Getting a Letter of Qualification from the IMLCC

I'm posting this because there are no posts on the timeline for IMLCC approval from application to Letter of Qualification.

In general, to obtain full medical licenses in various states across the USA, there are two primary methods:

1. Direct Application: This involves applying directly to each state's medical board, which can be time-consuming.
2. Interstate Medical Licensure Compact (IMLCC): Also known as a compact license, this allows physicians to apply for expedited licensure if they hold a full, unrestricted medical license in a Compact member state that serves as their State of Principal License (SPL). You can learn more about IMLCC and its requirements at https://www.imlcc.org/.

Here's a timeline detailing my experience with the IMLCC application process:

1. May 20th, 2024: Applied for the IMLCC and paid the $700 application fee.
2. May 21st, 2024: The Wisconsin licensing team contacted me to:
• Conduct fingerprinting for a background check. Completed on 05/24/2024.
• Complete additional paperwork (procedures may vary by state). Completed 05/23/2024
• Transmit USMLE/FLEX exam scores to the Wisconsin Medical Examining Board. Completed 05/28/2024
3. July 7th, 2024: I received my Letter of Qualification (LOQ) from the IMLCC.

Overall, the process took approximately 6-7 weeks from the initial application date.

For further details, please refer to the following links

• IMLCC FAQ section at https://www.imlcc.org/faqs/.
• Videos- Really helpful https://www.imlcc.org/videos/

How to buy a car at/below MSRP?

I bought my car (Subaru Forester LTD) in 2021, during the so-called car shortage which happened due to the micro-chip shortage during the pandemic. Since this was my first car, I was not really sure what I should be doing. During my research, I came across youtube videos by the 'Your auto advocate' group https://www.youtube.com/@YourAdvocateAllianceYAA  and started following them and learning more about car buying terminology through their free deal school course at https://community.joinyaa.com/c/deal-school/. It teaches you about car financing and quick terminologies to make you a smarter car buyer. 

After going through the deal school and learning the terminology/tricks of the trade, I created a pseudo-email account and started sending emails to different car dealers in the area, since I did not want to be spammed by the dealers with their 'last-minute' deals. I used the email templates that the team at @yaa so painstakingly have written, which can be found here [https://joinyaa.com/guides/email-templates-to-buy-a-car-online/] I am sure they have updated the templates since the last time I used them, but I got a decent deal on my car so I have no qualms in recommending them. Please note: The dealer will ALWAYS try to get you to come to the showroom to give you a good deal, but please do not fall for that trap. If they cannot send you an email with their so-called 'good deal' then it is NOT worth driving to the dealership. If they want your business they will need to work with you for it. 

Also, the yaa group had an add-on that looked up the car's VIN and could tell you have long the car sat on the dealer's lot. This just gives you some bargaining power when you are at the dealership. https://joinyaa.com/cars/#/ 

So coming to my journey. I started scrolling through the videos as noted above at the beginning of 2021 to just understand stuff. I started my search in earnest on June 20th, 2021, and finalized the car by June 22nd, 2021. I work in Wisconsin and I am comfortable driving around for a good deal, I contacted dealers in Illinois, Iowa, Minnesota, and Wisconsin. The dealers in Chicago gave me the best quote but the dealer in Iowa was amazing. Since in addition to the deal, he was ready to give me a FREE loaner vehicle till my car came in, and hence I decided to go with him.

The breakdown of my deal is approximately like this.
$ MSRP
-$2,566  Discount
$MSRP-discount-> Sales Price plus state tax and fees

Thanks to my credit score I got 0% financing for 36 months and hence I am paying it over 3 years.  I really could not have done/learned how to buy a car without the team at your-auto-advocate and a big thank you to Zach Shefska, Ray Shefska Kimberly Kline, and many others who directly/indirectly helped me in finalizing the deal.

