Collaboration, Education, Growth.

Month: March 2021

A devastating fall changes this doc’s life forever

Commentary by The Darwinian Doctor.

This PhREI Network post is via Ian Cook, MD from Carpe Diem MD, and tells the deeply personal story of a devastating fall and the changes this caused in his life as an ER physician.

His story is an inspiring story of triumph over hardship. It teaches us the importance of appreciating the present day and also adapting to life as things change.


This post first appeared on Carpe Diem MD.

The date was January 30th 2014.  I was getting ready to leave for my 4p to 2 am ER shift but decided to do a few quick chores before leaving.  We were getting the house ready for our annual Super Bowl Party/Lauren’s Birthday Party.  I decided that I needed to clean some cobwebs from the entryway and using my sleep deprived brain decided to clean these webs with a broom while standing on a ladder…. To make the situation a little more moronic I decided to throw a broom to reach the highest webs.  (This is literally why women live longer than men). I did this not once but three times and on the third try I lost my balance and fell 15 feet to the ground landing on my right side.

The pain was immediate and I simultaneously felt and heard my body break.  I looked at my wrist, it was grossly deformed (Colles’ fracture) but at least it was closed.  I was unable to move my right hip and the pain was beyond description.  My first thought was that I dislocated my hip, wishful thinking….

I was home alone, laying on the floor trying to diagnosis my various injuries.  I could breath, my ribs hurt, probably broken.  I didn’t hit my head, that was lucky.  The broken right wrist and my hip broke my fall….  Ok, now what.  Luckily, I had my cellphone in my left pocket… the problem was that I had flipped instinctively after the fall from my right side to lay on my left side and the phone was trapped in my pocket.

After some twister like moves, somehow, I was able to reach my left pocket while laying on my side.  I pulled the phone out and was never happier for that iphone finger print unlock.  After that, I just needed to pull off the one handed 911 call.  The 911 dispatcher took the call and help was on the way… she was about to hang up but I asked her to stay on the line until the fire paramedics arrived.   We talked about the upcoming game, Broncos vs Seahawks.  I thought Peyton Manning and the Broncos were going to win (l needed to keep my mind off the pain).  Looks like I got that one wrong… Seahawks 48-Broncos 8.

The paramedics arrived shortly after.  I was worried that they were going to have to break down the front door and I was stuck laying in front of it. Luckily, the garage door was open.  They did a great job on scene and got me out of there quickly.  I tried to be the best patient I could be with the exception of requesting weight-based morphine dosing to handle the pain…. This was not a 2mg Morphine injury…. More like 8mg with an 8mg chaser.

The paramedics got me to the ambulance and I asked to make some quick phone calls before I made it the ER. I knew I didn’t have a lot of time before my phone privileges were gone…. My first call in the ambulance was to my EM Director to let him know that I would not be making my 4p shift… It was 2:30p… I felt awful.  My next was to my Mom to tell her what was happening and to prepare her for a call from Lauren, my beautiful and very forgiving wife.  My third call was to Lauren… I did not know if I would be able to reach her because she was in the middle of her Interventional Radiology Fellowship.  The call was something like “I fell and I am on my way to the hospital, I’m pretty messed up, I’m sorry.” 

This was truly awful.  We had just bought our home.  I was out of residency and the main source of income.  We had two daughters under two (13 months apart) and Lauren was in the middle of her IR fellowship…. Did I already mention that she is awesome….?

At the Emergency department they performed a hematoma block and set my right colles’ fracture. I was grateful.  I had the full classic trauma scan which confirmed that I had a severe right sided comminuted acetabulum fracture, the hip was fine, but the pelvis was dusted.  My femur had become a hammer that was used to smash my pelvis like a plate.  This level of trauma was too severe for the Emergency department that I was at so I was transferred to a tertiary center.

At the tertiary hospital, I was admitted to the ICU.  While there, the pain in my wrist began to gradually increase and my sensation decreased.  The pain was so severe that is was more painful at times than my shattered pelvis.  This is what it feels like as your median nerve in compressed via acute carpal tunnel syndrome. 

