Dollars and cents

What residents are getting paid in 2021

Annual Medscape report reveals which specialties get paid the most and least, and how residents feel about their earnings.

This story originally published in 2018 and has been updated in July 2021 with data from Medscape’s 2021 residents salary and debt report.

The average medical resident is earning $64,000 annually, according to Medscape’s Residents Salary and Debt Report 2021, an increase of 1% from the $63,400 they earned in 2020.

Medscape’s report also explored how prepared residents feel for the challenges of COVID-19. Half of residents surveyed said they felt prepared to handle it based on their training, an increase over last year, when 40% of residents said they felt prepared for COVID. Nearly 9 in 10 respondents said they had cared for COVID-19 patients in person.

As expected, salaries increase with years of experience. Salaries in the sixth through eighth years of postdoctoral training average $70,300, considerably more than the $57,500 received in the first year of residency.

Medscape surveyed more than 1,500 trainees in 29-plus specialties to create the report.

Here are more highlights:

Just under half of first-year residents say they feel fairly compensated for their work, while only 41% of residents in years six-eight feel that way.

Overall, 43% of trainees were satisfied with their compensation. Of those who are dissatisfied with their compensation, reasons given include feeling salaries do not reflect the number of hours they work, or what other medical staff are paid.

About 90% of trainees say that future earnings have an impact on their chosen specialty. More men than women say potential earnings influenced their specialty choice (93% and 86%, respectively).

Almost half (47%) of primary care residents say they plan to subspecialize.

Of trainees surveyed, 24% said they have over $300,000 in medical school debt, while 22% have no debt. In between, 14% of trainees surveyed have $250,001-$300,000 in debt, 14% have $200,001-$250,000 and 8% have $150,001-$200,000.

Related reading:

Tips for negotiating your first salary after residency

For the first time, DOs and osteopathic medical students are over 168K strong


  1. Simon Holoubek

    This is pretty misleading. Surgical sub-specialty residents and fellows make more than primary care residents on average because they spend more years in training and residents get paid more based on the year of training. With almost no exception everyone in the same post graduate level gets paid the exact same salary within the same hospital. The other factor includes the fact that primary care physicians can be trained at rural hospitals which have a lower cost-of-living and therefore their salaries are adjusted to be slightly lower than those in bigger cities. Metropolitan areas train all types of physicians. I suggest the author be more careful before publishing such statements. Please forgive typos from first post

  2. david hill

    Having to service large loans probably influences choice of specialty. And, how many of those without significant debt are in that fortunate position because they are FMGs? This means that they have taken advantage of their own country’s educational system and once here effectively earn more than their US educated colleagues because they have little or no debt to service. FMGs should have to pay for their GME. This would remove the burden from Medicare and create a more level playing field.

  3. Sean Leonard

    Our Residency pays graduated salary of $45,000 to $47,000 for Family Medicine Residents. The midlevels make at least twice what we do, for essentially the same work, however we work a lot more hours and have a lot more education…what’s wrong with this picture?

      1. John

        Residents are in training but are already a more valuable resource than midlevels. You can’t be saying that a PGY1 is less valuable than an NP. To be an NP doesn’t even require a bachelor’s degree! You know those midlevels can start practicing after getting just an associates degree, then hitting up a 100% online NP course (1-2 years long) and completing a DIY clinical experience worth just a few hundred hours. At least PAs actually have a standard course of instruction across the country. You don’t know what you are getting with an NP. So, NPs aren’t even close to the value of a PA in my book.

        I believe most midlevels never really make it out of training because most were never properly trained in the first place. I refuse to be seen by midlevels now because they always goof something up or try to prescribe a near last line antibiotic for something minor. The NP degree was originally created as an advanced nursing degree with management and that sort of thing in mind – not independent practice.

        Of course, if it were not for the extreme amount of student loans these days this would not be such a biting issue.

