White Coat Investor Podcast – Milestones to Millionaire #268: Getting Financially Set Up During Residency

Date: March 30, 2026
Host: Dr. Jim Dahle
Guest: Dylan, PGY4 Interventional Radiology Resident

Episode Overview

This episode focuses on the unique financial challenges and milestones faced by medical residents. Dr. Dahle sits down with Dylan, a fourth-year interventional radiology resident based in the Southwest US, to discuss practical steps and lessons learned about setting up good financial habits during residency. Together, they dive into student loans, moonlighting, budgeting with a spouse, and investing early—even when you're still deeply in debt. Dr. Dahle also concludes the episode with an in-depth, balanced discussion on cryptocurrency as an asset class for high-income professionals.

Key Discussion Points & Insights

1. Dylan’s Financial Milestones During Residency

• Celebrated Achievements:

  • Paid off his wife’s car loan.
  • Maxed out both his and his wife’s Roth IRAs.
  • Paid down $7,000 of his wife’s student loans.
  • Opened and started funding a Solo 401(k) through moonlighting.

    “We paid off my wife's car, maxed out mine and my wife's Roth IRAs, we paid down about $7,000 of her student loans, and I actually also recently opened my own Solo 401k and started funding that.” (04:19, Dylan)

• Income Growth Over Residency:

  • 2022: Combined income just over $50,000.
  • 2023: Raised to just under $80,000 (due in part to a 10% resident salary boost).
  • 2024: About $110,000 (beginning of moonlighting).
  • 2025: Ramped up to a gross of $150,000, with adjusted gross income at $119,000.

    “So end of 2023, our combined income was just under 80,000. 2024 was about 110,000. That was when I started moonlighting. And then just this last year... the total gross was about 150...” (08:46, Dylan)

• Moonlighting Details:

  • Primary moonlighting activity: contrast coverage (“babysitting the scanner”), with some interpretive study reading.
  • Takes advantage of moonlighting downtime to study for boards.
  • Moonlighting has enabled much faster progress toward financial goals than he thought possible as a resident.

    “A lot of it is contrast coverage, just sitting and babysitting the scanner. But there are some interpretive moonlighting opportunities, basically like reading studies and getting paid for that.” (08:49, Dylan)

2. Household Dynamics & Money Management

• Spousal Dynamics:

  • Dylan’s wife is a pharmacy tech; both had previous marriages with varying financial habits.
  • The couple now sits down at the end of every month to review finances using spreadsheets and budgeting apps.
  • Conscious effort to build good money habits early to set up for future financial success once attending salary arrives.
  • Emphasis on transparency and learning from previous marital financial missteps.

    “We aren’t perfect, but we try to kind of sit down at the end of every month... Just to try to not get too ahead of ourselves...” (06:44, Dylan)

• Budgeting & Lifestyle:

  • Live well within their means, choosing reasonable rent and avoiding expensive car payments.
  • Maintain flexibility and still prioritize occasional splurges (e.g., a recent Disney World trip) to avoid burnout during demanding training years.

    “We know that once I'm an attending, we're going to have the income. And so we do still try to have fun during residency... but we're still within our goals for what we're trying to do.” (13:07, Dylan)

3. Assets, Debt, and Investment Approach

• Net Worth & Liabilities:

  • Current net worth: approximately -$250,000.

  • Liabilities:

    • Student loans: $312,000 (Dylan), $7,500 (wife)
    • Car loan: $4,500 (Dylan’s car; wife’s car paid off)

  • Assets:

    • Investments: $65,000+
    • Cash: $9,500
    • Total assets: ~$75,000

    “We are sitting right at negative $250,000.” (09:49, Dylan)

• Investing Approach:

  • Focus on broad index funds: S&P 500 and growth funds.
  • Some legacy tech stocks from medical school dabbling (“not smart decisions” but small amounts, good learning experience).
  • Both Roth IRAs are maxed annually.
  • Plans to aggressively pay off student loans within 3–5 years post-residency, plans not to pursue PSLF.

    “Right now it’s mostly just index Funds, S&P 500 and some growth index stuff and then some random tech stocks here and there…” (11:34, Dylan)

• Delayed Major Purchases:

  • Continuing to rent rather than buy a home until student loans paid off.
  • Intend to revisit major financial moves (like buying/building a house) once debt burden is resolved.

4. Building Financial Literacy & Advice to Peers

• Financial Education:

  • Dylan began learning about finances in medical school during the COVID era, inspired by WCI resources and personal research.
  • Early lessons from mistakes investing small dollar amounts in med school.

