First Attending Paycheck Calculator

The jump from training pay to an attending, staff or full-time salary is the biggest raise most people in healthcare ever get. But taxes and deductions take a bigger share, too. This calculator estimates your first paycheck and how much more you'll actually have each month, so you can plan what to do with it.

What this calculator does

Enter your new salary, your training salary, filing status, state tax rate, 401(k) or 403(b) contribution, monthly pre-tax health insurance and HSA deductions, and how often you're paid. It shows:

• your take-home per paycheck,
• your monthly take-home,
• your monthly increase compared with training,
• your effective tax rate, and
• how much you'd save per year if you kept living on your training take-home.

The formula in plain English

Retirement contribution = salary × your contribution %, capped at the 2026 employee limit of $24,500.

Take-home = salary − retirement − pre-tax health and HSA − federal income tax − Social Security and Medicare − state tax, using 2026 federal brackets and the standard deduction.

Per paycheck = yearly take-home ÷ paychecks per year.

Training take-home is estimated the same way, without retirement or health deductions.

Monthly increase = (new take-home − training take-home) ÷ 12.

A worked example

Dr. Rivera finished residency on a $75,000 salary and starts a job at $300,000. She's single, pays 5% state tax, contributes 8% to her 403(b) and has $450 a month in pre-tax health and HSA deductions. She's paid every two weeks.

• Take-home per paycheck: about $7,020.
• Monthly take-home: about $15,220.
• Monthly increase vs training: about $10,400.
• Effective tax rate: about 29%.
• If she kept living on her training take-home, she'd have about $124,800 a year to put toward loans and savings.

Even living on half the increase would let her pay off a large student loan balance in a few years.

Why it matters at each career stage

If you're: Resident / fellow

Run this before your first attending job so you can make a plan before the money arrives. Decide in advance what share of the raise goes to debt, savings and lifestyle.

If you're: Employed

In your first year after training, set up automatic transfers on payday: retirement contributions through payroll, a fixed amount to student loans, and a fixed amount to an emergency fund or investments.

A first-year plan

Get disability insurance. Your income is now your biggest asset. Own-occupation coverage is worth getting early.

Build an emergency fund. Aim for three to six months of expenses.

Max out tax-advantaged accounts. 401(k)/403(b), HSA and a backdoor Roth.

Make a student loan decision. PSLF, refinancing or aggressive payoff.

Wait on big purchases. Give yourself six months before buying a home or expensive car.

How to split the raise

There's no single right split, but many new attendings use a simple rule: about a third of the raise to lifestyle, a third to debt and a third to savings and investing, adjusted for their loan plan. If you're pursuing PSLF, the debt share can go to savings instead. If you have high-rate private loans, it may make sense to put more toward debt for a few years. Write your split down before the first big check arrives, and automate it so it happens without a decision every month.

Watch for surprises

Sign-on bonuses are withheld at 22%, which may not be enough at your new bracket. If you start mid-year, your first year's withholding may be too high or too low. And if you moonlight or have a spouse's income, check your W-4.

Next, compare with your resident take-home pay, see your full take-home pay, and read our first-year money checklist.