Last updated: May 2026.
How Much Do Doctors Make in 2026? Physician Salaries by Specialty, Location, and Experience
Becoming a doctor is often seen as the pinnacle of professional success. While the emotional rewards are undeniable, it’s natural to think about the financial side of your future too. If you’re considering a medical career or are already on your way there, you’ve probably wondered how your specialty, location, or even your demographic background could influence your earnings. In 2026, physician compensation continues to be shaped by multiple factors, including your field, where you live, how you structure your career, and significant federal policies that are reshaping the financial landscape of medicine.
The most recent data from the Medscape Physician Compensation Report 2026, which surveyed 5,916 full-time U.S. physicians across 29 specialties between September and December 2025, shows that the average physician earned $386,000 in 2025. That represents approximately a 3% increase from $374,000 the prior year. A separate report from Doximity, released in mid-2025, showed a slightly higher growth rate of 3.7% for the preceding year. While these figures confirm that medicine remains a well-compensated profession, they also suggest that salary growth, while steady, has not kept pace with inflation over the longer term, especially when weighed against rising student debt and significant new federal loan policies.
What the Average Physician Earns in 2026: A Quick Summary
Before getting into the details, here is a snapshot of where physician compensation stands as of the most recent data available in 2026. The average physician in the United States now earns $386,000 per year. Primary care physicians average $298,000, while specialists average $417,000. Eight specialties now exceed $500,000 in average annual compensation, up from just four the year before. Orthopedic surgeons lead all specialties tracked by Medscape at $611,000, followed by cardiologists at $575,000. Neurosurgeons remain the highest-paid physicians overall when including data from Doximity and MGMA, with averages ranging from $749,000 to over $900,000 depending on the source and practice setting.
The gender pay gap continues to widen. Male physicians averaged $429,000 compared to $327,000 for female physicians in the Medscape 2026 survey, a $102,000 gap that now represents a 31% difference. Racial and ethnic disparities persist as well, with White physicians earning an average of $391,000 compared to $342,000 for Black physicians. Meanwhile, the elimination of Graduate PLUS loans for new borrowers starting in July 2026 is fundamentally changing how future physicians will finance their education.
If you’re still in the early stages of deciding whether medicine is the right path, understanding compensation is just one piece of the picture. Thinking clearly about why you want to become a doctor will help you weigh the financial realities alongside the personal motivations that sustain physicians over a long career.
How Specialty Impacts Earnings
Not all medical specialties pay the same, and the differences can be substantial. Surgeons, procedural specialists, and those in highly technical or in-demand fields consistently earn more than generalists. One of the most notable findings from the Medscape 2026 report is that eight specialties now average more than $500,000 per year, up from just four specialties in the prior year’s survey. The eight specialties in this group are orthopedics and orthopedic surgery ($611,000), cardiology ($575,000), radiology ($571,000), plastic surgery ($554,000), anesthesiology ($543,000), urology ($535,000), gastroenterology ($530,000), and otolaryngology ($508,000). Otolaryngology is the notable new addition, crossing the $500,000 threshold for the first time. For students interested in what ENT physicians actually do on a daily basis, our guide to what an ENT specialist does provides a useful overview.
Neurosurgeons remain the highest-paid physicians in the country when data from multiple sources is considered. According to the Doximity 2025 report (still the most recent Doximity data available), the average annual compensation for neurosurgery was $749,140. Data from the Medical Group Management Association (MGMA) places the median total compensation even higher, at approximately $963,000. Physicians Thrive reports the average neurosurgeon salary at around $875,000, reflecting growth of roughly 45% to 50% compared to averages from ten years ago.
Orthopedics has topped the Medscape earnings list for six consecutive years, and its lead grew substantially in 2026, with orthopedic surgeons now averaging $611,000 annually, up from $564,000 the prior year. Cardiology saw the largest year-over-year increase of any specialty at 10%, followed by radiology at 9% and anesthesiology at 8%.
Primary care physicians saw their average compensation rise to $298,000, up from $287,000 the year before. Specialists averaged $417,000, compared to $404,000 the previous year. In a notable shift from the prior year, the growth rate for both primary care physicians and specialists was approximately 3%, with no major difference between the two groups. Over a five-year period, primary care specialties have actually led with a cumulative 21.8% total increase, according to SullivanCotter’s 2025 Physician Compensation and Productivity Survey. This trend partly reflects clinician shortages and persistent supply-demand imbalances in primary care.
