Educational

This guide is intended solely for educational purposes to help physicians understand common financial concepts that may arise throughout their careers. It is not intended as investment, tax, legal, or accounting advice. Individual circumstances vary, and financial decisions should be made after consultation with qualified professionals.

The Physician Financial Guide

Educational concepts for physicians throughout every stage of their career.

Physicians often face financial decisions unlike those of other professionals.

Medical training prepares physicians to care for patients. It does not cover the financial decisions that arrive alongside the career — educational debt, changing compensation models, practice ownership, risk, retirement, and what eventually gets handed on. This guide is an educational overview of those concepts, the stage of a career each one tends to surface in, and the professionals they are usually worked through with.

71%

of the medical school class of 2024 graduated carrying education debt — a median of $205,000.

AAMC, Class of 2024 fact card [1]

Over 70%

of physicians in one 2023 survey said their graduate medical education had not given them the tools for personal financial success.

Cureus, 2023 · n=50 [2]

Where each decision tends to land.

01 What this guide covers

Common financial focus areas for physicians

Topics physicians commonly evaluate at some point across a medical career. Each one tends to surface at a different stage.

01Income strategy

How physician compensation is structured, and how that structure changes moving from training to attending to ownership.

02Student loan management

Repayment considerations physicians commonly weigh as income and circumstances change.

03Tax strategy concepts

General concepts affecting how physician income is commonly taxed and structured.

04Practice ownership

The considerations physicians weigh between employment and owning part or all of a practice.

05Income protection

Why physicians often evaluate disability coverage and other forms of risk management.

06Retirement accumulation

Which vehicles are available to a physician often depends on employment model and practice structure.

07Estate coordination

The documents and beneficiary elections that tend to get revisited as circumstances change.

08Family & life events

Major financial decisions that often arise during career transitions and life changes.

Every physician's situation is different. These are educational discussion points, not recommendations.

02 Why coordination comes up so often

Income is one piece of a much larger picture.

Physicians frequently work alongside accountants, attorneys, practice consultants, insurance professionals, and financial professionals. Each contributes expertise within their own discipline.

Many physicians benefit from coordinating those conversations, so that decisions made in one discipline are understood in the others.

CPA

Handles tax preparation and tax strategy.

Attorney

Advises on legal structuring, contracts, and estate documents.

Financial professional Christopher's seat

Coordinates savings, investment, and retirement strategy concepts. Christopher works this seat as a financial coach — teaching the concepts on this page and keeping them connected across the others.

Insurance specialist

Evaluates income protection and risk management options.

Practice consultant

Advises on practice structure and operational decisions.

Lender

Supports financing decisions, including loans and practice purchases.

03 How the questions change

The four stages of a physician's career

What matters tends to differ from one stage to the next — and so does the order it tends to matter in.

Stage 1

Medical training & early career

Residency into the first attending role, often alongside major personal transitions.

Stage 2

Career development

Early attending years, when income and household responsibilities are both growing.

Stage 3

Peak earning years

An established, higher-earning period where priorities often shift.

Stage 4

Retirement & wealth transfer

Later-career considerations, including practice transition and estate coordination.

Four stages, and the questions change at every one.

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04 Frequently raised

Questions physicians frequently ask

Should I attack the loans first, or start putting money away? +

The variables that usually move this one: the interest rate actually carried on the debt, whether a federal forgiveness track is in play — and whether refinancing privately would forfeit it — and whether an employer match is being left uncollected in the meantime. The arithmetic also changes the month training income becomes attending income. Which way it points is a conversation for a financial or tax professional who can see the real numbers.

What actually changes the month I go from resident to attending? +

Several things at once, which is why this transition gets so much attention. Income can multiply in a single pay period. Tax bracket and withholding move with it. Benefit elections — disability, life, retirement — reset, and they are often chosen during a compressed onboarding window. Any income-driven loan payment calculated on resident income eventually recalculates on the new figure.

What am I actually buying when I buy into a practice? +

Usually more than one thing: a share of the entity, a share of its receivables and equipment, and in many cases goodwill — each valued differently and taxed differently. Beyond price, the operating or partnership agreement governs distributions, decision rights, and what happens to the stake if you leave. It is one of the few decisions that puts an attorney, a CPA, and a lender in the same conversation at the same time.

We're having a child. What tends to get revisited? +

Commonly: coverage amounts, beneficiary designations — which sit on the accounts themselves and override a will — guardianship provisions, and whether existing documents were written before the family looked the way it does now. Savings priorities also start competing with debt on a different timeline.

Why does everyone tell physicians to carry disability coverage? +

Because early in a medical career the largest asset is usually not what has been accumulated — it is the earning capacity still ahead. Two details do most of the work in these discussions: how a policy defines disability (whether it measures your ability to work in your own specialty or in any occupation), and whether coverage held through an employer follows you when you leave. Both are worth reviewing with an insurance professional against your own contract.

05 Who wrote this guide

About Christopher Gandy

Christopher Gandy has spent more than sixteen years working with physicians and healthcare professionals, helping them understand the financial concepts that commonly arise across a medical career.

Before financial services, he was a professional athlete, after playing at the University of Illinois. It is a career shaped like a medical one: years of unpaid preparation, then earning compressed into a window that closes on its own schedule.

His peers elected him national president of NAIFA — the National Association of Insurance and Financial Advisors, founded in 1890 and the oldest financial association in the country — for the 2026–2027 term.

He has spoken to physician organizations including the National Medical Association, the Student National Medical Association, and the Latino Medical Student Association, and served four years on the board of the SAME Network at RUSH Medical Center.

His work includes defined benefit plans — a retirement structure that tends to come up for physicians who own part or all of a practice.

16+ years with physicians MDRT — Top of the Table National President, NAIFA · 2026–2027 NAIFA member since 2003 SAME Network, RUSH Medical Center — 4 yrs Speaker: NMA · SNMA · LMSA Former professional athlete

MDRT is a membership organization for insurance and financial professionals; Top of the Table is a membership level qualified for on the basis of production. It is not a rating of investment performance and is not an indicator of client results.

The educational information in this guide reflects topics frequently discussed with physicians and should not be interpreted as individualized financial advice.

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06 After the guide

Ten minutes on which of these actually applies to you.

Christopher Gandy speaks with physicians and physician organizations about the topics in this guide. A ten-minute call covers the same ground the page does — the stage you're in, and the decisions that tend to surface there.

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