Physician Take-Home Pay Calculator
You're making $300K. Where does it actually go? Taxes, FICA, and student loans can quietly erase 40–55% of gross income before you pay rent. This calculator shows the full picture — annual and monthly — so you stop wondering why the bank account doesn't match the salary.
Your take-home breakdown
Effective tax rates
Why physicians feel broke on high incomes
A common experience: you finish residency at 32, sign a contract for $320K, and expect life to feel dramatically different. It doesn't — at least not right away. Here's why:
- Federal tax: ~$75,000 (effective ~23.4%; 2026 brackets per IRS Rev. Proc. 2025-67)
- FICA: ~$17,000 (SS capped at $184,500 wage base + Medicare + 0.9% additional Medicare above $200K)
- State tax (5%): ~$15,000
- IDR loan payment: ~$30,000/year (10% of discretionary income; 150% × 2026 FPL = $23,940)
- Net take-home: ~$183,000/year — or $15,250/month
After disability insurance (~$300/mo), malpractice tail coverage, rent in a physician-heavy market, childcare, and actually starting to fund retirement… $15,250/month goes fast.
This isn't complaining — $15,500/month is a good income. The point is that physician finances require deliberate planning, not assumption. Many early attendings make suboptimal loan decisions (refinancing before confirming PSLF ineligibility, or staying on IDR when refinancing would save $80K) because the numbers feel abstract until you map out the actual cash flows.
What actually moves the needle
1. The loan decision is worth $100K+ in NPV
If you qualify for PSLF — which requires a nonprofit or government employer — and have high debt relative to income (common for residents and fellows), staying on IDR and pursuing PSLF can beat refinancing by $100,000–$200,000 in total cost. Refinancing first destroys that option permanently. A physician-specialist advisor can model this for your specific loan balance and employer before you decide.
2. Pre-tax deferrals directly reduce what you see above
Every dollar deferred into a 401(k) or 403(b) reduces your federal and state taxable income by that dollar. If you're in the 32% federal bracket + 5% state, maxing the employee deferral ($24,500 in 2026) saves roughly $9,000/year in taxes — immediately. A solo 401(k) or cash balance plan as a 1099 contractor can extend this dramatically further.
3. The whole-life pitch doesn't solve the cash flow problem
Insurance salespeople target new attendings with whole life proposals partly because of the income spike. But adding $500–$1,500/month in whole-life premiums to an already tight cash flow, while carrying $300K in loans, usually makes things worse — not better. A fee-only advisor (not commission-based) can tell you whether permanent insurance actually fits your situation.
4. Disability insurance should come before wealth accumulation
Your income is your most valuable asset. A 34-year-old physician with $300K in loans and $0 in savings has a massive negative net worth — and it's secured entirely by their ability to practice. Own-occupation disability insurance sized to cover your loan payment plus living expenses is one of the highest-priority moves in year one of practice.