Episode 14: Crushing Student Debt During Residency In NYC with Dr. Yu Chiu

May 17, 2019


This Episode

Interview w/ Dr. Yu Chiu

You Will Learn

 – Yu’s path from the NIH to med school and how this helped him save money to pay a substantial chunk of his med school tuition in cash.
 – How Yu was able to build a lifestyle in NYC with his wife that enabled him to make financial progress even during residency in NYC
 – How Yu’s parents influenced his perspectives on finances and enabled him to make great financial decisions as an adult.
 – The resources Yu recommends to get financially informed as a young physician.

Resources & Links

Show Notes

This week I talk to Dr. Yu Chiu live at ASIPP 2019 about how he managed to knock out his student loans before finishing residency.  We discuss his parents’ influence on his financial perspectives, how to live affordably in NYC, and what resources he recommends for physicians wanting to move toward financial freedom.

Show Transcript

[[this transcript was auto-generated]]

Dr. Chiu: [00:01] My father actually died of cancer when I was young and when I saw that that was the moment that I told myself and just a light bulb turned on and said, you know what medicine is it? And that’s, that’s why I went to med school and that’s why I am a resident physician right now. Hey, this is Justin Harvey, your host of the anesthesia success podcast. My wife has an anesthesia resident and I’m a financial planner and I work with anesthesia and pain doctors as my clients. This podcast is designed to help the anesthesia community be informed about their careers, their finances, and more by taking important questions straight to the experts. Thanks for tuning in this week. I speak with doctor you to live at the ace at meeting. That’s the American Society of interventional pain physicians in Las Vegas, Nevada. You as a resident who has made a lot of great financial decisions through med school and residency, much of which he credits to his parents’ influence in his early years. So if you’re a resident or a fellow right now and you’re wondering what the financial possibilities exist for you before you become an attending position, you won’t want to miss this episode.

Justin: [01:08] Hey, it’s Justin Harvey with the anesthesia success podcast. Pleasure to be with you this week. I, I’m recording episode number two live from a sip with my new friend, doctor you chew. We were sitting here at the, Boston scientific lunch and he was just sharing how he was able to finish residency with no student loans. And we are sort of peeling back the layers of the onion and I think that his story is one that may really resonate out there with a lot of young physicians who are interested in financial independence and wanting to be responsible with their money early on rather than sort of having to make up for lost time in their late thirties or early forties. And I think he’s done a lot of things right at the outset, has a lot of really great philosophies with regards to money and life that seemed to be setting him up really well for success going forward.

Justin: [01:54] So I’m excited to unpack that with him. So doctor Yu Chiu, thank you very much for joining us today.

Dr. Chiu: [01:59] Thank you very much, Justin for having me on and it’s a pleasure being on your podcast and learning about you and what you’re doing for a lot of residents out there, especially the financial planning part. I definitely appreciate you having me on. Yeah, thanks to you. So a little bit of background, why don’t you just kind of tell us who you are and how you came to this moment. Yeah, absolutely. So I’m finishing up my residency at NYU right now, but just so you know, my background wise on a, I was, I graduated from North Carolina State University right after that. I did bell four years of research where I also did work at the NIH and the National Cancer Institute. I finished my med school in Erie, Pennsylvania. I then did by internship in Camden, New Jersey, and now currently finishing up my residency yet in Manhattan, New York, where it’s very expensive but doable.

Justin: [02:45] That’s right. So, you know, you did this research time period after Undergrad. Tell us a little bit about what that was all about.

Dr. Chiu: [02:51] Yeah, absolutely. so I actually worked with some very big names in at the Nih. It was a doctor, Steven Rosenberg. He authored the transforming cell. We worked very closely on immunotherapy in melanoma patients. It’s some very fascinating stuff that hopefully is going to become pretty popular in the medical field soon enough. But it was very enlightening, very hard work, was involved and a lot of hours.

Justin: [03:18] Did you know after Undergrad that you wanted to do med school or did you kind of discover that at the Nih?

Dr. Chiu: [03:23] I have to say, my background really was in auto mechanics, computers. I mean it was probably the furthest away from doctoring and medical stuff. But, I worked in this lab, saw how amazing these surgeons and researchers were. That pretty much told me and showed me the delight where medicine is at.