The dealership that I worked with was C&S Subaru in Waterloo [www.candscarcompany.com] and the person I worked with was Mr. Scott Thurn. (319) 291-7321 Office; (319) 415-8051 Cell

Things that I liked about my dealer

1.  The deal (got it below the MSRP)
2. Free loaner vehicle till the car came in 
3. Just being very responsive and super helpful and no additional sale gimmick. 
4. Even though he got the car I wanted from a nearby dealer he did not up the price because of that.

If you need any more detail please let me know.

Neil Fernandes

How/where do I open a Roth individual retirement account?

This post is NOT financial advice and I AM NOT A FINANCIAL advisor. Please talk to a financial advisor if you have one. 

This post is on how to open a Roth IRA while in training (residency/fellowship) and save 6k in a tax-free account per year (this post is in 2021 when the contribution limit is 6k). The general rule of thumb is to go for Roth (post-tax) when you are in training and a pre-tax (traditional) account when you are in your peak earnings (attending) years [Reason for this advice is your tax bracket changes based on the money you make].

One can open a Roth IRA account in ANY of the well-known trading companies like Vanguard, Fidelity, Charles Schwab, etc. The drawback of these companies, at least for me at the beginning of my financial journey was not knowing what to invest in. In other words, I really did not know much about the stock market, index funds, etc. Hence, for those who are still new to investing and want to play it safe but still get a head start on investing I recommend the company Betterment to do the investing. They generally invest in low-cost index funds which is what you want to put your money in instead of stock-picking. 

1. Once you open your account via the above link or http://betterment.com/friend-referral-offer?referral_key=neilfernandes2 you will get to a page where you will have to open your account. 
2. In the middle of the page, you should have an option saying 'Get Started'
3. Click on that and then go through the steps (should be pretty self explanatory)
4. Once the account set up is done you should reach the following screen 
   
   
5. Click on the option 'Invest for retirement'
6. Fill in the details (another couple of sell explanatory questions)
7. Towards the end, you will have an option to open a 'Roth IRA' which is what I would pick
8. Decide on how you will fund the account-> transfer the money-> and bingo you are done. 
9. You are now a proud owner of a Roth IRA. Money grows now tax-free!

Please note that Betterment charges you an advisor fee, which is around 0.1% or something like that which comes to a couple of dollars. Once you do become financially literate, you can rollover the money to another account like Vanguard or Fidelity which should be really easy to do. However, when you are taking baby steps in the journey of financial planning and while you are learning to become a better doctor, worrying about money should be the last thing for you.

A big thank you to the Whitecoat investor for helping me start on my financial journey!

Tips for new attendings

I had written on a post when moving between residency and fellowship. You can find the link here http://neilnf.blogspot.com/2018/06/moving-tips-for-residents.html   

I am updating the post to make it more all-inclusive and financial savvy. 

Things to do before graduating and planning the move.

Disability insurance: 

This is one thing that skyrockets as soon as you get out of residency/fellowship. I would try to get this one ASAP since your earning potential and disabilities will only go up as you get older. This insurance just safeguards your family and you, should something happen to you. I have found the following links to be really useful when trying to understand disability insurance and would recommend reading the same. 

The White coat investor is an amazing site for financial literacy, and this is the one for disability.

• https://www.whitecoatinvestor.com/disability-insurance-introduction/. It is a series and I would try to go in order

The following links are quick facts on the same so that you can quickly understand it.

• https://www.whitecoatinvestor.com/what-you-need-to-know-about-disability-insurance/
• https://www.whitecoatinvestor.com/top-ten-questions-physicians-ask-about-disability-insurance/

Group vs individual (an eternal dilemma during residency is if we need it but I hope these links are useful)

• https://thephysicianphilosopher.com/group-disability-insurance/
• https://www.whitecoatinvestor.com/ama-disability-insurance/ 
• https://www.whitecoatinvestor.com/how-i-review-existing-individual-disability-policies/

Utilities

You will have to end your current utilities i.e., water, electricity at your current place and begin the same at the new location.

