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We got married in our thirties. Started IVF in the middle of paying off $700,000 in student loan debt. And Nii was working locums shifts several states away — the very thing funding our fertility journey was also making it harder.
This is the episode we've never been able to fully tell. Until now.
You'll hear:
→ Why we got married later — and what that cost us biologically
→ The rule we made when paying off debt (and how it complicated everything)
→ IVF at $25,000 per round with no insurance coverage in Pennsylvania
→ How locums income was our financial lifeline — and our biggest complication
→ The appointments Renee attended alone while Nii was on the road
→ What the IVF doctor said when Renee ovulated through her medications (and where Nii was) → Multiple rounds. None of them worked.
→ How our boys came naturally — and the joke we make about their 529s
→ 3 practical tips for physician couples navigating debt and fertility simultaneously
TEXT US: Have you ever had to choose between your financial goals and starting your family? Tell us your story. 1-833-230-2860 We read every message.
3 PRACTICAL TIPS FROM THIS EPISODE:
1. Know your state's IVF insurance laws before you choose where to live or work. Some states mandate insurance coverage for IVF (NJ, NY, MA, IL, and others). Pennsylvania did not cover us at the time. This is a factor worth researching — especially if you're in your thirties or planning to start a family.
2. Have the fertility conversation with your partner before you need it. Don't wait until you're in the middle of debt payoff to find out you need IVF. Talk to a reproductive specialist early. Get your baseline numbers. If you're a woman in medicine who wants children — consider freezing your eggs earlier rather than later.
3. Build your financial plan around your whole life — not just your debt. Your financial plan needs to account for more than the numbers. Build in the fertility timeline. Build in the family goals. Build in the geographic constraints. And if locums is part of your debt payoff plan — decide how far is too far before you take the assignments. Not after.
Find us on YouTube: www.youtube.com/@docsoutsidetheboxpodcast
RESOURCES MENTIONED IN THIS EPISODE:
Locumstory.com - a free resource with unbiased information about locum tenens opportunities, real physician stories, and practical guidance to help you make informed decisions about your career. Check them out at https://dotb.s.gy/Pod
Resolve Website - https://resolve.org/
FREE DOWNLOAD:
Download the First-Gen Doctor Blueprint — everything we wish someone had told us about finances, career planning, and building a life in medicine. Visit: https://darkos.lpages.co/first-gen-physicians/
Have a question for us?
ABOUT DOCS OUTSIDE THE BOX:
Dr. Nii is a General Surgeon. Dr. Renee is an OB/GYN. We are first-generation Ghanaian and Haitian physicians who paid off $662,000 in student loan debt in 3 years, built a locum tenens agency, and navigated every major medical career decision without a family blueprint.
We created this podcast for first-generation doctors — physicians who are the first in their families and lack the inherited knowledge about money, contracts, career strategy, and the unwritten rules of medicine that many of their colleagues learned growing up.
Real conversations for first-gen doctors.
Website: https://drniidarko.com/
DISCLAIMER: Dr. Nii and Dr. Renee are physicians, not financial advisors or attorneys. Content shared in this podcast reflects personal experience and should not be considered financial, legal, or medical advice. Please consult qualified professionals before making financial or career decisions.
© 2026 Docs Outside the Box. All rights reserved.
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