Residency represents a unique phase in medical training, where physicians begin practicing while still earning structured training-level salaries.
After four years of medical school and hundreds of thousands of dollars in debt, Despite extensive training, resident compensation is relatively modest compared to other healthcare roles and professional positions.
However, recent trends show measurable improvements in resident compensation.
Resident salaries have increased significantly in recent years. The average U.S. resident now earns around $75,000 annually a 6.5% jump from 2024, following several years of stagnant growth . And depending on your specialty, year of training, and geographic location, that number can vary substantially.
This 2025 guide provides the definitive picture of resident physician compensation.
We rank specialties by starting salary, break down pay by postgraduate year, and give you the data you need to understand and advocate for your financial future during training.
Resident income is structured rather than market-based, meaning it is not determined by traditional supply-and-demand dynamics. Instead, salaries are shaped by standardized institutional pay scales, federal funding through graduate medical education (GME) support, program-specific adjustments, and geographic differences in the cost of living. This framework explains why variations in resident compensation tend to be relatively narrow, especially when compared to the wider income differences seen among attending physicians.
The 2025 National Snapshot - How Much Do Residents Actually Earn?
National Salary Overview
| Metric | 2025 Value |
|---|---|
| Average Resident Salary (All Years) | ~$75,000 |
| Year-over-Year Increase | +6.5% (from 2024) |
| PGY-1 Average | ~$66,000 – $68,000 |
| PGY-3 Average | ~$72,000 |
| PGY-4+ Average | ~$79,000 |
Source: Medscape's 2025 Resident Salary and Debt Report
Salary by Postgraduate Year (National Average)
| PGY Level | Average Annual Salary | Notes |
|---|---|---|
| PGY-1 | $66,000 – $68,000 | Intern year |
| PGY-2 | $68,000 – $70,000 | Small bump |
| PGY-3 | $72,000 – $74,000 | More significant increase |
| PGY-4 | $76,000 – $79,000 | Surgical residents and fellows |
| PGY-5 | $78,000 – $82,000 | Neurosurgery, ortho, etc. |
| PGY-6+ | $80,000 – $85,000+ | Fellows and advanced residents |
Important Context: These are national averages. Individual programs vary significantly based on geography, hospital funding, unionization, and cost-of-living adjustments .
Inflation and Real Earnings
Despite recent raises, resident pay hasn't kept pace with inflation over the long term. According to Medscape's analysis, 2020-2024 resident salaries did not keep up with the general inflation rate in the U.S. over that period .
What Residents Say:
- 58% say their salary does not cover living expenses and student loan payments
- 35% believe they need a 51% raise to feel fairly compensated
- 86% feel their compensation isn't comparable to other medical staff
"It was a rite of passage as a new intern to add up your actual hours worked and realize that effective hourly compensation can be relatively low when adjusted for hours worked." — David Shumway, DO, internal medicine resident
Resident salaries are standardized, but the financial experience of residency can vary widely depending on location, workload, and cost of living.
Salary by Specialty - Which Residents Earn the Most?
Not all residencies are created equal. Surgical and procedure-heavy specialties typically pay higher salaries, reflecting both the longer training duration and the higher clinical demands.
Top 15 Specialties by PGY-1 Salary (2025)
| Rank | Specialty | Avg PGY-1 Salary | Salary Range | Notes |
|---|---|---|---|---|
| 1 | Thoracic Surgery (Integrated) | $68,250 | $68,250 | 7-year residency |
| 2 | Medical Genetics & Genomics | $67,659 | $65,000 – $68,250 | Often research-heavy |
| 3 | Interventional Radiology (Integrated) | $67,395 | $61,750 – $68,250 | 6-year track |
| 4 | Nuclear Medicine | $67,321 | $61,750 – $68,250 | Often combined with radiology |
| 5 | Orthopaedic Surgery | $67,321 | $61,750 – $68,250 | 5-year residency |
| 6 | Radiation Oncology | $67,294 | $58,500 – $68,250 | Highly competitive |
| 7 | Neurology | $67,287 | $61,750 – $68,250 | 4-year residency |
| 8 | Otolaryngology (ENT) | $67,275 | $61,750 – $68,250 | 5-year residency |
| 9 | Anesthesiology | $67,250 | $58,500 – $68,250 | 4-year residency |
| 10 | Plastic Surgery (Integrated) | $66,896 | $61,750 – $68,250 | 6-year residency |
| 11 | Public Health/Preventive Medicine | $66,857 | $61,750 – $68,250 | Often academic |
| 12 | Vascular Surgery (Integrated) | $66,828 | $58,500 – $68,250 | 5-7 year track |
| 13 | General Surgery | $66,823 | $58,500 – $68,250 | 5-year residency |
| 14 | Emergency Medicine | $66,796 | $58,500 – $68,250 | 3-4 year residency |
| 15 | Neurological Surgery | $66,788 | $58,500 – $68,250 | 7-year residency |
Source: ResidencyMatch.ai
Factors Influencing Specialty Salary Differences
| Factor | Impact on Salary |
|---|---|
| Program Funding | Surgical programs often have more hospital funding |
| Length of Training | Longer residencies often have higher PGY-3+ pay |
| Clinical Demands | Call frequency and intensity can affect compensation |
| Unionization | Unionized programs typically pay more |
| Geography | Cost of living and local market rates matter |
Key Insight: While the range is narrow at the PGY-1 level (roughly $58,000–68,000), the gap widens significantly in later years as surgical residents receive larger annual increases .
