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MtoM #262: How a Pediatric Intensivist Became a Millionaire: Lessons for Doctors and Financial Boot Camp: How Does IDR Repayment Work
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- [00:00]
A
This is the White Coat Investor Podcast, Milestones to Millionaire Celebrating stories of success along the journey to financial freedom. This is Milestones to Millionaire podcast number 262. Pediatric intensivist becomes a Millionaire One of the most underrated financial moves in medicine is working locum tenens. It pays significantly more on average and you can work locums full time or on the side of your full time. When you work with Comp Health, the number one staffing agency, they cover your housing and travel costs, which on top of higher pay, really adds up. Locums also gives you more control of your career, allowing you to go where you want, when you want, with a schedule that works for you. It's the perfect way to get ahead financially while getting focused on what you love, whether it's locum tenens or regular permanent position. Visit whitecoatinvestor.com comp health and build your career your way with the power of Comp Health. All right, students, we've got a masterclass for you. We call it the Live Money Masterclass. Put it on your calendars. It is February 19, 6pm Mountain. I'm going to be doing this with Andrew Paulson of studentloanadvice.com fame and we're going to be talking about the million dollar decisions that you need to make now as a student. We're going to talk about how you really can't afford to wait to learn about money. We're going to talk about the secrets of being a financially successful doctor. Your medical school is not teaching you about money, but we are going to do it. We're going to teach you in this masterclass, you know, only the high yield stuff, the stuff that medical students need to know about money. And then just like as if I was coming to your medical school to speak to you, we're going to hang around afterward and answer all your questions. So you'll be able to submit questions throughout the presentation and we'll answer as many of those as we can afterward and give you help whether it's with your student loans loans or whether it's with your career decisions or whether it's with investments or whatever, disability insurance, I don't care. We're going to talk about all that stuff afterwards. Sign up for this great masterclass@whitecoatinvestor.com studentwebinar even if you don't end up being able to attend, we'll get a recorded version of it to you. All right, we've got a great interview for you today. Stick around afterward and we're Going to be talking about some cool stuff as well as part of our, you know, boot camp series that we've been doing, but I think you're going to like this interview. My guest today on the Milestones to Millionaire podcast is Neal Neil. Welcome to the podcast.
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B
Thank you, Jim, for having me. Really happy to be here.
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A
Let's introduce you to the audience. Can you tell people where you live, what you do for a living, how far you are out of training?
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B
So I live in the Midwest. I am a pediatric ICU doctor, and I am around five years out of training from fellowship.
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A
All right. Currently married. Does your spouse work? Are you single?
- [02:54]
B
Single. Just got engaged, so now I have a fiance.
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A
Yeah. Congratulations.
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B
Thank you. Thank you so much.
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A
Okay, so now we're kind of set up for what your situation is. Now tell us what you've done, what milestone we're celebrating today.
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B
I became a millionaire.
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A
Millionaire.
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B
Yes. Yes. February 2025.
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A
Okay, so it's taken us a little while to get you on this episode. It's going to be about a year by the time we actually run this episode. I think we have this scheduled for February 16th to drop. So it'll have been almost a year since you became a millionaire. As we're recording this, do you know what your net worth is now after the new year?
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B
Right now it is $1,700,000.
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A
$1,700,000. So you had a really good last year. That happens a lot, actually. You know, you're adding more money as you go along, and, of course, all your money's now working and investments did great in 2025. So I'm sure your money did some of the heavy lifting last year, but that's pretty awesome. Congratulations to you on both becoming a millionaire and just what you did in the last year, because that's pretty awesome.
- [04:01]
B
No, thank you. And I just want to say, it's like most of this is. I mean, I know you might hear this a lot, but this is all because of your training, your teaching, your books, the podcast, listening to other milestones from millionaire people. It's essentially like. I mean, I owe it to almost most of you guys. So I took the credit. I take the credit. But it's also because of you guys.
