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    From med school to late career

    Most decisions with a cost that arrives later happen when a physician moves from one stage to the next: signing a residency agreement, a first attending contract, a renewal, a last day. Each page here covers one of those moves.

    Every page has the same sections: what changes, how each party at the decision is paid, the costs agreed now that land later, what is fixed and what moves, who sets each deadline, the tools in the order the decision uses them, and questions for a professional. Each claim names its source and the date it was checked.

    1. Entering medical school and taking the first loans

      Accepting a seat, and the federal and private loans that pay for it.

      StudentsSources checked October 21, 2026

    2. The Match and the residency agreement

      Submitting a rank order list, matching, and signing the residency (GME) agreement.

      StudentsResidentsSources checked October 21, 2026

    3. From residency to the first attending contract

      Signing the first attending employment contract.

      ResidentsEarly careerSources checked October 21, 2026

    4. When the salary guarantee ends

      The first year paid on the productivity formula instead of the guaranteed base. Usually nothing new is signed.

      Early careerSources checked October 21, 2026

    5. A partnership track, a buy-in, or a practice sale

      A partnership vote and buy-in, or an offer to buy the practice from a hospital, a corporate buyer or a private-equity firm.

      Early careerMid careerSources checked October 21, 2026

    6. Renewing an attending contract

      Signing a renewed or amended employment contract.

      Early careerMid careerSources checked October 21, 2026

    7. Leaving a job or reducing hours

      Giving notice, reducing hours, or setting a last day.

      Early careerMid careerLate careerSources checked October 21, 2026

    8. Parental, medical and caregiver leave, and coming back

      Taking medical, parental, caregiving or mental-health leave, and returning to work.

      StudentsResidentsEarly careerMid careerLate careerSources checked October 21, 2026