The paradox of residency: you're a doctor, but your first real paycheck can dip below minimum wage when the hours are factored in.
You've spent four years of undergrad, four years of medical school, and hundreds of thousands of dollars in loans. You've earned the right to call yourself a physician. Then you match into residency - and discover that your first-year salary will be around $65,000–70,000.
On paper, that sounds reasonable. But when you're working 80-hour weeks, that translates to roughly $16–18 per hour . In some cities, that's less than the starting wage at a fast-food restaurant.
This isn't a complaint - it's context. Residency is temporary, and the financial rewards that follow are substantial. But understanding what you're actually earning (and what you're not) is essential to surviving and thriving during these critical training years.
This 2026 report breaks down real resident salaries from actual programs, analyzes the benefits that add tens of thousands to your total package, and reveals the financial reality that most residency websites won't tell you.
This report is designed for:
- Medical students preparing for the Match
- Incoming residents evaluating program offers
- Current residents assessing financial decisions
- Physicians comparing training environments across regions
Rather than focusing only on salary figures, this report emphasizes real compensation - what residents actually earn after factoring in workload, benefits, and cost of living.
The 2026 National Snapshot - What Residents Actually Earn
The Big Picture
Resident salaries vary dramatically by program, location, and funding. But looking at real data from institutions across the country tells the real story.
| PGY Level | Low End | Typical | High End |
|---|---|---|---|
| PGY-1 | $61,935 | $66,000–70,000 | $87,044 |
| PGY-2 | $64,151 | $68,000–72,000 | $88,867 |
| PGY-3 | $66,221 | $70,000–75,000 | $93,975 |
| PGY-4 | $69,299 | $74,000–80,000 | $100,382 |
| PGY-5 | $72,370 | $78,000–85,000 | $90,741 |
| PGY-6+ | $83,750 | $85,000–95,000 | $124,280 |
The spread is real: A PGY-1 at Stamford Health earns $87,044 - more than a PGY-4 at MUSC . The difference comes down to location, unionization, and institutional funding.
The Hourly Reality
Here's the math that residency programs don't advertise. Assuming an 80-hour work week (the ACGME limit) and 50 weeks of work per year:
| PGY Level | Annual Salary | Effective Hourly Wage |
|---|---|---|
| Low End (MUSC, PGY-1) | $61,935 | $15.48/hour |
| Average (PGY-1) | $68,000 | $17.00/hour |
| High End (Stamford, PGY-1) | $87,044 | $21.76/hour |
"It was a rite of passage as a new intern to add up your actual hours worked and realize that you were making less than minimum wage." — Anonymous resident ## What Actually Drives Resident Compensation. This calculation highlights one of the most overlooked aspects of residency: while annual salaries appear moderate, the combination of long hours and fixed pay structures results in one of the lowest effective hourly wages among highly trained professionals.
While salary tables provide useful benchmarks, they rarely reflect the full financial reality of residency.
Based on compensation comparisons across programs, three factors consistently have the greatest impact on a resident’s financial outcome:
- Geographic cost of living (especially housing)
- Benefits structure (housing stipends, retirement contributions, insurance)
- Access to supplemental income (moonlighting opportunities)
One key insight stands out: Residents at higher-paying programs do not always come out ahead financially. In many cases, lower salaries in low-cost regions result in greater disposable income than higher salaries in expensive metropolitan areas. This makes cost-adjusted income - not base salary - the most important metric for evaluating residency programs.
Real Program Data - What Residents Earn at Actual Institutions
Let's look at real 2025-2026 salary scales from residency programs across the country. These aren't averages—they're actual numbers from institutions hiring residents right now.
