From Growing Up Poor To Becoming A Wealthy Physician

FS asked me to write a short piece about my journey from growing up poor to becoming a physician, with mistakes and lessons learned. I’ll attempt the TL;DR version, but I’ve been known to ramble and it is a bit of a story…

Background: Growing Up Poor

My parents separated and divorced sometime around five to seven years of age, and my sister and I went to live with my mother, and thus began an interesting childhood. Long story short, my mother spiraled into the nightlife with alcoholism and increasing neglect and abuse in general. At the age of 11, she had my brother who she waited all of seven days until leaving him alone with a 10 and 11-year-old (the older I get the crazier that sounds). A few years later this devolved into a drug addiction and leaving us alone for up to two weeks at a time. Mixed in that backstory are the usual assortment of having attended five elementary schools and two each of middle and high schools, lots of moving and evictions, welfare, cps, living with friends and anyone who would take you in, poor decisions and the resultant outcomes of them.

Luckily at that time my father was able to get custody and we were removed from that situation. However, that transition did not go well and at the end of my freshman year of HS I ran away 150 miles to my maternal grandmothers. No reason, my dad is a wonderful person, I think in retrospect it was just a lot and teenagers are not the brightest demo in the human race. Things did stabilize there and I was able to finish out HS in one place, play sports and have a job. I supplemented my grandmothers SSI and food stamp checks by working for the apartment complex where we lived, and eventually the local grocery store as a bagger.

I wasn’t really doing anything academically, I was fortunately blessed with a voracious reading appetite and the ability to learn fast, which meant in school I really didn’t have to do much of anything to get by, and that’s exactly what I did. I had always planned to go to college, but more of that ephemeral idea of what you want yourself to be, without ever making strides to actually achieve it. Suffice to say I had zero financial knowledge.

Opportunity from missteps

Oddly enough, the thing that woke me up and caused me to reevaluate everything was a situation that is most likely to set you back. Just after HS graduation I found out my girlfriend was pregnant, and this is where introspection and laying out an overall life plan began. It started out with a simple goal; I would not let my child grow up to rehash the same life I grew up in. This was a principle that I was wholly devoted to. I continued working and moved up into better paying departments in the store, and over the year somehow, improbably, decided I wanted to be a doctor. When my son was nine days old I went to my first day of school at the local community college, taking a more than full schedule (including summers, I wasn’t fully at college level) and working full time.

A couple of months later we had our very own apartment. We compounded our teen pregnancy by “doing the right thing” and getting married, which spoiler alert, did not work out. There was a six-month stretch in my junior year of undergrad spanning the time I took the MCAT where I was a single parent, working and going to school full time and trying to take care of a three-year-old. This story would have a different ending if I had to keep that up for very long. I should start some bullet points because this is not the end of the mistakes by far. We got back together, had another child and toughed it out for six more years before divorcing.

Private medical school-super expensive, excellent education, but ouch
Used student loans to bail out ex from some cc debt, came right back
Private school based in one of the most expensive cities in US
Bought a house in residency in…2006
7 years training, loans doubled in that time
Liquidated (97-02) 401k for school expenses, again in (06-12) for moving expenses, ugh
Took a private practice position while having 496k in debt, forgoing pslf, etc…
Too much car, now down to just one for the family
Did not learn about money, debt, finance at all yet

Getting it together

Getting out into the real world came with a lot of waking up to economic realities. Between child support and student loan payments I needed to clear 5k after taxes a month before anything else. This lead to a lot of stress and sleepless nights. Ultimately, it led to giving myself a crash course in finance, from the absolute basics to eventually more interesting stuff. Thankfully, with knowledge came tools, a plan and sleep.

I read several books and devoured websites on personal finance and investing. Initially I was a debt pay down true believer. However, after further study and realization of what I think are key concepts of taxes, simple vs. compound interest and varying term length advantages between loans and investments…I became agnostic towards debt and focused solely on increasing my net worth to zero and beyond.

