Here's a question I hadn't even thought of until recently: Am I still in my prudent era? Does my namesake still hold? But first, why did I even start thinking about this over the past week?

Well…a few weeks ago, our plastic surgery residency graduated its very first chief resident. Now, if you've never been part of a surgical training program, there is a tradition that accompanies this milestone that I have been looking forward to for years: the Chief Resident Roast. Back when I was a resident, this was one of my favorite events every year. The chief resident gets up and roasts the attendings and co-residents. The junior residents roast the chief. Everybody gets made fun of. Everybody laughs. And if it's done right, nobody takes themselves too seriously.

When our department started a plastic surgery residency 4 years ago, I was excited for a lot of reasons. I love teaching residents. I enjoy the academic side of medicine. But I'd be lying if I said the return of the Chief Roast wasn't somewhere on the list.

This year was our first chance to bring that tradition back. And our chief absolutely crushed it.

The Joke That Hit Close to Home

One of his jokes during the roast was aimed at me was whether I have any business running a blog called The Prudent Plastic Surgeon.

He put up pictures of our house. He referenced posts where I've talked about spending money on things. Basically, he built a case that if someone stumbled onto my blog today without any context, they might reasonably conclude that the “prudent” part of the title is a little misleading.

Honestly, it was hilarious.

But like most great roast jokes, it was funny because there was some truth to it.

And on the drive home, I found myself asking: Am I actually still in my prudent era?

The Beginning of My Prudent Era

Six years ago, when I started this blog, the answer would have been easy.

Back then, I was coming out of residency and fellowship after experiencing significant burnout. Financially, I wasn't exactly starting from a position of strength. I had about half a million dollars in student loan debt. I had credit card debt. And I had no real savings. No investments. And despite spending over a decade becoming a physician, I knew very little about personal finance.

Like many doctors, I had become an expert in my profession while remaining almost completely uneducated about money.

That was really the beginning of my prudent era.

And if I'm being honest, prudence wasn't optional at that point.

It was necessary.

Phase One: Survival

Looking back, I think there have been several distinct phases in my financial life.

The first was survival.

The goal was simple: stop digging.

Pay off bad debt. Learn how money works. Create a plan. Start building positive momentum.

For many physicians, this phase feels overwhelming. We finish training with enormous earning potential but often find ourselves buried under mountains of student loans and years of delayed financial education. That's exactly where I was.

The key wasn't doing anything fancy.

The key was simply deciding to take control.

Phase Two: Building the Foundation

The second phase was foundation building.

This was where the savings rate really took off. During those years, our savings rate frequently lived in the 40% to 50% range. Every extra dollar had a purpose. We paid down debt aggressively. We maxed out retirement accounts. Plus we started investing in real estate. We built passive income streams.

Everything was geared toward creating a solid financial foundation.

At the time, it sometimes felt extreme.

But it worked.

Our net worth climbed from deeply negative territory to zero. Then it crossed six figures. Eventually it crossed seven figures. Today, our net worth is over $2 million.

Looking back, those early contributions were incredibly powerful. The dollars invested during those years will likely have a larger impact on our eventual financial independence than many of the dollars we're investing today.

That's the beauty of getting started.

Phase Three: Equilibrium

What's interesting is that somewhere along the way, without really realizing it, we entered a different phase.

And I think that's what our chief resident was poking fun at.

The reality is that our financial life today looks very different than it did six years ago. We're still saving. We're still investing. And we're still building wealth. But our lives are no longer entirely centered around accumulation.

Our savings rate today is probably closer to 20% to 30% than the 50% range that defined those earlier years. All of our debt is gone outside of our mortgage and a very small amount remaining on a car loan. The systems are in place. The investments are compounding. The foundation has already been built.

I've started thinking of this as the equilibrium phase.

In the beginning, every financial decision felt critical because it genuinely was. When you're half a million dollars in debt, every dollar matters.

Today, every dollar still matters, but in a different way.

