Doctor Salary by Specialty (2026): The Complete Physician Pay Breakdown

Picking a specialty is the most consequential financial decision you'll make as a physician. Not because money should drive that decision — it shouldn't — but because understanding the numbers helps you plan your financial life intelligently, whether you're a third-year medical student weighing your options or an attending trying to benchmark your current compensation.

This guide pulls doctor salary data from the most respected sources in physician compensation research: the Doximity Physician Compensation Report 2026, the 2026 Medscape Physician Compensation Report, and SalaryDr's specialty salary reports. Where the sources diverge, we show you both numbers and explain why.

The Big Picture First

According to the 2026 Medscape Physician Compensation Report, the average U.S. physician earned $386,000 in total compensation in 2025, up from $374,000 in 2024. Doximity's 2026 report, built on nearly 23,000 physician surveys completed in 2025, found average pay rose 2% from 2024 and breaks it down by specialty type: $318,865 for primary care, $442,573 for non-surgical specialists and $606,047 for surgical specialists. The two reports survey different physicians, so their numbers won't match exactly. For how U.S. pay compares with Canada, the U.K., Germany, Australia and other countries, see physician salaries around the world.

The more meaningful number, though, is the gap between specialties. In Doximity's 2026 data, neurosurgery ($829,161) out-earns pediatric infectious disease ($217,819) by more than $600,000 per year. Over a 30-year career, that's a difference of more than $18 million before taxes. Which is exactly why this data matters.

A few things worth knowing before you read the tables:

• •Total compensation includes base salary, bonuses, profit sharing, and other incentives — not just your W-2 salary
• •Group practices tend to pay more than hospital employment, but solo practice averaged less than hospitals in Doximity's 2026 data, and in some specialties employed physicians come out ahead
• •Geography moves the needle significantly — a neurosurgeon in rural Texas earns very differently than one in San Francisco
• •These are medians and averages — your individual offer will depend on your negotiation skills, practice setting, and market demand

Physician Salary by Specialty (2026)

The table lists all 51 specialties in Doximity's 2026 report, ranked by average annual compensation, alongside SalaryDr's median for 21 specialties, including every one we cover in a dedicated guide. An average and a median drawn from different groups of physicians won't agree, so read the two columns side by side rather than as one number. To put your own pay next to them, use the pay benchmark.

Doximity figures are average annual compensation for full-time physicians from the Doximity Physician Compensation Report 2026 (2025 survey data); Doximity notes that some specialties may be left out because of sample size. SalaryDr figures are medians of the approved, self-reported salary reports on each SalaryDr specialty page as of September 27, 2026, with the number of reports in parentheses; SalaryDr does not independently verify pay. Doximity lists oncology and hematology separately and has no hospital medicine row, so our hematology/oncology and hospitalist rows show SalaryDr only. Doximity's thoracic surgery row has no separate cardiothoracic listing, and its cardiology figure is not split by subspecialty. After-tax columns are our estimate of the Doximity average after federal income tax, FICA and state income and payroll taxes for a single filer under 2026 rules, with no retirement contributions; Texas has no state income tax and California has the highest top rate. Run your own numbers in the take-home pay calculator.

Every Salary Guide on MedMoneyGuide

Each specialty in the table links to its own guide when we have one. These guides answer the narrower questions: pay at a specific employer, a specific way of practicing, or how pay is set.

Pay at specific employers

• Kaiser Permanente salary by region: posted 2025–2026 pay for seven Permanente groups across 12 specialties.
• Kaiser pension and partner track: the shareholder buy-in, the pension and PSLF.
• Cleveland Clinic, Mayo Clinic, HCA Healthcare and Baylor Scott & White: salary structure and benefits at four large employers.
• VA physicians: federal pay tables, the FERS pension and loan programs.

Specific ways of practicing

• OB/GYN salary without surgery: what office gynecology and other non-surgical paths pay.
• Hospitalist pay per shift: day, night and swing-shift rates.
• Locum tenens pay: daily rates and take-home on 1099 income.
• Medical director and CMO pay: stipends and full-time executive roles.
• Physician side income: moonlighting, consulting and expert work.
• Resident salary: pay by PGY year and program.

How pay is set and compared

• MGMA data explained: what employers benchmark against and what to ask.
• What is a wRVU and AI scribes and wRVU pay: how productivity pay works.
• 2027 Medicare fee schedule and the Ambulatory Specialty Model: Medicare changes that move pay next year.
• Highest-paying specialties, what counts as a good salary and physician vs. PA vs. NP pay.
• Salary by state and salaries around the world.
• Salary negotiation, signing bonuses and the pay benchmark for checking an offer.