- [04:24]
A
Yeah, for sure. It's a community, and we're all helping each other, but you can lead a horse to water, right? And doesn't necessarily mean they're going to drink. I was just ranting on a podcast I just recorded. I don't know when that one's going to run. About how 25% of docs in their 60s are still not millionaires. And here you are, five years out of training, not only a millionaire, but not all that far from becoming a multimillionaire. And so, you know, there's still plenty of room to improve for us in our profession. Okay, give us a sense of what your income's looked like over the last five years. I don't know what pediatric intensivists are making these days.
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B
When I joined, my first job was around somewhere in the three twenties. It did go up to, I think, the four hundreds. And then I did a job change in the last one to two years, and then it went back to the three hundreds. So it's in the middle. Like, it's not too high, it's not too low. 300ish.
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A
But the bottom line is we look at your net worth now. It's basically everything you've ever made, you still have. Yeah, that's pretty impressive. Okay, so break down your net worth. What's it divided up into?
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B
I have a little bit of real estate. So my personal assets, that's the bank accounts, credit cards and stuff, it's around 32,000. In my taxable account, it's around 600ish thousand. And in my tax protected, that's the 401k, 403bs. And then through my job, it's around 756,000. And then I also have a locum, so I just do like the mega backdoor, Roth and stuff. And then I have a locum business that's around 30,000 assets. And then real estate is around 305,000.
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A
Is that your house that you live in or is that investment real estate?
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B
So two investment properties, and then we just bought a house, which is like a townhouse, so that's like nothing. Like, I just took out the mortgage, so it's worth like maybe 100,000 itself.
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A
All right, so a pretty typical mix. Some taxable, some tax protected, some home equity, some, you know, investment properties. You know, a pretty, pretty good swath of assets there. Sounds like you're doing things the right way to me. Right. Do you feel like you're making progress and doing everything right?
- [06:32]
B
True. I mean, it's essentially the same thing. I think it's like a mix of your podcast as well. Like live like a resident. And then there's another podcast as well, like giving myself like a 10% boost. And I mean, we enjoy ourselves. Like, we go on vacations and stuff, and I don't feel like I'm wanting money or anything. So I really think that that's like, that's the one thing that I think when I talk to my residents as well, they go like, oh, you should live like a resident. But I'm like, it's not like live like a resident forever. You're just living like a resident for maybe one, two years and then you can give yourself a boost. You have been fined with 60,000 or 70,000 as a resident. So when you get 300,000, why do you need to spend the entire amount? You were happy at 70. It was not like you were doing. I mean, you might have been paycheck to paycheck, but you can still live like, you can give yourself a boost to 100,000. You can still relax, you can enjoy. I don't see any reason why you have to deprive yourself is what I'm trying to get at.
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A
Yeah, Amen. Preach it. Okay, so what's your savings rate looked like over the last five years? What percentage of that income you made did you save?
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B
Initially I thought it was only 20%, but then when I was looking back and I was trying to add up everything, I think it's close to 50% if I'm not mistaken.
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A
50% of gross.
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B
Yes, that's what it looks like because I was just like looking at my locum's income. I was just looking at my 401ks and stuff. And if you add them all up, close to like 40 to 50% if I'm not mistaken.
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A
And you mentioned a couple of investment properties, what's the rest of your portfolio look like? You know, if we had to break down your asset allocation, can you tell us what it is?
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B
I have put like more like 90% stocks and 10% bonds and pretty much it's like the VT Sachs, but I just use the Fidelity because it's much more user friendly for me. So I just use the FX AIX thing and that's pretty much where most of my money is. And then I do do some self directed, like the self directed IRAs and the self directed 401k. So I do do it in the mineral rights and stuff and I consider that as my real estate. And then the rental properties are just essentially for the tax play, like using the short term rental loophole. And then now we've just converted it over to like long term rental because I felt like it's more headache than anything else. So then I've done it for the 12 years and then I just transferred transition it over to a long term rental. That's pretty much the entire breakdown of my entire network.
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A
Very cool. A little bit of everything. I love it. Okay, so we mentioned, you mentioned a mortgage. What other debt have you dealt with in the last five years?