At the lower end of the pay spectrum, pediatric endocrinology and general pediatrics continue to rank among the lowest-paid specialties, along with public health, preventive medicine, and diabetes and endocrinology. Pediatrics and rheumatology compensation remained flat year over year.
Seven specialties saw pay decreases in the most recent survey period. Physical medicine and rehabilitation, nephrology, and dermatology each experienced a 1% decline. Oncology, hematology, and pulmonary medicine dropped 2%. Psychiatry and allergy and immunology each declined 3%. These decreases are notably smaller than some of the sharper drops seen in the prior year, when dermatology experienced an 11% decline.
Key Takeaways:
- Neurosurgeons now average $749,000 to $875,000 or more, depending on the source and practice setting
- Eight specialties now exceed $500,000, up from four the prior year, led by orthopedics at $611,000
- Cardiology saw 10% growth, the highest of any specialty, reaching $575,000
- Primary care physicians average $298,000, with growth matching specialists at approximately 3%
- Pediatric subspecialties and preventive medicine remain at the bottom of the pay scale but often report high job satisfaction
- Seven specialties saw pay declines, led by psychiatry and allergy/immunology at 3% each
Does Location Matter? Absolutely
Where you practice medicine significantly influences your earning potential. According to the Medscape 2026 report, physicians in the Midwest reported the highest average salaries at $385,000, slightly above the national average. The South came in second at $375,000. Lower physician density, rural demand, and competitive recruitment incentives all contribute to higher pay in these regions.
At the state level, Bureau of Labor Statistics data published in 2025 shows that Wyoming has the highest hourly mean wage for physicians in the country, and it holds that position even after adjusting for cost of living. When cost-of-living adjustments are factored in, Rochester, Minnesota, secured the top spot in the Doximity 2025 report for overall physician compensation. Physicians in Rochester earned an average of $495,532, with an 8.7% year-over-year pay increase.
Urban areas with prestigious medical institutions don’t always offer the highest pay. Eight of the ten metropolitan areas with the lowest average compensation are located on the East Coast. Durham-Chapel Hill reported the lowest average physician compensation among major metros at $358,782. Boston and Washington, D.C., once again appeared near the bottom of cost-of-living-adjusted compensation lists. While nominal salaries in these cities may exceed $350,000, the actual purchasing power of those dollars is considerably lower than what physicians earn in less expensive regions.
High demand in underserved rural areas often means better compensation, especially when paired with signing bonuses, relocation assistance, or loan repayment programs. The Bureau of Labor Statistics projects that overall employment of physicians and surgeons will grow 3% from 2024 to 2034, about as fast as the average for all occupations, with approximately 23,600 openings projected each year. Much of that demand is concentrated in rural and underserved communities. For students interested in how physician demand varies globally, our article on which countries have the highest demand for doctors offers useful context.
Demographic Disparities in Salary Are Getting Worse
Despite ongoing awareness efforts, wage gaps based on gender and race persist across medical fields, and the most recent data shows these gaps continue to widen rather than narrow.
According to the Doximity 2025 report, the overall gender pay gap stood at 26% in 2024, up from 23% in 2023. In dollar terms, female physicians earned an average of $120,917 less than male physicians after adjusting for specialty, location, and years of experience. The Medscape 2026 data shows the gap growing even further: male physicians averaged $429,000 while female physicians averaged $327,000, a difference of $102,000 that represents a 31% gap. This is up from roughly $91,000 and 29% just two years earlier. A newer analysis from Marit Health, based on over 17,000 physician salaries shared on their platform, found that female physicians earn about $0.78 per $1 in total compensation compared to male peers. Even after controlling for specialty, hours worked, experience, geography, and practice setting, an unexplained 7% gap remains.
Racial and Ethnic Pay Gaps Now Quantified in Dollar Terms
The Medscape 2026 report provides the most granular racial and ethnic compensation data to date. White physicians reported an average of $391,000 in annual compensation. Asian American physicians averaged $383,000. Latino physicians averaged $361,000. Black physicians averaged $342,000, meaning a $49,000 gap between White and Black physicians.