Justin: [03:43] Wow cool was there like a catalytic moment when it clicked for you and you’re like, I love this and I want to be an MD or a video in your case? So, yeah. Yeah, absolutely. so there was actually one patient that we had seen that had terminal melanoma. I remember exactly. We saw these CT scans before the immunotherapy and the liver was just chocked full of tumors and cancers. This immunotherapy was a trial at the time, a clinical trial and I believe it’s still going on after they receive the immunotherapy cells, essentially the cells from the patient’s own body. But we selected just the cells that attacked the cancers. The next time we did a CT scan, you know, I’m not going to say it was a cure or anything, but, the liver had absolutely no cancers whatsoever.

Dr. Chiu: [04:36] And that was probably the moment when it clicked to me because, you know, going back a little bit more in depth, a little bit more private setting wise, my father actually died of cancer when I was young. And when I saw that, that was the moment that I, that told myself, and just a light bulb just turned on and said, you know, what medicine is it? And that’s, that’s why I went to med school. And that’s why I am a, eras and physician right now. Did you think at all about like a phd or something? A more research oriented track? Oh yeah. And just so you know, when I did this research for four years, I was actually doing a phd, but I decided, hey, you know what, let’s get away from it from research because I felt like I had learned enough for at least the basics part two then go into medicine where I can actually help people hands on.

Justin: [05:30] And then talk a little bit about your transition into med school and residency. How did that go as far as switching gears and being more like into the medicine in a way that you hadn’t been in the past?

Dr. Chiu: [05:39] Oh yeah, no. And, and I gotta Tell You, Med school, I remember the, the cliche phrase that people would say, it’s like drinking from a fire hydrant instead of drinking from a straw. I mean, it was a lot of information, but the good news is being in college, doing a lot of research, reading a lot of books and journals, articles, it does you how to read quickly enough to get the gist of it. And to also read deeper if you need to. so it’s, I guess I, when it comes to the way at least the American medical system works, there’s a reason to it.

Justin: [06:12] Yeah. So you’re currently wrapping up the residency? Yes. At Nyu. Congratulations. Thank you very much. PMNR why don’t you talk a little bit about your time in New York and obviously New York, one of the more expensive cities in the entire world. And we’re here talking about how you are able to, you know, almost be out of student debt after obviously, you know, med school very expensive. How did that all work out? How did you build a lifestyle in such an expensive city that enabled you to do that?

Dr. Chiu: [06:36] Absolutely. And obviously this is a financial podcast. I want to also kind of share my experience as well because I think that by sharing my experiences, other people in the same, you know, area could potentially benefit. So my internship was in Jersey. Jersey was a relatively cheaper area to live. standard of living was a little lower even though residents salary intern salary isn’t that great. I kind of bit my thumb and ended up living with a roommate at the time to kind of save money. That saves quite a bit of at least a few grand, maybe 10 grand plus. Wow. Awesome. Which I needed because once you go to New York, apparently the saying goes, you need at least 10 grand just to get an apartment. And it really is true. It was first month’s, last month’s security. I saw security brutal. They were right it, you need at least 10 grand to get an apartment.

Justin: [07:29] Wow. Where did you live in New York?

Dr. Chiu: [07:31] So I still live in New York. I’m actually almost done with my lease. I live in right near Columbus circle on the west side. Okay. and I’ll, I’ll let you know the price. So we, my wife and I, Mary Anna Lee, by the way, is my sweetheart. It’s my Mya Moore. Just my love of my life. Without her, I could not be doing what I’m doing right now. So shout out to you babe. And a, I gotta say, so my rent was 3000 a month. Deny include utilities. What was your share of the rent and, no, no, no, this was the entire entirety of the rent. But you also have to realize is in New York, so it’s a studio. So Square foot wise, I think it maybe barely hits 300, but we do have a, we have a, a, you know, a good size bathroom. We have a good size kitchen. The bedroom is essentially the living space right now. How did we get this to work? Okay. I will have to say having a wife, you know, splitting the rent a little bit is really one of the only ways to be able to live in New York City, both, comfortably and also financially beneficial.

Justin: [08:41] Yeah. When did you get married?

