White Coat Investor Podcast

Milestones to Millionaire #251: Dermatologist Hits $750,000 Net Worth Before Finishing Residency and Finance 101: The Basics of Real Estate Investing

Host: Dr. Jim Dahle
Guest: Dr. Garrett, PGY4 Dermatology Resident
Date: December 1, 2025

Episode Overview

This episode of White Coat Investor Podcast’s “Milestones to Millionaire” features Dr. Garrett, a dermatology resident who has achieved a remarkable milestone: amassing a net worth of $750,000 before even finishing residency. Dr. Jim Dahle interviews Garrett about the financial decisions, personal discipline, and strategies that made this feat possible. The latter half of the episode shifts to Dr. Dahle’s primer on real estate investing, exploring how it fits into overall wealth-building, its risks, benefits, and various approaches suited for high-income professionals.

Segment 1: Interview with Dr. Garrett, The $750K Resident

Background and Current Role

• [03:10] Dr. Garrett is a PGY4 dermatology resident in a high cost of living West Coast city, on a research track (80% research, 20% clinic).
• Finished MD/PhD at Johns Hopkins in 6 years, an unusually rapid timeline.

Notable Quotes

• Garrett: "I'm just about closing in on $750,000 net worth at this point." [03:37]
• Dahle: "Three quarters of a million dollars in residency. This is sort of unusual, you know." [03:41]

Keys to Garrett’s Early Wealth

1. MD/PhD with No Tuition Debt

   • [04:07] Full scholarship and stipend, finished in six years, avoided student loans.
   • Garrett: "Not having to pay for medical school was a big part of this." [04:21]
   • Advocated for fast-track graduation: Making “the lost income, the time value of money and everything else” a key consideration.

2. Early Start with Saving and Investing

   • [05:39] Began working at age 12 (paper route); over 50% of earnings saved/invested.
   • Opened IRA in high school, invested in QQQ and Berkshire Hathaway.
   • Garrett: "That worked out well, didn’t it?" (on investing in QQQ) [06:15]

3. Financial Literacy, Parental Support, and Lifestyle Choices

   • [06:56] Managed family budget at age 9 or 10; lived frugally through med school and residency.
   • Lived in Baltimore (low cost of living); bought instead of rented (used $35,000 forgivable loan from Johns Hopkins for home down payment).
   • Garrett: “[My parents] let me budget the entire family vacation...I apparently in a Dairy Queen told them we couldn’t afford ice cream because it wasn’t in the budget.” [06:56]

4. Side Hustles and Spousal Income

   • [08:01] Medical school admissions consulting — tutoring students on applications, essays, and interviews.
   • Wife worked in university administration (initially five-figure salary, now six-figure after relocating).

Advice to Others

• Weigh the time value of lost income for additional degrees or research years.
• Financial geography matters: “We made probably $250,000 difference of going to Johns Hopkins versus other options.” [09:21]
• Avoid unnecessary gap years, stay focused, and maximize every year of schooling and training.
• Discipline and long-term planning: Financial literacy is key, not just early wealth, but options and flexibility later (i.e., ability to pursue research over more lucrative clinical work).

Quote Highlights

• Dahle: “Your case for not wasting time, you've demonstrated pretty well. Right. There's no lost years there. There's no multiple gap year kind of situation.” [10:29]
• Garrett: “Having built up an amount of net worth really allows me to continue to pursue the research I want to pursue and go to a higher cost of living city and do a lot of these things that I think would be a lot more challenging when you want to have kids and do all the other things that life throws at you.” [10:55]

Reflections on the MD/PhD Path

• [12:01] Consider whether you want to dedicate the next 15 years to research career; think beyond your 22-year-old self.
• Garrett: "You have to think not just for the 22 year old self that's applying to MD/PhD, but I'm about as fast of a track as you can possibly be. And I'm still probably three or four years away from really having a big NIH funded lab."

What’s Next for Garrett?

• [12:59] Launching his own research lab, seeking NIH grants, beginning attending work part-time.
• Flexibility to shape career without financial pressure, thanks to early financial discipline.

Segment 2: Finance 101 – The Basics of Real Estate Investing

Host: Dr. Jim Dahle
Starts at: [14:03]

Dr. Dahle’s Philosophy and Overview

• Real estate investing is completely optional:

  • "You do not have to have a rental property to be financially successful." [14:08]
  • One can become wealthy with simple, diversified index funds alone.

