Christopher Guest Post: Senior Resident

Welcome to the latest Christopher Guest post. Today’s guest post is the “Resident Sensei” of his site known as Senior Resident.

Despite the name, the good doctor is no longer a resident, but is an attending radiologist in sunny Honolulu, Hawaii. Like me, he was initially anonymous to the public, but he has since revealed his identity as Walter Nguyen, MD.

Dr. Nguyen was kind enough to answer my inane questions in great detail and I think you’ll enjoy the banter between us. Although we haven’t met in real life, I hope to remedy that, perhaps within a year or two. I’m pretty sure we’re due for a CME trip to Hawaii in 2018, and I plan to stay for a few weeks to show our boys the natural wonders that are the Hawaiian islands.

I’ve sprinkled in a few photos from our 2013 visit to Oahu. Aloha!

What’s a Christopher Guest post?

 

Inspired by Nigel Tufnel, the character portrayed by Christopher Guest in Spinal Tap, I took Mr. 1500’s ten questions, and amped them up to eleven.

 

If you’re not familiar with the scene, take 50 seconds to watch this video and enjoy the dialog between Nigel and Rob Reiner.

 

I decided I’d start a Q&A of my own. Not satisfied with just ten questions, “this one goes to eleven”. Just like Nigel’s amplifiers.

 

Presenting: Senior Resident

 

What is your specialty or subspecialty and why did you choose it? If you could turn back time, would you choose to practice medicine and choose the same specialty? Why?

I’m a radiologist, with subspecialty training in neuroradiology. For those keeping count, that’s 1 year internship, 4 years of radiology, and 1-2 years of neuroradiology fellowship.

To be honest, radiology was kind of chosen for me by a certain astute neurology attending. I had my heart set on Neurology, but when I asked my neurology attending for a letter of recommendation of neurology, she said “You’re not a neurologist, you’re radiologist!”.  She went on to say that while I had good bedside manner and fund of knowledge, that she didn’t see me a neurologist. She explained that while I was interested in neurology, the only time during rounds that she saw me “light up” when when we reviewed the MRIs.

She was right.

I switched gears to radiology very late in my 3rd year and tried to get some radiology elective time as soon as possible. After sitting down with the radiologists and reviewing cases, I realized that I really liked imaging and diagnosis, especially in the realm of neuroradiology. So, in essence, my neurology attending pushed me into radiology with plans for neuroradiology.

If I could turn back time, I would still probably choose medicine and radiology. However, if I was a current senior in college, I think I would have to think long and hard about it. The loan burden continues for medical students coming out continues to increase, with relatively stagnant salaries (when accounting for inflation).

There is a saying when it comes to surgery:

“If you can do anything else but surgery, do that. If you can only do surgery, then do surgery.”

That’s kind of similar to choosing medicine nowadays I think.

Do it because you can’t see yourself doing anything else.

[PoF: How cool that you had a mentor set you straight like that. Equally cool that you would choose the same career if you go back your days as a young Samurai. 

I hadn’t heard that about surgery, but I felt it as a student and trainee. I can stand to be scrubbed in for all of ten minutes before I want to need to scratch an itch in the forbidden zone. My hours aren’t any better than a surgeon’s — I’m the first to arrive in the morning and the last to leave the O.R., but I prefer my job to that of a surgeon.

I tip my scrub cap to all of you who live the majority of your workday in a sterile environment under the hot lights.]

 

 

 

Describe your blog and tell us why your blog would appeal to a physician seeking FIRE in eleven sentences.

 

My blog has posts 3 times a week on Monday, Wednesday, and Friday. These are named Medicine Mondays, Whatever Wednesdays, and Finance Fridays. Overall, I think many would consider my blog to be “lifestyle” oriented with a few tidbits of financial information thrown in on Fridays.

I think PhysicianOnFire’s and WhiteCoatInvestor‘s blogs appeal to those who want to be able to reach Financial Independence and Retire Early (FIRE). However, I think my blog is more aimed at “the next generation,” at the medical students and residents coming out.

My plan is to provide my experiences as a way to not make the same mistakes I did and give them a good foundation for their financial and professional futures. In order to reach FIRE as soon as possible, it’s important to not make any big mistakes early in your career.

I think every physician in this generation should have the option that PoF does, which is working because you want to, not because you have to. Establishing good financial habits early on in your career (preferably as a medical student or resident) is of the utmost importance.

Compound interest matters. You don’t know what you don’t know.

[PoF: I think you’ve got a great blog and you clearly enjoy writing for us. When I’m in Hawaii, I like to spend as much time as possible, but when you have the option to be outside in Hawaii every day, I suppose some air conditioned computer time is welcome, too.

