The Best Retirement Savings Options for Physicians in the San Diego Area

Retirement planning is an important step in your financial journey. As a physician with family responsibilities, you may have many retirement savings options, and finding the one that best suits your unique goals may seem daunting. The key is to save aggressively and diversify your retirement income sources.

Imagine your financial stability as a sturdy stool, with each leg representing a particular source of income. Diversifying income sources is like adding more legs to the stool, making it more stable. Similarly, your financial situation will be more secure with multiple streams of income in retirement.

Physicians often start retirement planning later in their careers. During medical school and fellowships, they have limited opportunities to save for retirement. Given this delay, it’s often advisable for physicians to save 25–35% of their income toward retirement.

So, what are the best retirement savings options for physicians? Let’s explore. 

The Traditional Route

401(k) Plans: A Foundation for Physicians’ Retirement

Hospital systems often offer 401(k) plans as a primary retirement savings vehicle. These employer-sponsored plans allow physicians to contribute on a pre-tax basis. The tax advantages of contributing to a 401(k) are especially valuable in San Diego, where the cost of living can be high.

Physicians working in nonprofit hospital systems may have access to 403(b) plans. These are like traditional 401(k) plans but are specifically designed for employees of nonprofit organizations. Contributions to a 403(b) plan are made on a pre-tax basis, providing tax advantages for physicians.

Be sure to take advantage of employer matching contributions, if available. Matching contributions can significantly boost retirement savings over time. We recommend prioritizing contributions to the plans with employer matches.

Some health system benefits package examples (subject to annual revisions) include:

• Scripps Clinic Medical Group
  • 401(a)
  • Profit Sharing Plan (PSP)
  • Supplemental Benefits Group Plan
  • Cash Balance Plan
• Sharp Healthcare
  • 401(k)
  • Retirement Plan
  • Money Purchase Plan (MPP)
  • Cash Balance Plan

• Comparison Between Scripps and Sharp Systems:

• UC Health
  • 403(b) and 457(b) Plans, including traditional (pre-tax) and Roth (after-tax) contributions, and an in-plan conversion option
  • Defined Contribution Plan (allowed to make after-tax contributions)

As you break these down, you will see various opportunities within each. There are also specific rules you should be aware of as well. For example, the Scripps Clinic Medical Group supplemental benefit group plan asks for a one-time election to opt in or out of it. Once you opt in, you must stay opted in for the duration of your employment.

Sharp offers the Retirement Plan (RP) and the Money Purchase Plan (MPP). Between the two plans, employees may contribute up to the 2026 maximum of $72,000. There is also a Cash Balance Plan available that includes specific eligibility requirements. 

UC Health offers a 403(b) plan and a 457(b) deferred compensation plan, both pre-tax and with new Roth contributions, as well as a defined contribution plan. Employees can defer up to $24,500 to both the 403(b) plan and 457(b) plans for 2026 (with a catch-up of $8,000 for those age 50 or older). There is a special catch-up provision for 403(b) plan contributions for employees who meet certain requirements.

The complexity of benefits packages like those listed above may feel overwhelming. However, experienced financial professionals can help you figure out what’s best for your situation.

Pension Plans

As of 2026, some hospital systems still offer defined benefit pension plans. For example, UC Health and Kaiser offer pensions that provide a fixed, regular payment to physicians upon retirement. While less common than in the past, these plans can provide a stable, guaranteed income stream in retirement. If this option is available to you, you should carefully review the plan’s terms. You should understand the calculation method for benefits and payout options. It is typically based on a formula that includes the number of years worked, your age, and your average salary over the past few years.

There can be several options for pension plans. With UC Health, there are three different programs, depending on your hire date. 

Preventive Care for Your Finances

Relying on a single source of income is comparable to your metaphorical stool having only one leg. It might support you for a short while but it will ultimately become unstable. Diversifying your income can create a more balanced and stable financial structure and help you withstand economic fluctuations and unforeseen challenges. Some retirement plan options for physicians’ include:

Health Savings Accounts (HSAs)

HSAs are a great way to save for medical expenses in retirement. Consider maximizing your use of HSAs, especially if you are enrolled in a high-deductible health plan. HSAs offer a triple tax advantage: contributions are tax-deductible, earnings are tax-free, and withdrawals for qualified medical expenses are tax-free.

Physicians can use HSAs to cover current medical expenses or let the funds grow for future healthcare costs in retirement. With rising healthcare costs, an HSA can be a valuable tool for short- and long-term financial planning. If possible, sign up for the family HSA plan, and you’ll be able to contribute up to $8,750 in 2026.

Backdoor Roth IRA(s)

Physicians seeking to diversify their retirement planning should consider Backdoor Roth IRAs. This strategy involves contributing to a traditional IRA and then converting it into a Roth IRA. By doing this, physicians can benefit from tax-free withdrawals in retirement. Be mindful of tax implications and eligibility criteria. A financial advisor can help navigate the complexities of backdoor Roth IRAs effectively.

