A FIRE Calculator for New Medical Residents: What to Track

A new medical resident starts PGY-1 on a median stipend of $66,986^[] while carrying around $223,130 in education debt,^[] and will, five years later, step into an income that is often three to five times higher. That single income step is the reason most generic FIRE calculators quietly misrepresent the trajectory — they assume a steady salary and a steady savings rate, and residency is the opposite of both. The question a resident should be asking isn't "when will I reach FI at my current rate?" It's "what am I actually committing my attending income to, and how early does that commitment have to start?"

Why residency breaks most FIRE calculators

A FIRE calculator is a two-variable engine: savings rate and time. Both assume stability. During residency, savings rate is a rounding error — maybe five percent of a stipend that is eroding in real terms.^[] Then the attending contract lands and that number jumps into a range that can plausibly clear thirty percent. If you plug a single "savings rate" into a generic calculator, you get an answer that's wrong in both directions during training, and the mistake compounds into a years-to-FI estimate that is typically off by five to ten years. This is the same structural problem that makes a FIRE calculator tricky for software engineers at startups, where equity vests replace the income step — the engine wasn't built for non-linear paths.

The resident-to-attending income jump in numbers

The MGMA 2025 Provider Compensation Data Report puts median total compensation for primary care at $329,780, drawing on survey data from more than 220,000 U.S. physicians.^[] That is roughly 4.9x the PGY-1 median stipend. Specialty medians run higher still — radiology, anesthesiology, and surgical specialties typically clear $500,000. The practical point for a FIRE calculator is that residency spending and attending spending are two different regimes. The most useful model treats them as two separate phases, each with its own inputs, and stitches them together at attending year one.

Student debt is the other half of the equation. The AAMC reports the Class of 2025 carried an average of $223,130 in education debt, and 70% of graduates finished with some.^[] Until income-driven-repayment installments are sized against attending income, most residents simply cannot meaningfully contribute to retirement.

The three inputs residents usually get wrong

When I walk through a resident's calculator entries, the same three fields are almost always off.

• Current savings rate. Residents default to ten percent because it's the round number they hear repeated. Reality is usually two to five percent once IDR loan payments clear. A calculator fed "10%" overstates residency accumulation by 2-3x.
• Real return. Most tools default to an eight percent nominal figure with no inflation adjustment. For a 30-year horizon, a five percent real return is the honest input. It's what a boring 80/20 index portfolio has delivered on a smoothed basis, and it's what the math rendered below uses.
• Safe withdrawal rate. A 35-year-old attending planning to retire in their fifties is looking at a 40-60 year retirement horizon. The original 4% rule was built for a 30-year window. For a 60-year plan, 3.3% is the defensible number. Moving from 4% to 3.3% raises the FIRE target by roughly 20%.

A worked example: PGY-1 through attending year twenty-six

The calculation rendered below integrates the two phases. During residency — four years, $72,000 average stipend, 5% savings rate — the ending balance is $15,516 at a 5% real return. That's the residency contribution: small in dollar terms, useful mostly as a Roth IRA habit. The attending phase takes over from there: on a $329,780 MGMA median, with $250,000 take-home after federal, state, and FICA, a 30% savings rate puts $75,000 a year into tax-advantaged and taxable accounts. Compounding that from $15,516 toward a $3.64 million FIRE number (driven by $120,000 annual spending at a 3.3% SWR) takes 26 attending years. Thirty years from PGY-1 start. That number is directionally stable — small changes to the savings rate or SWR shift it by a few years, not a decade.

PSLF vs aggressive paydown, inside a FIRE plan

Public Service Loan Forgiveness reshapes the math in a way that is easy to miss.^[] Every month of full-time employment at a 501(c)(3) or government hospital counts toward the 120 qualifying monthly payments. A four-year residency at a qualifying program burns through 48 payments — forty percent of the clock — before the first attending paycheck lands. A resident who is confident the attending job will also be at a qualifying hospital can run IDR at a minimum during training, treat the loan as "forgiven in year seven of attending," and redirect what would have been a private-refinance-and-blitz toward a taxable brokerage instead. The FIRE calculator needs to know which fork is taken: the PSLF path accumulates investments earlier; the aggressive-paydown path deleverages the balance sheet earlier. Both reach FI. They do it on different curves.

What I'd actually track during residency

The three dashboards worth keeping open: Roth IRA balance versus the $7,500 annual 2026 limit,^[] IDR payment against AGI, and a single rolling twelve-month savings rate. The one I would ignore is "net worth versus peers" — during residency it's a noise signal that drags morale without giving you a decision. The win during training isn't optimizing the portfolio. It's installing the tracking habit so that when the attending paycheck arrives, the infrastructure is already there to catch the step.