The following day January 31st I was taken to the OR for an ORIF of the right wrist with carpal tunnel decompression/release.  The pain resolved but the loss of sensation remained.  The loss of sensation in my right hand (I’m right hand dominant) was devastating.  That night in the ICU I experienced an excruciating episode of pain as my pelvis inadvertently shifted. I was blessed that Lauren was there and was able to convince the resident and nurse to increase my pain medication.

The next day February 1st 2014 I gave Lauren a birthday present that I will never live down.  The present was 8 hours of waiting while I went back to the OR for an ORIF of my acetabulum fracture.  Some great friends visited Lauren and celebrated her birthday with a cupcake in the cafeteria.  The surgery was long but the outcome was good.  My hemoglobin had dropped to 8 and I was weak but recovering well…. The hard work was yet to come.  I asked Lauren to go home and have a Super Bowl party tomorrow… she about slapped me.

After about 5 days in the ICU I was transferred to an Inpatient rehab for the next two weeks and it was the best thing that could have happened to me.  I had twice daily rehab sessions and occupational therapy.  The focus was on regaining sensation and movement in my right hand and learning to use a walker… with one hand while hopping.  I was prescribed non-weightbearing status for two months to allow the right pelvis/acetabulum to heal…

Learning to hop on one leg and use a walker with one hand was a challenge to say the least.  I rarely slept during my hospital stay and I was so thankful for the Winter Olympics.  I think I watched every event.  Lauren and I love to snowboard and I set a goal to someday make it back to the mountain.  I would consider myself recovered when I could ride again… It seemed like a ridiculous goal considering that I was hopping on one leg and could not feel the fingers in my right hand… I had more important things to worry about… The nurses both named Angel were amazing and kept me going.  My wife and family kept me positive. 

I learned during this hospital stay to practice visualization and to work on my mindset.  I was terrified that I would never be able to practice Emergency Medicine again. How could I intubate if I couldn’t feel the endotracheal tube?  Would I be able to walk?  I was broken…

After two weeks I was discharged to home on Valentine’s Day.  My wife and family had set up an amazing home hospital room for me to continue my recovery….  (Yes, I ordered flowers, with our wedding colors from my hospital bed to be delivered before we got home).  I was still in a lot of trouble….

I did not sleep more than an hour at a time for the next 2 months due to severe pain, both musculoskeletal and neuropathic.  Physical therapy kept me motivated and I went 4 days a week.  After 2 months I was cleared for pool therapy which was a great day.  It was an amazing sensation to touch my foot to the ground after two months of non-weightbearing status.  The pain in my leg began to decrease… Gradually, I advanced to using a cane and then to walking solo.  After some time, I was able to go upstairs and eventually sleep in my own bed.  I went to physical therapy/Occupational therapy 4 days a week for 9 months…

Eventually, I was able to return to work.  During this time, I was practicing Emergency Medicine and Wound Care.  I spent my recovery time increasing my Wound Care knowledge as I did not think I could ever return to Emergency Medicine.  I also spent this time working on photo albums and spending everyday with my two daughters Lily (21 months old) and Bri (8 months old). 

This was one of the toughest experiences of my life and it was life changing.  I loved Emergency Medicine but this experience made it clear to me that my time on this world is not guaranteed.  I was so grateful to be a practicing EM after my injury that I was willing to work through shifts with severe pain.  The pain decreased over time and the shifts improved but the pain has never left completely and I knew that I would not be able to practice Emergency Medicine until retirement.  I continued to practice EM but overtime I gradually increased my Wound care practice and increased my time home with my family. 