I write this from a cool basement office, while it’s sunny and 88° F outside.]

 

 

What inspired you to start a blog of your own? Was there a particular event you remember that made you feel your blog had arrived? Any big plans for your blog in the future?

 

I began reading WhiteCoatInvestor back in 2011 or so when I was a radiology resident. It was around the same time that I started buying and reading finance books to try to learn about how to save for retirement. What was so unbelievable to me was that as hard I tried to get my co-residents to read WhiteCoatInvestor and/or any my finance books, very few would listen to me. They had their own ideas about how to save for retirement and/or invest without ever reading a single book. 

That didn’t make any sense to me at all.

Why do physicians, who study so hard and learn so much refuse to learn anything related to finance? Then I realized why. We don’t have enough time… or at least we think we don’t. In terms of our priorities, for many it’s not even on the list of priorities to think about. That needs to change.

However, it’s not just finance, it’s kind of everything. Physicians tend to only trust the opinions of other physicians, even if this other person has no knowledge on the subject. After all this reading during medical school and learning day in and day out… we don’t really want to learn anymore, so we rely on those that we think have more experience. We are so focused on medicine that everything else takes a back seat. And well… it’s understandable.

The feeling I get from many physicians when it comes to anything that isn’t medicine related is “Can’t someone else do that for me?”  That is because we come for a culture where our time is so important that we literally must do whatever possible to maximize our skills/knowledge at all times. There are only so many hours in the day, right? We must try to help as many patients as possible in the smallest time span possible. That’s the culture that is ingrained in us. It’s not worth my (our) time to deal with anything else.

That’s why we (as a group) are considered financially illiterate. That’s why many of us end up making big mistakes when it comes to anything other than medicine. The biggest hurdle to all of this is that physicians don’t talk to each other about non-medical stuff, especially finance/investing/retirement. I realized that in order to change this, I needed to start with the next generation, the medical students and residents who are now coming out with huge loan burdens. They need to understand in medical school or in residency, what awaits them, and learn from my mistakes.

To be honest, I don’t feel like my blog “has arrived” yet. It’s certainly nowhere near as good as either PhysicianOnFire or WhiteCoatInvestor. However, I was ecstatic when PhysicianOnFire included me in his Sunday Best and when WhiteCoatInvestor included me in his The Other Guys post. At that point, I was like, “Oh wow, these GIANTS actually read my blog… and linked to it?”

At that point I felt a sense of pride in the content I was creating, and so I’ve continued to try to create content as best I can. Oh, I also got a decent amount of views on Quora when I copy/pasted by Doctors Marrying Doctors post. It has 3,500 views at the moment, which is a lot (to me).

Ideally, I would like to create a youtube channel at some point doing a little show of my most popular posts, as told my daughter: Vietaliana. However, I haven’t had the time (or the ability) to do that yet. I think it would be much more entertaining to have my cute daughter give you advice instead of me.

[PoF: I don’t know about GIANTS, although I do stand about six feet tall and Dr. Dahle’s got a few inches on me.

I think we all share a similar mission and passion for learning and sharing our knowledge of personal finance. It is painful to see so many others make the same choices we once did that we now see as mistakes in hindsight.

I agree with your assessment that it can be tough to get other physicians on board with our recommendations. The best thing you can do to get the word out is to actively get the word out. I have a massive post on all my best blog tips to accomplish exactly that.]

 

 

Give me eleven posts you think Physician on FIRE readers might want to read?

 

1. Why Do Doctors Marry Other Doctors
   • I contemplate the circumstances for why Doctors Marry Other Doctors.
2. The Biggest Mistake of Your Life
   • This is the the biggest (financial) mistake of your life. This one mistake shapes your whole future.
3. Dual Income No Kids (DINK)
   • This is for my readers who don’t plan to have children, and how your priorities are a little different than mine.
4. I Wouldn’t Choose Medicine Again
   • I talk about the reasons for why people wouldn’t choose medicine again.
5. I’m Leaving Medicine
   • I talk about two colleagues of mine who recently told me they were going to leave medicine.
6. Talking to Med Student Me
   • Things that my current attending self would tell my past medical student self, and mistakes I’ve made
7. Retiring Early
   • I talk about how in order to retire early that it must be the priority in your life.
8. How to Retire Early
   • In this post I explore the “how” of retiring early.
9. Early Retirement is Easy?
   • I provide commentary on why early retirement is easy (or not).
10. Best Bang for Your Buck Retirement Locations
    • I explore how where you retire to can affect your retirement and withdrawal because of cost-of-living, taxes, etc.
11. Stock Market FOMO (Fear of Missing Out)
    • When the stock market is doing very well, you may have FOMO (Fear of Missing Out). I explain why you don’t need to feel this way.