Use USPS mail forwarding service to forward any/all mail addressed to you at your old location to the new place https://bit.ly/3pPwqia. There is a charge of <$2 when I did this, but this is worth it.

Bank accounts

• Close old accounts that you will not use and streamline the ones that you will use going forward.
• Consider opening a new bank account in the new job place to get account opening bonuses (check https://www.bankrate.com/banking/ or https://www.doctorofcredit.com/best-bank-account-bonuses/ for the latest information.
• I would recommend updating your banks with your new details around 2 weeks before the move since this will help you in using the same as address proof for getting your driver’s license (they need 2 forms of address proof). 

Credit cards

Consider opening new credit cards since you may have a LOT of expenses while you are house hunting/doing a house make over. My list of credit cards is as follows https://maxrewards.app/refer/neilf120 

International graduates

Do not forget to update USCIS with your new address since your immigration is linked to the same. https://www.uscis.gov/addresschange 

Financial tips

This podcast/video by the white coat investor is worth a watch https://www.whitecoatinvestor.com/financial-priorities-as-a-new-attending/. In summary

1. Do a back door roth IRA 
2. Max out the 401k/403b
3. Max out the 457b if available- This is a judgment call since it depends on the financial stability of your practice.
4. Max out the HSA (please note that you can contribute money ONLY for the months you are eligible) For example, for me I became eligible in Aug and hence I can contribute only 300*5months= $1500.
5. DO NOT opt for COBRA since you can retroactively activate it should you become ill.

#tipsfornewattendings

Sending/receiving money from your loved ones

So should your family want to send you money from your home country (for me it is India/INR) to the place you are currently living (for me it is the USA/USD/$) how would they have to go about it? The general norm/websites that I could find always go the opposite (from the USA (USD/$) to India(INR/₹), but should you need to do India to the USA this post should help you.

I personally use Transferwise to do the transaction. The minimum/maximum amount that one can transfer will be based on which country you are sending the money from. The money generally gets transferred in 3-4 business days and you can get the best rate possible, which means more money to you. The setup process is simple but you will need some sort of identification (driver license/passport), to make sure you are a legit person and not a computer bot. So one can create an account for his/her family and himself/herself and get money with not a lot of hassle.

The entire process (from the person sending money) in short is as follows. 

1. You need to open an account with Transferwise. You can use my referral link here and get up to 600USD for free with no transaction fees.
2. You have to confirm that you are a human being and they ask you for either driver's license/passport for identity verification purposes
3. How much money you want to send. You will get to know at this step HOW much the receiving person will get along with the transaction fees that they will charge 
4. Who do you want to send the money to- You will need information on the receiving person (their bank account details like account number and routing number)
5. How would you like to pay: They give options for bank transfer/card transfer (depends on the country you are sending the money from)

Now should you choose bank transfer in the above step, the way that I understand it is that you have to make a transfer to THEIR (transferwise) bank in your home country and then they transfer the money to THEIR (transferwise) bank in the recipient country and then to YOUR bank account finally. In all, this is the reason for the lag period of 3-4 days, given the multiple middle players. OR you can watch this video where he explains the process. 

The other reason I like transferwise is that they will give you a debit card, in which you can open an account in any country in the world and it will function as a traveling card! So instead of getting a cashier's check for my trip to Europe or use my credit card with no transaction fee, I can just open an account in the local currency, and then I can transfer my money to that account. The exact details can be read about over here or watch the video here

What are the ways you transfer money to or from your home country? Let me know in your comments and I can update the post should it be useful.

Fellowship application timeline

This is regarding my fellowship application for Pediatric intensive care application. This is based on my personal journey. I had a LOT of help during the same and I am ever thankful for my mentors, seniors and colleagues for guiding me through the way.

