Disclaimer: This post contains affiliate links. Financestu does not provide investment or tax advice.
I went through 20+ personal finance blogs authored by doctors, signed up for dozens of their newsletters, listened 6 hours of podcasts featuring doctors no longer dependent on W-2 clinical income, and scrolled through countless forum discussions and comment sections, where physicians and other high-income busy professionals debate about the best ways to earn side income.
This post aggregates everything I found.
And it’s for you if you’re an MD looking to build enough investment income to work on your own terms in the next few years, not decades.
I’m calling it the “roundtable” strategy. But before I tell you why, here’s what you can expect from this long read:
- The most common mistake people make when looking at index fund returns (causes them to understand how superior “roundtable” returns are too late in the game).
- How firms are running billion-dollar private equity strategies at a smaller scale specifically for professionals like doctors, but most don’t take advantage of it.
- A managing entity that spelled out their entire investment strategy for free online and no one seems to care.
If that sounds good, let’s dive right in.
Imagine this:
You walk in the hospital before the sun rises…
Already tired from a restless night of interrupted sleep.
The day is chaotic. Patients lining up in the ER, paperwork piling up, and the EMR system crashes mid-shift.
By the time you leave late at night?
You realize you haven’t eaten, barely drank water, and missed your spouse’s text. Driving home, you wonder how long you can keep this pace before something gives.
A lot of doctors don’t need to imagine what’s it like to live this way, it’s reality (maybe for you too).
You spend more and more time talking to insurance companies and doing administrative tasks instead of treating patients and talking to people like you signed up to do.
Like you, many doctors worry about burnout. It puts you at risk of losing your passion for medicine.
Worse:
Too many physicians live paycheck to paycheck, weighed down by hundreds of thousands in student loan debt and daily stress that leaves no time to manage finances.
Fortunately, there’s a shift in this trend…
Many doctors now realize it’s possible to put their high income to work for them.

When it comes to high-paying salaries, it’s hard to beat a career in healthcare.
And that’s for good reason.
No need to apologize for it.
Now, how do you put your income to work for you?
Most of the advice online will tell you to invest in an index fund regularly. And for good reason:

The S&P has by far generated the strongest returns.
According to the chart above, a $100 investment in the S&P 500 (including reinvested dividends) in 1970 would be worth an impressive $22,419 in 2023.
U.S. stocks outpace other investments by a wide margin. Look at how a $100 investment in corporate bonds only grew to $7,775 over the period, or 65% lower than an investment in the S&P 500.
Real estate is also considered a safe haven asset but grew on average 5.5% annually since 1970.
So it’s clear that if you were to pick between stocks, bonds, or real estate, you should pick stocks.
Here’s the thing though:
Have you have wondered, as I have, why so many wealthy people have most of their money parked in real estate?
And have you noticed this trend where many physicians are getting financial independence by taking advantage of real estate?
And why most Americans think real estate is more reliable for building a nest egg than stocks?