I refinanced my variable private loans twice in the last year using SoFi and Earnest getting a shorter term and better rate, while my federal (about 55%) stays consolidated and fixed at a low rate of 3.125%. Im about to hit my three years out mark and I haven’t paid off my student loans yet, so I’ve no magic formula here and am simply continuing to work and improve as a professional, and financially so by methodically building up assets and paying down debt, slow and boring like.

I max out all my tax advantaged space, a SEP and HSA and am thinking of adding a defined benefit plan as well (Im self-employed). I pay nominally extra on my student loans and nothing more. Everything else is invested aggressively, that is we are aggressive about saving as much as possible, not taking on too much risk. This is basically a carry trade with a huge fringe benefit of liquidity.

Our house is simple and 55% of my gross salary. We do travel some, mostly as a benefit of occasional credit card bonuses and normal spending that allow us to visit family for low to no cost. We are otherwise pretty boring so spending isn’t a big deal, it’s the fixed costs that are the problem. The great thing about growing up poor is the perspective, and feeling very content to have what I do and not feeling much pressure to “keep up with the Joneses”.

In the beginning I was super stressed about my debt, and it certainly felt unfair and there are valid points in there somewhere to that argument on a systemic basis. In reality I think a lot of those feelings stem from uncertainty and fear about how you are going to deal with it. The first step to improving that is to educate yourself and come up with a plan, and if you’re on this site you’ve already made that decision. Next is to implement said plan, and let consistency in your plan and work bring down your anxiety and give you back control. Running the numbers (I love spreadsheets) is a great way to put yourself at ease. Yes, I have a fairly large debt burden, and I’m sure if it wasn’t there I would like what I do even more. However, I no longer feel unduly burdened by it. It was an investment that has so far paid off and should continue to do so, it was worth it (did not always feel this way). I know it will be paid off in due time and a nest egg will be growing alongside it as well.

Closing – Growing Up Poor Helped

One of the more powerful yet subtle things I’ve noticed looking back is how small someone’s world can be, and how that translates to how small their dreams become. Mind you this was before the internet and cell phones, but from what I recall there was nothing outside of my neighborhood, group of friends, etc.…. No one thought about a future outside of that. There was no college, no studying abroad, no aspirations to be anything other than the local turf ruler. It’s thought of as so impossible that it would be ridiculous to consider. This is a horrible worldview that is not conducive to social mobility or people reaching their potential. I don’t have any answers for that, just something I’ve often reminisced about.

So how did I do it? Honestly, there were many places where I could have given up, or had something untoward happen to make it so I did not. That thankfully didn’t happen so in retrospect here are some of the things I think contributed. Obviously an innate drive to learn, amidst everything I always read like crazy, and taught myself about things I was interested in.

Good models on my father’s side of the family, normal stable relationships and jobs that were in stark contrast to the ones I lived with. I think that was very important, not only did I look up to and respect them, I did not want to disappoint them. All along the way people took a chance on me. At 15 I was allowed to work for the apartment complex, at the store I rapidly moved up to a position that paid very well, and had not been given to someone of my age very often.

For a position in a prestigious medical school and then again in a very competitive residency. I had to make good on those chances, but the opportunity and risk was first taken by someone else. Looking over these words it kind of looks like blind stubborn persistence and forgetting to quit with a bit of luck. Now being older and wiser, I am very thankful to be where I am today. These are not things I think about often anymore, and it’s kind of strange to write and remember it even, seems so surreal.

In the end our life is shaped by experiences and our responses to them, each one of our decisions building upon another to culminate in an overall direction that isn’t necessarily obvious at the start. Something I tell patients along these lines is to start making small better choices today, then next week, month and year and in the end you’re compounding (really accretive but doesn’t quite roll off the tongue) these choices, and they can attain a much better result than trying a drastic yet short lived option.

It can be hard to see the snowball effect of making a bunch of small but good choices aligning your present day life with your long term goals, but they will start to add up to something substantial over time. My single most important choice made was to bring my son up in a world completely different from the one I grew up in, and that has resulted in this whole journey. This is a powerful example of hard work and determination applied to a singular goal.


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