Dr. Chiu: [08:42] I got married a few years ago. When did it have been like before in New York? It was before New York. Yes. Yes. so, you know, I think tax benefits obviously are a big thing when it comes to doing your taxes together. But living wise in New York, it is expensive. And I would tell anybody that is coming in, especially for internship or residency, you know, unless you’re made out of money, you need to get a roommate or live below your means because you know, just to let you know, my paycheck, it’s around, I mean this was after taxes, after 401ks and or in our case, four oh three B’s, maybe a little less than 2000 every two weeks and that money goes away pretty quick.

Justin: [09:23] Yeah. Yeah. So, you know, if we go back to med school, obviously med school is a very expensive investment. Yes. And you know, I do a lot of student loan analyses where I routinely see people well into the six figures, not the average number that I’ve seen I think is like 160 [inaudible] that feels really low to me based on very low based on what I actually see in real life. And maybe I have some adverse selection for. It’s all the worst than people who I end up speaking. But, so what was your experience with taking out loans for med school? Did you know what you were getting into? Did you save money during, you know, those research years to pay for it or how much did you end up graduating with?

New Speaker: 09:57 Yeah, and I’ll go a little bit more detailed. So just so you knew before I went to med school, I did know about the debt burden that med students had a, at that time I was told one 50 k was kind of the average, but I’ll let you know. I know people that are married to other doctors that have a crude. I mean just by just one, one physician himself had over 400 K in debt. Oh yeah. Okay. And he went to a very big MD school that was 80 k a year ish. And that did not include room and board and you know, after interest rates. And then he also married somebody else that was in the medical field, another four. I mean we’re looking at close to a million dollars after interest. And I just, that blew my mind. And obviously this was after the fact, before I knew that if I was going to have 160 k plus of debt, that I needed to save up as much as I could. And when I was at the Nih, I only made 30 k a year. But I, you know, again, bit my thumb. I had roommates, I had six roommates and Bethesda, Maryland.

Justin: [11:04] Wow.

Dr. Chiu: [11:05] Okay. I picked, you know, maybe not the smallest room, but it was like closest to the smallest room and you know, I was still paying a bit, I can’t remember the price wise, but it was enough to be able to have fun. I’m not the type of person that just sits at home, does nothing. I go out, you know, have, have drinks, you know, eat out with, you know, friends and all. But it was just making sure that you had a system that saved money. And to answer your question about my med school loans, I took out the maximum amount for the first year or two, even though I had enough to pay for two years, just from saving alone. And I forget who it was that, maybe told me about it, but maybe it was a financial advisor. Maybe he was, I, I can’t remember. But the money that I had saved up, I invested during that time. And, just, I’ll give you a timeframe. This was 2011 so it was right after the crash. I put in, you know, as much as I could, I can’t remember the exact number, but it was enough to pay off my entire med school loans when I was in residency. so, and just so you know, stock market, yes, it is a, it’s very scary for people that have never done it. But I will say this and I’m sure Justin, we’ll, we’ll kind of back me up on this when it comes to index funds, mutual funds, I mean, once you look closely into it, they are made up of stocks, you know, bonds, cds and things like that.

Justin: [12:32] So, yeah. And there’s a lot that’s probably a little bit beyond the scope of this discussion, but, that’s, it’s great that you were able to make really informed financial moves early on.

Dr. Chiu: [12:41] So you took on the Max for the first two years of med school and then presume for the last two years, did you just kind of pay from your savings? Yeah, yeah. So I essentially paid for my savings. I took out some of my profits from stocks to pay off the loans. By the time I graduated I had about I think 50 k, maybe 50, 60 k from that I paid off most of it just from working as an intern, as residency and you know, obviously, you know, being married at the time. It also helped a little bit when it came to tax returns. So, yeah, which is, which is a good way I think. And what does your wife do? So my wife is not medical. she graduated from Penn state in hospitality management. Okay. She currently works for a very, very large diamond company. Some, some of you guys may know it. It’s Harry Winston, amazing, amazing woman. And also definitely knows her diamonds.