What I found is the numbers in the chart above are from the Case-Shiller Home Price Index, which only follows price changes in houses over time.
You also have to look at the unique tax advantages, constant cash flows, and leverage you can use.
You can buy a home by putting down only 20% of your own money, but no one will give you a 5x stock trading margin account even if you invest safely in index funds only.
This means that to understand the gap between real estate and stocks we have to look beyond simple returns.
The key differences are:
- Leverage: It’s far less common for individual investors to use leverage when investing in stocks.
- Taxes: With real estate you can claim valuable tax deductions like depreciation. This is especially worthwhile for high earners like physicians whose W-2 income hits those higher tax brackets. Stocks allow you to deduct nothing, plus they have capital gains and dividend taxes.
- Tangible asset: Stocks are ownership in a company. Gains feel abstract because it’s not a physical asset. Compare that to providing homes to families in your hometown.
- Volatility: Stocks are more sensitive to market risk due to investors’ emotions and billion-dollar hedge funds exploiting inefficiencies in the market.
- Recession behavior: People need a house to live. It’s the last thing they give up in a recession, unlike stocks. During 2008, multifamily real estate had the lowest default rate among other asset classes.
In a nutshell real estate is more boring.
Boring because your money will grow steadily while you hold an investment for years, but the truth is you can rarely go wrong with it.
In contrast, in the stock market you can get rich overnight but your money is up and down every day.
But once you add the tax-free rental income (and its reinvestment), the equity build-up from debt paid down by your tenants, the market appreciation, and the tax savings?
Even the most conservative estimates will show you real estate beats the S&P.
As this doctor described:
“Every year I see the benefits of real estate more and more and I think it suits us [physicians] as a profession. You know, if you’re a professional with a busy day job you cannot be a day trader, you’re not sitting by a computer all day long. I think real estate has even more advantages because it gives you peace of mind, you know it will have steady flow returns. Every now and then there’s a little hiccup but I think the hassles are so less.”
Or Dr. Jordan Frey, a plastic surgeon and financial educator who went from $500k in debt to financial freedom. He said:
“We started with 1/3 of our savings going to paying off debt, 1/3 to investing in the stock market, and 1/3 to real estate. Now if you look at our net worth about 80% is real estate and it also generates $10,000 of cash flow a month. So it all started out even but real estate has now become a very big part of our wealth. I still invest in stocks, max out my retirement accounts, and invest in a taxable account, but real estate certainly has accelerated that path for us so I think it’s very reasonable for people to invest now.”
Alright, we’re finally getting somewhere.
However, in my mind it still doesn’t make sense…
Why do so many people prefer real estate considering all the work it is to own a property?
Especially physicians, who are busy all day working themselves to the bone.
Reading through forums I counted 22 things people hate about direct real estate investing:
- Having the time to find good deals in the current economy.
- Having the time to learn about your market and building relationships (relationships are what get you great deals, you won’t find them on Zillow or Redfin).
- Picking a location—in your neighborhood or out of state?
- Which type of property—single family, condo, multi-unit?
- Crunching the numbers on all the metrics to make sure an investment meets all your criteria, including cash on cash return, cap rate, net operating income, internal rate of return, equity multiples, repairs/renovations estimates, estimated vacancy and turnover rates, utility costs, insurance costs, annual property taxes, estimated maintenance costs, (and remember there are different philosophies for the ideal numbers should look like).
- How to negotiate a deal all by yourself without anyone to help you see blind spots (saying one wrong thing can cost you thousands).
- Finding a good inspector who guarantees the house won’t fall apart 2 weeks after you write the check for it.
- Banging your head against a wall trying to create/understand the confusing legalese in a lease agreement.
- Big cost of a down payment.
- Attracting tenants (vacancies equal lost money).
- Drafting and sending offers.
- Setting up your first tenants.
- Hiring someone to maintain the apartment.
- How to deal with bad tenants living off of you for free and smoking inside the house.
- How to deal with evictions, especially with rentals out of state.
- Finding a good investor agent who can research and vet deals for you as well as filter tenant applications.
- Finding an asset protection lawyer to set up your real estate investments in the correct way to protect you from lawsuits.
- Construction, remodeling, and maintenance issues such as the dreaded broken toilet at 2 AM.
- Having to deal with insurance companies for major repairs, which you’re already tired from doing during the day.
- How to actually benefit from the tax savings from depreciation.
- Keeping up with changes to taxes and regulations, zoning laws, tax laws on rentals vs. primary residence, and all the rules related to insurance.
- Keeping up with migration patterns—Idaho and Florida are hot right now but who knows how long that’s gonna last?
Sheesh.
Sorry for the wall of text.
But knowing all this, how confident would feel investing in real estate alone?
Seems like so-called real estate “passive income” is not “passive” at all.
Maybe that’s why there are so many courses/coaches out there promising to teach busy physicians how to invest in real estate in just 1 hour per day.
These often cost thousands of dollars and are sold by physicians.
So you’re getting info from someone who’s been in your shoes.
See, being a landlord doesn’t have to feel like a second job.
It’s possible to work full-time as a doctor while building a real estate portfolio and juggling family life.
It’s all about hiring the right people.
Some physicians question how legit these courses are. And just want to get the financial task of investing in real estate done as quickly as possible.
So they invest in REITs.
They fail to realize REITs you pay additional taxes on the dividends REITs are obliged to pay you.
You don’t get any of the depreciation tax deductions from the properties the REIT invests in.
Not to mention REITs are correlated with the stock market (meaning, they don’t give you the diversification benefits).
For example in 2022, the S&P 500 delivered a total return of -18.1%, while U.S. REITs returned -25.1%. Meanwhile, home values jumped up 10.49% in 2022.
They don't know there are ways to:
Invest in real estate and still get the tax benefits...
Still get the recession-proof returns...
And get access to private deals individual investors cannot access or afford on their own...
Without being a landlord...
Or paying thousands for a course...
Or giving up expensive fees to property management companies...
I'm talking about private-market commercial real estate syndications.
You see:
Private-market commercial real estate is not available to the public.
It's a direct investment in specific properties, such as commercial buildings, residential complexes, or land development projects.
This 2024 whitepaper from a real estate syndication platform explains why private real estate outperforms the stock market during recessions:

