Physicians · Dentists · High-Income Professionals · Southern Illinois

High income is not
the same as
financial security.

Years of training. A demanding career. A salary that finally reflects what you have sacrificed. And a financial life that has not had time to catch up. We help medical and high-income professionals build both with the same precision they bring to their work.

See What We Do
The Reality

You started late,
owe more than most,
and pay taxes at the
highest rates.

By the time a physician completes medical school and residency, they may be in their early to mid-thirties before drawing a full attending salary. The years when most professionals are building wealth and contributing to retirement accounts were spent in training, often on a resident's income of $60,000 to $70,000 per year.

Meanwhile, the average medical school graduate in the Class of 2025 carries over $200,000 in education debt. Once in full practice, the income is there, but so is the pressure: student loans, a mortgage, a family, and a tax bill that reflects the top marginal federal rate.

Add in the demands of clinical practice and there is simply no time left to build a financial plan. That is exactly why high-income medical professionals benefit most from fee-only, fiduciary advice with no competing interests.

By the Numbers

The financial starting line for physicians looks different from everyone else.

Medical school, residency, and in many specialties a fellowship can add up to 10 or more years of post-secondary training before full-time earning begins. Every year of delayed savings compounds over a career.

$223K Avg. med school debt, Class of 2025
70% Of 2025 grads with education debt
$68K Avg. first-year resident salary

Sources: Association of American Medical Colleges (AAMC) 2025 Graduation Questionnaire; AAMC 2025 Survey of Resident/Fellow Stipends.

What We Do

Financial planning built
for your specific situation.

Student Loan Strategy

Evaluating your federal vs. private loan mix, Public Service Loan Forgiveness eligibility, income-driven repayment options, and whether aggressive payoff or minimum payments plus investing makes more financial sense given your interest rate and tax situation.

High-Income Tax Strategy

Proactive strategies to reduce your federal and state tax burden at the highest marginal rates. Retirement plan maximization, entity structure, income timing, and coordination with your CPA to ensure your tax plan and financial plan are working together.

Own-Occupation Disability Coverage

Evaluating and coordinating disability coverage that pays if you cannot perform the duties of your specific specialty, not just any job. Understanding your existing group coverage and where individual own-occupation policies fill the gaps that employer plans leave open.

Retirement Plan Setup

For physicians in private practice, establishing the right retirement plan structure to maximize tax-deductible contributions. Solo 401(k), SEP IRA, and for high-income practice owners, a cash balance plan paired with a 401(k) for dramatically larger annual contributions. Learn more about cash balance combo plans.

Investment Management

Evidence-based investment strategy for your personal and retirement accounts. Low-cost, diversified, and aligned with your timeline and goals. No proprietary products. No commission-based recommendations. Full transparency.

Estate Planning Coordination

Ensuring your estate plan keeps pace with your growing wealth. Beneficiary reviews, life insurance analysis, trust coordination, and working alongside your estate attorney to make sure your financial plan and legal documents are aligned.

Critical Coverage for Physicians
Own-Occupation Disability

Your income depends on
a specific, highly trained
skill set. Your coverage should too.

A physician's earning capacity is tied to a specific, highly trained specialty. A surgeon who develops a condition affecting their hands, a dentist who sustains an injury preventing clinical procedures, or a procedural specialist whose neurological condition prevents precise work. Each of these represents a disability that eliminates the ability to practice in their specialty, even if they could theoretically perform other work.

This distinction matters enormously in disability insurance. Own-occupation disability coverage pays benefits if you are unable to perform the duties of your specific medical specialty, even if you are capable of working in another role or occupation. Any-occupation policies, by contrast, only pay if you are completely unable to work in any capacity.

Many employer group plans only provide any-occupation coverage, or provide own-occupation coverage for a limited period before converting to any-occupation definitions. Individual own-occupation policies are the standard recommendation for physicians and other procedural specialists who want comprehensive income coverage aligned with their specialized training.

We do not sell insurance products. What we do is help you understand your existing coverage, identify gaps in your employer-provided plan, and coordinate a disability coverage strategy that matches your specialty and income level. We work alongside your insurance advisor to make sure your coverage aligns with your broader financial plan.

Information on disability insurance definitions sourced from the American Medical Association (ama-assn.org) and physician financial planning resources. Disability insurance is not provided by 1618 Wealth. Consult a licensed insurance professional for coverage recommendations specific to your situation. See our disclosure page for additional information.

Understanding Your Coverage

Not all disability policies are the same. The definition of disability is everything.

Pays benefits if you are unable to perform the substantial and material duties of your specific medical specialty, even if you are able to work in another capacity. A surgeon who cannot operate due to a hand injury collects full benefits even while working in a teaching or administrative role.
Modified Own-Occupation
Pays benefits if you cannot perform the duties of your occupation and are not working in any other capacity. Benefits stop if you take another job, even at significantly lower income. Common in group employer plans.
Any-Occupation
Only pays benefits if you are completely unable to work in any occupation for which you are educated, trained, or experienced. The most restrictive definition and often the least suitable for physicians with specialized skills.

