Step-by-step guide for high-income physicians to contribute to a Roth IRA in 2026 using the Backdoor Roth strategy—even with income over $200K. Includes pro-rata rule tips and Form 8606 instructions.

How to Do a Backdoor Roth IRA for Physicians in 2026

Published: January 24, 2026 | Category: Personal Finance | Reading Time: 8 minutes

Key Takeaways

2026 Contribution Limit: $7,000 ($8,000 if age 50+)
Income Limits: No income limit for Backdoor Roth IRA (regular Roth IRA phases out at $161,000-$176,000 for single filers)
Tax Benefit: Tax-free growth and withdrawals in retirement
Best For: High-income physicians who exceed Roth IRA income limits

What Is a Backdoor Roth IRA?

A Backdoor Roth IRA is a legal strategy that allows high-income earners—including internal medicine physicians, cardiologists, and other specialists—to contribute to a Roth IRA even when their income exceeds the standard contribution limits.

As a physician, your income likely exceeds the 2026 Roth IRA income limits of $161,000 (single) or $240,000 (married filing jointly). The Backdoor Roth IRA provides a workaround by first contributing to a Traditional IRA (which has no income limits for contributions) and then converting those funds to a Roth IRA.

Why Physicians Should Consider a Backdoor Roth IRA

For high-earning physicians—whether you're an orthopedic surgeon earning $600,000+ or a family medicine physician making $250,000—the Backdoor Roth IRA offers significant advantages:

Tax-Free Growth: All investment gains grow completely tax-free
Tax-Free Withdrawals: Qualified withdrawals in retirement are 100% tax-free
No Required Minimum Distributions: Unlike Traditional IRAs, Roth IRAs don't require withdrawals at age 73
Estate Planning Benefits: Roth IRAs can be passed to heirs with continued tax-free growth
Tax Diversification: Balance your retirement portfolio between pre-tax and post-tax accounts

Step-by-Step: How to Execute a Backdoor Roth IRA in 2026

Step 1: Verify You Have No Existing Traditional IRA Balances

Before proceeding, check if you have any existing Traditional IRA, SEP-IRA, or SIMPLE IRA balances. If you do, you may face the "pro-rata rule" which can create unexpected taxes. Many physicians use the strategy of rolling existing Traditional IRA balances into their employer's 401(k) plan first.

Step 2: Contribute to a Traditional IRA

Make a non-deductible contribution to your Traditional IRA:

2026 Limit: $7,000 if under age 50
2026 Catch-Up: $8,000 if age 50 or older

Important: Do NOT deduct this contribution on your taxes. It must be a non-deductible contribution.

Step 3: Wait for the Contribution to Settle

Allow 1-2 business days for your contribution to settle. Some financial advisors recommend waiting until the funds clear before converting, while others convert immediately. Both approaches are valid.

Step 4: Convert to Roth IRA

Request a Roth conversion through your brokerage. This moves the Traditional IRA balance to your Roth IRA. Most brokerages allow you to do this online in minutes.

Step 5: File IRS Form 8606

When you file your taxes, complete IRS Form 8606 to report:

Your non-deductible Traditional IRA contribution
The Roth conversion

This form documents that you've already paid taxes on the contributed amount, so you won't be taxed again on conversion.

Frequently Asked Questions

Can physicians do a Backdoor Roth IRA if they have a 401(k)?

Yes! Having a 401(k) through your hospital or practice does not prevent you from doing a Backdoor Roth IRA. These are separate retirement accounts with separate contribution limits. In fact, many anesthesiologists and radiologists maximize both their 401(k) and Backdoor Roth IRA each year.

What is the income limit for a Backdoor Roth IRA in 2026?

There is no income limit for a Backdoor Roth IRA. This strategy specifically exists for high-income earners who exceed the regular Roth IRA income limits ($161,000 single / $240,000 married filing jointly in 2026).

How much can I contribute to a Backdoor Roth IRA in 2026?

The 2026 Backdoor Roth IRA contribution limit is $7,000, or $8,000 if you're age 50 or older. This is the same as the regular IRA contribution limit.

Is a Backdoor Roth IRA legal?

Yes, the Backdoor Roth IRA is completely legal. Congress has been aware of this strategy for years and has not closed this "loophole." The Build Back Better Act attempted to eliminate it in 2021 but did not pass.

Common Mistakes Physicians Make with Backdoor Roth IRAs

Ignoring the Pro-Rata Rule: If you have existing Traditional IRA balances, a portion of your conversion will be taxable
Forgetting Form 8606: Failing to file this form can result in double taxation
Investing Before Converting: If your Traditional IRA gains value before conversion, you'll owe taxes on the gains
Missing the Deadline: IRA contributions must be made by April 15th of the following year

Backdoor Roth IRA vs. Mega Backdoor Roth: What's the Difference?

While the Backdoor Roth IRA allows $7,000-$8,000 in annual contributions, the Mega Backdoor Roth can allow up to $46,000+ in additional Roth contributions through your employer's 401(k) plan. Learn more in our Mega Backdoor Roth Guide for Physicians.

How Physician Income Affects Retirement Planning

Your specialty significantly impacts your retirement planning options. Higher-earning specialists like neurosurgeons and plastic surgeons may have more capital to invest but also face higher tax brackets, making tax-advantaged accounts even more valuable.

Compare physician salaries across specialties to understand how your income compares:

Next Steps for Physicians

Ready to optimize your retirement savings? Here's what to do:

Check your current physician salary against market rates
Open a Traditional IRA and Roth IRA with a low-cost brokerage (Fidelity, Vanguard, or Schwab)
Execute your first Backdoor Roth IRA contribution
Consider the Mega Backdoor Roth for additional tax-advantaged savings

Disclaimer: This article is for informational purposes only and does not constitute financial or tax advice. Consult with a qualified financial advisor and tax professional before making any investment decisions.