Justin: [13:41] so I’m curious, you know, it’s clear based on all, you know, ever since Undergrad, you clearly saved very conscientiously during your research time to the point where you’re able to pay for the second half of med school out of pocket as a med student. Yup. Which is very, it’s remarkable. Oh, absolutely. you don’t just wake up one day and decide to pay for the second half of med school. That is something in your personality that is forged over years. Absolutely. So I’m curious like where, where did that come from for you?

Dr. Chiu: [14:08] So I started looking into the debt burden based on interests. It was actually around that time I started listening to Dave Ramsey, believe he had some podcasts and now he’s on youtube now. there’s a lot of things that I, I really believe in and that’s from him. And that is, you know, try not to use credit cards as much as you can, you know, try to only spend what you have in cash if you can. And then I started looking into another podcast slash website physicians on fire, which I believe you, you had interviewed him, just recently and I got to say physicians on fire is by far one of the, one of my bibles when it comes to financial planning and success. And for the uninitiated, why don’t you just explain what that, what does that mean? Physician on fire? Cause we’re, that conjures a weird, right, right. Yeah. Everybody is, is you know, wise to what this means. Does that mean you know, setting physicians on prior? No, no, not at all. So fire is an acronym for financial independence and retiring early. I will say this, I don’t agree with just retiring early. I always see myself working as much as I can, but I also do believe 100% that physicians, residents, even interns or even med students, they need to be financially savvy and financially independent as, as soon as possible. If, if they can. You know, I did not take any money from, you know, my family, my mom, bless her heart, my mom and my dad were restaurant owners. They worked their butts off ever since immigrating from Hong Kong. And I knew the value of a dollar very, very early on. And I knew that even though my mom wanted to help pay for my med school, I told her, you know what? I think I can handle this if I absolutely need it. I’m glad that you know, family is there, but you know, because it’s, it’s me being stubborn, obviously trying to make my own path. I wanted to make sure I could do it. And you know, now I’m on this podcast, hopefully helping the, the new generation.

Justin: [16:08] That’s right. Are there any, as you think back to the example of your mom and dad and the way that your current financial perspectives are shaped from their work ethic and they’re valuing a dollar, as you said, are there any specific instances that you can remember where they kind of, you hadn’t experienced that stuck with you as far as being able to appreciate and apply those principles?

Dr. Chiu: [16:27] Yeah. You know, I remember one day, I mean, again, this was when I was barely six years old. Maybe I was very young. I wanted this Ninja turtle toy and I, I mean I didn’t care about the price or anything, but I’m sure it was, it was not more than 10 bucks at the time or maybe a five. I’m not really sure. But I remember my, my mom and my dad, they both kind of looked at me and said, look, you know, we want to get you this but we just don’t have the money for it. We came here really just to get some clothes for you for school and, and maybe some pens and paper, but toys, it’s not really in the budget. And I remember my mom telling you this, she said that I broke down and I cried. I even like ran off, in, in middle of Walmart, you know, hiding from them cause also upset. But looking back at it and just hearing it, it’s true. Like again, and just so you know, I was never deprived of having fun as a child, but I did know early on that my wants versus my needs. There was a very defined line and that line had a pretty big gap too. I didn’t, you know, when it came to getting the newest Ninja Turtle or, I think I was into matchbox cars at the time. I, I just knew that do I really need it or do I just want it? And I think that was probably the moment when I started thinking, Oh, you know, my mom and dad really did work their butts off and it was for a reason. It was because they had just came here to the u s with really nothing and they built something for themselves and thank God for them, you know, they are comfortable and obviously the money I make will be for them as well. So.

Justin: [18:13] Yeah. That’s really excellent. Are there any other resources or sort of places from what you’ve drawn this inspiration to be able to be where you are now with these perspectives you have about debt and about earnings and lifestyle and living beneath your means and creating that extra financial capacity in your life?