I spent years feeling guilty about cutting back on Emergency Medicine.  Emergency Medicine was my specialty and my identity, how could I change.  How could I practice Wound care, a field that is completely different than Emergency Medicine…?  What I found was that my experience in Emergency Medicine was a perfect fit for Wound Care.  I found the practice very rewarding and over time I gradually increased my Wound Care practice.  I am grateful that I found Wound Care and it honestly allowed me to practice and appreciate Emergency Medicine longer than I would have without it.  I retired from Emergency Medicine February 2020.

Ps.  Two years after my injury I made it back to the mountain.  We ride as a family now and it is one of the great joys of my life.

Pps.  Thankfully, I had bought disability and life insurance one year prior to this fall.  The disability insurance saved us financially and I recommend having both.


What do you think of Dr. Cook’s story? For me, it’s an intense reminder to value and take advantage of the blessings of the present day. Because life can change in an instant. It’s also inspirational proof that time and intentional evolution can reveal new paths forward on the journey of life.

Please visit a PhREI Network member blog for more content!


Are you a physician or physician spouse interested in real estate investing? Come chat with The Darwinian Doctor, Carpe Diem MD, and the Prudent Plastic Surgeon in the PhREI Network Facebook Group!

Invest in assets or pay down your student debt?

Commentary from The Darwinian Doctor

This PhREI Network post is via Ian Cook, MD at Carpe Diem MD, and goes over their debt paydown strategy.

Ian and his wife both accumulated $300,000 of student debt on their way to becoming physicians. (That’s the same amount I accumulated by the time I finished residency!)

But their approach to student debt paydown is different from traditional advice. Read below how Carpe Diem MD decided to invest capital into real estate, rather than pay down their debt. He also does an analysis on the financial outcome of his decision.


This post first appeared on Carpe Diem MD.

Lauren and I both accumulated $300,000 in student debt on our path to becoming Physicians.   That is $600,000 of combined debt before our first paycheck.  We are not bitter or mad about this debt.  We view student debt as an investment in ourselves. 

The promise of Medicine and the ability to improve the lives of others was worth the investment.  We knew that when we completed the journey a personally and financially rewarding career would be waiting. 

Lauren and I have no regrets about choosing Medicine and would do it again.  We do have some concern about the future of Medicine and a desire to secure our family’s financial wellbeing. 

We look at our debt as the cost of achieving our dreams and plan to pay it off gradually

There are a ton of sites that will tell you to pay off your student debt rapidly.  

Our philosophy is let it ride…

Now to be fair it does depend on your interest rate.  If you are able to refinance your loans to less than 4% then there is little advantage to paying off your loans.  You can pay off your loans for peace of mind, which is reasonable, if you hate debt… 

Your debt tolerance will determine if you hold your loans or pay them off. 

Lauren and I are very debt tolerant.  We have been swimming in debt since our young 20s.  

Our income has increased significantly since our 20s and we could pay off this debt more quickly than the 30-year term.  However, we do not see the advantage in paying off student debt.  We would rather let the student debt ride and use our current savings for other investments.

The counter argument would be to pay off your loans as soon as possible.  By paying off your loans you will decrease your monthly expenses.  You also increase your net worth by resolving your debt balance…. In our case that would be $600,000… not bad.

Lauren and I chose to invest in assets rather than paying off student debt. 

In, 2016, Lauren and I decided to invest in a short-term rental (10 Reasons to Invest in Short Term Rentals). The best part of STR investing is that you can get started with 10% down if purchasing as a second/vacation home.  Traditional investment properties require 25-30% down. 

STR Purchase

So Lauren and I invested $50,000 (10%) on a $500,000 snow resort STR.   The mortgage for that property is covered by Short-term rentals.  The property equity has increased significantly since 2016. 

The STR property is valued at $800,000 and we owe $400,000 after loan paydown provided by rental income.  If you subtract the down of $50,000 then we have increased our net worth by $350,000 in 4 years… That is a 7x return on our $50,000 investment.

Student Loan pay off

If we “invested” $50,000 to pay down our student debt then we would have decreased our debt by $50,000 and increased our net worth by $50,000. 

