Physician Budget Planner
You know your salary. You don't always know where it goes. This planner maps your full monthly cash flow — taxes, student loan payments, and every major spending category — so you can see your actual savings rate and what that means for long-term wealth building.
Pre-filled with physician household estimates. Edit any field to match your situation.
Housing & core living
Insurance & medical
Lifestyle & discretionary
If your combined monthly savings (pre-tax contributions + surplus) were invested at a 7% real annualized return:
Why physicians feel broke on high incomes
A common first-year attending experience: you sign a contract for $320K, expect financial relief, and find the bank account still feels tight. The math explains it. Consider a single attending in a mid-tax state, $280K in loans on IDR, 2026 tax year:
- Federal income tax: ~$75,000 (effective ~23.4%; 2026 brackets per IRS Rev. Proc. 2025-67)1
- FICA: ~$17,000 (SS capped at $184,500 wage base;2 Medicare + 0.9% additional above $200K)
- State tax (~5%): ~$15,000
- IDR loan payment (~10% of discretionary income above 150% FPL):3 ~$27,000/yr
- After-tax, after-loan: ~$186,000/year — $15,500/month
That $15,500 covers housing, childcare, disability insurance, term life, food, transportation, and building wealth. With $3,200/month in housing and $1,500 in childcare, you're at $10,800 before anything else.
How to prioritize when everything feels urgent
New attendings face a queue of competing demands. This roughly optimal sequence applies to most situations:
- Disability insurance. Your income is your largest financial asset. Own-occupation coverage sized to cover loans plus living expenses protects everything that follows. Buy it during residency if you can — premiums are lower, and future-insurability options lock in before your health changes.
- Employer 401(k)/403(b) match. Free money. Never skip it. Match-eligible contributions should come before almost anything.
- Emergency fund. Most new attendings arrive with $0 in liquid savings after training. Three to six months of expenses in a high-yield savings account insulates you from the unexpected before you have investment assets to draw from.
- PSLF vs. refinance decision. If you work at a nonprofit health system, this decision is worth more than most financial decisions combined. A $300K balance on PSLF at a qualifying employer can mean $150K–$250K in forgiveness over 10 years on IDR. Refinancing before confirming PSLF eligibility destroys this option permanently. Model it here before you act.
- Max pre-tax retirement accounts. 401(k)/403(b) employee deferral ($24,500 in 2026 for under-50),4 457(b) if your employer offers it, backdoor Roth IRA, HSA if you're on an HDHP. See the 457(b) stacking guide for hospital physicians.
- Term life insurance. If you have dependents or carry debt a spouse would inherit. Keep it simple — term coverage that matches your income replacement need. Whole life can wait until your situation is more settled (and you've gotten a second opinion from a fee-only advisor who doesn't earn commissions from it).
- Additional wealth building — taxable brokerage, real estate, cash balance plan for practice owners — after the items above are handled.
Physician budget benchmarks
These are reference points, not rules. Your market, family size, and goals determine the right numbers for you.
- Housing (mortgage + insurance + taxes): Standard guidance is ≤28%. Many physicians in high-cost markets run 30–35%. Either can be fine — the key is choosing it deliberately rather than drifting into it.
- Retirement savings (all accounts): Target 20–25% of gross by your late 30s to compensate for the late start. This includes pre-tax deferrals, backdoor Roth, and HSA contributions. The retirement catch-up calculator can show how your current rate maps to a retirement target.
- Student loans: On IDR/PSLF, often 5–10% of gross. On refinanced terms with a high balance, can run higher. The loan strategy is the single biggest swing variable in most early-career physician budgets.
- Insurance (disability + life + health): Budget 2–4% of gross for properly sized physician coverage.
The three levers that move the budget
Housing: the biggest fixed cost
Housing is the most consequential budget decision for most physicians, and it's relatively permanent. Upgrading from a $2,500/month rental to a $3,800/month mortgage locks in $1,300/month of additional fixed obligation. Physician mortgage programs can help with the down payment, but the monthly commitment remains. Model it in the planner above before signing a purchase agreement.
Student loan path: the biggest variable
A $300K balance being forgiven under PSLF has a monthly "cost" approaching zero in NPV terms. That same balance refinanced at 5.5% over 10 years costs roughly $3,200/month. The monthly difference exceeds most physicians' entire discretionary spending budget. The loan calculator will model your specific balance, employer, and timeline.
Pre-tax deferrals: the highest-return tax move
At the 32% federal + 5% state marginal rate, maxing the 2026 employee deferral ($24,500) saves approximately $9,065 in taxes — immediately, in the current year. Hospital physicians with a 457(b) alongside their 403(b) can shelter $49,000/year pre-tax. Practice owners adding a solo 401(k) or cash balance plan can extend this dramatically further. See the physician tax strategy guide for the full picture.
- IRS — Tax Inflation Adjustments for Tax Year 2026 — 2026 federal income tax brackets and standard deductions (Rev. Proc. 2025-67).
- SSA.gov — Contribution and Benefit Base — 2026 Social Security wage base ($184,500).
- HHS ASPE — 2026 Poverty Guidelines — Federal poverty levels used to compute IDR discretionary income (10% of income above 150% FPL).
- IRS — Retirement Topics: 401(k) Contribution Limits — 2026 employee deferral $24,500 (under 50); catch-up $8,000 (age 50+); super catch-up $11,250 (ages 60–63 per SECURE 2.0).
Tax values verified against 2026 IRS and SSA publications. Budget benchmarks are illustrative; results depend on individual circumstances.