Why the Numbers Vary So Much

You might notice that Doximity's average and SalaryDr's median for the same specialty can sit more than $100,000 apart. Ophthalmology is one of the widest gaps: $487,438 in Doximity's report against a $670,000 median at SalaryDr. That's not a data error — the two sources survey different physicians, and one reports an average while the other reports a median. Pay also varies within every specialty because of a few very real variables:

Practice setting matters. Group practices tend to pay more than hospital employment (in Doximity's 2026 report, single-specialty groups averaged $480,961 against $454,440 for hospitals), though solo practice averaged less, at $440,424. The gap can be much wider in procedural specialties: in SalaryDr's reports, private-practice orthopedic surgeons average $995,038, against $772,919 for hospital-employed orthopedic surgeons. It can also run the other way. Hospital-employed cardiologists and pediatricians out-earn their private-practice peers in SalaryDr's reports.

Geography creates significant variation. Physicians in high-demand rural markets often command premiums over urban counterparts in the same specialty — largely because there's less competition for the role. Among the 60 metro areas in Doximity's 2026 report, the highest average pay was in Oklahoma City. High cost-of-living states tend to pay nominally more but often less on a purchasing-power-adjusted basis.

RVU-based vs. salary-based compensation. Many physician contracts are structured around work RVUs (wRVUs) — a measure of the complexity and volume of care you provide. High-volume proceduralists on wRVU-based compensation can significantly exceed the averages shown above. This is especially true in orthopedics, GI, and interventional cardiology.

The Specialties Worth Watching in 2026

A few compensation trends stand out this year that are worth understanding:

Interventional radiology and neurosurgery are pulling away. The two largest raises in Doximity's 2026 report went to interventional radiology (10.8%) and neurosurgery (10.7%), and radiology is the only specialty in Doximity's top 10 for pay growth in both 2024 and 2025. Many of the fastest-growing specialties are already among the best paid, which Doximity says may reflect a widening gap between the highest- and lowest-paid specialties.

Emergency medicine picked up in 2025. Doximity's 2026 report says emergency medicine physicians saw relatively larger raises than primary care physicians, and EM ranks sixth on its list of the most in-demand specialties. The staffing market is still shaped by private equity consolidation of staffing firms and the shift toward APP-heavy EM coverage models. If you're in EM, contract negotiation matters more than ever.

Psychiatry is in heavy demand. Psychiatry ranks third on Doximity's 2026 list of the most in-demand specialties, behind only internal medicine and family medicine. Telepsychiatry models have also opened up significant income supplementation opportunities. Our psychiatrist salary guide covers hourly pay, child and adolescent psychiatry, telepsychiatry and pay by state.

Primary care still faces headwinds. Despite policy rhetoric about paying primary care physicians more, Doximity's 2026 report found the gap widened in 2025: surgical specialists earned 90.1% more than primary care physicians, up from 87.3% in 2024. Medscape's 2026 report puts the primary care average at $298,000, against $417,000 for specialists. Concierge medicine and direct primary care models are increasingly how primary care physicians escape this dynamic.

Physician Salary by State (2026)

Where you practice moves pay in two ways: what employers offer, and how much of it you keep. For what employers pay by state, our physician salary by state guide has the Bureau of Labor Statistics figures for every state, adjusted for local prices.

The table below isolates the second part. It holds gross pay at $442,573, Doximity's 2026 average for non-surgical specialists, and shows what a single physician keeps after federal, state and payroll taxes in each state. Between Texas and California the difference is $43,475 a year on the same salary.

Our estimate for a single filer under 2026 rules with no retirement contributions, including state payroll taxes such as California SDI and Washington's paid leave and long-term care premiums. Local income taxes (New York City, Portland area, most of Pennsylvania's municipalities) are left out, so the real figure in those places is lower.

The Cost-of-Living Adjustment Changes Everything

Nominal salary rankings flip significantly when you factor in taxes and purchasing power. According to analysis from Becker's Hospital Review using BLS data and the World Population Review cost-of-living index:

• •Wyoming, Wisconsin, Montana, Minnesota, and the Dakotas consistently rank at the top on a purchasing-power-adjusted basis
• •California, New York, Massachusetts, Hawaii, and Washington D.C. rank near the bottom — high nominal pay is significantly eroded by state income taxes and cost of living
• •As Medcruit's 2025–2026 Physician Salary Report notes, a $600,000 salary in California often delivers the same real purchasing power as $400,000 in the Midwest

States with no state income tax include Texas, Florida, Tennessee, Washington, Nevada, Wyoming, South Dakota and Alaska. On the same $442,573, a physician in Texas keeps $43,475 more a year than one in California, where the top rate is 13.3%.

The Rural Premium Is Real

Across all specialties, physicians practicing in rural or underserved markets consistently command premium compensation. According to Weatherby Healthcare's analysis, states like Wyoming, Montana, and Mississippi rank at the top specifically because physician supply is low relative to patient demand. For physicians comfortable with rural or semi-rural practice, the financial case is compelling — particularly when paired with federal loan forgiveness programs tied to HPSA (Health Professional Shortage Area) service.