real estate versus the S&P 500 during
recessionary years from 1980 through
2019, Source: EquityMultiple (2024)
Private-market real estate gives you returns both from the increase in value of the property and also income from rent.
While recessions hurt rent growth, rental income does not disappear in most cases.
Maybe this sounds familiar:
During a rare lunch break, you scroll through headlines: “S&P 500 Drops 20% Amid Recession Fears.”
Your portfolio, once “safe,” has evaporated two years of savings.
A resident jokes, “Guess we’re working until we die, huh?”
You laugh nervously, but your stomach churns.
“Stocks are supposed to be secure… but this feels like gambling. How am I gonna retire earlier like this?”
Whether you've been through 2008 or 2020 or fear how bad stock market volatility can be, the reality is this:
No matter what, everyone needs a place to live. Companies need warehousing and distribution. Businesses need offices.
Contrast this with the returns in REITs and the stock market, a lot more sensitive to economic conditions. Additionally, they go up and down depending on corporate performance and future growth expectations.
But not commercial real estate.
Probably the greatest example of this was when Blackstone, the world's largest private equity fund ($1.1 trillion in assets) acquired Hilton just before the Great Recession of 2008.
The deal had everything to go sideways but instead Blackstone made a fortune.

Deals even just 1/10th of this size seem unattainable for an individual investor like you.
But thanks to real estate syndication, they're not.
You see, commercial real estate used to be exclusive to small wealthy groups and Wall Street fat cats doing business behind closed doors, but now it's open to everyone.
Syndication platforms allow you to invest in large commercial properties with small capital while still benefitting from the tax benefits of owning real estate.
All this without the headaches of directly owning property.
Here's an overview of how it works:

It all starts with a sponsor. This is a firm similar to Blackstone.
And although this sponsor probably does not operate at the same scale as Blackstone, the same principles apply.
They will hunt for deals where they see opportunities to take advantage of market inefficiencies, changes in supply/demand, and manufacturing value. The goal is of course to later exit at the right time.
After they find a deal they need investors, and that's where managing entities (like EquityMultiple, Fundrise, RealtyMogul, or CrowdStreet) come in.
They analyze everything about the deal, looking to answer important questions such as:
- How much can you earn as an investor?
- How much experience does the sponsor have?
- What does the sponsor plan to do to improve the property?
- How old is the property and when was it last renovated?
- What are the demographics in the investment area?
- What risks can make the sponsor's business plan fall through?
- And so much more...
So even if the sponsor is well-known, managing entities verify everything.
It's a much more rigorous process than what I could fit in one article.
Taking EquityMultiple as an example again, only 2% of submitted transactions are approved and posted on their platform for investors like you.
Last year they explained their entire process from investment selection to approval in a public whitepaper.
This is a must-read before you ever jump into direct real estate investments on your own.
Doctors specialize… and so do finance professionals. You can reduce your risk by focusing on what they look at.
As obvious as it sounds, if you copy people who know what they're doing you'll be successful.
And the whitepaper above will open your eyes to the work it takes to analyze if a real estate deal is profitable or not.
It's free professional guidance giving you a clear path if you ever decide to be a landlord.
Now:
Let's say there's a deal good enough to be part of the 2% presented to investors like you.
What happens next?
You can think of it as a gigantic roundtable where the managing entity brings together all the investors on its platform (usually thousands).
Then, anyone happy about the deal and the sponsor who wants to invest can simply raise their hand to participate.
The next step is for the managing entity to create an SPV (special purpose vehicle) to pool the investors' money together.
This protects you as an individual investor from liabilities that may come from the investment.
It also means that if EquityMultiple becomes insolvent, investments through the SPV live on.
After the investment, the asset management team stays in close contact with the sponsor throughout the years to ensure a profitable exit.
Let's look at an example:
The latest investment opportunity at EquityMultiple is a building in Manhattan's East Village.
It's a 100% occupied mixed-use property with 2 retail tenants—one of them being Bradley Cooper’s popular new cheesesteak shop—and 8 fully-renovated multifamily units.