If you calculate the interest saved over four years: 3.5% x $50,000 x 4 years the savings would be $7,000. 

(The savings of $7,000 is over-estimating because this does not account for balance pay down). 

STR purchase vs. Student Loan pay off

Therefore you can see that:

$50,000 invested in our STR resulted in a $350,000 increase in net worth

vs

$50,000 “invested” to pay down student debt would have saved $7,000 in interest and increased our net worth by $50,000

The results achieved on our STR purchase may not be reproduced on every purchase. However, if we only received 25% of the return we would still be better off than paying down our student debt.

Now this plan does not work for everyone. Some debt might not be worth letting ride:

  1. High interest student loans that you are unable to refinance. 
  2. Credit Card debt with high balances and high rates
  3. You are not comfortable with debt and the peace of mind is worth the price of paying your debt off.

Lauren and I are swimming in student debt and plan on letting it ride…


Thank you Carpe Diem MD for sharing your student debt paydown strategy!

So is this the definitive answer to the question of whether you should invest into assets or pay down your debt? Perhaps not, but it’s a valuable anecdote showing one option. You could certainly argue that Ian took a risk and got lucky with the appreciation on the property. Debt pay down, on the other hand, is a guaranteed (albeit small) return.

What is your debt pay down strategy? Visit a PhREI Network member blog for more content!


Are you a physician or physician spouse interested in real estate investing? Come chat with The Darwinian Doctor, Carpe Diem MD, and the Prudent Plastic Surgeon in the PhREI Network Facebook Group!

7 Financial Habits of Highly Successful Physicians

Commentary from The Darwinian Doctor.

This PhREI Network post is via Jordan Frey, MD at the Prudent Plastic Surgeon, and goes over the financial habits of highly successful physicians.

I agree with his feeling that financial education is a life superpower. A few good financial habits can mean the difference between a retirement of prosperity or scarcity. In the post below, Dr. Frey outlines 7 simple tips that can spark your own evolution into a financial success story. Enjoy!


This first appeared on The Prudent Plastic Surgeon.

I love the idea that not sucking at money is a superpower. My superpowers are my financial habits.

It makes me feel like I’m some sort of fiscal Avenger. Now mind you, only a few months ago, I was the equivalent of pre-spider bite Peter Parker, getting shoved into lockers by financial bullies. But now I’m swinging around tall buildings and webbing the bad guys.

How did I make this drastic change? The answer is simple…My financial habits underwent a massive retooling.

Habits make you what you are. If exercise is a habit of yours, you are in shape. If eating well is a habit, you are healthy. Financial well-being is no different. Nurture your financial habits and you will become financially successful – based on whatever definition you give financial success.

When I decided to finally face my financial illiteracy and dedicate myself to financial freedom, the task seemed almost insurmountable. 

There are endless amounts of material and resources. The topics are intimidating and can be complicated. We worry that making one wrong action can ruin us financially for the rest of our lives.

We can easily fall into this limiting belief that there is an invisible timer and if we don’t reach financial success by the time it goes off, we will never have another chance. 

I can assure you, there is no such timer!

You can start at any point and be successful. The key is starting. After starting, the key is to keep moving forward. You cannot learn everything, take every actionable step, and reach your financial goals in one day, or one month, or even one year.

financial habits

This is a marathon, not a sprint

The best way to approach your financial well-being is by forming healthy habits that continuously strengthen your financial muscles and help you to make the right financial decisions. These habits are formed through daily practice that becomes ingrained. 

That’s how I did it when I faced my financial fears and intimidation, determined to overcome my past mistakes and create a life of financial freedom. I focused on small, achievable daily habits that over time would yield massive gains in financial education and inspire massive actions towards financial well-being.

These marginal habits and gains will lead you to achieve your BIG financial goals!

1. Read at least one financial blog entry every morning

It’s #1 for a reason. This was the first of my financial habits and really got me going.