Dr. Chiu: [18:31] Yeah, I remember hearing other physicians as a med student. For me. I rotate it literally in 20 plus hospitals all across the u s I mean in Ohio, Jersey, Pennsylvania, all over. And I remember speaking with a variety of docs in anesthesia, in surgery and pain and pmnr everything and a lot of frustration from these physicians come from money. And again, you know, when I was rotating as a med student, you rotate during your third and fourth year. That’s when I decided to pay off at least a little bit, you know, my third and fourth year with my own money because just hearing them say, Oh, I’m still paying off my med school loans, which are currently at $1,200 a month. And bear in mind these docs are in their late forties maybe early fifties I even know of a one surgeon who was in his sixties if I’m not mistaken though, still paying off his loans. And that’s scary that that also brought a lot of attention to my ears because I wanted to learn from them. And obviously I have the philosophy of standing on the shoulders of giants and that is to learn from other people’s experiences. And when they told me this, they had issues buying a house, they eat, they even had issues buying cars and, and which is like essentially a life’s necessity. Just hearing that, learning from it that really put into perspective how important it is to be financially savvy and also financially independent.

Justin: [20:09] Yeah, yeah. That’s something that really resonates with me. And I know some others in the, you know, you mentioned physician on fire, there’s a handful of others that physician philosophers on that comes to mind who is a actually an anesthesiologist or down in North Carolina who is a friend of mine. And He, the angle that he takes in a lot of his writing and content is trying to equip physicians through finances and through giving them, helping them move towards financial independence, helping them to live beneath their means and have excess financial capacity every month to be able to then free them from the need to, you know, make $400,000 a year just to continue to finance a lifestyle that is a bunch of debt. And that represents like a credit card payment that like every time you’re checking account gets filled up with your paycheck, it instantly gets emptied to pay your two credit cards and two car payments like that is that will, that will stress you and that will wear you down, that will contribute to burnout and that will make you just mentally unhealthy.

Dr. Chiu: [21:05] Absolutely.

Dr. Chiu: [21:06] And so I think you’re very wise to have at this early age and obviously through the influence of your parents and, and other mentors to be like really positioned for success. I think that’s really excellent. Thank you very much. Have you found it to be a challenge at all? And this is probably less true for residents, but have you found it to be a challenge in, you know, hanging out with your other physician friends, even as residents? Probably like they’re in New York, they’re like, listen, we’re not going to be in Manhattan forever.

Dr. Chiu: [21:32] Yeah, we owe 400 k but let’s go out on the town, and we’ll pay that off and we’re making the biggest bag dollars. Do your friends do that? And how does, how does that work for you? So, you know what I have noticed, especially with my co residents and my juniors, you know, I’m not saying that I know exactly what their financial status is, but I will say that we all have fun and we also make sure that when we go out, we don’t go to a five star, you know, $5 sign on Yelp type of restaurants or anything. I have to say, we do go to happy hours a lot because, well, guess what, dollar oysters and $3 beers. I mean, that’s, that’s not bad in New York. But I will say that a lot of us are very savvy and, but at the same time, a lot of us are very scared because the loan debt is pretty massive. I know of one who has over 300 at the point and his monthly payments or I remember his loans, they wanted him to pay 1200 a month at the time, which I thought was ridiculous. And instead he ended up doing a income based repayment and it did go down a bed, but it was still in the hundreds. And you know, when it comes to hundreds, there’s not much left after your paycheck. Right. That’s why I, I’m very open about my finances. I am not making a hundred k, I am making a resident salary. And even though New York has one of the highest, residence salaries, you also have to realize the standard of living here is pretty massive. Right. And just doing it alone is impossible, you know? And then that’s why I think, you know, making sure you have people to help you out with your finances and maybe even going through it would be very beneficial. And that’s exactly why I’m on this podcast with Justin here.

Justin: [23:28] So, you’re sharing a little bit about kind of your aspirations for the future. So you’re just finishing pmnr. You’re looking at doing a, a pain fellowship out in the Midwest, and then what, what do you see in the years to come for yourself and your family?

Dr. Chiu: [23:41] What am I going to do in the future? So I’m going to be doing pain. I’d like to learn much as I can when it comes to interventions. And this program in Milwaukee is going to be very comprehensive. the actual fellowship is called a comprehensive pain fellowships. So, so in case anybody out there is interested in applying, I think this is a great program. You know, I’m not saying that because I’m biased and I’m going there, but I truly believe it is a, when it comes to what’s going to happen afterwards, you know, I think, it’s a little early for me to know.