First off, once you have decided you want to pursue a fellowship I would start working on building contacts in the field. I spoke to my seniors and mentor and asked what I could do to make myself more marketable.

Couple of things that I did/things that were recommended

• Away electives- If your program lets you do so. Generally, helps in building rapport with attendings at other programs and thereby your network.
• Research in the field of your interest/application
• Presentations: Try presenting at a National conference if possible in your 2^nd /3^rd year of residency prior to applying for a fellowship if possible.
• Work on your personal statement during your down-time in 2^nd year. Since this is generally the bane of existence for most residents

For Pediatric fellowship the time line is a bit as follows

Somewhere in the middle to end of June	Apply for a token to create an ERAS account
End of June to 2nd week of July	- Work on the ERAS application. - Get LOR’s (take into consideration that your attendings are busy and have a life of their own! They will take at least 2-3 weeks to write you a STRONG LOR. Do consider that it takes 5 business days to upload the same to ERAS. The Program Director LOR has to be one of the 3-4LOR’s that you send to programs) P.S.- You should be dropping hints to them in the end of May that you are expecting them to write LOR’s for you in case I missed mentioning that.
2nd week of July	You can technically apply if your application is ready to the programs. P.S- The programs CANNOT see your application yet
July 15th	Moment of truth. This is when the real application begins, and programs call for interviews
July 15th till the mid November	Interviews take place here. So, a lot of post call travelling and leave requests and what not. Finances/travelling tips for fellowship interview in another post that you can find here
Mid October to end of November	Work on your ROL. Trust me a month seems like a LONG time
End of November to Mid December	The MAGICAL match process takes place in NRMP. Start praying for good news.
Mid December	Cheers! You have matched at your desired program!  If not take part in SOAP (post-match scramble in residency)

Please note: NRMP token opens somewhere in between. I do not remember the exact date unfortunately.

Tips on looking up programs

•  Talk to seniors, attendings on the places you are applying to PRIOR to applying.
• Visa is another criterion that some of us used prior to applying. Unless you do not have such restrictions
• FRIEDA is a good place to read on programs as well
• Lastly email the coordinator for places that you have no information on. They will generally get back to you within 2-3 days.

 Hopefully this helps all individuals who will be applying the following year for fellowship! Best of luck and fingers crossed

Credit Cards and Terms made easy

I am not sure how far it is true. But referral links seem to help some people get credit cards quicker than if they try to apply for the card themselves.

Just as an FYI, some people wonder what it is to have a credit card and what does it entitle you to 

• Credit line- This is your spending limit
• Cash access- When you use your credit card to withdraw money like a debit card
• FICO score/credit score- It measures your credit worthiness to credit card companies. It is a BIG deal in the States, at least if you planning to buy a house or take a huge loan. A good number is anywhere >700 I believe and an ideal number is >750. This site is useful for people interested in knowing more about credit scores. Factors that impact the score

1. Payment history (35%) Timely payments on all your accounts can help you get a higher score. The score is lowered for late payments, delinquent or over limit accounts, bankruptcies, and liens.
2. Total amount you owe (30%) This is the ratio of what you owe to the amount of your available credit or your debt-to-credit ratio. A high credit card balance can lower your credit score as it may reflect difficulty affording your monthly payments. However, if you have a high credit limit and you keep your balances low, your debt-to-credit ratio will be low, so a higher credit limit can help you protect your good credit score. But this is only the case if you continue to keep your balances low.
3. Length of credit history (15%) This shows how long you've been using credit and how well (or poorly) you've managed your finances in the past.
4. New credit accounts and inquiries (10%) This includes accounts you've opened recently and recent inquiries from companies you've applied to for credit. Be aware that applying for too much credit can lower your score.
5. Types of credit in use (10%) This includes all your credit accounts—credit cards, installment loans, mortgages and other types of credit.