• Benefits of Real Estate Investing:

  • Provides another asset class with relatively low correlation to stocks.
  • Offers unique tax advantages and the possibility to add value (especially direct investing).

Types of Real Estate Investing

1. Direct Ownership (Active)

• Higher involvement (“second job”), but high level of control and ability to increase value (e.g., renovations).
• Can start with managing properties yourself.
• Fastest way out of medicine for those who want immediate financial freedom: “Live like a resident, build capital, invest in short-term rentals” (5–10 doors potentially gets you to financial independence quickly) [14:55]

2. Passive Investing
   • Public REITs: Buyable through mutual funds or ETFs (e.g., VNQ), low cost and highly diversified.
   • Private Investments: Syndications, partnerships, and real estate funds. Pros: Potentially higher returns, access to unique properties, depreciation benefits for tax purposes.
   • Barriers: High minimum investments (often $100,000), illiquidity, and need for diversification over time—usually only for those already at millionaire/multimillionaire status.
   • Risks: Over-leveraged, variable-rate debt, market downturns (illustrated by 2022's interest rate spike causing losses). Debt investments can be safer than equity.

Investment Principles Apply Across Asset Classes

• Diversification, fee consciousness, tax efficiency, and due diligence are as essential in real estate as in stock/bond investing.

Notable Warnings

• Not all sponsor-vetted investments are guaranteed; “People have lost money in investments that they first heard about at White Coat Investor.” [23:59]
• Risk management is key—Don’t start with the riskiest real estate deals.

Quote Highlights

• Dahle: “People have lost money in investments that they first heard about at White Coat Investor. These people are paying us to introduce you to them. There's not some sort of guarantee...that you're guaranteed to make money on them...” [23:59]
• Dahle: “There are less risky ways to invest though, right? ... Why don't you invest your first few investments into some of the less risky ways to invest in real estate, less leverage, a better place in the capital stack.” [25:28]

Memorable Moments & Takeaways

• Personal finance isn’t about a single windfall, but layers of discipline, opportunity, and early action.
• Quote: “All of a sudden… you add it all up, it's a huge win.” [08:25]
• Thinking long-term versus only short-term academic/professional goals profoundly boosts financial and personal flexibility.
• Real estate: It’s one of many viable tools—get educated, don’t be rushed by the hype, and remember, simple can also mean successful.

Important Timestamps

| Time | Segment / Discussion | Speaker | |---------|--------------------------------------------------------|--------------| | 03:10 | Garrett’s background and career path | Garrett | | 03:41 | Celebrating $750K net worth during residency | Dahle, Garrett | | 04:07 | MD/PhD at Hopkins, paying for school, avoiding loans | Garrett | | 05:39 | Early work, savings, and IRA | Garrett | | 06:56 | Financial literacy, frugal living, first property | Garrett | | 08:01 | Admissions consulting side hustle | Garrett | | 09:21 | Advice for aspiring high-net-worth residents | Garrett | | 10:29 | The case for not wasting time, maximizing each year | Dahle | | 12:01 | Advice to MD/PhD hopefuls: Consider your 35-year-old self | Garrett | | 12:59 | What’s next: Launching own research lab | Garrett | | 14:03 | Dahle’s real estate finance primer begins | Dahle | | 14:55 | Fastest way out of medicine: live like a resident, invest in rentals | Dahle | | 20:05 | REITs, private investments, and their pros/cons | Dahle | | 23:59 | Investment risks and sponsor due diligence | Dahle | | 25:28 | Advice: Start with less risky real estate investments | Dahle |

Summary Table: Garrett’s $750K Wealth-Building Approach

| Pillar | Actions | |---------------------------------|------------------------------------------------------------| | Avoided Medical School Debt | MD/PhD scholarship & stipend, graduated in six years | | Early Investing | Opened IRA in high school, disciplined long-term investing | | Frugality / Cost of Living | Lived in Baltimore, bought instead of rented home | | Multiple Income Streams | Side hustles: admissions consulting; spouse’s income | | Financial Literacy & Planning | Family influence, budgeting experience from childhood | | Career & Life Optimization | Avoided gap years, planned career for flexibility |

Closing Thoughts

Dr. Garrett’s story exemplifies how discipline, smart decision making, and early financial literacy can catapult even young professionals in high-cost careers toward financial freedom. Dr. Dahle’s real estate primer anchors the episode: investing success flows not from complexity or hype, but from fundamentals—be they in the market, in real estate, or simply in consistently prudent choices.