Salary by Program - Real Examples from 2025
To give you a concrete sense of what residents actually earn, here are real salary scales from specific programs in 2025. The following examples illustrate how resident compensation varies across institutions:
Mount Carmel Health System (Ohio)
| PGY Level | 2025-2026 Salary |
|---|---|
| PGY-1 | $66,035.79 |
| PGY-2 | $68,264.33 |
| PGY-3 | $71,799.21 |
| PGY-4 | $73,216.99 |
| PGY-5 | $76,639.38 |
Benefits:
- $2,500/year CME fund
- $600 technology fund (PGY-1)
- $3,000 food stipend
- 5 CME days/year
- Onsite gym and sanctuary spaces
Source: Mount Carmel Health System
University of Cincinnati (Primary Care Differential)
| PGY Level | Base Salary | With Primary Care Differential* |
|---|---|---|
| PGY-1 | $68,141 | $69,140 |
| PGY-2 | $70,387 | $71,387 |
| PGY-3 | $72,530 | $73,529 |
| PGY-4 | $74,693 | $75,692 |
| PGY-5 | $77,693 | $78,692 |
| PGY-6 | $80,683 | — |
| PGY-7 | $84,302 | — |
| PGY-8 | $85,613 | — |
*Primary Care Differential applies to FM, Psych, IM, Med-Peds, OB-GYN
Source: University of Cincinnati
International Comparison - How U.S. Residents Stack Up
United Kingdom (NHS)
| Training Stage | Basic Salary (2025) | Total NHS Earnings (Est.) |
|---|---|---|
| Foundation Year 1 | £38,831 | ~£45,900 |
| Foundation Year 2 | £44,439 | — |
| Specialty Registrar | £52,656 – £73,992 | ~£80,500 avg |
Key Differences: UK residents receive additional pay for nights, weekends, and on-call hours, which can add 27% or more to base salary .
Canada
| Province | Median Annual Salary | Range |
|---|---|---|
| National | $232,227 | $90,826 – $435,240 |
| Quebec | $268,808 | $95,137 – $505,024 |
| Ontario | $233,752 | $84,266 – $451,418 |
| Manitoba | $240,395 | $97,422 – $487,678 |
Note: Canadian resident salaries may appear higher due to differences in reporting and inclusion of senior trainees because the data includes all residents (including senior fellows) and may reflect total compensation packages.
Source: Government of Canada Job Bank
Beyond Base Salary - Total Compensation: Benefits and Additional Value
Base salary provides only a partial view of total compensation. Resident benefits packages can add thousands of dollars in value annually.
Common Resident Benefits
| Benefit | Typical Value | Notes |
|---|---|---|
| CME/Education Fund | $1,500 – $3,000/year | Conferences, books, boards prep |
| Food Stipends | $1,000 – $3,000/year | On-call meals, cafeteria credit |
| Technology Allowance | $500 – $1,000 | Laptops, tablets, equipment |
| Parking | $500 – $2,400/year | Free or subsidized parking |
| Health Insurance | $5,000 – $15,000/year | Often heavily subsidized |
| Retirement Match | 2-8% of salary | Vesting schedules vary |
| Disability Insurance | Included | Essential for protecting future income |
| Malpractice Insurance | Included | Occurrence-based preferred |
| White Coats/Scrubs | Provided | Typically 2-4 coats |
Real Example - Mount Carmel Health System :
- $2,500/year CME fund
- $600 technology fund (PGY-1)
- $3,000 food stipend
- North Face jacket every other year
- Onsite gym access
Compensation Discussion: Are Resident Salaries Adequate?
