the gap from the top.

Automatic saving solves the burn rate problem in a way budgeting never will.

Here’s the structure:

Income → Automatic Savings → Remaining Income → Spending

On the first of every month, move a set amount from checking to your investment account.

This lowers the “top number” — the money your lifestyle can reach.

Your lifestyle adjusts on its own.

Then the magic happens:

As a wealth advisor for physicians, I see this missing all the time.

Here’s what most physicians do instead:

Spend first → Save what’s left

That fails at $200K.
It fails at $300K.
It even fails at $500K.

Your lifestyle always expands to available income.

Take-home pay: $16,000/month

Scenario 1: The Traditional PGY-to-Attending Jump
You try to “spend less.”
Savings swing all over: $1,500, then $500, then nothing.

Your gap collapses.
Your progress stalls.
You feel behind again.
Rinse and repeat (until the end of time).

Scenario 2: Physician Who Controls the Gap
You automate 25% savings.
$4,000 leaves your account on day one.
Your real spendable income becomes $12,000/month.

That’s $48,000/year invested on autopilot.
Nearly $250,000 in five years before growth.

No budgeting.
No tracking.
No guilt.

Just structure.

You can try to spend less.
But I’m telling you this as someone who’s walked a lot of new attendings through this moment:

The day your burn rate becomes intentional is the day everything gets lighter.

This is the foundation of financial freedom for physicians.

And that’s all I want for you — not perfection or restriction, just a system that lets you enjoy your life and build the one you want next.

If you want to see how this applies to your own finances, just reply to this email.
I’d love to hear what’s on your mind.

You can also sign up for a free one-page financial plan.

I’ll give you a clear snapshot of your burn rate, savings, debt, taxes, and investments…personalized to your situation.

That’s all I’ve got for today!

See you next week.

— Carlos

P.S. You don’t need a hundred changes. You just need the right next move.

P.P.S. No matter where you are, there’s always a next move.