University of Arizona College of Medicine – Phoenix
| PGY Level | Annual Salary |
|---|---|
| PGY-1 | $66,500 |
| PGY-2 | $69,000 |
| PGY-3 | $72,000 |
| PGY-4 | $76,000 |
| PGY-5 | $79,750 |
| PGY-6 | $83,750 |
| PGY-7 | $89,750 |
| PGY-8 | $91,500 |
University of Pennsylvania
| PGY Level | Annual Salary |
|---|---|
| PGY-1 | $76,348 |
| PGY-2 | $79,262 |
| PGY-3 | $83,115 |
| PGY-4 | $87,758 |
| PGY-5 | $90,741 |
Medical University of South Carolina (MUSC)
| PGY Level | Annual Salary |
|---|---|
| PGY-1 | $61,935 |
| PGY-2 | $64,151 |
| PGY-3 | $66,221 |
| PGY-4 | $69,299 |
| PGY-5 | $72,370 |
Stamford Health (with Housing Allowance)
| PGY Level | Annual Salary |
|---|---|
| PGY-1 | $87,044 |
| PGY-2 | $88,867 |
| PGY-3 | $93,975 |
UC San Diego (OB/GYN)
| PGY Level | Annual Salary |
|---|---|
| PGY-1 | $91,211 |
| PGY-2 | $93,829 |
| PGY-3 | $97,035 |
| PGY-4 | $100,382 |
What These Numbers Tell Us
| Insight | Why It Matters |
|---|---|
| Location drives pay | UCSD PGY-1s earn $91,211; MUSC PGY-1s earn $61,935—a $29,000 difference for the same year of training |
| Unionization matters | Programs with strong resident unions consistently pay more |
| Housing allowances | Stamford's $87,044 includes a housing stipend—always ask what's included |
| Experience premiums | The gap between PGY-1 and PGY-5 ranges from $10,000 to $20,000, depending on the program |
What This Means in Practice
For applicants, these differences are not trivial. A $25,000 salary gap between programs can significantly impact quality of life - especially when combined with differences in housing costs, taxes, and benefits. In practical terms, choosing between two residency programs is not just a clinical or academic decision - it is also a major financial decision that can affect savings, debt repayment, and long-term financial stability.
The Benefits Package - Where Real Value Hides
Base salary tells only part of the story. Benefits can add $10,000–25,000+ in annual value, and some programs offer perks that dramatically improve quality of life. In many cases, benefits represent the most underestimated portion of resident compensation.
Programs with slightly lower salaries but stronger benefits - such as housing stipends or retirement contributions - can provide significantly higher total compensation than higher-paying programs with minimal support.
Common Resident Benefits
| Benefit | Typical Value | Examples |
|---|---|---|
| Health Insurance | $5,000–12,000/year | Covered at all major programs |
| Dental/Vision | $500–1,500/year | Often included or low-cost |
| Retirement Plan | 4–10% of salary | Denver: 6% employer + 3.5% match; Stamford: 4% automatic + 1% match |
| Disability Insurance | $600+/month value | Basic LTD included at most programs |
| Life Insurance | 1× salary typically | Provided at no cost |
| Malpractice Insurance | $10,000–50,000+ | Always included (and essential) |
| CME/Book Stipend | $1,500–5,000/year | SIU: $1,750–5,000; Denver: $150–300 |
| Conference Travel | $1,250–1,500/year | Denver: up to $1,250 for posters, $1,500 for seniors |
| Meals/Food | $500–2,000/year | Denver: meal cards, cafeteria subsidies; SIU: lunch provided |
| Parking/Transport | $500–2,400/year | Denver: free parking + EcoPass; MUSC: paid parking |
| Technology | $500–1,500/year | MUSC: free iPhone; SIU: laptop package |
| Gym Membership | $300–1,000/year | MUSC: free Wellness Center; Denver: discounted membership |
Standout Benefits Worth Noting
Denver Health's Retirement Plan:
- Required 6.2% employee contribution to 401(a)
- Denver Health adds 6% of eligible pay
- Optional 457(b) with employer match up to 3.5%
- Note: Employees don't pay Social Security significant additional savings
Stamford Health's Housing Allowance:
- Monthly housing allowance included in salary figures
- Plus 4% automatic 403(b) contribution + 1% match
- Effectively adds $10,000+ to total compensation
MUSC's iPhone Program:
- Free Apple iPhone with unlimited data
- Yours to keep after residency
- Small perk, but signals institutional investment in residents
SIU's Book Stipend:
- PGY-1: $1,750
- PGY-2: $2,250
- PGY-3: $5,000
- Sports Medicine Fellow: $8,500
- Plus $5,000 onboarding bonus
The Financial Reality - Why Residents Struggle
The average medical school graduate carries $200,000–250,000 in student loan debt (including undergraduate loans). For a resident earning $70,000:
| Debt Load | Standard 10-Year Payment | Monthly | As % of Take-Home |
|---|---|---|---|
| $200,000 at 6% | Standard | $2,221 | 50%+ |
| $250,000 at 6% | Standard | $2,776 | 62%+ |
| $300,000 at 6% | Standard | $3,331 | 74%+ |
This is why virtually all residents use income-driven repayment plans during training - they reduce payments to 10% of discretionary income, typically $300–800/month.