Every morning, I wake up around 5 to 6 A.M. depending on my schedule. With breakfast, I read one financial blog piece. I do not have a set list of topics to cover or any sort of formal curriculum. I simply pick a blog, find the most recent post on that site, and read it.

Some days, the topics are very technical and take a lot of time and thought to get through. Other days, the topics are more philosophical and lighter. Sometimes, the topics are ones that I am very familiar with. Other times, they are very niche and new to me.

Regardless, without fail, I learn something new. 

When I first started, it was like drinking from a fire hose. I constantly had to Google terms to see what they meant and had to sit and digest many concepts before I could move on. Now, most posts are on familiar topics and I can read through them fairly seamlessly. But I am still learning every day.

Pick a few blogs that resonate with you and subscribe to their email lists. You will receive an email with each new post. Read at least one each morning when you wake up. 

Not a morning person? Read them in between patients in clinic or OR cases. Read them while you eat lunch. They generally should not take more than 5-10 minutes to read.

2. Check your accounts and follow your money

I check my checking account every day, usually at the end of the day when things are winding down.

This may seem obsessive but it serves a very important purpose. I know from experience.

When I was a trainee, my apartment rent was always due at the end of the month. I would log into my bank account on the last day of every month and hold my breath that we had enough to pay rent. We usually did but sometime just barely so. (Remember, I lived in NYC with 2 young kids and a subsidized apartment with rents equal to 75% of my income!) Then, the next month would start, I would get my paychecks and spend until the cycle repeated at the end of the month.

What a terrible habit! This makes your checking account a slush fund. It becomes so easy to spend money without a conscience.

By checking my money every day, I get immediate feedback as to what our daily expenses are. Discuss anything that seems off.. What expenses are adding up even though they seem small initially?  What monthly subscriptions are stacking up even though we don’t really use them? Do we need to adjust our spending? Could we be saving more?

All of a sudden, there are no surprises and you have control over your money again. Make checking and following your money a habit.

Savings and investment accounts don’t need to be checked as often since they are not as fluid. But I recommend checking on your savings account every month as positive feedback for maintaining your (at least) 20% savings rate.Check your investment accounts even less, likely only once or twice a year to rebalance according to your written financial plan.

3. Invest in the margins of your life

I’ve discussed this idea previously. 

You don’t miss money that you didn’t know was there. For instance, if someone took $20 out of every paycheck, you probably would never notice. You would live your life and intuitively just spend $20 less each time.

Take this phenomenon further and put some saving money aside with each purchase that you make on a daily basis. 

I just started using an app called Acorns. Basically, the way it works is that for every purchase you make, Acorns will round up to the nearest whole number and save the change. Example, you buy a sandwich for $4.75. Acorns will set aside $0.25 from your account. This extra “change” goes into a a broad, low-cost index fund portfolio of your choice and invested for you. 

It might seem like this doesn’t add up. But it does. Go back in your last month’s bank statement. Add up all the spare change. You’re a high income earner. I bet it was a decent amount. 

Now combine that with a $20 weekly recurring withdrawal to your Acorns account and a multiplier (2x, 3x, your choice) for each spare change withdrawal and your investment account will build up quickly.

I just started mine a little bit ago and already have about $500 in my investment account (I use a 2x multiplier and weekly $20 recurring withdrawal). At this rate with a modest 6% yearly interest, my spare change fund will grow to above $110,000 in twenty years. Likely it will be much higher. 

Not bad for spare change.

4. Read one chapter (or ten pages) in a financial book each night

Before bed, I used to watch about 10-20 minutes of Netflix before falling asleep. I now keep a book at my bedside and read about one chapter each night before going to bed. Sometimes a little more, sometimes a little less. But without fail, I read before going to bed.

Some of these are long books that might take me a month to read if I follow an average of ten pages. However, I have easily read over 10 financial books in the past couple of months using this method. 

Heck, sometimes I find myself going to bed earlier than I otherwise would just to get in some extra reading time. Other times,  I’ll be exhausted so I’ll only read one page. It seems ridiculous, but this maintains the habit. Skip one day and it’ll become easier and easier to skip the following days.