Where else do you have the opportunity to invest in stuff like this as a small investor?
I mean, how can you even get a piece of expensive Manhattan real estate by yourself?
But it gets better. Here's an excerpt from the executive summary of the deal:
"The Sponsor is purchasing the Property for $10.75M ($1.1K PSF) representing a going-in cap rate of 6.8%, substantially higher than comparable sales that average 5.2%. The attractive purchase price is reportedly the result of a partnership dispute, leading to a sale at an inopportune time to maximize value despite strong property performance."
Pay attention to that last sentence.
It's a prime example of how relationships are everything in real estate.
As a beginner investor, it's really hard to invest in opportunities like this. How will you even find them?
You are bidding against mega-corporations.
For every 10 units you buy, Blackrock buys 10,000 units, plus they can leverage themselves much more while paying less interest.
But when you pool your money together with other investors in the roundtable? Not only you can get bigger deals, but also access to higher-quality assets and minimize risk.
As Dr. Jordan Frey (mentioned above) and this podcast host said:
"Local knowledge is so valuable when it comes to who is the sponsor of a real estate deal. If you were born and raised in a city, you've got what we call in economics an unfair advantage because you can understand that market with much more nuance than a national player trying to come in and make some big sweeping play. If you're investing with a sponsor you want to work with someone who knows the market and has that unfair advantage. The cool thing about real estate is it is inefficient. I love learning about the stock market but in this day and age, it is just so efficient that I personally don't think anyone can exploit the inefficiencies enough to beat the market. But in real estate, you can. And we've shown that. We've taken those inefficiencies in our hometown and used them to our advantage and we are getting cash on big cash on cash returns (they're 15 to 20%)."
Again, sorry for the wall of text.
The point is it's easier to work with professional sponsors to find market inefficiencies and take advantage of them.
By the way...
You can read everything about this Manhattan deal (including the official documents) by creating a free account on the EquityMultiple website.
The only thing is you must be an accredited investor ($200,000 individual income, $300,000 joint income, or $1 million net worth).
Also, by the time you read this the investment period may have closed already, as the deadline is February.
Now, local knowledge is not the only thing you should look for in a sponsor...
Because here's the biggest drawback of syndications...
You're basically handing your money to someone and trusting them to invest it well.
How do you make sure they know what they're doing?
Since you are investing as a limited partner, you will have no control, so vetting the sponsor is important.
Especially considering syndication investments last for 3-7 years usually.
The 6 most important things to look out for when vetting a sponsor are:
- Background: You can find general information from the sponsors’ website, including their investment philosophy, acquisition criteria, and previous successes.
- Track record: How many deals have they exited? Do they have experience (local knowledge) in the same market as the new investment? If the answer the these two questions is yes, it's a good sign. You can review their portfolio and the investment offering to get this information.
- Team: As you can imagine, there are many steps, tasks, and responsibilities included in acquiring and managing a property, so you should know all the team members involved and their roles in the deal. Especially the property management team, which is the boots on the ground and involved in the everyday operations of the property.
- Fees: Both the sponsor and the managing entity will charge you fees. This should always be detailed in the investment documents. Look for structures where the fees increase with higher returns on the investment. Why? Because it guarantees their interests are aligned with yours. Either way, the sponsor will typically present the investor returns as net returns, which already take into account the fees and profit splits.
- Professionalism: Good sponsors will provide timely, consistent, and transparent communication to their investors. This is often done on a monthly or quarterly basis.
- Previous investors: You can ask for previous investors’ contact information and ask about their experience with the sponsor.
Keep in mind the managing entity will do this screening for you, but it's always good to double-check.
If you find good deals with strong sponsors, private-market commercial real estate syndications are the best way to diversify away from traditional stock and bond portfolios.
In medical school, after mastering the essentials to be a general practitioner, you choose to specialize in a specific area of medicine, right?
Similarly, many physicians are choosing to "specialize" in real estate syndications as a way to make more money.
Money that allows you to practice medicine on your own terms.
That allows you to focus on patients and not lose sight of why you love medicine because of financial distress.
A lot of people argue sponsors and managing entities charge high fees.
But if you have no time to manage your property, hiring a property management company will often cost more.
Some also say buying real estate on your own allows you to have full control over your portfolio.
But online syndication platforms also allow you to build a portfolio tailored to your goals.
You're not giving your money to a fund and letting them take the lead.
Taking EquityMultiple as an example again, they detailed all these options specifically for MDs based on your risk appetite and where you are in your career:

