Financial Planning for Doctors: A Complete Roadmap

Ideally during residency. The most impactful early decisions are: choosing the right student loan repayment strategy (PSLF vs refinancing), starting disability insurance while premiums are lowest, contributing enough to capture any employer 401(k) match, and building a 3-month emergency fund. Even small actions during training compound significantly over a 25-30 year career.

It depends on your complexity and interest. Physicians with straightforward W-2 income, index fund investing, and standard tax situations can manage their own finances effectively. Those with complex situations — practice ownership, multiple income streams, real estate investments, S-corp elections, or estate planning needs — often benefit from a fee-only financial advisor who specializes in physician finances. Avoid advisors who earn commissions on product sales.

Lifestyle inflation in the first 2-3 years after residency. The jump from $60,000 resident salary to $300,000-$500,000+ attending salary creates a powerful urge to immediately upgrade housing, cars, and lifestyle. Physicians who maintain a resident-level lifestyle for 2-3 years post-training and aggressively pay down debt or invest the difference can reach financial independence 10-15 years earlier than peers who inflate immediately.

A target of 20-30% of gross income is appropriate for most physicians. This includes 401(k)/403(b) contributions ($23,500 in 2026), backdoor Roth IRA ($7,000), HSA if eligible ($4,300 individual/$8,550 family), and additional taxable investing. At $400,000 income with 25% savings rate, you are investing $100,000/year — which, at 7% returns, grows to $3.7 million in 20 years.

If pursuing PSLF: make minimum IDR payments and invest aggressively — the forgiven amount will exceed what you would save by paying extra. If not pursuing PSLF: compare your loan interest rate to expected investment returns. Student loans above 5-6% should generally be paid aggressively. Below 4%, investing likely wins. Between 4-6%, a hybrid approach (extra payments + investing) is reasonable. Always capture the full employer 401(k) match regardless of debt level.