I used this same strategy to study for the yearly in-service exam as a trainee. Everyone would always be cramming the week before the test. I just read 10 pages of a review book every day starting at the beginning of the year and was prepared without stress by exam day.

Start with a manageable book and just commit to reading the introduction on the first night. I would be willing to bet that you get hooked and are reading much more in depth financial treatises in no time.

Books are very cheap investments that will yield you extraordinary returns on your financial literacy and actual net worth. 

The last 3 books I’ve read are:

  • Rich Dad, Poor Dad Cash Flow Quadrant by Robert Kiyosaki
  • The Doctors’ Guide to Navigating a Financial Crisis by Cory Fawcett
  • The Doctors’ Guide to Eliminating Debt by Cory Fawcett

5. Read your financial goals

When you write your personal financial plan, you should have a section where you list your financial goals. 

financial habits
If you need help getting your finances in order, check out my course, Graduating to Success!

My financial goals are as follows:

  • Pay off consumer debt in 2 years (2022)
  • Pay off student debt in 5 years (2025)
  • We will be worth $1 million in 12 years (2033)
  • Save $40,000 to buy car 1 in 3 years (2023), save $40,000 to buy car 2 in 6 years (2026)
  • Save enough to cash flow at least $250,000 in retirement (goal retirement at least 2045)
    • This will be via hybrid approach using equity and real estate investing
    • Save $1-2 million in equities for 4% yearly withdrawal of ~$71,000
    • Cash flow >$200,000 from real estate investments in 5 years (2025)
  • Save $400,000 for Samuel/Emery college
  • Save $250,000 for renovation/down payment new home
  • The mortgage on the home we are living in will be paid off when we retire

I try to read these goals on a daily basis. Sometimes in the morning, sometimes at night. Again, it may seem obsessive, but this keeps my mind actively focused on these goals.

It’s easy to lose focus of long term goals within the craziness of daily life. It is often hard to do the things necessary to maintain the trajectory towards our goals. If we forget what the goals are or why we want to achieve them, they all too often fall to the wayside. Before we know it, we are completely off track.

Reading the above list of goals takes all of 30 seconds. At this point, they are essentially committed to memory and I can review them mentally in the shower each morning.

This way, I keep my eyes on the prize and don’t get tripped up by any daily annoyances that otherwise may distract me from what’s important.

6. Talk with an accountability partner

We’ve all seen that keeping up a habit is much easier when we have a partner sharing in it. It’s why we run with a buddy and start a diet with a friend. It’s why I watch the New York Jets inevitably lose every year with my dad.

This makes us accountable to ourselves and to someone else who is depending on us. It’s much harder to let someone else down. On days where we feel like quitting, we fight through for our partner. They do the same thing in return.

Find someone like-minded with a similar interest to share your journey with. They are out there, I promise. As soon as I made my interest in personal finance known, it was amazing how many of my friends and colleagues started talking to me about it. I had no idea they were interested before. 

Once you identify your partner, make it a habit to talk shop with them on a daily or near daily basis. It’ll keep you moving in the right direction and your combined knowledge will grow exponentially!

My main accountability partner is my wife, but I also share with many members of my family as well as friends and colleagues.

7. Keep a checklist of financial tasks

It can be overwhelming to manage all of the financial considerations and tasks that need to be dealt with over time. Some people get so overwhelmed or frustrated over forgetting certain tasks that they give up.

I have an easy solution: keep a list that you check/update daily. This can be a physical list or a virtual list. Whatever works best for you.

I keep virtual “post-it” on my Mac computer using the Stickies app. I have different colors denote different aspects of my life and I list out the financial tasks that need to be completed, even way in the future.

This helps me keep track of everything. Then I don’t need to worry about remembering to review my monthly budget or contribute to my backdoor Roth IRA. It’s on my list and I’ll automatically be reminded as the date approaches.