The way I see it? It's a lot like the 80/20 rule.
Sure you have all the control and returns just for yourself (but also responsibility and risk).
And by investing with a partner like EquityMultiple you get 80-90% of the benefits of active real estate investing from just 1% of the effort.
You actually regain free time instead of adding a second stressful job as a landlord.
You leverage other people’s time, capital, and expertise so you can live life on your own terms.
And as you can see from the diagram above, you can invest in many different types of investments—basically debt or equity.
If you're more conservative you can go with senior debt like this doctor. He says:
"The S&P average return is about 9.25% over 20 years. So when I look at an investment, I’m going to look and say, “Can I beat the market?” Because if I can beat the market, then I’m in good shape. The senior debt opportunities with EquityMultiple are at least 10%, more likely in that 11%, 12%, or sometimes even 13% range. So for me, I’m going to look at something that has low risk—senior debt, for me, has low risk. I can get my principal back quickly. If I can get my principal back in, say, one to three years, that’s good. And I’m going to look to create cash flow immediately."
If you're like most doctors you have no real estate investing experience...
The only thing you know is to practice medicine...
You've never imagined yourself as an owner of real estate...
But the examples above are a few among thousands of doctors taking advantage of syndication.
The niche deals you will only find on these platforms can accelerate your retirement earnings.
And many doctors are catching on to this trend.
Taking advantage of their high income and accredited investor status.
And a platform like EquityMultiple is a good place to see how exactly they allocate their money:

Safe to say doctors are well represented at the roundtable.
And if you read the whitepaper, you'll see physician investors prefer investments in this order:
- First, debt investments that provide recurring income.
- Second, junior equity investments with more risk but also higher potential upside.
- And third, senior debt, which is very safe and will generate predictable cash flows.
In general, a case study published in December 2024 revealed older investors and lower-net-worth investors are more conservative with their real estate investments.
Not surprising, right?
It makes sense for folks closer to retirement to be more conservative while younger people risk more because they have more time to recover in case things go bad.
But regardless of your age, if you want a retirement portfolio big enough to cover your future expenses, it's time to leverage the opportunities your medical degree provides.
So if there's one thing I want to take you from this post?
Is to diversify your portfolio with real estate. That's all.
If you have the time and know-how to do it by investing directly, you probably already do.
But if you don't? Create a free account at an online syndication platform (I recommend EquityMultiple) and scroll around the available deals.
The information these platforms provide for free is invaluable.
You deserve the good life of a doctor, not the burned-out life of a healthcare factory worker.
It's possible to replace your clinical income completely. Throughout my research I found many doctors have done so.
Now they work because they want to and not because they have to.
Now they can focus on patients more.
Now their financial well-being improved.
And as a result, their overall well-being also improved, which helped make them better doctors. The same will happen to you.
Questions? Thoughts? Feedback? Let me know in the comments below.
very interesting read
Another great post, thank you!
Does this have the same tax advantage as traditional active real estate investing?
Not exactly the same but the investments are setup through LLCs, which are pass-through entities. This means you can benefit from depreciation deductions, mortgage and interest deductions, and 1031 exchanges depending on the type of investments. These flow directly to you via Schedule K-1 forms, similar to direct ownership. However, investment losses can only offset passive income (other real estate investments), not ordinary income. Hope this helps!
Thanks for this post. I would like to know what are your thoughts on gold?