Over the two-year period covered by the Medscape data, White physicians reported 6.1% higher total compensation on average. Asian American physicians saw 6.0% growth. Hispanic and Latino physicians saw 3.5% growth, while Black physicians experienced only 2.9% growth. In other words, compensation grew fastest for the groups that were already earning the most, causing the disparity to widen further.
- The gender pay gap widened to 31% in the Medscape 2026 report ($429,000 for men vs. $327,000 for women), and to 26% in the Doximity 2025 report after adjusting for specialty and location.
- White physicians average $391,000, while Black physicians average $342,000, a $49,000 gap that grew over the most recent survey cycle.
- Even after controlling for specialty, hours, experience, and geography, an unexplained 7% gender pay gap persists.
Several factors contribute to these disparities, including specialty selection, negotiation patterns, institutional bias, and unequal access to mentorship. Female physicians are more likely to enter lower-paying fields like pediatrics and family medicine. They also report spending more time on documentation and patient education tasks that are not directly compensated.
This doesn’t mean change isn’t possible. Awareness is increasing, and many institutions are implementing pay transparency policies and equity audits. But the data makes clear that awareness alone has not been sufficient to close these gaps.
Is Starting a Practice Still Worth It?
Entrepreneurial physicians can sometimes out-earn their salaried peers. Current estimates place private practice physician earnings in the range of $320,000 to $450,000 annually, compared to $280,000 to $400,000 for hospital-employed physicians. Autonomy, flexibility, and the ability to shape your own practice remain major draws for those who choose this path.
However, the broader trend is moving decisively away from private practice. According to the American Medical Association’s 2024 Physician Practice Benchmark Survey, only 42.2% of physicians now work in private practice, down 18 percentage points from 60.1% in 2012. AMA President Bruce A. Scott, MD, described the situation starkly: “The share of doctors working in practices wholly owned by physicians is unraveling under compounding pressures.” He noted that after adjusting for inflation in practice costs, Medicare physician payment has fallen 33% over the past quarter century.
Hospital Ownership and Private Equity Are Reshaping Practice Structures
The shift away from physician-owned practices is not simply a matter of doctors choosing employment. The AMA data shows that the percentage of physicians working in hospital-owned practices increased from 23.4% in 2012 to 34.5% in 2024. The percentage of physicians working as a direct hospital employee or contractor more than doubled in that same period, from 5.6% to 12.2%. While hospitals dominated early acquisitions of physician practices, private equity has been much more active in recent years, accounting for 38.3% of practice purchases after 2019 compared to just 10% for hospitals over the same period.
Running your own clinic means covering business expenses, equipment, insurance, and compliance requirements. Staffing challenges, credentialing delays, and rising operational costs can eat into profits quickly. However, there is a small piece of good news for 2026: the CMS Medicare Physician Fee Schedule final rule includes a conversion factor of $33.40 to $33.57 (depending on qualifying participant status), representing approximately a 3.3% to 3.8% increase from the 2025 conversion factor of $32.35. This is the first meaningful positive change in Medicare physician reimbursement in years, though it still falls far short of recovering the 33% inflation-adjusted decline over the past 25 years.
If you’re considering entrepreneurship, take the time to learn the business side of medicine. Consult with healthcare business advisors or take coursework in healthcare administration. The payoff can be worth it, but only if you go in with realistic expectations about the administrative and financial demands involved.
The Growing Weight of Medical School Debt
Medical school debt remains one of the most pressing concerns for future doctors, and the numbers continue to climb. According to the latest data from the Association of American Medical Colleges (AAMC), medical students in the Class of 2025 graduated with an average of $223,130 in education debt, up 5% from the prior year. The median debt figure was $215,000. Seventy percent of 2025 medical school graduates carried education loan debt.
Breaking this down further, AAMC data shows that Class of 2025 graduates who attended a public medical school had an average of $210,147 in total education debt, a 3% increase from the prior year. Graduates of private medical schools carried an average of $244,964 in total debt, up 8%. That gap of nearly $35,000 between public and private school debt underscores why school selection is a significant financial decision, not just an academic one.
The cost of attendance continues to rise as well. For the Class of 2026, the median four-year cost of attendance is $297,745 at public medical schools and $408,150 at private institutions. Federal student loan interest rates for graduate or professional loans disbursed between July 1, 2025, and June 30, 2026, are set at 7.94% for Direct Unsubsidized loans and 8.94% for Direct PLUS loans. These rates are substantially higher than what borrowers faced a few years ago and significantly increase the total cost of borrowing over a repayment period.