Factors Supporting Higher Compensation
| Factor | Reality |
|---|---|
| Hourly Wage | Many residents earn less than minimum wage when hours are calculated |
| Student Debt | Average medical school debt: $250,000+ |
| Inflation | Real wages have fallen over the past decade |
| Work Intensity | Residents manage critically ill patients, often with minimal supervision |
| Comparison to APPs | Nurse practitioners and PAs often earn more with less training |
The Data:
58% of residents say salary doesn't cover expenses + loan payments
35% need a 51% raise to feel fairly compensated
Real-terms pay has fallen 4-10% since 2010 in the UK
Counterpoints
"At the end of the day, nurses and physician assistants are fully trained in their disciplines, and residents still require supervision to practice. Compensation should focus on meeting cost of living and improving benefits." — David Shumway, DO
Counterpoint: Residency is still training. The low wages are offset by the enormous future earning potential of physicians.
Strategies to Optimize Resident Income
1. Negotiate Your Contract
While base salaries are often fixed, you can negotiate:
- Signing bonuses (less common but occasionally available)
- Relocation assistance
- CME fund increases
- Research stipends
- Housing subsidies (in some programs)
2. Understand Moonlighting Policies
| Moonlighting Type | Typical Pay | Restrictions |
|---|---|---|
| Internal moonlighting | $50-150/hour | Often allowed |
| External moonlighting | $80-200/hour | Requires approval |
| Locums | $100-250/hour | Rare for residents |
Important: Not all programs allow moonlighting. Know your policy before committing.
3. Maximize Your Benefits
| Benefit | Action |
|---|---|
| CME Fund | Use it - don't let it expire |
| Retirement Match | Contribute enough to get full match |
| Health Insurance | Understand your coverage; use FSA/HSA |
| Disability Insurance | Ensure you have own-occupation coverage |
4. Choose Programs with Stipends and Differentials
Some programs pay more for:
- Chief resident roles (+$5,000–15,000)
- Research years (often funded)
- Night floats (shift differentials)
- High-cost areas (COL adjustments)
5. Plan for Loan Repayment Early
| Strategy | Best For |
|---|---|
| PSLF | Non-profit hospital employees |
| REPAYE/SAVE | Those seeking lower payments |
| Refinancing | Those with high-interest private loans |
Key Takeaways
Positive Trends: Resident salaries are rising. The 6.5% increase in 2025 is the largest in years, and pay has grown more significantly in the past three years than in the decade prior .
Ongoing Challenges: For many residents, it's may not fully meet financial demands for some residents. With inflation, student loans, and the sheer hours worked, nearly 60% of residents report that their salary doesn't cover basic expenses .
The reality: Residency represents a period of financial constraint within a longer-term career trajectory. But understanding the numbers, knowing what your peers earn, and maximizing your benefits can make the years of training more manageable and set you up for long-term financial success.
Key Insight: Whether you're matching into thoracic surgery at $68,250 or family medicine at $66,000, know that this is temporary. Attending physician compensation is typically significantly higher, which influences long-term financial outcomes.
These insights can help guide informed financial and career decisions during training.
About This Analysis
This article is based on data from Medscape Resident Salary Reports, institutional salary disclosures, and residency program data. The objective is to provide a structured overview of resident compensation by combining salary benchmarks with training year, specialty, and geographic variation. All figures are estimates and may vary by program, location, and individual circumstances.
Written by: MedSalaryData Editorial Team
Healthcare Salary & Career Analysis
Additional Resources
| Resource | Purpose |
|---|---|
| Medscape Resident Salary Report | Annual survey data |
| ResidencyMatch.ai | Specialty-by-specialty salary comparison |
| AAMC | Loan repayment and financial planning |
| White Coat Investor | Resident-focused financial education |
Disclaimer: Salary data are 2025 projections based on Medscape surveys, institutional data, and residency matching platforms. Individual offers vary significantly by program, geography, and specialty. This information is for career planning purposes only.
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