Dr. Chiu: [24:11] But I am looking at different pathways. You know, there’s always the academics, which my heart’s always been in, but at the same time, I’ve also been talking to a lot of private practices and there’s a lot of financial incentives as well, but at the same time, you know, I want to make sure that I have a very good background knowledge in both before I, I pick and choose. And it is true, once you become a paint attending, the salaries should increase quite dramatically, but at the same time, a lot more other financial burdens can pop up. Yeah. You know, I think I still have some time to figure that out, but at least up until now, the only debt I have so far, you know, knock on wood and is my car loan, which is only about 13 k. And, and just so you guys know, I don’t drive a Ferrari. I don’t drive a Lamborghini or anything. Although I have a friend that does and he’ll probably be on this podcast, later. no, I, I have a Toyota Rav four. It was a used Rav four. and you know, I, I think it’s just enough for me to go around and then, obviously my wife will probably get a car as soon as well, but hopefully I can get her a little bit better, you know, cause I obviously, she, she’s earned it. Cool.

Justin: [25:25] so I got one question left for you and this is something that I ask all of my physician guests and I’m excited to hear how you’re gonna Answer. So to get to this point in your life, this point in your training and with your financial situation, it takes a lot of dedication and sacrifice. So I want you to just share with us a brief anecdote or a story from a time when you maybe have looked at either with a patient or maybe with your financial situation when you were kind of in the midst of thinking about this is where we’re at. This is the situation and you maybe reflected on the hard work that you put in the sacrifices that you made. Any thought, you know what this is right now, where are we at with where we’re at with what I’m doing, with the way that my family is set up? It’s, it’s been worth it way that I’ve lived and the decisions that I’ve made.

Dr. Chiu: [26:07] Yeah, I guess going into, well you had said one thing that really popped up was, patients I remember being at, at a very busy residency as you can and I’m sure you know pretty well because your wife is, is in medicine as well. seeing patients, you only have a certain amount of time and it’s maybe not all about money, but it’s about moving, moving quickly. And one thing that, I have become very passionate about is explaining diseases, injuries, illnesses, but with a timeframe that allows for true education. The patient. So actually one of my pet projects, which is completely free, completely extra work for me, but it’s very passionate for is, my own podcasts. It’s called a region med. One O one essentially explains in very simple form what these conditions are, what these owners are. I have podcasts on Plantar Fasciitis, shoulder pain, knee pain, back pain. I even have one for measles. And, and it’s really just to show the general population and the audience what kind of conditions they have in the most simple fied form possible in being an intern or resident, even med students. You know, we, we are, we are reading, you know, terminologies that are just foreign language to pretty much 90% of the population yet. And I think doing something for the patients means you have to understand where they’re coming from. So that, I guess that’s one of my passionate pet projects that I have. And, and I appreciate you asking me about that.

Justin: [27:49] So, yeah, that’s great. And we’ll definitely link to that in the show notes. Regen Med 101 Thank you. That’s a great lay person’s guide to different, medical terminology. I’ve had a couple of those things you just named, not measles, but I’m a, I hope not in a, you know, checking that out. And I, you know, even being here, talking to some of the, you know, the exhibitors, they’re using all these terms. Oh yes. That I am like, yeah, like I don’t know what that means. No. Yeah, that’s, that’s great for, that’s a great resource. I’m glad you’re being able to provide, so doctor, Yu Chui. Thank you very much. Thank you for joining us in this thesis success podcast. That’s right.

Dr. Chiu: [28:23] Pleasure speaking with you. Thank you very much.

Justin: [28:27] Hey Justin here, this may shock you to learn, but I am actually not a fulltime podcast or I also run a financial planning company called quantify planning where I work closely with anesthesia and pain docs to build and implement customized financial plans. If you’re interested in working with a financial planner who knows many of the ins and outs of your profession, shoot me an email or head on over to quantify planning.com for more information. If you’re a resident or fellow, I can also offer you a free student loan analysis if you’re interested, but there might be a waiting list, so check out the link over there to see if you’re interested in learning more about the topics we discussed today. Head over to anesthesia, success.com to join our community, residents, and attendings and others to ask a question or get more free resources. If and only if you liked this episode, please leave us a review and subscribe. Thank you very much for listening to the anesthesia success podcast.