How much a doctor should save after fellowship comes to roughly 20 to 30 percent of gross pay each month, and Assante Wealth Management treats 20 percent as the floor for a late starter.
Maxing the 403(b) feels like enough, but the 2026 limit of $24,500 is only 8.75 percent of a $280,000 salary, well under half of a 20 percent savings rate.
The trade-off is straightforward: saving more now reduces flexibility today, while saving too little leaves fewer reversible choices later; most doctors underrate the cost of waiting.
Assante Wealth Management handles this by counting the accounts together and protecting a cash reserve. The savings rate goes on a single page that a doctor can walk a spouse through at the kitchen table.
Maxing the 403(b) falls short on a $280,000 salary
The IRS sets a ceiling, and a ceiling is a different thing from a savings plan. In 2026, the employee deferral into a 403(b) tops out at $24,500, and employee and employer contributions together can reach $72,000. People shorten that to “max your 403(b) and you're fine.” On $280,000, the calculation is $24,500 divided by $280,000, or 8.75 percent. A 20 percent target is $56,000, which leaves $31,500 a year to put somewhere else.
What will 20 or 30 percent of my pay grow to by 61?
Twenty percent of $280,000 is $56,000 each year, or about $4,667 each month. Thirty percent is $84,000 each year, or $7,000 each month. Those are savings targets, not promises about what an account will be worth.
Hypothetical: Omar is 36, single, works as a hospitalist at a nonprofit hospital, earns $280,000 and has $90,000 saved. He also has $310,000 in federal student loans and access to a 403(b) and a non-governmental 457(b).
First, Omar's 20 percent target is $280,000 × 0.20 = $56,000 each year. The monthly amount is $56,000 ÷ 12 = about $4,667. Over 25 years, the illustration uses a factor of 47.73: $56,000 × 47.73 = about $2.67 million.
At 30 percent, Omar saves $280,000 × 0.30 = $84,000 each year. His monthly amount is $84,000 ÷ 12 = $7,000. The same 25-year factor gives $84,000 × 47.73 = about $4.01 million. The difference is about $1.34 million at age 61.
His existing $90,000 also grows in the illustration. Using a 25-year factor of 3.39, $90,000 × 3.39 = about $305,000. That starting balance sits on top of either savings path.
Which monthly amount fits a different salary? The table answers that question. Doubling the monthly amount roughly doubles the result, and the gap between rows widens sharply between year 10 and year 25. Find your monthly row and read across. The figures leave out a starting balance.
Up to $24,500 of Omar's amount above the 403(b) limit could go into his non-governmental 457(b), but that money remains the hospital's asset and is exposed to its creditors until paid out. Staying on PSLF gives the 457(b) more weight because pretax deferrals lower the adjusted gross income used for his loan payment. Refinancing gives a taxable account more weight because he can reach it on any day.
The 5 percent is for illustration only. Markets fall as well as rise, and the balance at 61 could be well below these figures. Omar still has a choice to make: creditor exposure and lower AGI, or access and control.
| Monthly saving | Yearly total | After 10 years | After 25 years |
|---|---|---|---|
| $3,000 | $36,000 | $453,000 | $1.72 million |
| $4,667 (20% of $280,000) | $56,000 | $704,000 | $2.67 million |
| $7,000 (30% of $280,000) | $84,000 | $1.06 million | $4.01 million |
| $9,000 | $108,000 | $1.36 million | $5.15 million |
Should I save more in my first two attending years or hold cash first?
Save at least 20 percent from the first attending paycheck, but build three to six months of spending in cash before pushing toward 30 percent. Choose between PSLF and refinancing before making extra loan payments, because the order can change whether that money helps or simply reduces a balance that might be forgiven.
1. Pull three recent pay stubs and the loan bill. Write down take-home pay and fixed costs. 2. Put three to six months of spending in cash. 3. Set the 403(b) deferral in the HR benefits portal. 4. Decide between PSLF and refinancing before making any extra loan payment. 5. Place the rest of the 20 percent in the 457(b) or a taxable account. 6. Raise the rate two percentage points with each raise until it reaches 30 percent.
Paying ahead on loans that are on the PSLF track before choosing between PSLF and refinancing is a mistake of order. For Omar, $2,333 each month for two years is about $56,000; if he stays on PSLF, that payment only shrinks a balance that would have been forgiven, plus whatever the money could have grown to by 61.
