Life | Medicine | Real Estate: Year End Review 2023

by The Darwinian Doctor

This is my year end review for 2023, in which I go over milestones in my life, career, and business. How has your life changed this year?

As we come to the end of yet another year, it’s natural to look back at the previous 12 months and take stock.  One of the joys of having a blog is that I can track various things from  year to year.  Generally I’ll track milestones in my life, career, or business.

I believe that milestone tracking is an important way to create a sense of momentum and joy in life.

For example, in late 2021, we celebrated hitting six figures of gross revenue in our real estate business. Then in March of 2023, we celebrated again when our gross revenue rose to $600,000.

When it comes to net worth, in early 2022, I celebrated hitting $4 million of net worth. This was $900k higher than the prior net worth update and a far cry from my negative net worth when I graduated from medical school in 2010. I believe that net worth isn’t as useful as we all think, but it’s a convenient way to track overall financial progress in life.

And finally, in late 2022, I celebrated a big life milestone when my family decided to move across the country from Los Angeles to Memphis.

In the aftermath of our cross country move, this year continued to be a tremendous time of change specifically in the areas of life, medicine, and real estate investing.  


As I mentioned above, my family moved from Los Angeles to Memphis at the end of 2022, so this year was one of new beginnings.  Just as I was reaching a breaking point of burnout and existential crisis in SoCal, my wife was offered an intriguing career opportunity in Tennessee.  After a visit to Memphis in the summer heat to meet the board members, saying “yes” to the offer was surprisingly easy.  Once we thought about our long term goals and overall life trajectory, it was clearly a risk that we needed to take.

So my wife took the job offer and I quit my employed surgery job.  Then we packed up our family and shipped everything across the country to the mid-south.  

Over the year, my kids settled in to a fantastic new school, my wife over performed in her new role as is her habit, and we all adjusted to a new normal in our humid new home.  


My year end review for my medical career reveals a huge seismic change. This change was equal parts scary and exciting.

After quitting my full time job, I had some encouraging talks with the local private practices in Memphis before deciding that it wasn’t a great fit.  Instead, after a 5 month hiatus from medicine I started working as a locum tenens at the end of March.  I tried out a couple of locations before settling on a recurrent assignments in Ohio and Mississippi.  

Despite the significant freedom and autonomy from locum tenens which I love, it did require quite a bit of travel which was an adjustment for my family.  

Although I only practiced in medicine about ⅓ of the month in 2022, when I was gone, I was physically absent in a way that was new for my family.  When I was home in Memphis for the rest of the month, I was fully present and available in a way that had been impossible when I worked 1.5 FTEs as a urologic surgeon in SoCal.  But the contrast between full absence and full availability was a bit jarring.  

But now after 9 months of locum tenens, I can say that it a great solution for right now.  It gives me incredible schedule flexibility and control over where and when I practice medicine.  Locums lets me exercise my surgical and diagnostic skills in a varied and challenging environment.  Compared to my prior pay rate in SoCal, it’s a more efficient way of trading time for money. And since my services are in high demand where I practice, I also feel the satisfaction of knowing that I’m making an impact.  

I will be cutting down my medicine hours even further in 2024 to just ¼ of the month.  I’m doing this for two reasons:  1) to reduce my time away from the family and 2) to leave more time for an exciting new business venture.  

The real estate portfolio

The year end review for real estate is clearer than it’s every been. Now that I have an accountant to track my books, in January I’ll have a very detailed insight into my entire real estate portfolio’s financial performance for 2023.  So I’ll defer the comprehensive real estate portfolio review until then.  

Having tracked our monthly financial reports over the last year, though, I can predict a few themes:  1) Underperformance of our short term rental portfolio and 2) overall great performance from our long term rental portfolio.  

The short term rental prediction is due to the Airbnb bust and an unfortunate permit suspension in Palm Springs, together which caused a loss in our STR portfolio.  Things have been much better in recent months in regards to our short term rental income, but it’s unlikely enough to recover all of our losses for the year.  

However, when I consider the immense tax benefits we got from these buildings over the past two years, we are still coming out far ahead.

Read more: Amazing Tax Deductions from Your Short Term Rental  

When it comes to the long term portfolio, I had several standout properties and some laggards, but as a whole it delivered on the five ways that real estate makes you money:

  • Consistent rental income
  • Tax protection via depreciation
  • Appreciation
  • Principal paydown
  • Inflation hedge

Especially with the marked post-pandemic inflation in 2023, it was great having our capital invested in real estate, which typically moves with inflation.


I hope you’ve enjoyed my year end review for 2023. The past year has been a huge year of change for my life, my medical career, and my business.  On a personal note, the year taught me that my wife and I can still take calculated risks and do hard things. It taught me that I am not shackled by the decisions I’ve made in the past, and that I have the ability to reinvent myself and my life trajectory.

It’s been a tough year, but I also feel certainty that we’ve built a strong foundation from which we will launch the next era of our lives.

With regards to real estate, some of these new developments also involve you as well. I’m excited to share this news with you in January!

— The Darwinian Doctor

What milestones have you encountered in 2023? Let me know in the comments below!

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6 months ago

Nice post it’s encouraging since in 2024 I am also leaving my full time employment and venturing into locums for the freedom, flexibility, and decreasing housing costs since leaving a high living cost area. It’s a courageous jump into the unknown and I am ready. Building my financial and real estate knowledge foundation. And buying my first property. Ready to put it all to practice. Happy holidays and cheers to happiness and success!

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