The Childcare Crisis
A 2024 nationwide study found that childcare is unaffordable for residents in 98% of programs. Even when subsidies exist, childcare consumes more than 12% of income - far above the federal affordability threshold .
Real Story: Jackline Joy Martín Lasola, MD, a second-year ob/gyn resident, faced a brutal choice. With her husband in residency in Baltimore and their three children needing care, she relocated to San Francisco - not because it was affordable (her 1,100-square-foot apartment costs $4,400/month), but because family was there to help. Employer-sponsored childcare would have cost $1,000+ for a toddler and $2,000–3,000 for an infant - "the equivalent of two Bay Area mortgages" .
"It would be like the equivalent of two Bay Area mortgages." — Jackline Joy Martín Lasola, MD
The Housing Crunch
Ryan Brewster, MD, who co-authored the 2024 childcare affordability study, previously researched housing affordability for residents. His finding: "There is a mismatch between our payment and cost of living, particularly in coastal metropolitan areas" - something every resident knows intuitively.
| City | Typical Resident Salary | 1-Bedroom Rent | Rent as % of Gross |
|---|---|---|---|
| San Francisco | $80,000–90,000 | $3,200–4,200 | 48–63% |
| New York | $75,000–85,000 | $3,000–3,800 | 48–60% |
| Cleveland | $65,000–75,000 | $1,100–1,500 | 20–27% |
The 2026 Advocacy Landscape - What's Changing
The Push for Better Pay
Groups like Parent Resources in Medical Education (PRIME) , founded by medical students at the University of Chicago Pritzker School of Medicine, are organizing to advocate for parental support, policy changes, and resources for parent trainees .
The American Medical Association (AMA) has adopted policy recommendations aimed at increasing on-site or subsidized childcare for medical trainees .
Institutional Progress
At the UNC School of Medicine, the Family Support Initiative helped develop a New Child Adjustment Policy in 2019, creating structured support for students when a new child enters their livesincluding options for time away while maintaining benefits .
"One of the drivers behind the [childcare affordability] study was to put the data behind what we already know and to create momentum for that structural change at a programmatic level. And, more broadly, to revise how our residents' compensation model is framed." — Ryan Brewster, MD
Moonlighting - The Income Supplement
For residents who can handle the extra hours, moonlighting offers a path to significantly higher income.
Typical Moonlighting Pay
| Setting | Typical Hourly Rate |
|---|---|
| Internal moonlighting | $50–100/hour |
| External (urgent care, etc.) | $80–150/hour |
| Locums (rare for residents) | $100–250/hour |
The Catch
Moonlighting is not permitted at all programs, and even where allowed, duty hour restrictions limit how much you can work. But for residents who can manage it, even 8 hours per month at $100/hour adds $9,600 annually - a significant boost to a $70,000 salary.