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B
Pretty much the only things that I think the mortgage. I am an international medical graduate, so I came from India, so my parents kind of paid for everything. And when I came over here, like I think initially I did not really understand the investing, like the philosophy. I just thought you need to save and you'll be fine. Because in India, I mean you're saving like, I mean the banks kind of give you 10% for a fixed deposit. So I thought that was the same thing that applied in the US and then I realized that's only like 2%. And in my final year of fellowship is when I read your book initially, like people had did tell me about the white coat investment and I was like, it's just somebody who's like peddling something and they're just trying to make money off of it, people. But then that's true.
- [09:45]
A
We are a for profit business, to be fair.
- [09:48]
B
That is true. I mean you guys have to make money. But in my head it was just like everybody says that, you follow me, you'll become a millionaire. But it's not true. I mean you give the you. I mean you do take like it's like a horse to the water and then you have to like teach a man, like take a man towards the pond and teach them how to fish or give them a fish or something along those lines. But I think when I initially read your book, I definitely was overwhelmed. I wasn't really sure what I'm supposed to be doing because the funds that you say sound so simple. But then when you look at your portfolio, like, wait, he says vtsax, but this is some other name. What the hell? What's the difference between this? And then like did some. What do you say? Reading and learning more about it. And then slowly I started getting back into like, what do you mean by it? Reading some vocal head forums. They all essentially are the same thing. Then I started understanding what the index responders so kind of along those lines and then slowly teaching myself. What do you mean? Because the book I think is meant for a genetic audience and then it's not for an individual person. So then I'm like, okay, what does my hospital have? It doesn't look the same thing. He's saying, go and find VTSAX. And I'm like, it's in my 401k. So like where Do I find this? So then I realized, I think in one of the forums they were like, it's not going to be there in every 401k. You need to go and find out what looks like at the index. And I was like, oh, okay, that makes much more sense. And then I think I read your boot camp. And then I think the bootcamp was super simple. It's got 12 steps. You just need to do those 12 steps. You'll be fine. And I was like, oh, this is easy. And then that's what I technically try to do for my residents. So, like, every year that they graduate, I just try to give them the bootcamp book. Because I'm like, even if you don't listen to me the entire three years that you. Because I do pediatrics residency, like, I help with the teaching of the residents. I'm like, even if you don't listen to me, at least read this book. These 12 steps. You will be fine. Like, no matter how much you mess up right now, you will be fine. So that's essentially my thing. And again, in the grand scheme of things, it's not a lot of money. Yes, sure, it's like 500, 600 bucks. I'm like, it's fine, but it's for the medical residents. And I really wish somebody had done that for me when I was a president, when I was graduating and stuff.
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A
Amen. I went looking. I went looking for the white coat investor. When I got out of medical school, I couldn't find it. So too bad. Too bad.
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B
It was nothing. Yeah.
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A
All right. Well, you're a first generation Indian immigrant, right?
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B
Yes.
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A
So Indians have a reputation for allocating some of their investments to gold. Do you have any substantial amount of money in gold?
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B
So, yes and no. I mean, not a substantial amount. I mean, it's like 30 to 40,000. It's not a lot, but it's there. I'm like, I'm just keeping it. I'm not doing anything. I'm like, in case. If the entire stock market crashes, at least I have some odd gold. And I'm like, I'll just keep that and I won't do anything else with it.
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A
And you had a good year with it last year?
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B
Yes. Oh, my God, yes. When I started the year, I think it was 20, and now it's like 30. And I was like, oh, this is great.
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A
Okay. So along with that immigrant upbringing, how did that affect how you manage money now?
