Smart Tax Strategies for New Physicians

Transitioning from residency to your first attending position comes with big changes, especially for your taxes.

Watch now to learn how to keep your first-year taxes to a minimum, avoid surprises, and make smarter financial choices as you start your new career.

Transcript:

Transitioning From Residency to Attending: What to Expect for Your Taxes

So you’ve gotten the good news that you’re about to become an attending, and your income and paycheck are about to change—congratulations! But the other thing that’s about to change is your taxes.

I’m Ben Martinek with Bona Fide Finance, and we want to talk a little bit about income taxes and what you can do in your first year as an attending.

From Resident to Attending: The Big Income Jump

In your situation, you’ve been making less money as a resident, and you’re well aware of this.

The good news of less income is that you pay less in income taxes.

But when you step into your attending role, you’re now seeing a substantial increase in income—maybe two, three, or four times what you made as a resident. Perhaps even more, especially if you’re in a dual-physician household where both of you are transitioning from residency or fellowship.

You’ll need to adjust to a new baseline for your taxes. What may have worked previously for tax withholding will no longer be sufficient.

Common Tax Surprise: Not Enough Withholding

One common surprise in that first year relates to bonuses or the transition itself from low to high income. In your lower-income role, taxes were withheld based only on that income. Because we have a progressive tax system, as your income increases, each additional dollar is taxed at a higher rate. The withholding from your residency paycheck likely won’t be enough once your attending income kicks in.

If you receive a large sign-on bonus or relocation incentive, you may also not have enough taxes withheld. It may not cause immediate issues, but when you file your taxes, you could be surprised to owe thousands.

It’s not your tax professional’s fault, it’s simply that your withholding wasn’t adjusted for your higher income.

This is why it’s a good idea to have a tax projection done early, so you can plan ahead and avoid an unexpected tax bill.

Relocating? Don’t Overlook State and Local Tax Changes

If you’re relocating as part of your transition from residency to attending, you may face new state or locality taxes.

Changing your state of residence mid-year can complicate your return, especially if you end income in one state and start again in another.

There can also be tax planning opportunities in how income is allocated between the two states—something to review with your advisor.

Additional Tax Considerations for Physicians

As your income grows, additional taxes may apply, such as the Net Investment Income Tax or the Medicare surtax.

If your household income exceeds $200,000 (single) or $250,000 (married filing jointly), these surtaxes come into play and can impact your investment income.

Strategic Moves: Roth Conversions and Inherited IRAs

If you have any pre-tax money or have made pre-tax contributions while your income is still relatively low, consider whether a Roth conversion makes sense before your income spikes.

Or if you’ve recently received an inherited IRA, it might be beneficial to recognize that income now—before your attending salary increases—so it’s taxed at a lower rate.

Get Professional Help Navigating Physician Taxes

These situations can get complicated, and that’s where professional guidance makes all the difference. If you want peace of mind knowing your taxes are handled correctly, consider reaching out to me and my team at Bona Fide Finance.

Trust the professionals; this is what we do for a living.To schedule an introductory call, email hello@bonafidefinance.com.

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Bonnie Martinek

Administrative Assistant
Bonnie (Ben’s mom!) is a mother of 9 and a grandmother of 17. She has lived in rural Indiana her whole life and has a master’s degree in Special Education. In her own words, she’s done a little bit of everything but is a master of none (teaching, construction, manager of a corn maze, CNA, farm work, cashier, auto bodywork, and the list goes on!). Widowed in 2019, she is reinventing herself through her work in the day-to-day operations of Bona Fide Finance and client relations. Bonnie loves getting to know our clients and is happy to serve them well!

Deb Martinek

Relationships Specialist

Deb has been with Bona Fide Finance since its inception in 2015 and long before that with her support of Ben studying for the CFP designation and the dream of starting the business of helping individuals and families meet their financial goals.

She fills the Relationships Specialist role – Deb is typically the first encounter our new clients have as she walks them through our service offerings and introduces them to the map of financial literacy.

She has a bachelor’s degree from Ball State University and a master’s degree from the Franciscan University of Steubenville. Deb lives in Bismarck with Ben and their two young daughters, is a card-carrying member of the CDL club (read more about those adventures here) and is happiest reading an epic novel, solving a 1000-piece jigsaw puzzle, or working in her kitchen where she can serve love to the people in her life through quality food (clients enjoy her holiday shipment of homemade goodies each December!).

Ben Martinek

CFP®, EA, CSLP®, RICP®, Founder and Advisor

Ben Martinek, CFP®, EA, CSLP®, RICP®, is the founder and lead advisor at Bona Fide Finance, an independent, fee-only firm dedicated to helping doctors, young professionals, and growing families take control of their financial future. With a deep understanding of student loan debt—having tackled his own—Ben specializes in guiding clients through debt repayment strategies, smart investing, and comprehensive financial planning so they can build wealth with confidence. Ben’s passion for financial planning comes from his desire to provide honest, objective advice tailored to each client’s unique situation. He loves seeing the impact of his work, whether it’s helping a family pay off student loans years ahead of schedule, setting up an early retiree for financial freedom, or giving clients the peace that comes from knowing their finances are in order. His clients appreciate his thoughtful, high-touch approach, often saying that working with him has changed their lives.

Before launching Bona Fide Finance in 2015, Ben’s career path was anything but conventional. The fourth of nine children, he grew up in rural Indiana and initially pursued a path in academia, earning a B.A. in philosophy and classical languages, followed by a master’s degree in philosophy. Along the way, he explored careers in construction and truck driving—logging over 600,000 miles across the U.S. with his wife, Deb—before finding his true calling in financial planning.

Now based in Bismarck, North Dakota, Ben and Deb stay busy raising their two daughters, Edith and Virginia. Since their truck-driving days, Ben is happiest on a long road trip—preferably behind the wheel of his TDI Volkswagen Jetta. He enjoys sailing on Lake Sakakawea, camping in their vintage ’90s pop-up camper, and smoking a pipe by the grill. A lover of strategy board games, he favors Clans of Caledonia (mostly because Deb refuses to play Risk with him). When he’s not working with clients, he can be found smoking meat, gardening, hiking, or diving into The Lord of the Rings or Dune. Ben also serves on the school board for his daughters’ Montessori school and is actively involved in pre-marriage ministry in the Bismarck Diocese.