Now the question isn't always, “How do we save more?” More often, it's, “How do we use our money in a way that aligns with our values?”

That's a very different question.

An Example of What Prudence Looks Like Today

One thing that hasn't changed is our focus on keeping fixed costs relatively low.

In our household, we really only have two major fixed expenses: the first is our mortgage, which we still pay extra toward every month. The second is private school tuition.

Soon we'll have three children in private school, which is certainly not inexpensive. This is something we've gone back and forth on over the years. But our older kids have had a fantastic experience. They've made incredible friends. Their education is extremely important to us. And we've decided that this is an area where we're willing to spend money.

Importantly, it's still a choice.

If our financial circumstances changed tomorrow, we could send our children to public school. We don't want to do that. We don't anticipate doing that. But maintaining flexibility matters.

That's one of the lessons I've learned over the years. Prudence isn't necessarily about spending as little as possible. It's about avoiding financial decisions that eliminate your options.

Frugal and Prudent Are Not the Same Thing

Because if I'm being completely honest, I don't think anyone could reasonably call me frugal anymore.

At least not in the traditional sense. But I also don't think frugal and prudent are the same thing. There was a time when being prudent meant squeezing every possible dollar toward debt payoff and investing. That's exactly what our situation called for.

Today, our situation is different.

Today, prudence looks a lot more like intentionality. We spend money on things that matter to us. Like experiences. We spend money on our kids. We spend money on things that make our lives better. But every dollar has a purpose.

That's the key.

Something that seems completely unnecessary to one person may create tremendous value for another. The goal isn't to spend as little as possible forever. The goal is to ensure that your spending aligns with your values.

That's very different.

The Real Purpose of Money

The older I get, the more I realize that the goal was never to accumulate money for the sake of accumulating money.

Money is a tool. Financial independence is a tool. The purpose of building wealth is to create freedom, flexibility, security, and options.

The years of aggressive saving and investing weren't the destination. They were the foundation. And foundations are meant to support something.

I think that's what this equilibrium phase is really about. We continue investing. We continue building wealth. Our investments continue compounding. But we're also allowing ourselves to enjoy the life we've spent years building through medical school, residency, fellowship, and practice.

After all, if you never allow yourself to enjoy the benefits of the foundation you've built, what was the point of building it in the first place?

The Next Phase

Eventually, there will be another phase.

That phase will be retirement, whether it's traditional retirement or some version of financial independence.

At that point, we'll stop accumulating and start living off the foundation that was built during all those earlier years. Rather than contributing to our nest egg, we'll rely on it.

I suspect that's still a long way off. For now, though, equilibrium feels about right. The investments continue growing. We continue contributing. And we continue trying to balance preparing for the future while enjoying the present.

So Am I Still in My Prudent Era?

Here's where I've landed.

If prudence means being frugal at all costs, then no, I'm probably not in that phase anymore. We spend money on things that matter to us. Like travel. We pay for private school. We enjoy the life we've worked incredibly hard to build.

But if prudence means being intentional, making sure your money aligns with your values, maintaining flexibility, and continuing to build wealth while enjoying the journey, then I think I'm still very much in my prudent era.

It just looks different than it did 6 years ago.

And honestly, I think that's exactly how it's supposed to be.

The Most Important Step

One final thought.

If you're reading this and you're still in the survival phase or the foundation-building phase, don't get discouraged. It doesn't matter whether you're a medical student, resident, fellow, new attending, or twenty years into practice.

The most important thing isn't when you start. It's that you start. Earlier is better. But today is always better than tomorrow. That's true whether your net worth is negative $500,000, zero, or positive $2 million.

Because the thing that changed my financial life wasn't reaching any particular number. It was deciding to begin. Here are some good universal first steps (as well as some tips if you are a bit further along in your clinical career)…

What do you think? Am I still in my prudent era? Are you in your prudent era? What does that mean to you? Does it ever change? Let me know in the comments below!