Treating the 403(b) maximum as the whole savings plan creates another measurable gap. The unsaved amount is $56,000 minus $24,500, or $31,500 each year. Over ten years, assuming 5 percent for illustration, $31,500 × 12.58 = about $396,000.
Simplicity has a practical test here. Before raising the rate, Assante Wealth Management counts accounts: one 403(b), one 457(b) and one taxable brokerage account can hold Omar's 30 percent. Nothing in this example calls for a fourth account.
The 20 percent shortcut breaks in the forties for some doctors
A doctor who starts saving at 45 has 16 years to age 61 instead of 25 and needs a target built from planned spending. A doctor facing a practice buy-in needs cash first, and someone on PSLF may lose money by making extra loan payments. At a nonprofit hospital with weak finances, a large non-governmental 457(b) balance carries employer credit risk.
Pretax deferrals reduce W-2 Box 1 wages and adjusted gross income, but not FICA wages. With both plans full, $280,000 minus $49,000 equals $231,000. Social Security tax stops at the 2026 wage base of $184,500. Even after deferrals, $231,000 is above the IRS 2026 Roth IRA phase-out of $153,000 to $168,000 for a single filer, so a direct Roth IRA contribution is out.
Before raising the rate, line up three things against the steps above: your take-home pay and fixed costs, your cash reserve in months of spending, and your PSLF-or-refinance decision. If one of them is still blank, settle it before the deferral goes up.
- Gross pay on the latest W-2
- 403(b) deferral percentage in the portal
- 457(b) distribution election on file
- Months of spending in cash
- PSLF qualifying payment count
- Taxable account balance
Catch-ups at 50 and 60 raise the ceiling late
Turning 50 adds an $8,000 catch-up for 2026, bringing the 403(b) total to $32,500, and ages 60 to 63 allow an $11,250 catch-up. If prior-year FICA wages exceed $150,000, the catch-up is allowed only as a Roth contribution. At Omar's $280,000 that rule would cover him once he reaches 50. These amounts help a late starter, but for Omar they arrive 14 years after the habit needed to start.
A savings-rate check with Assante Wealth Management needs three pay stubs
A conversation with Assante Wealth Management makes sense once the PSLF-or-refinance choice is close and a 457(b) election form is due. Bring three recent pay stubs and the 457(b) plan summary with its distribution options. Also bring the number of qualifying PSLF payments shown in your studentaid.gov account. Assante Wealth Management sets out the full cost of its advice on paper before any agreement is signed. Meetings happen remotely over video calls or the phone, and the office is at 317 South Juniper Street, Philadelphia, PA 19147, United States.
Related questions
Is saving 20 percent of gross pay enough if I didn't start until my mid-thirties?
Often, but not automatically. Saving 20 percent of gross pay from age 35 can build a substantial base, especially when the rate rises with future pay. A doctor starting in the mid-thirties should also check student loans, planned spending, cash reserves and any practice purchase. A 30 percent rate may be needed for early retirement or a late start after 45.
My hospital offers a non-governmental 457(b) next to my 403(b); should I count both toward my savings rate?
Yes, but the accounts don't carry the same risk. A 403(b) is generally an employer retirement plan, while a non-governmental 457(b) remains the hospital's asset until distribution and is exposed to creditor risk. Count both in the savings rate, then decide how much belongs in the 457(b) after reviewing the hospital and distribution terms.
Is it better to save 30 percent for ten years or 20 percent for all 25 years?
Saving 20 percent for all 25 years produces more in the illustration than saving 30 percent for only ten years, because the 20 percent saver keeps contributing for 15 more years. Ten years at 30 percent builds about $1.06 million ($84,000 × 12.58). Left alone for 15 more years at 5 percent, that grows to about $2.20 million ($1.06 million × 2.08). Twenty-five years at 20 percent reaches about $2.67 million.
Do employer contributions count toward the 20 percent, or only what comes out of my paycheck?
Employer contributions count toward your total savings rate, but first separate your own deferral from the employer amount. A 20 percent target that includes employer money may require less from your paycheck. Check the plan statement, then keep enough personal saving to meet the target if the contribution formula changes.
Sources and further reading
This is general information, not advice tailored to your finances or circumstances. Investing involves risk, including the possible loss of principal. Before making any decision about money, taxes or your practice, talk with a professional who knows your full situation.