Nearly 58% of 2025 medical graduates reported that they intend to pursue federal student loan forgiveness, a figure that reflects both the scale of the debt burden and the importance of understanding which repayment programs are available and how they work.
Major Changes to Student Loans and Forgiveness in 2026
The federal student loan landscape changed dramatically on July 4, 2025, when the “One Big Beautiful Bill Act” (P.L. 119-21) was signed into law. These changes are among the most significant to affect physician finances in years, and students entering medical school in 2026 or later need to understand what’s different.
The most consequential change: Graduate PLUS loans will be eliminated for new borrowers as of July 1, 2026. Previously, students could borrow up to the full cost of attendance through the Grad PLUS program. Beginning in the 2026-2027 academic year, new borrowers will face annual and lifetime caps that vary based on degree type. For professional students (which includes medical students), the new limit is $50,000 annually in Direct Unsubsidized Stafford loans, with a lifetime cap of $200,000. For graduate students in non-professional programs, the limits are lower: $20,500 annually with a $100,000 lifetime cap. A new overall lifetime cap of $257,500 across all federal student loans (including undergraduate borrowing) also applies.
These caps mean many medical students will need to find alternative funding sources to cover the gap between their federal loan limits and actual costs. At private medical schools where the four-year cost of attendance exceeds $400,000, the gap between federal loan limits and total costs could exceed $200,000, potentially pushing students toward private lenders with higher interest rates and no access to federal forgiveness programs. Students who received a Grad PLUS loan by June 30, 2026, for the program they are currently enrolled in should be grandfathered into the existing system, with access to those loans for up to three more years.
New Repayment Plans Replace Existing Income-Driven Options
A new repayment structure called the Repayment Assistance Program (RAP) will replace existing income-driven repayment plans for borrowers taking out their first loans on or after July 1, 2026. Under RAP, monthly payments will range from 1% to 10% of adjusted gross income, with a minimum monthly payment of $10. Forgiveness of remaining balances occurs after 30 years of repayment. One important benefit: RAP eliminates negative amortization by subsidizing any unpaid interest after each monthly payment, meaning borrowers’ balances will not grow even if their monthly payments don’t cover the full interest charges.
For borrowers with existing loans, the law sunsets current income-driven repayment plans, including Income-Contingent Repayment (ICR), Pay As You Earn (PAYE), and the SAVE plan, by July 1, 2028. The SAVE plan itself was separately vacated by the Eighth Circuit Court of Appeals on March 10, 2026, after extended litigation. The AAMC’s Class of 2026 fact card now references RAP as a repayment option alongside Income-Based Repayment (IBR), with estimated monthly payments of $335 under RAP compared to $363 under IBR based on a standard resident stipend.
Public Service Loan Forgiveness: Still Available, but Watch the Details
The Public Service Loan Forgiveness (PSLF) program still exists. Congress did not repeal it. The core structure remains: 120 qualifying monthly payments (approximately 10 years) while working for a nonprofit or government employer, after which remaining federal loan balances are forgiven. However, on October 31, 2025, the U.S. Department of Education published a final rule revising the PSLF program. The rule, set to take effect July 1, 2026, allows the Secretary of Education to disqualify employers from PSLF participation based on a “substantial illegal purpose.” Multiple lawsuits have already been filed challenging this rule. It’s worth noting that the American Academy of Family Physicians (AAFP) successfully pressed Congress to remove a provision from the reconciliation bill that would have excluded medical and dental residents from PSLF participation, so residency years currently still count toward the required 120 monthly payments.
Other loan repayment and forgiveness programs continue to be available:
- Public Service Loan Forgiveness (PSLF): Still requires 120 qualifying payments (approximately 10 years) while working in a nonprofit or government setting. This includes most academic hospitals and community health centers. The October 2025 final rule introduces new employer disqualification criteria that may affect future eligibility; litigation is ongoing.
- State-specific programs: Many states offer partial or full loan repayment in exchange for working in underserved areas for two to four years.