  4. John Cottle DO

    How can there be a gender income gap in medicine? 3rd parties pay the same for a given service, right? Are the figures corrected for hours worked, and the males simply put in more hours? Are the female docs less likely to be aggressive in contract negotiations? Perhaps I am just old and out of touch, but I thought medicine of all professions would be egalitarian.

    1. Bob Barker

      I imagine it has mostly has to do with number s of hours worked. But this would have to be studied to know for sure. I know in my practice, my coworker has had 3 babies in 3 years and takes 3 months off each time. I should be making more than her In those years.

    2. Jon Alley DO

      I have been an independent rural Family Practitioner for 27 years….when I submit a bill to a patient or to insurance, I have NEVER been asked what is my sex/gender….They don’t know, so they can’t discount me on that basis. If a male or female Family Practitioner sees the same number of patients in a day, with the same acuity, there should be no discrepancy in pay based on gender….there is obviously some other reason for this disparity.

    3. Mirianna

      Excellent point, thank you! I was just trying to make sense of that, too. And, as a female, I felt upset by the data. Because it is 2020…I sincerely hope that the income gap is a result of a different number of hours worked, nothing else.

    4. Thomas F. Steele, D.O., FACOFP, Professor Emeritus of Family Medicine

      I agree. The salary gender gap is discriminatory as well as arrogant.
      My Wife and 2 Daughters are D.O.s
      They have not only experienced salary gender inequities but also sexual abuse and intimidation.
      The “suits” need to get it straight and absolutely make certain the salary gender disparity stops now.
      Even D.O. Osteopathic Professors as my Wife and were for almost 30 years, experienced gender salary discrimination where female D.O. teachers with similar or more credentials and more responsibility are paid less than some of their lazy male counterparts.
      Also, comments like, this “woman doctor is taking the place of a male doctor” was told many times to my Wife and Daughters. They know their civil rights protection as other Women Physicians do.

  5. NYCResident

    I trained in a NYC area hospital. As a pgy 4 and with the $3500 extra stipend for chief resident i earned ~$75,000

    It was a blessing as cost of living is sky high. Was married with kids.

    Unions in the NYC area paid off…..

  6. Joe Shmoe DO

    I earn about 150K/yr with moonlighting as a PGY3. I wonder what the average would be if they factored in additional income sources.

  7. Charles Cook, DO

    I think it ridiculous and insulting to pay these physicians so little during their residency. It is only about 10% more than I was paid in 1982! Needless to say, cost of living has gone up considerably since then, but resident pay it deplorably low.

      1. Thomas F. Steele, D.O., FACOFP

        The “You are in training” comment is a bit rough.
        If residents’ pay has always been deplorable, then the statement of fact needs corrected.
        Valuing our residents for patient care, working long hours, tolerating aloof attendings’ comments deserves more and equal pay than a less trained PA or NP



    1. Jason

      Really? I was thinking it’s really high. I was paid $36K during internship in 2004. Was paid $46 for fellowship in 2008. Seems like it’s almost doubled in a few years.

      1. Still a poor FP

        Agree. I want to know where the doc did his residency in 1982 where this current salary is only 10% higher? These salaries are more than twice (almost 3x)what I made in what would now be seen as PGY 3. It was 20,000 for PGY1 (rotating internship); $22,000 for PGY2 (first year of FP residency); 24,000 for PGY3 (2nd year of FP residency). 1989-1992.

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    1. Bobbie Schneller

      No. All residents within the same class are paid the same at our program, with the exception of the chief residents, who receive an extra stipend. Our DOs and MDs become chief at similar rates.

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  18. Anonymous

    community Health of South Florida Inc located in Miami paid their residents only 48k a year , and the cost of living in Miami is exponential! Each year is only a 1k salary raise, very sad

  19. Robert H

    Do these numbers take into account residents in military residencies? We are a small group but our take-home pay is usually around $80,000 due to locality food and housing allowances, and that could skew the mean significantly.

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