Going to 0.8 FTE as a Physician: What Happens to Pay, Benefits, Retirement and PSLF (2026)

Part-time work is now common in medicine: a 2021 JAMA Internal Medicine study put the share of U.S. physicians working part-time at nearly one in four. A common first step is 0.8 FTE, often four days a week in an outpatient job. Employers present it as a simple 20% cut. It rarely is. Taxes, benefits, call and retirement each move differently, and most of the difference is decided by contract language you can negotiate before you sign.

What happens to take-home pay

Taxes cushion a pay cut, because the income you give up was taxed at your highest rates. The cushion is thin, though: at physician incomes the overall tax rate is already close to the top rate, so the lost pay was taxed only a little more heavily than the rest. The table uses Doximity's 2026 average for each specialty and our take-home calculator's 2026 tax math for a single physician in Texas.

One thing makes the cut feel bigger than the table: if you keep putting the full $24,500 into a 401(k) or 403(b), that amount doesn't shrink, so spendable pay falls 19.2% to 20.8%. A state income tax changes the result a little, depending on its brackets: in California, a family physician's take-home falls 17.0%.

The practical test is whether your budget works on the 0.8 take-home. For a family physician at the average, that is about $189,768 a year, or $15,814 a month, before any retirement savings.

Hours, call and productivity

“0.8 FTE” is a payroll number. What it means in hours is whatever your contract says, and the common trap is that only the scheduled clinical time shrinks.

• Call: if a 1.0 FTE job is 40 scheduled hours plus 10 hours of call a week, and the 0.8 version cuts scheduled time to 32 hours but keeps the same call, you work 42 hours (84% of full-time) for 80% of the pay. That is about 5% less per hour.
• Productivity targets: if you are paid on wRVUs, the threshold for bonuses should drop to 80% too. A full-time target on part-time hours means the bonus disappears. See our wRVU guide for how these contracts work.
• Inbox, charting and meetings: patient messages and required meetings don't shrink on their own. Ask how they are handled on your day off.
• Panel size: in primary care, an unchanged panel on fewer clinic days means more work outside clinic hours.

Benefits: what stays, what shrinks

Physician employers commonly set benefit eligibility at 0.5 FTE, 0.75 FTE or 30 hours a week, so 0.8 FTE usually keeps you eligible. Kaiser Permanente's Colorado medical group, for example, made physicians scheduled at 0.5 FTE or more eligible in its 2024 benefits summary. The questions are what each benefit costs you and how big it is.

Watch the line between FTE levels. An employer that pays 90% of premiums at 0.8 FTE might pay much less at 0.6, and dropping below the eligibility floor can end coverage entirely. Get the eligibility rule and the premium table for your FTE before you sign, not after.

Retirement: you can still max it out

The 2026 employee deferral limit for a 401(k) or 403(b) is $24,500, and it isn't prorated for part-time work. A 457(b), if your employer offers one, has its own $24,500 limit. A family physician at 0.8 FTE ($260,032) can still defer $49,000, or 18.8% of pay, before taxes. See the 2026 and 2027 contribution limits.

The employer contribution is usually a percentage of pay, so it falls by the same 20%. At about 4.5% of pay (the gap between Vanguard's average total and employee contribution rates), the family physician's contribution goes from $14,627 to $11,701. The exception is high earners: plans can only count pay up to $360,000 in 2026, so an anesthesiologist at the average still earns $445,705 at 0.8 FTE and keeps the full $16,200.

A pension works differently. Defined-benefit plans usually build on both salary and years of service, and some count part-time years at a reduced rate, so part-time years can lower a pension more than the pay cut alone suggests. Ask for the plan's rule for part-time service in writing.

PSLF and loan payments

PSLF counts you as full-time if you average at least 30 hours a week at a qualifying employer. The average includes paid vacation and leave, but not volunteer time. A 0.8 FTE physician job is nearly always above 30 hours, so it counts. If you split your time, hours at two qualifying employers working at the same time can be combined to reach 30. See our PSLF guide and whether your hospital qualifies.

Going part-time can also help with PSLF. Income-driven payments follow income, so a lower salary means a lower payment and more forgiven at the end. Under the Repayment Assistance Plan, which charges 10% of adjusted gross income once it is above $100,000, a family physician maxing a 403(b) would pay about $2,505 a month at 1.0 FTE and $1,963 at 0.8 FTE. The difference, about $542 a month, partly offsets the pay cut.

Disability and malpractice insurance

Disability insurance is the one to check before you cut back. Group long-term disability usually pays 60% of current salary, so the benefit falls with your pay. An individual own-occupation policy generally fixes the monthly benefit when you buy it, but its partial (residual) disability benefit compares your earnings after an illness or injury with your earnings before it, and some policies require a minimum number of hours to count you as working in your occupation. Going part-time first can shrink what a later claim pays. Read the policy's residual and future-increase provisions, or ask your broker. Our guide to residual disability coverage explains how these benefits are measured.

Malpractice rarely changes at 0.8 FTE. Employers usually keep paying it, and insurers' part-time discounts generally start at 20 to 30 hours a week or less.

Partnership and career

Part-time work can slow a partnership track. At Kaiser's Southern California group, physicians become eligible for partnership after three consecutive years of full-time work or six of part-time work, according to its job postings (see our Kaiser pension and partner track guide). Private groups often prorate buy-ins, voting and profit shares. Ask how part-time years count, and whether you can return to 1.0 FTE later on the same terms.

Many physicians go part-time to stay in medicine at all; the AMA's 2025 survey found part-time physicians slightly more satisfied with their jobs than full-time ones (78.1% against 76.0%). If burnout is the reason, see our guide to the financial side of burnout, and for the long view, financial independence for physicians.

What to get in writing

1. FTE in hours or sessions: what 0.8 means in clinic days, shifts or sessions.
2. Call: prorated to 80%, or paid separately.
3. Productivity targets: wRVU or panel targets prorated to 80%.
4. Benefits: the eligibility rule and your premium share at 0.8 FTE, and what happens at lower FTEs.
5. PTO, CME and group insurance: what is prorated.
6. Retirement and pension: the employer contribution formula and how part-time service counts.
7. Returning to full-time: whether you can, and on what notice.
8. Noncompete: still enforced at the same radius on part-time pay? See our noncompete guide and contract negotiation guide.