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B
So I think it was more of a, like, I think, like, that's too bad. Question. I would say so. My dad was pretty good with finances. Like, he made sure that the money was okay with everyone. We never took any debt. When we were in med school, he paid for everything out of pocket with no loans, nothing. It was always cash that he had. And he retired. I think. Honestly, I think he was the fire, if I'm not mistaken, because I think after the year age of 40 or 45, he did not work and all his investments were essentially paying off for everything. So I was like, okay, I want to be like that. And it was amazing just looking at him and he could do whatever he wants to. And it was just like he had a high savings. I think he might have saved like 60 to 80%, I think, of his take home pay. So that's one part of it. So I think that definitely affected me. And that made me like, hey, if I don't really need it, I'm not going to buy it. But I was happy with what I had. And then coming to the other side, to the second part of this one, I feel that I was never wanting anything. And like in India, you have everything that you need to. And there was never anything that I needed, like a fancy car or anything. I'm happy with the car if it takes me from point A to point B. I don't need, like, cars don't excite me. Gadgets definitely excite me. Like electronic, like laptops, headphones, they excite me. But they are like, again, in the grand scheme of things, it's like 100 or 200 bucks. It's not like going to make a big dent in my paycheck. So I'm like, it's the little vices. And I'm like, I'm okay with that.
- [14:24]
A
Very cool. Okay, so a brand new intern walks into your residency program and walks up and says, neil, I want to get this right. I want to do what you've done. What advice do you have for that, doc?
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B
So I think for me, I think the best thing was, I think every initially my biggest advice was, oh, we should invest and you should do the Roth and stuff. And I think when I take a step back, I think right now my philosophy has changed. Rather than just saying, hey, you need to focus on investments, I think you need to protect the way that you can earn. So, like the disability insurance, the boring stuff, you need to take care of the boring stuff before you start. Like, oh, yeah, let's just do the S&P 500 or so. I mean, it's, it's sad. They feel like, oh, my God, you should have told me something more exciting. And I'm like, no, it's actually the boring stuff that will get you to where you need to be. It's not the let's buy $50 of the cryptocurrency bitcoin or anything. It's all the boring stuff that will make you a millionaire, if not a multimillionaire. Yeah.
- [15:21]
A
Awesome. All right, well, what's next for you? What's your next financial milestone you're working on?
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B
So, for me, honestly, I think that I want to get to the multimillionaire, and I know I will get there, but my hope is in the long term, maybe to back up, because I'm working the icu. So my biggest thing at least, looking through all the podcasts, I think my biggest thing is I want to get rid of my night shifts. So once I make enough, or at least when I think it is enough, which I'm hoping is going to be by the age of 45 or so, I am hoping I can cut down on my night shifts and just do day shifts. I love teaching. I love day shifts. Night shifts, not the best.
- [15:59]
A
Yeah, I can relate to that. That was the first thing I bought with financial freedom. I bought my way out of night shifts, you know, subsequently, you know, fewer shifts, and got rid of my evenings eventually so I could play hockey and coach in the evenings, you know, and we have housekeepers now. You know, we bought other stuff along the way, but that was the first thing that was a big motivation for me for financial independence, for sure. So totally relate to that. Well, Neil, thank you so much for being willing to, on the podcast, share your story and inspire others to do the same. And thank you for your work directly with your residents and colleagues and for helping them to become financially literate, become financially disciplined, and be able to focus their lives on what really matters. So thank you so much.
- [16:40]
B
No, thank you. Thank you. I really, like, I'm indebted to you and to the entire whiteboard investor. The entire physician team, I think, are the community that actually is responsible. I mean, you might not know me directly, but thank you, guys.