Brokerage Accounts

Traditional brokerage accounts do not offer the same tax advantages as retirement-specific accounts. However, they often allow for greater flexibility in investment choices and withdrawals. Physicians can use taxable brokerage accounts to bridge income gaps in retirement. They can also use them for investments that are not available in their retirement plans.

Real Estate Investing

Real estate investment can be a valuable addition to your retirement savings strategy. Physicians may explore opportunities such as purchasing rental properties. Rental properties can provide a dual benefit: long-term appreciation in property value and rental income that can supplement retirement funds.

Fat FIRE

FIRE (Financial Independence, Retire Early) is a popular retirement savings strategy that emphasizes minimal spending and aggressive saving and investing (typically around 50% of your annual salary) to retire earlier than the traditional age of 65. Typically, those implementing this strategy aim to have between 25 and 33 times their annual spending, providing a humble retirement with minimal “extras.” 

Increasingly attractive to physicians and other high-earning professionals is Fat FIRE, which continues to focus on extreme saving and investing but with the goal of providing an above-average retirement that enables hobbies, travel, and other pursuits. You can determine how much you want to earn in retirement (e.g., $200,000 a year) and multiply that number by as much as 44. This could mean saving up to 70% of your annual salary today.

Side Gigs and 1099 Income

As you’ve become more established in your career, you may have found you have some flexibility to boost your income by adding a secondary income stream, also called a “side hustle.” A side hustle can be part of your financial planning — it can help you pay down debt and put money toward long-term financial goals, perhaps allowing you to build an off-ramp for an early retirement. Here are a few opportunities you may consider that take advantage of your medical expertise and knowledge:

• Locum Tenens Work: Involves providing work at healthcare facilities on a temporary basis, to fill gaps in care or occupy vacant positions until a full-time provider can be found. 
• Telemedicine: Physicians can work from home, providing patient care remotely or using videoconferencing software. Physicians who pursue telemedicine or telehealth work may have greater flexibility in hours and scheduling.
• Medical Expert Witness Testimony: Lawyers sometimes retain medical expert witnesses to provide opinions during depositions or in court on the medical evidence presented in a case. The average expert witness can earn between $350 and $500 an hour for this type of work, according to The Expert Institute. 

Solo 401(k)s

If you earn 1099 income from a side gig and have no other full-time employees (other than a spouse), a solo 401(k) can provide additional tax-advantaged savings opportunities and flexibility in retirement. You can contribute as both an employee and employer, with employee contributions made on a pre-tax or Roth basis, depending on the plan you choose. Combined employee and employer contributions can total up to $72,000, excluding catch-ups (for 2026).

Are You a Physician Seeking Retirement Help?

Our team of thoughtful and caring advisors at Blankinship & Foster is ready to help you gain clarity, confidence, and direction as you prepare your retirement planning strategy. Over the past 30 years, we have provided integrated investment management and financial planning for more than 100 physicians and their families. Our  CERTIFIED FINANCIAL PLANNER® professionals can help map out your goals and milestones, prioritize and track your progress, and more. Together, we can take actionable steps toward achieving your personal definition of success. Contact us to learn more about how our wealth management for physicians can benefit you.

Retirement planning requires a thoughtful and multifaceted approach. Leveraging employer-sponsored plans such as 401(k)s, tax-advantaged accounts such as HSAs and IRAs, and considering additional investment avenues are essential steps in building a robust portfolio.

Frequently Asked Questions:

1. Can I have a 403(b) and a 457(b) at the same time? Yes, you can, and a key benefit is that contributions to each account are separate (up to $24,500 each for 2026), so you can double your tax savings and significantly reduce your taxable income. 
2. Is a Backdoor Roth IRA still legal in 2025? Yes, as of 2026, a Backdoor Roth IRA is still a legal and available strategy. However, we continually monitor new legislation that may affect our clients and plan accordingly.
3. How much should a doctor save for retirement? We commonly advise physicians to save at least 20% of their gross income annually to replace 70% to 90% of their pre-retirement income. However, many doctors aim for a higher percentage, often saving between 30% and 60% of their income, depending on their financial goals and personal expenses. Another method to help ensure you’re on track is the Rule of 25. Calculate your annual spending amount and multiply it by 25. Be sure to consider inflation, which could double your final savings goal by the time you retire. In general, many of the doctors we work with aim for a retirement savings goal of $3 million to $5 million, depending on their desired lifestyle and retirement expenses. 
4. What is the “super catch-up” for doctors in their 60s? Anyone who is 60, 61, 62, or 63 is eligible to make a super catch-up contribution to a 401(k), 403(b), or 457(b) plan of up to $11,250 (for 2026) to supercharge their savings before retirement. Your plan must enable this feature, and you must max out your standard $24,500 contribution first (for 2026).

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