Wealth Building · 12 min read
Your Retirement Account Map
Four account types, two limits, one fill order
Four accounts, $65,250 of room — most physicians fill one
Your first payroll portal asks a single question: what percent of salary do you want to defer? Most physicians type a number that feels responsible, watch it reach the $24,500 federal deferral cap, and consider the job done. At a typical academic medical center, that number is barely a third of the map. In 2026, a university employer commonly offers a ($24,500 of your own deferrals), a separate 457(b) with its own additional $24,500, an worth up to $8,750 for family coverage, and — through the backdoor — a $7,500 . That is $65,250 of personal before counting a single dollar of . The pre-tax portion alone, deferred at a 32 percent , keeps roughly $10,600 of this year's federal tax in your accounts instead of the Treasury's. This module draws the map first — which accounts exist and which limit each one answers to — and then gives you the fill order, because the order you fund them changes what every dollar is worth.
The section 402(g) elective deferral limit
The 2026 cap of $24,500 on what you personally defer from salary into and plans — one limit per person across all employers combined (IRS Notice 2025-67).
The four account types split into two buckets. Workplace plans — and — hold both your money and your employer's, and each bucket answers to a different limit. Your own salary deferrals answer to section 402(g): $24,500 in 2026 (IRS Notice 2025-67). Total additions to the plan — your deferrals plus plus any after-tax contributions — answer to section 415(c): $72,000 per employer in 2026. A governmental 457(b) sits outside both: section 457(e)(15) gives it its own separate $24,500. IRAs ($7,500) and HSAs ($4,400 single, $8,750 family) sit outside the workplace system entirely. Physicians aged 50 and over add an $8,000 catch-up to workplace deferrals ($11,250 in the years they turn 60 through 63) and $1,100 to the IRA. One person, several limits — and the match never touches your $24,500.
Why it matters: If you believe there is one limit, you stop at $24,500 and never ask what else exists. The 402(g) versus 415(c) distinction is why an employer match does not shrink your deferral room, why after-tax contributions can exist at all, and why a 457(b) — governed by neither — can double your deferrals at the same job.
The fill order: why the match beats the HSA beats the unmatched dollar
Every dollar you invest goes somewhere, so rank the destinations by what each one pays you per dollar. The pays an immediate, guaranteed return no market matches. The is the only account that is never taxed when used correctly. Everything below them is ranked by how much tax each rung removes. Fill from the top; move down only when a rung is full.
| Rung | 2026 room | Why this order |
|---|---|---|
| 1. Employer match (403(b)/401(k) up to the match) | Set by your plan's formula | A 50 to 100 percent instant return on each matched dollar; skipping it is a voluntary pay cut |
| 2. HSA (requires a qualified HDHP) | $4,400 single / $8,750 family (Rev. Proc. 2025-19) | The only triple-advantaged dollar: deductible going in, untaxed growth, tax-free out for qualified medical costs — and payroll contributions also skip FICA |
| 3. Remaining 403(b)/401(k) deferral, then 457(b) | Up to $24,500, plus a separate $24,500 if a governmental 457(b) exists | Deferred at your 32 to 37 percent marginal rate now, withdrawn at a lower blended rate later; the 457(b) stacks a second full limit on top |
| 4. Backdoor Roth IRA | $7,500 (plus $1,100 at 50+) | Above the $153,000 to $168,000 single MAGI phase-out you contribute nondeductibly and convert; decades of tax-free growth per dollar |
| 5. Taxable brokerage | No limit | Last because it is the only rung with annual tax drag on dividends and gains — still far better than leaving cash idle |
One academic job hides $65,250 of tax-advantaged space
You are a 38-year-old academic hospitalist earning $260,000 at a university hospital that offers a with a 4 percent dollar-for-dollar , a governmental 457(b), and a qualified high-deductible health plan covering your family.
Bottom line: Filling the map instead of stopping at $24,500 shelters an additional $40,750 of your own money — the $33,250 pre-tax portion alone keeps roughly $10,600 of federal tax this year at a 32 percent marginal rate, before any state tax savings.
Does the match count against your $24,500?
This step is a quick self-check. Open the full module to try it with your numbers →
The map in four sentences
- Your $24,500 section 402(g) limit and the $72,000 section 415(c) limit answer different questions: what you defer versus what everyone contributes in total per employer.
- A governmental 457(b) carries its own separate $24,500 under section 457(e)(15), stacking on top of your 403(b) rather than sharing its limit.
- The fill order is match, then HSA, then remaining deferrals, then backdoor Roth IRA, then taxable — each rung ranked by what it pays per dollar.
- At a typical academic job the full 2026 map holds $65,250 of personal tax-advantaged space, before the employer match adds more under section 415(c).
Do this next: Before your next pay period, pull your summary plan description and write down four facts: your match formula, your vesting date, whether a 457(b) exists and what kind, and whether your health plan qualifies you for an HSA.
Run this with your own numbers
The interactive version of this lesson works through your actual paycheck, loans, and benchmarks — and your AI advisor can take it from there. Free to start, no card required.
Keep reading
The Backdoor Roth IRA
Congress closed the front door. Physicians use the back door. Completely legal. Worth $7,500 of tax-free growth per year — forever.
The HSA: A Stealth Retirement Account
The only account in the tax code where money is never taxed — going in, growing, or coming out. Most physicians use it as a debit card and waste the whole trick.
Your First Attending Paycheck
The 12 months around your residency-to-attending transition contain more financial decisions than the rest of your career combined. Here is what to do, in order.
Stocks, Bonds, and the Funds That Hold Them
ETFs, mutual funds, index funds, expense ratios — the four-word vocabulary lesson medical school skipped, and the fee math that pays for a house.