- [16:56]
A
I hope you enjoyed that interview. Let's talk for a moment about the basics of income Driven Repayment programs, or IDR programs. There have been a number of these over the years. And they come and go, okay? They come and go by acts of Congress, which are obviously harder to get rid of the program if it came through Congress. And sometimes they just show up by fiat of the executive branch, often through the Department of Education. But some of the programs that have existed at some point or still exist include ICR Income Contingent Repayment, IBR Income based repayment. There's actually two versions of that pay, pay as you earn, revised pay as you earn or repay, and the SAVE program, which is perhaps the shortest lasting one of those IDR programs. It's likely there will be future IDR programs with different rules and amounts, but these all have a few things in common. The most important one is that your payments on your loans are not based on your interest rate and they are not based on how much money you owe. They are based solely on two things. Your income, and that's as of often a year or even two years ago, and your family size. The more family members you have, the lower your payments. The lower your income, the lower your payments. That's what payments are based on. And the payments may not even cover the interest that these loans are generating. For example, if you had $200,000 in student loans at 6%, right, that's generating $12,000 in interest a year. But your payments on those might only be $100 a month. So you're not even coming close to covering that interest. Now, some of the IDRs have had features where they subsidize your interest and kind of lower your interest rate or even waive your interest completely. But those programs are coming and going. There's constant change in them. So pay attention to the current landscape as far as which is the best IDR program for you and just how generous is it right now? And be aware you might have to change programs during the course of paying off your student loans. Another feature of these IDR programs is often a forgiveness component. And typically you can get student loans forgiven via IDR forgiveness after making 20 to 25 years of payments. Whatever is left after making 20 to 25 years of Payments is forgiven. That forgiveness is taxable. So if you had $400,000 forgiven, it's like your taxable income just went up by $400,000 that year. That is likely going to be taxed at a pretty high rate because it's going to be in the top tax brackets. Wouldn't be unusual for that to be taxed at 40% or so. So while it's cool to have $400,000 forgiven, it's not so cool to have $180,000 tax bill from it. So be aware of that tax bond. That's why the IDR forgiveness programs are generally much less attractive than something like Public Service Loan Forgiveness. Public Service Loan forgiveness comes after 10 years of payments. IDR forgiveness after 20 to 25. Public Service Loan forgiveness has tax free forgiveness. IDR forgiveness is taxable, okay? So it takes a lot longer and it's taxable. So for most doctors, which a typical doctor income and a typical doctor amount of loans, you'll pay off your student loans before you ever get that forgiveness after 20 or 25 years. Now, if you have a particularly low income or you have particularly high loan burden, that might not be the case. And those are the people who should look at maybe considering IDR forgiveness. Just be aware, you better be saving up for that tax bomb as you go along as well. It's not my favorite plan for dealing with student loans. I think you're a whole lot better off refinancing them, living like a resident, paying them off quickly, or going for public service loan forgiveness. But there are a few people for whom that plan might be right. If you're wondering if you might be one of them, you might want to consider booking a consult. Studentloanadvice.com for a few hundred dollars, you can get advice that might be worth literally hundreds of thousands of dollars to you. It's money well invested, well spent to get some specific advice. If you're in that sort of a student loan situation where you would consider, consider IDR forgiveness. But most docs are going to use an IDR program, at least throughout their training, right? And maybe the entire time they're paying back their student loans. But generally for federal loans, while you're an intern, while you're a resident, while you're a fellow, you're going to keep those in one of the federal IDR programs to help you make more affordable payments. And that's the whole point of the program, is to make low income people have lower payments on their student loans. So learn about the IDR programs, plan to use them at least for a while. But you need to have a comprehensive plan for dealing with your student loans, whether that is paying them back by living frugally and sending big checks to your lender, or whether that is going for a forgiveness program. Have a plan, follow your plan. You'll be amazed how quickly you can get those student loans taken care of. Earlier we mentioned working locums with Comp Health, the number one staffing agency. But Comp Health isn't just a locums agency. Comp Health staffs regular permanent positions across the nation as well. They also offer telehealth, medical missions and more. And that's what makes them unique. They can look at your situation and offer multiple solutions to build your career the way you want it and meet your financial goals. And they know their stuff, especially when it comes time to negotiate contracts, which they're willing to do for you. So whatever career move you're looking for, visit whitecoatinvestor.com comp health and use the power of Comp Health to build your career your way all right, we've come to the end of this podcast. I hope you are making progress toward your milestones. If you want to share them on this podcast, you can do so. Whitecoatinvestor.com Milestones is where you sign up to make your contribution to this community. Until next time, keep your head up and your shoulders back. You've got this. We're all here behind you to help. You're going to get there and you're going to be able to reach those goals. So congratulations on what you've done so far and let's get going on to the next goal. The White Coat Investor Podcast is for your entertainment and information only and should not be considered financial, legal, tax or investment advice. Investing involves risk, including the possible loss of principal. You should consult the appropriate professional for specific advice relating to your situation.