How to Evaluate a Residency Program's Financial Package
When ranking programs, don't just look at the salary number. Consider:
Questions to Ask on Interview Day
| Question | Why It Matters |
|---|---|
| What's the salary scale by PGY year? | Know how your income will grow |
| What benefits are included? | Health insurance, retirement match, CME stipend |
| Is there a housing allowance or subsidized housing? | This can be worth $10,000+/year |
| What's the moonlighting policy? | Potential for extra income |
| How does the program support residents with families? | Childcare subsidies? Parental leave? |
| What's the call schedule? | Affects both quality of life and moonlighting ability |
Red Flags to Watch For
| Red Flag | Why It Matters |
|---|---|
| No clear salary scale | You won't know what to expect |
| No retirement match | Leaving free money on the table |
| Unclear moonlighting policy | Limits income potential |
| No childcare support | Critical if you have or plan to have children |
| No mention of wellness resources | May indicate lack of resident support |
The Bottom Line: Resident Compensation in 2026
Residents in 2026 earn between $61,935 and $100,382, depending on year, location, and program.
| PGY Level | Typical Range | Effective Hourly Wage* |
|---|---|---|
| PGY-1 | $62,000 – $87,000 | $15.50 – $21.75 |
| PGY-2 | $64,000 – $89,000 | $16.00 – $22.25 |
| PGY-3 | $66,000 – $97,000 | $16.50 – $24.25 |
| PGY-4 | $69,000 – $100,000 | $17.25 – $25.00 |
| PGY-5+ | $72,000 – $124,000 | $18.00 – $31.00 |
**Based on 80-hour weeks, 50 weeks/year*
The Reality:
| Factor | Impact |
|---|---|
| Base salary | Varies by $25,000+ between programs for the same PGY level |
| Benefits | Add $10,000–25,000 in annual value |
| Location | A $70,000 salary in Cleveland goes twice as far as $90,000 in San Francisco |
| Student debt | Income-driven repayment plans are essential |
| Childcare | Can consume 12%+ of income - or be impossible to afford |
The good news: Resident salaries are rising, benefits packages are increasingly generous, and advocacy efforts are making real progress. Programs like Stamford Health's $87,044 PGY-1 salary with housing allowance and strong retirement benefits are setting new standards .
The challenge: For residents with families - or those who want to start them - the system remains stacked against you. Childcare costs, housing prices, and the cultural expectation that training comes first create impossible choices .
The bottom line: If you're a resident - or considering becoming one - understand the numbers, maximize your benefits, and advocate for yourself. The data is on your side.
About This Analysis
This
report is based on publicly available residency salary data,
institutional program disclosures, and aggregated compensation
benchmarks. The goal is to provide a clearer picture of resident
compensation by combining salary figures with benefits, workload
estimates, and real-world financial considerations. All figures
represent estimates and may vary based on specialty, institution, and
individual circumstances.
Written by: MedSalaryData Editorial Team
Healthcare Salary & Career Analysis
Additional Resources
| Resource | Purpose |
|---|---|
| ACGME | Duty hour requirements and policies |
| AAMC FIRST | Financial planning tools for residents |
| PRIME (Parent Resources in Medical Education) | Advocacy and support for parent trainees |
| White Coat Investor | Resident-focused financial education |
| StudentAid.gov | Income-driven repayment plans |
Sources:
- U.S. Bureau of Labor Statistics (BLS)
- AAMC Resident/Fellow Compensation Reports
- University of Arizona College of Medicine – Phoenix (GME Salary Data)
- University of Pennsylvania Graduate Medical Education
- Medical University of South Carolina (MUSC) Residency Salary Data
- Stamford Health Residency Program Compensation
- UC San Diego Graduate Medical Education
Disclaimer: Salary and benefit data are 2026 projections based on current AAMC, ACGME, COTH, and institutional GME survey data. Individual program offerings vary significantly and change annually. This information is for career planning and advocacy purposes and does not constitute legal or financial advice. Always verify current compensation and benefits directly with your institution's GME office.
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