You don't pay taxes in the first forty or so thousand dollars that you actually get as income. So it makes a lot of sense, as a doctor, when you're earning a lot right now, to do a pre tax contributions now and then a do roth conversions later. Once you die, your heirs can stretch that money out, that tax protection out for another ten years. It's not as good as it used to be. They used to be able to stretch it over their entire life,. but you can still stretch it for ten years after death.

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