Building Financial Confidence as a New (or In-Training) Anesthesiologist

By Kayla Knuf posted 23 days ago

Like

Highlights from the ANESTHESIOLOGY 2025 Finance Panel. By Dr. Kayla Knuf, with Drs. Christopher Malgieri, Herb Chen, and Shyamal Asher.

After years of training on modest resident salaries, the first real paycheck as an anesthesiologist feels both exhilarating and surreal. But between loan repayment, lifestyle upgrades, and complex benefits packages, many new anesthesiologists realize that financial freedom doesn't come automatically.

At the 2025 ASA annual meeting, four anesthesiologists offered a road map for managing money early in your career. Their message was clear: You can't outsource financial literacy. It's as essential to long term wellbeing as mastering the airway.

Facing the Debt

Dr. Christopher Malgieri opened the session by tackling the elephant in the room…student loans. With median medical student debt now hovering around $200,000 to $300,000 he emphasized the importance of understanding repayment structures before choosing a plan.

Dr. Malgieri broke down the major options:

Standard Repayment: predictable 10-year term but inflexible
Income Driven Repayment: payments tied to income
Public Service Loan Forgiveness (PSLF): tax free forgiveness after 120 qualifying payments and eligible employment

But he warned against blind optimism. PSLF is law but it's not guaranteed for everyone. Always have a backup plan and save as if forgiveness might not happen. His parting advice: live like a resident a little longer and direct that extra income towards financial resilience.

The Path the Financial Independence

Dr. Herb Chen followed with a straightforward truth: a high income doesn't equal financial independence. Many physicians spend years chasing income milestones without ever achieving true wealth. Through consistent investing Dr. Chen illustrated the power of compound growth, where money earns interest on its own interest, creating exponential momentum over time.

He stressed the following steps:

Maximize your 401(k) and Roth IRA early.
Favor low-cost index funds over stock picking and social media hype.
Keep an emergency fund and avoid unnecessary fees.

Avoiding the Big Three Financial Pitfalls

I took the stage with three pitfalls every new attending should look out for:

Lifestyle Inflation: While a high income pays the bills, wealth is what is left over when you stop inflating your lifestyle.
Forgetting the budget: Treat savings like an expense and track your money. A bigger paycheck doesn’t replace a budget, it just makes overspending easier.
Ignoring the emergency fund: Save three to six months of expenses. Emergencies don't care about your income level, they just care if you’re ready.

Takeaways included: Spend with Intention. Own your money, don’t let it own you. Protect yourself.

Protect Your Most Valuable Asset: You

Dr. Shyamal Asher rounded out the panel with a reminder that financial planning isn't complete without protection. As an anesthesiologist, your greatest asset isn't your car or your home, it's your ability to work.

He outlined the key coverages every physician should consider early:

Disability insurance: get an “own occupation” policy while young and healthy; it protects your income if you can't perform your specialty.
Life insurance: term life is inexpensive and ensures your loved ones are protected.
Umbrella policy: a safety net once your assets grow, covering liability beyond home and auto policies.

In Summary

Financial independence isn't about luck, it's about discipline, awareness, and a few good decisions repeated over time. For residents and early career anesthesiologists, the best time to start is now.

Kayla Knuf, MD is a board certified anesthesiologist who practices in Texas.

The ASA Committee on Young Physicians is pleased to present this monthly article series on personal finance. These articles are not written by hedge fund managers or real estate tycoons but by practicing physicians. Some have business degrees and some do not – but every contributor is an anesthesiologist who has some guidance to offer the rising generation of attending physicians. It is not the intention of the committee to offer definitive financial advice, but rather some pearls of wisdom to consider while developing a personal fiscal plan.

#CommitteeonYoungPhysicians
#PersonalFinances