[PoF: Those are right up my alley. Like you, we’re not  DINKs, but actually totally SICK (single income, couple kids). I had read most of these previously, but hadn’t caught the Bang for Your Buck retirement spots. It would be an interesting followup to explore international retirement destinations.]

 

 

 

At what age are you most likely to retire (or at what age did you retire) from full-time work? What are you doing to help realize your retirement target?

 

My current plan is to have the option of going part-time about 20 years from now, at the age of ~55 or 56. At that point, I would expect to have both my wife’s student loans and my student loans paid off and have enough saved in 529s for the kids to not need to worry about college tuition or significant debt. My mortgage will have 10 years left on it, but should be manageable at that point.

My plan is to have student loans all paid off, > $5 million in retirement, and my house mostly paid off.  My daughter would be 24 and my son would be 22 and would be finished, or finishing college. At that point a lot would depend on where they plan to settle. If they decided to come back to Oahu (and I hope they do) then I’d probably continue working full-time a little bit longer. However, if they settle back on the mainland, the option to go part-time and live near and spend more time with my children (and grandchildren) is important to me.

Currently, I am putting away $34k into my retirement account and my wife is putting away $36 into hers every year. This year we plan to also do the Backdoor Roth IRA for another $5500 each. As such, that adds up to $81k put away a year. If we can do that for another 20 years, on top of what we already put away, that should put me pretty close to the $5 million mark. Additionally, I will have a federal government pension beginning at the age of 65 as well, so that also helps buffer my withdrawal from retirement accounts post age 65.

[PoF: I noticed you’ve got your wife doing the heavier lifting. 😉 

I know living in Honolulu is not exactly taking advantage of geographic arbitrage when it comes to salary versus cost-of-living, so saving that much is a feat to be proud of.

Your retirement goal is seemingly quite a bit higher than mine, but on an inflation-adjusted basis, it’s actually quite similar. I won’t have a pension, but eventually Social Security should be available.]

 

What does an ideal retirement look like for you? What will you do with your time when full-time work is in your rearview mirror?

 

My “ideal retirement” keeps on changing. At first, I imagined myself sitting on a beach just reading books and drinking piña coladas. However, that has kind of changed. I enjoy blogging a lot, so I don’t think I’ll ever give it up completely, unless I run out of things to write about. So maybe, sitting on a beach drinking Miami Vices and writing on my laptop.

Now that I have a family of my own, I think that is now my highest priority at all times. Retiring would provide me the flexibility to be with my family as much as possible.

One of the other benefits of retirement is the ability to do whatever you want. Maybe I could finally learn to code, or write a book, or become a sommelier. Or whatever. There are so many interesting things to learn and know. Part of having my own blog is that it forces me to step outside my comfort zone of radiology/neuroradiology and learn other things. Additionally, in retirement, I hope to be able to support my children in the pursuit of their dreams. I hope they will want to change the world.

 

 

I’ll give you eleven sentences to dish out advice to a young physician. Any and all advice is welcome. We talk about personal finance, so money is fair game, but if you have advice on being a better doctor, a better parent / spouse / friend / human, we’re all ears.

1. You don’t know what you don’t know.
2. Learn something new everyday.
3. Take responsibility for your mistakes and learn from them.
4. Don’t be afraid to ask for help.
5. Save early and save often.
6. Grow slowly into your money.
7. Make retirement a priority.
8. Buy experiences not things.
9. Don’t go to sleep angry at your spouse.
10. Try to be a better person than you were yesterday.
11. Be happy. Life is too short to spend it unhappy.

[PoF: Excellent words to live by. This should be on a plaque. Or maybe a cross stitch.

I try to do these things, although I probably have the most trouble with #4. I like to figure things out myself. It’s a great way to “learn something new every day,” but I could learn more efficiently if I reached out for help more often.]

 

 

You’ve got eleven days to visit anyplace in the world with an $11,000 budget. Where do you go and what do you do?

$11,000?

Hmm…. I’d take the wife, kids, and my in-laws to visit my parents and sister in Southern California for the 11 days. We’d all go to Disneyland and I’d let my daughter and son do the whole Princess/Prince for a Day thing. We’d eat In-N-Out, get some real Vietnamese food in Westminster, and some real Mexican food pretty much anywhere in Southern California.

If my brother is home, we’d go out for All You Can Eat Korean BBQ and try to put them out of business. Then we’d all drive everyone down to San Diego and go to the San Diego Zoo and Legoland. After the 11 days of eating great food and being with family, we’d all go back to Oahu full and happy.

My plan would be to have everyone in the family remember that trip forever… and then maybe we make it a yearly thing to go to Southern California ever year for a week or so.