Some people will prefer a physical paper list or a phone app. Whatever you use, just review it daily and update it whenever a task comes up that needs to be remembered.

By developing these financial habits, you will strengthen your financial muscles every day

These tasks should be viewed much like a budget. They are not restrictive tools or annoying “things to do” but are empowering supports, guiding you to financial freedom.

Before you know it, you will be mastering advanced financial concepts, improving your financial well-being, and taking massive action towards your financial success!


I hope you enjoyed this PhREI Network post from The Prudent Plastic Surgeon. Please visit a member blog for more great content!


Are you a physician or physician spouse interested in real estate investing? Come chat with The Darwinian Doctor, Carpe Diem MD, and the Prudent Plastic Surgeon in the PhREI Network Facebook Group!

Revealing My Secret Strategy to Pay My Huge Student Debt

Commentary from The Darwinian Doctor

In this post, Jordan Frey from the Prudent Plastic Surgeon discusses debt payoff strategy.

Read below about how he amassed over $450,000 during training, and his detailed plan to pay it off.

He’s on an aggressive path to debt payoff and I have no doubt that he’ll wipe out this debt very quickly.


This post first appeared on The Prudent Plastic Surgeon.

Until now, I’ve written a lot about very personal aspects of my financial life and overall life. I’ve used actual numbers as much as possible. I want to be completely transparent. We’re in this together and it’s not fair to you if I am not totally forthcoming. However, so far, I have not revealed my strategy for paying back my massive student debt.

I have shared some information about my student debt

Here are some refreshers:

  • I took out student loans to pay for just about every cent of my private undergraduate and medical education
  • During my 7 year residency and fellowship training, I deferred all of my loans
  • Upon graduating training in June 2020, I owed over $450,000 in student debt

And here are some other random factoids about my debt situation:

  • My wife and I also had credit card debt upon graduating. In fact using our credit card was one of our biggest financial mistakes.
  • However, we paid off all of our consumer credit card debt (>$20,000) within 4 months of my finishing training
  • My wife is a smarty-pants. Because of this, she had full scholarships for her undergraduate and most of her graduate education. So, she has very little student debt
  • So, this post will be pretty much exclusively about my strategy to pay back my student debt

Why haven’t I shared my student debt strategy until now?

It’s a fair question.

As I reflect back, I think it is for a few reasons:

  1. I think I was still figuring out my plan and didn’t want to share half-baked advice
  2. A small part of me was still embarrassed about how much student debt I had and how badly I had mismanaged it
  3. There are a LOT of opinions out there on how to best pay back debt. And most people feel very strongly one way or the other.

But now here I go into the crossfire!

student debt strategy

My loan pay back strategy

First, some baseline facts:

  • My current student loan burden as of this writing (1/19/21) is: $438,787
  • Approximately 2/3 of these loans are federal and the remainder are private
  • The average interest rate on ALL loans is currently 6.1% (some of the private rates are variable)
    • The interest rate for federal loans in 6.8%
    • The average interest rate currently for my private loans is 5.34%
  • I have not yet refinanced any loans

And now some general tenants of ours:

Ok, ok…now for the actual student loan strategy

I’ll keep with the theme and share this in bullet form as well:

student debt strategy
In all its glory…
  • Selenid and I organized my private student loans by lowest to highest amount
    • If two loans are very similar in size, we prioritize the one with a higher interest rate
  • We also organized all of my federal student loans from lowest to highest amount due
  • Currently, we pay off the minimum amount due for all of my private loans each month
  • The remainder of the monthly allotment for student loans plus any monthly budget surplus then goes to pay the private loan with the lowest amount due
  • Once that loan is paid off, we move onto the next one on the list of private loans
  • We currently are NOT paying back any federal loans given the current 0% interest rate forbearance
  • I have NOT refinanced no private loans yet. Once I know if the federal loan forbearance will be extended, I’ll examine rates and may refinance the private loans

“Ok Jordan, that’s all well and good. But what about when the 0% federal interest rate is lifted?”

