FIRE for Doctors: Retire Early Despite a Late Start

Doctors face a paradox in FIRE planning: among the highest earners in the country ($250,000–$500,000+ for many specialties), but starting their wealth-building journey a decade later than peers due to 4 years of medical school and 3–7 years of residency/fellowship at $60,000–$80,000/year. A 35-year-old physician with $50,000 in savings and $200,000+ in student debt is financially behind a 35-year-old software engineer who started earning $150,000 at 22.

The physician FIRE calculus changes dramatically after year 1–3 of attending practice. With a $280,000 salary and $200,000 in student loans, many physicians pursue "physician FIRE" by aggressively paying down high-interest loans first, then pivoting to maximum investing. Dave Ramsey-style debt payoff (avalanche method: highest interest first) combined with a $60,000–$80,000/year debt payoff plan can eliminate $200,000 in physician loans in 3–4 years, clearing the way for maximum retirement investing.

Physicians have access to tools other earners don't: 403(b) plans (non-profit hospital employers), 457(b) plans (government or non-profit), and defined benefit pension plans at some institutions. A physician at an academic medical center might have a 403(b), 457(b), AND pension — potentially sheltering $60,000–$70,000+/year in tax-advantaged savings. Understanding all available accounts and maximizing them is the single highest-leverage action for physician FIRE.

The physician lifestyle inflation trap is severe. An attending physician earning $300K after 12 years of deferred gratification (college + medical school + residency) faces enormous social and internal pressure to "finally enjoy" a $900,000 home, BMW, and expensive vacations. Physicians who avoid this trap and maintain a $150,000-equivalent lifestyle on $300K income can typically retire by 52–58. Those who live to their full income often find themselves at 55 with the same net worth as a schoolteacher who saved consistently.