Somewhere in orientation week, between EMR training and the badge photo, a benefits portal asks you to make retirement decisions you were never taught to make. Most physicians click through and revisit the choices years later, after forfeited dollars and a decade in the wrong fund. The entire assignment takes about 30 minutes and five findings — this article is the checklist, at 2026 numbers throughout.
| Minutes | Task | Where it lives |
|---|---|---|
| 0–5 | Find the match formula and vesting schedule | Summary plan description or benefits portal |
| 5–15 | Set the deferral percentage | Contribution election screen |
| 15–20 | Choose traditional or Roth | Same screen, one toggle |
| 20–25 | Pick the fund | Investment election screen |
| 25–30 | Name and confirm beneficiaries | Beneficiary designation form |
Minutes 0–5: find the match formula, then read the vesting schedule twice
Open the summary plan description or the plan highlights page and extract two facts: the match formula and the vesting schedule. Formulas vary widely — dollar-for-dollar on the first 4 percent, 50 cents per dollar on the first 6 percent, or a flat employer contribution with no match at all. On a $300,000 salary, a dollar-for-dollar 4 percent match is $12,000 a year of compensation that exists only if you claim it.
Vesting decides whether you keep it. Some plans vest employer money immediately; others use a three-year cliff or a five-year graded schedule. A three-year cliff means leaving at two years and eleven months forfeits every match dollar — a detail that belongs in your job-change math, not in a footnote.
Key insight
The match is not a bonus; it is contracted compensation with a claiming requirement. Every pay period your deferral sits below the match threshold, you work the same call schedule for less pay. Vesting is the second half of the sentence: an unvested match is compensation you have earned but not yet kept.
Minutes 5–15: size the deferral — the match is the floor, $24,500 is the ceiling
For 2026, IRS Notice 2025-67 sets the elective deferral limit at $24,500, with an $8,000 catch-up at age 50 and $11,250 at ages 60 through 63; catch-up contributions must be Roth if your prior-year wages exceeded $150,000. In residency and fellowship, reaching $24,500 would take more than a third of the median salary — there, the match is the assignment. At attending income, the full limit is the default target, and the election needs arithmetic, not intuition.
Example calculation
Assumptions, stated explicitly: $300,000 salary paid semi-monthly (24 checks of $12,500); whole-percentage elections; contributions start in January; 2026 limit of $24,500 per IRS Notice 2025-67.
Exact percentage: $24,500 ÷ $300,000 = 8.17% Election: 9 percent — the plan stops contributions automatically at the limit Per check at 9 percent: $1,125, crossing $24,500 in late November Mid-year variant: start September 1 with 8 checks remaining and nothing deferred this year: $24,500 ÷ $100,000 of remaining pay = 24.5 percent election
One caution on finishing early: if the match is deposited per paycheck rather than trued up annually, hitting the limit in November can forfeit December match dollars. Ask whether the plan has a true-up before electing more than the smooth percentage.
The mid-year job change: the limit follows you, not your employer
The $24,500 elective deferral limit under section 402(g) is one limit per person per year, aggregated across every employer — your new payroll system does not know about your old one and will not stop you. Deferrals made January through June at your training program count against the same $24,500 you elect at the attending job. Employer money is the exception: the match does not consume your limit, because employer contributions count against the separate $72,000 overall cap under section 415(c), applied per unrelated employer.
Important
Track the combined total yourself in any job-change year. Excess elective deferrals are taxed twice — once in the year contributed, again when distributed — unless you notify a plan and withdraw the excess by April 15 of the following year. Pull your final training-program paystub, note the year-to-date deferral, and give the new plan a dollar target, not just a percentage.
Minutes 15–20: traditional or Roth — a bracket decision, not a philosophy
The default follows career stage. In residency and fellowship, at a 12 or 22 percent , Roth deferrals prepay tax at rates you are unlikely to see again. At attending income in the 32 or 35 percent bracket, traditional deferrals usually win, and they carry a second effect: pre-tax contributions lower AGI, which also lowers income-driven student loan payments for physicians on a forgiveness track. State taxes, future moves, and expected retirement spending shift the answer at the margins — the full decision tree lives in the retirement account map. When genuinely uncertain, many plans allow a split.
Minutes 20–25: pick the fund — a target-date default beats a guess
Until you have a written investment plan, the honest default is the target-date fund nearest your expected retirement year: one decision, automatic rebalancing, and a glide path you do not have to manage during call weeks or an attending ramp-up. Check the expense ratio on the fund fact sheet — large employer plans commonly offer target-date options costing well under a quarter of a percent per year, and a materially higher number is worth a question to HR. You can refine the allocation later; you cannot recover years the money spent parked in the cash default because no election was ever made.
Minutes 25–30: the beneficiary form outranks your will
Retirement accounts pass by beneficiary designation, not by will. Name a primary and a contingent. If you are married, federal law generally requires notarized spousal consent to name anyone else as primary on an employer plan. Revisit the form after marriage, divorce, or children — the plan pays whoever the form says, including an ex-spouse left there by inertia.
Quick takeaway
Thirty minutes, five findings: the match formula, the vesting schedule, a deferral no lower than the match and sized toward $24,500 when income allows, the Roth-or-traditional toggle set by bracket, a target-date fund, and a completed beneficiary form. Everything here is revisable except match dollars already forfeited.
Common questions
My employer offers both a 403(b) and a 457(b). Which comes first?
The 403(b) up to the full match, always; then the comparison depends on the 457(b) type. A governmental 457(b) carries its own separate $24,500 limit, effectively doubling deferral space. A non-governmental 457(b) remains employer property until paid out and deserves scrutiny before a single dollar goes in. The distinctions are mapped in the physician retirement contribution guide.
What if I cannot afford even the full match right now?
Elect what you can and calendar a one-percentage-point increase at every PGY step or contract raise. A partial match captured beats a perfect plan postponed.
Do employer contributions count against my $24,500?
No. Only your elective deferrals count toward the 402(g) limit. Employer match and nonelective contributions consume the separate $72,000 section 415(c) limit for 2026.
What happens to the match if I leave before vesting?
Unvested employer dollars are forfeited back to the plan; your own deferrals and their earnings are always yours. If a cliff date sits months away when a job change looms, the vesting schedule belongs in the negotiation math.
What to do next
- Download the summary plan description today and highlight the match formula and the vesting schedule — five minutes, zero cost.
- If you changed employers this year, pull the final paystub from the old job and write down the year-to-date elective deferral.
- Set the deferral election: never below the match, and at attending income, the percentage that reaches $24,500 by December.
- Set the Roth-or-traditional toggle by career stage, then confirm the money lands in a target-date fund rather than the cash default.
- Complete the beneficiary form with a primary and a contingent, and calendar an annual re-check.
- Slot these elections into your broader attending transition plan so the first-week defaults become a deliberate system.
A plan set in week one compounds quietly for thirty years; a plan postponed compounds regret at the same rate. The protocol above works with or without us. This is education, not individualized financial advice.