Great question, Jordan.

As of this writing (1/19/21), I am still adhering to the above strategy. It has been intimated that Biden will extend the 0% federal student loan interest rate forbearance for some more time before it expires on 1/31/21.

If he does extend the forbearance, I will keep going as stated. I will likely refinance my private loans.

But, eventually, the interest rates on my federal loans will go up and they will start coming due.

Once federal student loan forbearance is ended, my amended strategy will be one of two options

Option #1

This is the most likely option.

Once I have to start paying back my federal student loans, I will refinance all of my loans for 5 years with a variable rate. I plan to pay back all of my loans in 5 years or less and the 5 year variable is the best rate in most cases.

Currently, I qualify for a 5 year variable rate of 3.06%. This would amount to monthly payments of $7,896. This is less than what I currently pay most months and fits very well within my budget and financial plan.

Option #2

This would be the scenario if interest rates for some reason go back up and my current student loan rates are more favorable.

In this case, I would keep my loans separate and pay them back in the “snowball” fashion that I described above. Basically, I would organize them by lowest to highest amount, make all minimum payments, and pay lump sums based on my monthly budget to each loan progressively down the list.

If refinancing some or all of the loans then becomes beneficial down the line, I would pursue it at that point.

My student debt advice for you

This was a run down of my student debt circumstances and my plan to address them.

However, I think most of it is very much applicable to any physician with student debt. My student debt:income ratio is roughly 1:1.

Some may have a lesser ratio. A few of you may even have a greater ratio, but probably not by much. Regardless, these techniques work.

I also want to emphasize again that paying off debt is the most important thing that you can do to boost your financial well-being and advance towards financial freedom.  

That’s because this really is the first step to financial freedom. You need to stop taking on new debt and get rid of any and all debt you have. Look, when you are in a hole the first step is to stop digging. Then start climbing out. You can’t run until you get out of the hole.

So, this is a huge thing that should definitely be at or near the top of your financial priority list that will go in your financial plan (more on this in future videos). Each $1 you use to pay off debt is $1 that your net worth increases.

student debt strategy
Still need a financial plan, my course will help you write one plus so much more!

Here are the actionable steps you can take NOW to manage your student debt

  • Create a list or table of all of your debts (including mortgage)
  • Decide how to prioritize them (highest to lowest interest, lowest to highest amount, etc)
  • Rearrange list so that they are in that order
  • Make lowest required payments on all debts
  • Take the remainder of the monthly amount budgeting for loans as well as any extra discretionary savings from that month and pay it to the first loan on your list
  • Keep doing this until that loan is paid off
  • Once that first loan is eliminated, repeat for the second loan and so on. Each time you eliminate a loan, you will be adding that required monthly payment to the rest of the allotted monthly amount for debt paydown, increasing the size of the snowball and the speed at which you pay off your debt

An ode to PSLF [All of this could have been avoided]

I could have taken advantage of the PSLF program because my training was 7 years, during which I could have made small income based repayments. Then I would only need 3 more years of repayments at a qualifying hospital to have the remainder of my loans forgiven. But I was ignorant and didn’t take advantage of this as a trainee. Now that my salary is much much higher, income based amounts are very high and any forgiveness, if at all, would be minimal.

Could have planned that better with just a little bit of financial education.

But no reason to live in the past!

In general, if you have a longer training period and/or have a low income/debt ratio (<1), PSLF likely will be a good option for you. If neither of those are true, a student debt strategy like the ones I covered above are likely your best options.

Well, there you have it! That is my student debt pay down strategy revealed

Most importantly, just keep remembering to break these concepts up into their most important tenants. Don’t get lost in the weeds.

Focus on the simple strategies to build wealth as a physician and you will be set!


Thank you Jordan for sharing your debt paydown strategy!

What are you doing to get out of debt? Please visit a PhREI network member blog for more great content!


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