• You can also use credit score checking sites like Credit Karma or Credit Sesame which helps to keep track off credit checks on your account

Example for the use of a credit card-

I want to buy a 4K item but I have only 2k in my BANK account. For people from my country where debit is the mode of payment, one would have to wait till you have the money to buy things and only then can you buy it. This is where a credit card comes into play, it gives you the power to pay for stuff that you DO NOT have money for at the moment. So say I have a credit line of 5k, now I can definitely buy this item since it WITHIN my spending capacity, in other words, I have an invisible amount of 5k which can be used to buy it. Now the only trick is that you HAVE to pay off this balance before the set due date on your credit card. So you have to link your bank account to this credit card and pay off the amount you spend on it. PLEASE NOTE YOU HAVE A DEADLINE for payments, so if you are sure you WON'T have the ACTUAL money to pay off the credit card DO NOT, I repeat DO NOT BUY the item.

People do say that one should not MAX out a credit card. It means, if I am not mistaken, DO NOT over spend. So say the item was 6k and your credit card limit is 5k, then sorry to say my friend YOU CANNOT buy the item ONLY on the credit card. However, you can pay 4.99k from the credit card and the rest from the 2k that you have in your bank account. Once again a reminder YOU HAVE to pay off the credit card before the due date for the card.

Now coming to the actual credit cards for people, the following are some credit cards that I have which I feel are useful

Discover

This was my first credit card. I got it when I had no history and I guess the referral from my friend made the difference, since I know of people who did not use a referral and were rejected. So in case you want a referral this is my referral link

Pros

-         I feel the cash back bonus in different categories is extremely useful. Details can be found here

-         Also, link this card to your Amazon account and see the rewards building.

-         There is a promo that at the end of your first year, they will double your reward points which is pretty good

-         You can also get referral bonus of 50 bucks which is a pretty sweet deal to be frank

-         You get your FICO score for free on a monthly basis (when you have at least 6 months of history if you are an IMG like me)

Cons

-         International transactions are charged an extra of 3%

-         It at times is NOT accepted everywhere

Chase Freedom

This is one of the steady cards that I know off. I heard rumors of this card shutting down since there is Freedom Unlimited, but I highly doubt it. This is a card one must get once your Discover card starts showing you a FICO score. So in case you want a referral this is my referral link

Pros

-         The card is by Chase, which is a big name in the banking sector

-         Rotating 5% reward categories like Discover, calendar can be found here

-         You earn a $150 Bonus after you spend $500 on purchases in your first 3 months from account opening

-         Unlimited 1% cash back on all other purchases - it's automatic

Cons

-         You don’t get a FICO score like Discover

_____
    I have switched from sapphire preferred to freedom unlimited due to the fact that I earn 1.5x points for everything. My referral link is here.

Chase Sapphire

A sleek metal card design which was my BIGGEST reason to get the card. So in case you want a referral this is my referral link

Pros

-         You earn 75,000 bonus points when you spend $4,000 on purchases in the first 3 months from account opening. That's $625 in travel when you redeem through Chase Ultimate Rewards®. (I now it is a A HUGE AMOUNT, but guess offering to spend for others helps here)  

-         For those who travel and eat A LOT, you get 2X points on travel and dining at restaurants & 1 point per dollar spent on all other purchases

-         Earn 5,000 bonus points after you add the first authorized user and make a purchase in the first 3 months from account opening- You can add random person and once they swipe destroy the card

-         $0 foreign transaction fees- This is another awesome feature when traveling outside the States

-         1:1 point transfer to leading frequent travel programs at full value - that means 1,000 Chase Ultimate Rewards points equal 1,000 partner miles/points- I have NOT used this feature but it is really enticing

-         Travel confidently with premium Travel Protection Benefits, including Trip Cancellation/Trip Interruption Insurance, Auto Rental Collision Damage Waiver, Trip Delay Reimbursement and more

Cons

-         Annual fee after the first year $95, which though is high I feel is worth the cash back

-     

That's all folks for now!