- Indian Health Service (IHS): Offers up to $50,000 in loan repayment ($25,000 per year) for physicians working with Native American or Alaska Native communities. This amount was increased from the previous $40,000 cap starting in FY2023.
- National Health Service Corps (NHSC): Provides up to $75,000 for full-time primary care providers in a two-year initial service term. A Spanish-language proficiency enhancement can increase this to $80,000 for 2026. The NHSC Rural Community Loan Repayment Program offers up to $100,000 for a three-year commitment to substance use disorder treatment in rural areas. The Students to Service program provides up to $120,000 for a three-year commitment.
- Military service: Each branch offers repayment programs for active duty and recently separated personnel.
Students who are still early in their pre-med preparation, especially those preparing for medical school while still in high school, should factor these changes into their long-term financial planning. The elimination of Grad PLUS loans means that scholarship applications, early savings, and careful school selection will matter more than ever.
How Physician Satisfaction Is Changing
One of the most encouraging findings from the Medscape 2026 compensation report is a modest improvement in physician satisfaction with pay. When asked whether they were satisfied with their compensation, 53% of physicians said they feel fairly compensated, up from just 48% the prior year. While that’s a meaningful improvement, it still means nearly half of all physicians feel they are not paid fairly for their work. And 61% of physicians believe that the medical profession generally in the United States is underpaid, the same figure as last year.
The improvement in individual satisfaction coincides with the approximately 3% compensation increase and is likely also influenced by the first meaningful Medicare physician fee schedule increase in years. Still, broader workforce strain indicators remain concerning. In Doximity polls from mid-2025, 85% of physicians reported feeling overworked. More than two-thirds said they were looking for an employment change or considering early retirement. And 77% reported they would be willing to accept, or have already accepted, lower compensation in exchange for greater autonomy or better work-life balance.
Nearly 40% of physicians are now engaging in outside paid work to supplement their income or diversify their professional activities. The average physician still works approximately 50 hours per week, a figure that has remained largely unchanged for seven years. Meanwhile, a 2025 study found that 45% of physicians reported at least one symptom of burnout.
These numbers matter for anyone considering a medical career. Compensation is important, but so is understanding the full picture of what daily practice looks like. For students comparing different healthcare career paths, it’s worth considering how roles like physician assistants or nurse practitioners balance compensation, autonomy, and lifestyle differently than physicians do. Understanding the scope and training differences between PAs and doctors can also help you think through which path best matches your priorities.
Will Your Income Rise Over Time?
Yes, but how much depends on your field. Most physicians see significant salary increases after five to ten years in practice. Surgeons and other specialists tend to peak in their late 40s to early 50s. Primary care providers also see gradual increases, but the curve is typically less steep. Physicians who consistently take on leadership roles, teach, or pursue certifications like board subspecialty credentials also see larger gains over time.
It’s worth noting that the path to a physician’s peak earning years is long. Between four years of medical school, three to seven years of residency (and potentially additional fellowship training), most physicians don’t begin earning a full attending salary until their early to mid-30s. When you factor in debt repayment during those early career years, the effective take-home pay is considerably lower than the headline salary figures suggest.
There is also an important context that gets lost when looking at single-year compensation numbers. While the 3% annual increase reported in the Medscape 2026 survey is stable, it barely keeps pace with general inflation and falls well short of offsetting the rising costs of medical education, malpractice insurance, and practice overhead. The physicians earning $386,000 in 2025 have more purchasing power than they did a decade ago in nominal terms, but the net gain is smaller than it appears once you account for rising costs on both the education and practice sides.
Financial Realities Beyond the Salary Number
Even with high salaries, physicians often face high expenses. Between loan repayments, licensing fees, malpractice insurance, continuing education requirements, and relocation costs, it can take years before your income feels truly “disposable.” Licensing requirements vary significantly from state to state and can delay your ability to practice after moving.
With the elimination of Grad PLUS loans for future borrowers and the shift to the new RAP repayment structure, physicians entering practice in the late 2020s and beyond will be working within a very different financial framework than their predecessors. Those who borrow through private lenders to fill the gap left by Grad PLUS will face different repayment terms, potentially higher interest rates (federal graduate loan rates are already at 7.94% for the current disbursement year), and may not qualify for federal forgiveness programs. The new $257,500 overall lifetime cap on federal borrowing means that students who also carry undergraduate debt will have even less room to borrow at the graduate level.