• Advice to Residents/Younger Trainees:

  • “Find a way to supplement income”—moonlighting if possible varies between specialties.
  • Live below your means, avoid lifestyle creep (“a lot of colleagues...have ridiculous car payments”).
  • Keep perspective and allow yourself to enjoy some things during residency, avoiding all-or-nothing deprivation.
  • Build habits now to position yourself for success as an attending.

    “Finding a way to do that and supplement that income has really helped take a lot of the burden off... I think we try not to limit ourselves too much... during residency, it's hard and I think it's important to still have fun. But whatever we can do to develop those habits early, I think will pay off long term.” (12:35, Dylan)

Notable Quotes & Memorable Moments

• On student loans and career choice:

  “If you told me $650,000 in student loans, or you told me you were going into preventive medicine, that's a different scenario. But $250,000 in radiology, no problem. You're going to pay this back within a couple of years of getting out of training.” (06:08, Dr. Dahle)

• On money conversations as a couple:

  “Both of us divorced and we just remarried. And I know she had said from her past relationship there were some not so great financial habits and practices from her past marriage. And so really just trying to kind of start on the right path, moving forward and build those habits during this time...” (06:44, Dylan)

• On being transparent about net worth:

  “We are sitting right at negative $250,000.” (09:49, Dylan)

• On learning from mistakes:

  “That's how I feel is I made all my mistakes early on with small amounts of money. That's the time to make them for sure.” (12:09, Dr. Dahle)

Timestamps for Important Segments

• 04:00 – 05:00: Dylan introduces himself and outlines financial milestones.
• 07:44 – 09:10: Discussion about household income progression and moonlighting details.
• 09:49 – 10:47: Net worth deep dive; breakdown of loans, assets, and investment approach.
• 11:14 – 11:34: Student loan strategy and timeline; plans for future home ownership.
• 12:35 – 14:01: Dylan’s advice to residents and trainees about supplementing income, building habits, and balancing fun with discipline.

Special Topic: Cryptocurrency as an Investment

[14:34 - End (~5 minutes)]

Dr. Dahle provides a thorough and pragmatic overview of crypto assets, primarily Bitcoin, with clear-eyed pros and cons for physician investors.

Pros:

• Potential for “fabulous wealth” (market run-ups; some early investors became multimillionaires).
• Invested interest encourages learning about a new financial technology.
• Useful in certain scenarios, e.g., moving wealth across borders (“It’s way good for smuggling money... might be the best use case for bitcoin.” (~15:30))
• Favorable tax treatment (capital gains, no wash sale rule).
• Low correlation with other assets—a possible portfolio diversifier.
• Blockchain security—never hacked at the protocol level.
• 24/7 tradability.

Cons:

• Highly speculative asset; produces no income, dividends, or rents.
• Significant volatility—huge drawdowns can challenge even experienced investors. (“I'm not sure I can tolerate the volatility of bitcoin.” (~18:20))
• Steep learning curve; many investors don’t grasp what they're buying.
• Counterparty risk (exchanges frequently hacked/go out of business).
• Prevalence of scams, regulatory uncertainty, and lack of historical track record (“wild, wild west” nature).
• Most cryptos do not scale well; everyday use as a currency remains limited.
• Pragmatic asset allocation advice: limit to 5–10% of a portfolio if you choose to speculate, to avoid catastrophic impacts from a future total loss.

“If you believe in this stuff... I would recommend that you don’t just put like $500 or $5,000 into it. Put 5% of your portfolio into it... Not so much that it’s going to tank if you’re wrong, but enough that it's going to make a difference.” (~20:10, Dr. Dahle)

Summary & Takeaways

• Residency is an ideal time to start building good money habits: consistent budgeting, living below your means, and regular financial check-ins are critical.
• Moonlighting, when available, can dramatically improve financial progress and reduce stress.
• Open, honest communication with a spouse sets the groundwork for future success and helps prevent repeating past financial mistakes.
• Delaying “doctor purchases” like homes/cars until student debt is resolved puts you in a stronger long-term position.
• Early investing in index funds and maxing out Roth IRAs is possible even with negative net worth by prioritizing cash flow and maintaining discipline.
• Crypto may be a portfolio curiosity or speculative play, but it should never be the foundation of a physician’s wealth-building plan. Know the risks and never over-allocate.

For More

If you want to share your own financial milestone or story, visit: whitecoatinvestor.com/milestones

Listener Review Highlight (re: sponsor):
“Bob has been absolutely terrific to work with… has been able to help explain the implications and underwriting process in a clear and professional manner.”

This in-depth and candid discussion showcases the reality that financial progress—especially in medicine—happens milestone by milestone, not overnight, and that discipline, teamwork, and a willingness to learn (and try, and fail, and try again) are more important than a high attending salary alone.