You say you are not yet a Dad, but trying... so why not stay where you're at, doing what you're at, for as long as you can...
Who knows how long it will take you to have your own child or to adopt if that's your decision ( We've done both ), and it may be that by the time the baby comes you're AT the point where you can turn it into a work from home situation and get the best of both worlds.

I guess the only advice I could give you would be to search deep for what you truly want out of life. No amount of advice, books, classes, or forums could have prepared me for either the highs OR the lows I have experienced as a SAHD, but I wouldn't trade it for anything else out there.

this would be a no brainer. Wife is making plenty and then some, 2 hr commute each way, give up a 60K to potentially 100K job (yawn) to be with my kids (when they arrive) and wife.

I'd be looking for a place to live close to my wifes work, planning and preparing to devote my life to my family, buying all the things I've always wanted with the bank roll the wife is pulling in, taking plenty of sexual enhancers to help get the whole ball of wax rolling along and thinking of clever ways of telling my boss where to go and how to get off.
But that's just me, a full time SAHD who also works to help make ends meet. I'd say time is on your side and you're potentially looking a gift horse smack in the mouth, all depends on you.

If you give more details about why you are torn with having to leave your career, I and others could likely answer more specifically. Good luck...

You're an urban elitist
I'm Not a Slacker

Your wife is making a lot of coin. Though a bit simplistic, ask yourself -- if you switched positions with her and were the one pulling in $600K while she held onto a good but inconvenient job, one that required her to live outside the home for a few nights each week, would you not want her to stay at home? If the answer is, "Not necessarily," I guess you have something to think about. But if your answer is a trigger quick, "Yes, I'd expect her to stay home," then I think you should consider doing the same.

FWIW -- I made similar money to you and my wife is also a physician (though not a radiologist -- I need to have a word with her about her chosen specialty!). I worked (and traveled for work) for a while but soon realized that the time away from home and the otherworldly craziness of our lives was worth neither the job satisfaction (and I loved my job) nor the extra money. Though being away from the office has taken some getting used to, I love what I am doing today.

I decided to become a S@HD when, besides my wife support:

0. My baby son was born
1. My wife job was more satisficing and needed than mine (she does research in alzheimer's disease)
2. We decided to grow a healthy baby, so been aware of all the process.
3. We don't want to outsource our parenting responsibilities and happiness
4 and most important, we want to have the Peace of Mint of having our son under our own care.

The money was a factor but no the big one. Actually we were making, by far, less than your wife alone is gonna make.

So, take the time you need to reach a good decision. I guess right now you are no in hurry, talk with your special other and be aware of whatever you and your other half decided, it should be with mutual respect, love, courage, and for a better future of the family.

======================
Congregatio pro erudio et auxilium
Information Technology User X
Itux

I'll try to answer each poster briefly:

Ironcat:
Waiting for a while longer is an option, but I'm very burnt out on corporate America. I'm dying to leave. But I'm equally dying to get a promotion, work in a better position, etc. I feel like I've been doing entry-level for years with no upward movement. But at this job, I have two teams wanting me to join them once they can afford me (6-12 months). At that point, my salary would break $100K. It's a struggle between me wanting to be happy and me wanting to make money for my family. Should be a no-brainer, right? It's not a rational thought, for sure.

KevH:
You have my brother's first name and last initial :) Yeah, she's going to need someone to pick up around the house - me or a maid.

SugarMamasBoy:
Good plan, this would be the one I would follow if I became a SAHD. Regarding details why I'm torn: I work for three teams of investment managers. Two of those teams have told me that they will hire me once they can expand operations. And if I joined one of those teams I would be included in a very generous bonus pool. So my base salary would go up to $100K+, and my bonus might be the same. Plus, I would be doing client service and marketing for huge firms, which I've always wanted to do. So it feels like if I wait a little longer, I could get that promo, and get that higher salary. I just don't know if I could leave it once I was making it.

Shuaeven;
I'm actually a country boy, and so is the wife. We both grew up rurally. In fact, if I become a SAHD, we want to live in a more remote area, so I can raise animals, farm and garden.

Ticktock:
LOL :p Contribution sent! ;)

AMR:
I wouldn't expect the wife to stay home if our positions were reversed, but I'd prefer it. Wife is the same way.
Your situation sounds almost identical to mine. We need to speak further - I'll send a PM if you don't mind.

CIA Alum:
I never even thought about the having to take off work to be with the sick baby thing (we don't have kids yet, obviously). I knew we'd have to have day care (which I'm not keen on), but never thought how that could affect our lives. The kids, in the split residence scenario, would be living with the wife during the week, so she'd have to take care of the sick ones. She gets ten weeks of vacation, so it wouldn't be too bad of a situation, but she would need emotional support too. Very good point.

Itux:
Those reasons are also very similar to ours.

RenoDad:
Yes, her salary is average for a radiologist. However, she has several great perks that compensate for not being top-end salary:
1.) No call - EVER
2.) No nights
3.) No weekends
Just a straight 9 to 5 shift. That alone is worth $100K to us!
Plus, I'm from Indiana, and she from Illinois, so we wanted to stay close to home :P

Morgannon

We had a similar situation. We were living in New York City with options:
1. I could move into an administrative job as a Social Worker and go from making about $50K to $70K. Wife would continue to work (she's a psychiatrist), put kid in daycare after about 2 months. We would both have to continue working in order to afford living in NYC.
2. We could move to Montana where my wife would get a huge raise, work fewer hours and have student loan repayment, and I could quit my job and become a SAHD. Plus, we would move from a 1BR apartment into a house and be closer to family.
We chose the latter and it's been a good ride with trade-offs. Montana is kind of boring probably like suburbia will be if you become a SAHD, but boring can be good once you have kids. Parenting is really hard and having one person stay at home can make having kids much easier. I say, pull the trigger and join us as a SAHD.
http://montanadad.blogspot.com/