[PoF: You’re the first Guest to incorporate visiting family into your dream vacation, and I think that’s fantastic.

We took our boys to Florida’s Legoland a couple years ago, and they absolutely loved it.]

 

 

Name eleven beverages you enjoy. You can be as general or specific as you like.

1. Johnnie Walker, prefer Blue Label, but Black Label is best bang for your buck
2. Beer, only once in awhile, I prefer Sapporo or Samuel Adams (Winter Lager if available)
3. Venti Pike from Starbucks, increases productivity by 1000%
4. Red Wine, I prefer Cabernets and my wife and I like Layer Cake (we get it from Costco, good bang for your buck imo)
5. Diet Pepsi, because sometimes I want carbonation, but not calories
6. Dr. Pepper (not Diet), because sometimes I feel like different carbonation
7. Horchata, because it’s awesome
8. Miami Vice, my vacation drink of choice for lounging at the pool/beach
9. Vietnamese Tea, my mom used to make this for me when I was studying to Step 1
10. Brita Water, my wife makes me stay hydrated, she keeps me pseudo-healthy
11. Gatorade, my drink of choice whenever I’m playing tennis (this hasn’t happened for awhile)

 

[PoF: Good variety there, Sensei.

I think I could open your eyes to some local beers brewed in the archipelago. And don’t be fooled by that Kona stuff. I’m not saying it’s bad, but it’s brewed in several mainland breweries, too. Maui Brewing Company is excellent; for a mainland option, you guys get Clown Shoes distributed there, which is outstanding.]

 

 

Now, eleven foods.

 

1. Sashimi, I dream of tuna and salmon
2. Poké, because see #1
3. Lobster, just steamed with a little butter – I would eat this way more, but my wife is deathly allergic
4. Crabcakes, the best I ever had were from G&M Restaurant, just outside Baltimore, MD –  the crab:filler ratio was perfect (very high)
5. Steak, I prefer filets, medium rare – but will on occassion eat porterhouse, prime rib, or chateaubriand
6. Steak, part two, I can eat bottom sirloin in bulk with chimichurri sauce if you take me to Fogo de Chão
7. Bacon, everything is better with bacon, who wants to make my restaurant “Everything Comes with Bacon”?
8. Pizza, I have not found a better pizza than Grandma’s Pizza from Casa Calamari over in Brooklyn, get it Sicilian (rectangular)
9. In-N-Out, Double-double animal style with animal style fries – one of the things I miss from California
10. All You Can Eat Korean BBQ, all you need is bulgogi – another thing I miss from California
11. Vietnamese Food, including Phở , Nem Nướng, Bò nướng lá lốt, and Bò lúc lắc
    • Note: You can find all of this in Westminster, CA, however, for Nem Nướng, go to Brodard’s

[PoF: I’m totally coming to your house for dinner. I’ll bring the beer.

We had a little back and forth on one of your posts discussing Poké. It needs a larger presence in the midwest. I can imagine walking into a local Kwik-Stop and asking for a scoop of spicy tuna. After about ten seconds of blank stare, the guy might point to the bratwurst rollers.]

 

 

How did you first learn about PhysicianonFIRE.com? What one piece of advice do you have for me?

Actually, the first time I learned about PhysicianonFIRE.com was when he commented on my blog. I wandered over to his blog and was impressed by what he had accomplished. In particular I really enjoyed his segment on 4 Physicians. Being shown in black and white on excel spreadsheets just where the money is going for these 4 individuals and how it affects their futures and retirement was great. This led me to realize just how powerful numbers are and convinced me to put away money as early as possible.

Also, I have tried to incorporate more numbers into my posts with “back of the napkin” type calculations and trying to account for inflation. This was particularly important for my recent segment on Roth 401k/403b in Residency and the How To. Although it’s not a super popular post at the moment, I think it’ll gain momentum over time as medical students/residents become more aware of their financial futures.

I’m not sure I have any advice for PhysicianonFIRE, he seems to have all his ducks in a row at this point. I guess my only advice is to never change, and be happy.

Thanks for giving me this guest post opportunity!

Walter Nguyen, MD aka “Sensei”

 

 

[PoF: Thank you for participating and giving our readers a peek behind the curtain. While there are increasing numbers of physicians writing about personal finance, I don’t know that there are other attendings with a focus on the student and resident.

Attendings tend to speak to attendings, residents to residents, students to students. I more or less write for a younger version of myself, but I think what you’re doing is selfless and valuable.]

 

 

Is there a twelfth question you’d like to ask our Senior Resident? Comments? Just want to join him for some Foodland poke on your next CME trip to Waikiki? Let the two of us know below!