E111: Can I retire at 55 with $2M as a CRNA?

Almost every retirement number floating around, from headlines to coworkers to financial personalities online, was built for a standard career. The standard career is 40 years of W-2 income, retirement around 65, and 30 years of spending after that. The CRNAs and nurse practitioners Brett Fellows, CFP®, works with earn heavily for 15 to 20 years, often mixing W-2 hospital work with 1099 locum contracts, and some are aiming for 55 or earlier. Run a standard number through a career like that and the answer comes out wrong for them.

Why the Headline Number Feels Off

One 2026 survey found that Americans now believe they need $1.46 million to retire comfortably. A CRNA or nurse practitioner who has built well past that can still feel behind. Brett calls the feeling an anxiety problem, and he traces it to measuring yourself against a number that was never built for your career shape.

Start With the Gap

The number a portfolio has to produce is the difference between what a household spends and the income that shows up without managing investments. The income usually comes from Social Security, plus a small pension if there was one early in a career. The average retired worker collects a little over $2,000 a month right now, and when both spouses collect, a household typically gets more than $3,000 a month.

Years of 1099 locum work deserve a closer look. Paying yourself a small salary out of an S corporation to cut payroll tax also lowers the earnings Social Security sees, so the benefit can come in below what a W-2 nurse practitioner with the same lifetime income would get. Brett’s advice is to check the statement itself, since any shortfall lands on the portfolio.

Spending changes over time too. Researchers describe a spending smile, with spending highest in the early active years, easing through the middle, and climbing again later as healthcare takes a bigger share of the budget. Projections that hold spending flat inflate the number you think you need.

Say a household spends $130,000 a year in early retirement and Social Security covers $50,000 of it, once the earnings record has been verified. The portfolio has to produce $80,000. On $2 million, that works out to a 4% withdrawal rate, which sits in line with what historical research supports for a long retirement.

A Plan That Can Adjust

A flat 4% is where the planning starts. Someone retiring in the mid-50s needs the money to last 35 or 40 years, and a rigid withdrawal number gets riskier if the market has a rough stretch early. Some of the CRNAs Brett works with set aside several years of spending in cash and short-term investments, so a drop right after they retire doesn’t force them to sell stocks to cover the bills. Pair that with withdrawals that ease up a little in good years and pull back in tough ones, and the plan can take being wrong. Nobody can predict 30 years of markets or tax rates, so room to adjust is the goal.

One expense belongs in the budget for the transition year. Anyone leaving a hospital job or ending an independent contract should check what happens to their malpractice coverage, since tail coverage may be needed for claims tied to care given before leaving, even after practice has stopped.

The Years Before Required Minimum Distributions

For a CRNA retiring at 55 or 56, there are roughly 15 to 18 years between the last paycheck and required minimum distributions at 73 or 75. Brett calls that the most valuable planning window a CRNA will have. Income drops the day work stops, often to a lower bracket than during peak earning years, sometimes a much lower one, which makes it the time to convert pre-tax money to Roth at today’s lower rates, before required distributions push income onto you at rates nobody can predict. It can also be the time to realize long-term capital gains in a taxable account at a 0% federal rate, depending on total income that year.

Two CRNAs can retire with the same $2 million and land in different places. One holds almost all of it in a traditional 401(k) or 403(b), so almost every dollar she withdraws is taxed as ordinary income for life. The other spread her $2 million across pre-tax, Roth, and taxable accounts while working, then kept converting in that early window, so she can draw from whichever bucket keeps her taxable income low in a given year. Over 15 years, Brett says, that flexibility can add up to tens of thousands of dollars a year in taxes she never pays.

Anyone still making backdoor Roth contributions in the final working years should watch for the pro rata rule. Pre-tax money sitting in a rollover IRA means the IRS taxes a conversion across all of the IRA money, including the pre-tax balance. Moving old pre-tax IRA balances into a current employer 401(k) or 403(b) first usually clears the way for clean, fully tax-free conversions.

A Hypothetical 54-Year-Old CRNA

Take a hypothetical CRNA, age 54, with $1.8 million saved, mostly in a pre-tax 403(b), plus a smaller taxable brokerage account and no Roth money. She plans to leave full-time hospital work at 56 and pick up occasional locum shifts, mostly for the flexibility. Her household spends about $115,000 a year. Once her Social Security record is verified and her spouse’s pension is counted, guaranteed income covers around $45,000, which leaves $70,000 for the portfolio to produce. On $1.8 million, that comes to under 4%.

She has enough either way. How much she keeps depends on what she does in the next 15 years, converting pre-tax dollars to Roth while her income is low, harvesting gains in the taxable account, and lining all of it up before required distributions start at 73. Brett points out that her taxable income often looks surprisingly low that first year after the W-2 salary ends, even with locum shifts coming in. Used on purpose, those years can make the same $1.8 million behave like a bigger number over the next two or three decades, because less of it goes to taxes.

Run Your Own Number

Brett closes with a three-step exercise. Pull your Social Security statement and check your projected benefit, especially if you have 1099 or locum years. Write down what your household spends in a typical year. Subtract your stable income from that spending, and what remains is the only number your portfolio has to produce.

The point is a number built from the household’s own spending and income, which lets a CRNA judge whether the years of work and saving add up to leaving on her own timeline.

Ready to see how Oak Capital Advisors can help? Schedule a meeting.

Contents hide

1 Links Relevant to this Episode

2 Never miss a new episode! Subscribe wherever you listen to podcasts.