From Resident Stipend to Attending Salary: The Full Journey

One of the most jarring financial transitions in medicine is going from a residency stipend to an attending paycheck. Understanding that journey helps you plan for it before it happens — and avoid the mistakes most physicians make in year one. Our breakdown of resident pay by PGY year covers the training years in more detail.

What Residents Actually Earn

According to the AAMC's 2025 Survey of Resident/Fellow Stipends, the national averages by training year are:

Source: AAMC 2025 Resident Salary Report, Panacea Financial 2025 Residents & Fellows Report

High-cost programs can skew these numbers considerably. For reference, UCSF's internal medicine residency pays PGY-1s $92,284 — nearly $25,000 above the national mean — specifically to account for Bay Area cost of living. Conversely, programs in lower-cost regions may pay below the national average while still offering more comfortable day-to-day finances after housing and expenses.

The Hidden Math on Hourly Pay

The ACGME caps residents at 80 hours per week, but many work right up to that limit. Run the math on a PGY-1 earning $68,000 working 75 hours per week for 50 weeks and you get roughly $18 per hour — comparable to skilled trades, and far below what most people assume given the level of clinical training involved.

According to Panacea Financial's 2025 survey, residents rated their compensation satisfaction at just 5.1 out of 10. That dissatisfaction is understandable — the average trainee carries nearly $300,000 in student loan debt while earning a wage that barely covers living expenses in most major metropolitan areas.

That said, residency compensation is not meant to reflect market wages. It's transitional. The return on investment materializes after training — and for most specialties, it materializes significantly.

The Attending Income Leap

The jump from final residency year to first-year attending is one of the largest single-year income events in any profession:

That transition, if not managed carefully, is exactly when lifestyle inflation takes root. A physician who upgrades their car, home, and lifestyle in month one of attending life will find their financial trajectory looks surprisingly similar to their peers who earn half as much. Our Resident's Financial Masterclass and The Attending Playbook both go deep on this.

The Gender Pay Gap in Medicine: What the Data Shows

This is a topic that often gets avoided in physician compensation conversations, but the numbers are too significant to leave out. Female physicians in the United States earn substantially less than their male counterparts — and the gap persists even after controlling for specialty choice, hours worked, and years of experience.

The Core Numbers

According to Medscape's 2024 Female Physician Compensation Report:

• •Male physicians earned an average of $400,000 annually
• •Female physicians earned an average of $309,000 annually
• •That's a 29% gap — slightly narrowed from 32% in 2022, but still representing nearly $100,000 per year

Among specialists the gap is even wider: male specialists averaged $402,000, female specialists averaged $307,000 — a 31% difference. In primary care the gap narrows somewhat but remains meaningful: male PCPs averaged $295,000, female PCPs averaged $253,000.

Newer data shows the gap isn't closing. Doximity's 2026 report, which adjusts for specialty, location, and years of experience, puts it at 26% for 2025, the same as in 2024: men averaged $474,443 and women $352,167, a difference of $122,276.

Over a 40-year career, that gap compounds to roughly $2 million in lost lifetime earnings for the average female physician, according to a landmark study published in Health Affairs analyzing income data from over 80,000 physicians tracked by Doximity from 2014 through 2019.

It Starts at the Beginning and Grows Over Time

The gap is present from day one. Among physicians aged 28–34, men earned an average of $53,000 more than women in Medscape's 2024 survey. The gap widens through mid-career, peaks in the 45–54 range ($409,000 for men vs. $298,000 for women), and narrows only slightly after 55.

Critically, this gap persists even after accounting for hours worked. Female physicians in the survey reported working an average of 49 hours per week — just one hour less than their male peers at 50. The compensation difference cannot be explained by effort or volume of work alone.

What's Driving It

Specialty distribution partially explains the gap — women are underrepresented in the highest-compensating procedural specialties. In cardiology, male cardiologists averaged $613,000 while female cardiologists averaged $520,000 — an 18% gap within a single field.

Negotiation dynamics contribute meaningfully. Research consistently shows women negotiate starting salaries less aggressively, and because many institutions anchor future offers and raises to prior compensation, gaps established at hiring tend to compound over careers.

Structural and institutional factors including productivity models, implicit bias in compensation decisions, and career interruptions related to childbearing also play a role.

What Female Physicians Can Do Right Now

• •Request a formal salary review annually — don't assume equity is being maintained
• •Discuss compensation with trusted colleagues — salary transparency within physician groups is growing and it matters
• •Understand your wRVU rate relative to peers — it surfaces structural inequities that are harder to dispute
• •Work with a physician-specific contract attorney before signing or renewing — see our contract negotiation guide for vetted options

The AMA has formal policy supporting gender-neutral, objective pay structures. Institutional change moves slowly. But physicians who understand the data and negotiate from a position of knowledge are the ones most likely to close the gap on their own terms.