Practical financial strategies remain essential:
- Keep living expenses low for your first few years post-residency
- Pay off as much student debt as possible early on, especially private loans that don’t qualify for forgiveness
- Avoid luxury purchases until your financial base is solid
- Understand whether PSLF, NHSC, or state-level repayment programs fit your career plan before making employment decisions
- If you’re considering private practice, build a realistic financial model that accounts for the improved but still historically low Medicare reimbursement rates and rising operational costs
- If you plan to borrow for medical school starting in the 2026-2027 academic year, map out how you will cover costs beyond the $50,000 annual federal loan limit before committing to a specific school
For students still in the pre-med phase, understanding these realities early can shape better decisions about which schools to apply to, how much debt to take on, and which specialties to consider. Understanding the distinction between MD and DO pathways can also factor into your cost calculations, as osteopathic programs sometimes offer different tuition structures.
What the Future Holds for Physician Income
The U.S. healthcare system continues to evolve in 2026, with more emphasis on value-based care, preventive medicine, and integrated digital platforms. While some providers are experimenting with direct primary care and concierge medicine, others are seeing expanded roles for telemedicine. The shift toward value-based reimbursement is slowly changing which types of work generate the most revenue, though procedural specialties still command premium compensation.
The expansion of the $500,000-plus club from four specialties to eight in a single year is a significant development. It suggests that market forces, including clinician shortages, hospital competition for specialists, and growing procedure volumes, are driving up pay for the most in-demand fields faster than the overall average would suggest. Cardiology’s 10% single-year increase, radiology’s 9% gain, and anesthesiology’s 8% gain all outpaced the 3% average considerably. Students choosing a specialty should understand that these high-growth fields also tend to require the longest training pipelines and carry the highest opportunity costs in terms of years spent in residency and fellowship before reaching full attending compensation.
The Bureau of Labor Statistics projects approximately 23,600 annual openings for physicians and surgeons over the next decade, with 3% overall employment growth. Demand is particularly strong in mental health, geriatrics, and rural family medicine. High-tech specialties, including interventional radiology and cardiac electrophysiology, are also growing.
However, the combination of steady but modest salary growth (approximately 3% annually), rising practice costs, declining private practice ownership, increasing corporate and private equity consolidation, and fundamental changes to federal student loan programs means that the financial calculus of becoming a physician is more complex than it was even five years ago. The slight improvement in physician satisfaction (from 48% to 53% feeling fairly compensated) is a positive signal, but the fact that more than two-thirds of doctors continue to consider employment changes or early retirement suggests that the profession remains under real strain.
For pre-med students, this doesn’t mean medicine is a bad financial choice. It means that going in with clear expectations, a realistic financial plan, and genuine motivation matters more than ever.
Putting It All Together
Becoming a physician is still a financially viable and personally rewarding choice. But compensation depends on many moving parts: your specialty, your work setting, your geographic location, your gender and race, and now, when you borrow your student loans and under what terms. The good news is that with the right planning, transparency, and advocacy, you can build a career that’s both sustainable and meaningful.
The 2026 compensation picture has some bright spots. Average pay is up. Eight specialties now exceed $500,000. The Medicare physician fee schedule includes the first notable conversion factor increase in years. Primary care salary growth has kept pace with specialist growth for the first time in recent memory, and over a five-year period, primary care compensation growth has actually led all specialties. Physician satisfaction with pay, while still low by most standards, improved meaningfully.
At the same time, the challenges are real. The gender pay gap is now 31% in the Medscape data. The racial pay gap between White and Black physicians stands at $49,000. Graduate PLUS loans are being eliminated for new borrowers. Federal interest rates on graduate student loans exceed 7.9%. Private practice ownership continues to decline. And nearly half of all physicians still feel they are not compensated fairly.
If you’re early in your preparation, focus on what you can control. Build strong clinical exposure through structured experiences like pre-med internships, invest in the academic credentials that keep your options open, and start thinking about your financial strategy now rather than after you’ve already committed to a specific school or debt level. Students considering how physician assistant salaries compare with physician compensation should weigh not only the salary difference but also the years of training, the debt load, and the lifestyle implications of each path.
To learn more about some of the highest-paying paths in medicine, see our guide to becoming a neurosurgeon or orthopedic surgeon.
