AS PHYSICIANS, WE’RE ACCUSTOMED TO CHANGE. During training, rotations often take us to towns both large and small, with frequent moves that can make uprooting feel almost routine. Landing our first attending position might seem like a familiar shift—just with better pay. But this transition holds unique financial implications. Decisions made in this period can set the stage for our financial futures, particularly when that attending salary feels like a sudden windfall compared to residency or fellowship earnings. 

Conventional financial wisdom advises treating a windfall carefully: Hold on to the money for a while, avoid hasty decisions, and proceed with purpose. For new attendings, however, this advice is easier said than done. Moving to a new city and setting up living arrangements mean immediate financial commitments, often requiring choices that can feel overwhelming with the influx of income. 

It’s easy to overestimate how far a new salary will stretch. Tax implications and student loan payments can hit hard, sometimes after big decisions—like buying a house—have already been made. Many attendings quickly feel financially stretched despite their higher income. But with mindful planning and a bit of restraint, new attendings can set themselves up for significant financial progress. The three particular biggest expenses to watch out for while being in a new town are housing, cars and food. 

Housing 

After years of delayed gratification, it’s natural to crave that dream house—but consider waiting just a bit longer. Data shows that new physicians stay in their first job for only about two years—an unexpectedly short time to own, sell and recoup on a home. Selling a house too soon can result in losses. 

Renting in your new city allows you to get to know the area, your neighborhood and your workplace, buying only once you’re confident you’ll stay. If you’re familiar with the city and committed to buying, stay conservative. Buy just enough house to meet your needs. It’s much easier to upsize after a few years than it is to downsize. Keeping housing costs reasonable allows for strong financial growth and early financial independence. A quick calculation can help: Add your monthly mortgage, insurance and tax payments along with other debt payments, and keep this total under 36% of your gross monthly pay. The lower, the better.

Cars 

Transportation is another major budget item, often with hefty loan payments. Yet this expense is entirely optional. If possible, consider keeping your current car until you can pay cash. While saving that amount as a resident might seem impossible, an attending with reasonable housing costs can save that within a few months. Fewer monthly expenses and no interest payments allow for faster financial growth. 

Food 

Food costs, though variable, are one of the biggest controllable family expenses. In a new city, take the time to explore all your grocery options, including budget stores like Aldi and Costco. Shopping around can make a big difference in monthly costs. Try different stores and mindfully select where to shop after some experimentation. Moving provides a fresh chance to establish cost-effective shopping habits. Batch cooking, or preparing large quantities of food at once, can also minimize last-minute takeout and make dining out a treat rather than a routine expense. 

Set yourself up for financial success 

By carefully managing housing, transportation and food costs, new attendings can create a stable financial foundation. With a bit of mindfulness and intentional choices, you’ll set yourself up for long-term financial success in your new chapter as an attending. •