What Most New Grad PAs Realize After Their First Paycheck

You graduate. You pass your boards. You land the job.
That six-figure paycheck hits—and then... reality sets in.

If you’re a brand new PA, you know exactly what I’m talking about.
It’s not quite the dream you imagined. Expenses feel overwhelming. Loans are looming. And you’re wondering, “Wait… where did my paycheck go?”

Let’s walk through exactly what you should be doing in your first year of practice to get your money right.

Why Generic Budget Rules Don’t Work for PAs

You’ve probably heard of those 50/30/20 budgeting rules:

• 50% to needs
  
• 30% to wants
  
• 20% to savings/investing
  

I hate those.

They’re made for the masses—not for people like us.
If I followed that rule? I wouldn’t be a millionaire by 31. I needed a lot more than 20% going toward debt and wealth-building.

What you really need is a cash flow system that helps you grow your net worth—not just track your spending.

Inside the Millionaires in Medicine Club, I break down exactly how to do this with a free tracker you can use today.

Budgeting ≠ Wealth Building

A lot of new grads become hyper-focused on budgeting—but if your net worth isn’t moving, you’re just treading water.

Yes, budgeting helps you stay afloat.
But wealth building is what moves you forward. That’s why your plan has to include both:
✅ A smart student loan strategy
✅ A real investment strategy

And they must work together.

Student Loan Plan? You Need One—Now.

You need to decide early on:

• Am I going for Public Service Loan Forgiveness (PSLF)?
  
• Will I pursue taxable loan forgiveness?
  
• Should I be on a standard or accelerated repayment plan?
  

But here’s the kicker—you can’t decide your loan plan in isolation.
You have to map it with your investing plan.

You can’t tell me, “I’m paying off my loans in two years and hitting Coast FIRE by 30” unless you’re working 7 jobs.

The math has to math.

Don’t Sleep on Early Investing

The number of PAs I’ve worked with who say, “I wish I had started investing at 28…” is staggering.

Your dollars now are more powerful than they’ll ever be.
What you do with money in your 20s will set the tone for your entire financial life. Don’t wait.

Maximize Your Income from Year One

Negotiation is hard when you’re new—you’re still building clinical skills, you’re slower, and everything feels overwhelming. But income optimization should already be on your radar.

By year three, you should have a clear plan for how you’ll increase your income by $30K–$50K.

Ask yourself:

• Who around me is crushing it financially and clinically?
  
• What skills or credentials are they stacking?
  
• What side gigs actually make sense right now?

Should New Grad PAs Side Hustle?

Yes—but strategically.

In your first year, your main goal is to get really good at what you do.
If you work full-time in urgent care, pick up extra shifts in urgent care. Don't moonlight in a specialty that stretches you too thin or confuses your skill set.

I made that mistake.
Took a per diem urgent care shift while working as a hospitalist and ended up seeing kids.
I was like, “Wait, what do you mean it’s not an inpatient adult with sepsis?” 🤯

Stick to your lane—at least at first.

Side Hustles That Actually Work for PAs

Here’s what I recommend:

Even if you’re just starting out, plant the seeds now. Build relationships with reps, say yes to professional opportunities, and position yourself early.

Want to Save Money as a New Grad PA? Start Here 👇

There are two big things that will make or break your finances early:

1. Housing

Don’t spend more than 20% of your gross income on rent or mortgage (including taxes and insurance).

Yes, that means you might need to wait on buying the dream home.

2. Transportation

💡 Buy used if you can.
💡 Keep your car payment under 8% of take-home pay.
💡 No 72-month financing—don’t fall for that trap.

These two decisions determine whether you’ll be able to invest and get ahead—or be stuck living paycheck to paycheck even with six figures.

Your First Year Is Everything

If you’ve just started your career, this is your most important financial year.

Don’t try to deprive yourself forever.
Just create a small delay between when your income goes up and when your lifestyle does. 

Want to Learn How to Set Up Your Money for Long-Term Freedom?

📢 Join the Millionaires in Medicine Club for FREE:
https://www.millionairesinmedicine.com/community

📌 Need help with student loan + investing strategy?
https://www.millionairesinmedicine.com/coach

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