Many employer group LTD plans begin with modified own-occupation definitions for 2 to 3 years before converting to any-occupation definitions for the remainder of the benefit period. Individual policies should be evaluated accordingly.

Who We Work With

Medical and high-income
professionals across Southern Illinois.

01

Physicians and Surgeons

Attending physicians, specialists, and surgeons at SIU School of Medicine, Herrin Hospital, Memorial Hospital of Carbondale, and private practices throughout the Route 13 corridor.

02

Dentists and Pharmacists

Dental practice owners and associates, SIU School of Dental Medicine graduates, pharmacists, and other doctoral-level healthcare professionals navigating student debt, practice ownership, and long-term wealth building.

03

Advanced Practice Providers

Physician assistants, nurse practitioners, CRNAs, and other advanced practice providers whose income and financial planning needs differ from both physicians and traditional earners.

04

Dual-Income High Earners

Households where both partners have professional careers and incomes. Coordinating two financial plans, two tax strategies, and two retirement timelines into one coherent household financial picture.

Local Roots. Regional Reach.

We know Southern Illinois
medicine from the inside.

Southern Illinois University is one of the defining institutions of this region. SIU School of Medicine trains physicians who go on to serve communities throughout Illinois and beyond. SIU School of Dental Medicine has graduated dental professionals for decades. Many of them stay in Southern Illinois to build their practices and careers.

We are based in Carbondale. We understand the local healthcare landscape, the institutions that shape it, and the specific financial challenges that come with building a medical career in a region that depends on its physicians to stay.

Whether you are a resident at SIU Med completing your training, an attending physician at a regional hospital, or a graduate building your own practice in the Route 13 corridor, 1618 Wealth is built for the professionals who choose to serve this community.

A Note on Local Practice

From residency through retirement, the financial questions change. The need for a trusted advisor does not.

During residency: student loan strategy, disability coverage, and emergency reserves.

Early attending years: maximizing retirement contributions, accelerating loan payoff, and building a financial foundation.

Mid-career: tax efficiency, practice ownership decisions, and growing wealth.

Pre-retirement: income sequencing, Social Security coordination, and transitioning from building to preserving.

"Every stage has its own financial priorities. We help you navigate each one."

Common Questions

Medical professional planning, answered.

What is own-occupation disability insurance and why do physicians need it?

Own-occupation disability insurance pays benefits if you are unable to perform the duties of your specific medical specialty, even if you are capable of working in another capacity. For physicians and procedural specialists whose earning capacity is tied to a specific skill set, this coverage ensures that a disability affecting your ability to practice in your specialty does not eliminate your income entirely. It stands in contrast to any-occupation policies, which only pay if you cannot work in any capacity whatsoever.

How should a physician manage student debt alongside investing for retirement?

The optimal strategy depends on your loan interest rate, loan type, Public Service Loan Forgiveness eligibility, and your marginal tax rate. High-interest private loans generally favor aggressive payoff. Federal loans with PSLF eligibility may favor minimum payments while maximizing retirement contributions. There is no single right answer, and the optimal approach is individual and should be evaluated with a fee-only financial advisor who understands both the loan repayment landscape and retirement plan options.

What financial planning challenges are unique to physicians?

Physicians face a combination of challenges including a delayed start to earning due to years of training, significant student loan debt averaging over $200,000 for the Class of 2025, high marginal tax rates once in full-time practice, and limited time to manage finances due to demanding clinical schedules. Many physicians enter their first attending role in their early-to-mid thirties, leaving fewer years to compound retirement savings before traditional retirement age.

Does 1618 Wealth work with SIU School of Medicine or SIU School of Dental Medicine graduates?

Yes. 1618 Wealth is based in Carbondale, Illinois and works with medical professionals throughout Southern Illinois, including those connected to SIU School of Medicine and SIU School of Dental Medicine. Mark Chalem, CFP® understands the specific financial planning needs of physicians at every stage of their career, from residency through retirement.

What tax strategies are available to high-income physicians in private practice?

High-income physicians in private practice have access to several strategies including maximizing qualified retirement plan contributions through a Solo 401(k) or SEP IRA, establishing a cash balance plan paired with a 401(k) to make significantly larger tax-deductible contributions, entity structure optimization, and income timing strategies. These approaches should be developed in coordination with both a fee-only financial advisor and a qualified CPA or tax advisor.

When should a physician begin financial planning?

As early as possible. Even during residency, establishing a financial plan allows informed decisions about student loan repayment strategy, disability coverage, emergency reserves, and early retirement contributions. The years lost to a delayed start are not recoverable, making early and intentional planning especially valuable for medical professionals. A fee-only financial planner can work with physicians at any career stage.

Take the Next Step

You have invested everything
in your career.
Invest the same care in your financial life.

Schedule a free 30-minute consultation with Mark Chalem, CFP® to discuss your student loan strategy, tax planning, coverage evaluation, and how to build personal wealth alongside a demanding medical career. No obligation. No pressure. Just clarity.

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