Employed vs. Private Practice: The Compensation Divide

One of the most consequential decisions an attending physician makes isn't which specialty to choose — it's what practice setting to join. The compensation implications are significant and often underappreciated.

Doximity's 2026 report breaks average physician pay down by practice setting:

By Doximity's numbers, the setting gap is smaller than the usual rule of thumb: single-specialty groups averaged about 6% more than hospitals in 2025, and solo practice, which had the largest drop of any setting (-3.8%), averaged less than hospital employment. The gap is wider in procedural specialties, where private-practice physicians can share in facility and ancillary income.

That said, employed positions offer meaningful benefits: malpractice coverage, health insurance, structured retirement contributions, protected time off, and predictable scheduling. For physicians managing large student loan balances, the stability of an employed position — particularly at a nonprofit eligible for PSLF — often makes more financial sense in the short term.

The smartest approach: model both scenarios over a 10-year horizon before signing anything. See our physician financial advisors comparison for fee-only options.

How Compensation Is Actually Structured

Understanding what's in your paycheck is just as important as knowing the headline number. Most physician compensation packages include some combination of:

Base Salary — Your guaranteed minimum, regardless of productivity. This typically makes up 50–70% of total compensation for employed physicians.

Productivity Bonus (wRVU-based) — You earn an additional amount per wRVU generated above a threshold. The higher your volume and complexity of cases, the more this component grows.

Quality Metrics Bonus — Many hospital systems now tie 5–15% of compensation to quality measures, patient satisfaction scores, or utilization benchmarks.

Signing Bonus — Increasingly common across specialties. Most come with 2–3 year payback clauses if you leave early — read the fine print before signing.

Profit Sharing / Partnership — In private practice settings, partnership represents the single biggest compensation jump a physician can experience. Partnership timelines typically range from 2–5 years post-hire.

What This Means for Your Financial Planning

Here's what we tell every physician who asks about salary data: the number on your contract is a starting point, not a ceiling — and not a guarantee of financial security.

A cardiologist earning $650,000 with poor financial habits can end up in a worse position at 55 than a family medicine physician earning $270,000 who invests early and lives intentionally.

Tax drag is real. At physician income levels, you're in one of the top federal tax brackets. Without a solid tax strategy — including maxing pre-tax accounts, considering an S-corp structure for 1099 income, and using a backdoor Roth — you can lose 35–45 cents of every dollar earned. Our Tax Strategies for High Earners guide covers this in detail.

Lifestyle inflation is the silent wealth killer. The jump from resident stipend to attending salary is dramatic, and it's easy to let spending scale faster than savings. We wrote a whole guide on this: The Attending Playbook.

Your contract matters as much as the number. A $50,000 difference in base salary can be entirely offset by a bad non-compete clause, a punishing wRVU threshold, or a poorly structured signing bonus with tight clawback terms. Before you sign anything, consider a contract review service.

Know Your Number Before You Negotiate

If you're about to enter contract negotiations, here's a practical framework:

1. 1.Find out which benchmark the employer is using. MGMA's specialty medians are paywalled, so ask your recruiter which survey, edition, and percentile the offer represents (our MGMA data guide lists what to ask), then check it against the free figures in this guide and self-reported benchmarks such as Marit Health.
2. 2.Factor in your total package, not just base. A lower base with strong wRVU upside and genuine partnership potential can far exceed a higher base in a dead-end employed role.
3. 3.Know your wRVU conversion rate. A rate of $45–$55/wRVU is typical; anything below $40 deserves scrutiny.
4. 4.Ask about the production threshold. If it's set at the 75th percentile of national benchmarks, you may rarely hit the productivity bonus.
5. 5.Get a professional contract review done. Physician contract attorneys typically charge $500–$1,500 for a full review. See our contract review comparison for vetted options.

The Bottom Line

Physician compensation in 2026 remains strong across the board, but the variance between specialties, practice settings, geographies, and genders is enormous. The average number means very little without context.

What matters more than your gross salary: how much you keep after taxes, how early you start investing, how smartly you structure your practice and contracts, and whether your compensation reflects your actual market value. A high salary with poor financial habits is a treadmill. A moderate salary with a solid plan is a path to real wealth.

Use the numbers above as a benchmark — not a finish line.

Update Log

• October 2026: Added after-tax pay for every specialty (Texas and California), replaced the state salary ranges with a take-home comparison across 18 states, added a directory of every salary guide (including the new Kaiser regional pay and OB/GYN without surgery guides), and added three FAQs.
• September 2026: Specialty table rebuilt from Doximity's 2026 report and SalaryDr's current medians, checked September 27, 2026.