Embarking on a career as a doctor is a marathon of education and training, marked by hefty tuition fees and, for many, substantial student loan debt accumulated during medical school. Upon graduation, aspiring physicians enter residency – the crucial period of practical training. A significant shift occurs at this stage: residents begin to receive a salary. For the first time, they are compensated for their work as doctors. However, questions often arise about the amount of this compensation and whether it adequately addresses the financial burdens they carry.
This guide aims to clarify resident doctor pay, explore the demanding work hours residents face, and consider whether residents themselves perceive their compensation as fair.
Do You Get Paid During Residency?
The answer is yes, doctors in residency in the United States do receive a salary. It’s a common misconception that residency is an unpaid extension of medical school. However, while residents are paid, it’s important to understand that the compensation is often modest relative to the extensive hours they dedicate to their training and patient care.
While resident salaries tend to be within a similar range, some variation exists across different medical specialties. This is often linked to the typical workload and hours associated with each specialty.
What is the Average Resident Salary in the US?
According to the 2023 Medscape Resident Salary & Debt Report, the average resident salary in the United States has reached $67,400 annually. This figure represents a 5% increase from the previous year’s average of $64,200 in 2022.
Generally, residents can expect to earn in the upper $50,000s to upper $60,000s per year, with the specific amount influenced by their chosen specialty. Salaries also incrementally increase as residents progress through their training, which can span from 3 to 7 years depending on the specialization. For instance, a family medicine residency typically lasts 3 years, radiology is 5 years, and neurosurgery extends to 7 years.
Further Reading: How Long Is Residency? (By Specialty)
Breaking Down Resident Hourly Pay
Calculating a resident’s hourly wage reveals a stark reality. While residents receive an annual salary, the number of hours they work can fluctuate significantly based on their specialty, the institution, and their year of training. This variability in hours directly impacts their effective hourly pay rate.
Consider a resident earning $60,000 annually. If they work 50 hours per week, their approximate hourly rate is $23. However, if their workload increases to 70 hours per week, their hourly pay drops to around $16.50.
The situation becomes even more concerning when residents are overworked, a sadly frequent occurrence. Working 85 hours a week translates to an hourly wage of just $13.50, which is less than the minimum wage in numerous states across the US, according to the Department of Labor.
After years of rigorous medical education and accumulating substantial medical school debt, it can be disheartening for residents to find themselves working 80+ hour weeks for what amounts to minimum wage or less.
While the Accreditation Council for Graduate Medical Education (ACGME) implemented an 80-hour weekly limit on resident work hours in 2003, instances of non-compliance are still reported.
The reasons for this are complex, but it’s understandable that after the demanding journey of medical school and the associated financial burden, residents may be hesitant to complain or risk their position, even when faced with excessive work hours.
Dr. Jubbal delves into this issue on his YouTube channel, highlighting the harsh realities of residency in the US. His video addresses the concern of residents being utilized as inexpensive labor, sometimes earning below minimum wage when factoring in work weeks exceeding 80 hours.
Salary Growth During Residency: Expectations vs. Reality
Resident salaries do increase as they progress through their training, but the growth is modest when compared to the substantial earnings of fully licensed physicians.
Average salary by year of residency chart
Image showing a bar chart illustrating the average resident salary increase by year of residency training, sourced from the Medscape 2023 Resident Salary & Debt Report.
Residents in the longest training programs, lasting 6-8 years, can anticipate earning approximately 21% more by the end of their residency compared to their starting salary. This can bring their annual income to around $75,000 in the later years of residency. However, when compared to other healthcare providers like Nurse Practitioners (NPs) or Physician Assistants (PAs), residents often earn only about half as much, despite providing comparable levels of patient care.
While a salary of $75,000 is certainly a livable wage, it’s crucial to remember the significant financial context for physicians. By the time they begin residency, they typically carry hundreds of thousands of dollars in student loan debt, which is already accruing interest. This is in addition to the highly skilled labor they provide and the considerable responsibilities and risks they undertake.
The Financial Strain of Medical Training: A Closer Look at the Numbers
To truly grasp the financial realities faced by residents, let’s examine the interplay of salary, debt, and living expenses.
With an average resident salary of $67,400 per year, a resident earns approximately $5,600 per month before taxes and deductions.
The average medical school debt is around $250,000. Using a conservative 7% interest rate on these loans, the monthly interest accrual alone amounts to nearly $1,500.
Income-driven repayment plans (IDR) can offer some relief by allowing residents to make lower minimum payments, potentially as low as $300 per month. However, it’s critical to understand that paying only the minimum means that the loan balance continues to grow each month due to the unpaid accrued interest.
To illustrate the slow progress against this debt, even if a resident were able to dedicate $2,000 per month towards their medical school loans for a year, they would only reduce their principal debt by approximately $6,000. After a year of consistent payments at this level, a $250,000 debt would only decrease to $244,000.
It’s highly probable that residents will not make significant headway in paying down their medical school debt during residency and may even find themselves with a larger debt burden due to accumulated interest by the time they complete their training.
To understand the monthly financial picture further, let’s consider a hypothetical budget:
Assuming zero state income tax, federal income taxes on a $67,400 salary would be roughly $12,000 per year, or $1,000 per month, reducing the monthly take-home pay to $4,600.
A low minimum loan payment of $500 further reduces this to $4,100.
The average rent across the US is around $1,400 per month, leaving $2,700. A modest grocery budget for one person is approximately $300, bringing the remaining amount to $2,400.
Car ownership costs vary, but conservatively estimating $500 per month for transportation leaves just $1,900.
This remaining $1,900 must cover a wide range of essential and expected expenses, including dining out, utilities, phone bills, fitness, medical costs, travel, social activities, gifts, coffee, prescriptions, clothing (including scrubs), unexpected emergencies, disability insurance (crucial for residents), retirement contributions, and educational resources for board exams – and this is not an exhaustive list.
The financial reality for a resident earning around $70,000 is far from luxurious. The compensation does not fully reflect the value residents provide to the healthcare system compared to other medical professionals, and it certainly doesn’t align with the demanding hours they are expected to work. While residents are not facing starvation, the constant financial strain of managing living expenses while watching student loan debt increase can be incredibly stressful, especially while working upwards of 80 hours a week in a high-pressure hospital environment.
Resident Sentiment on Compensation Fairness
The 2023 Medscape Resident Salary & Debt Report reveals that only 20% of residents feel they are fairly compensated for their work during residency.
Average salary by year of residency chart
Image depicting a bar chart showing the percentage of residents who feel fairly compensated, broken down by year of residency training, based on data from the Medscape 2023 Resident Salary & Debt Report.
This average satisfaction rate varies throughout residency. In the first year of residency, 21% of residents reported satisfaction with their salary, while by the eighth year, this figure increased slightly to 29%.
Residents who expressed dissatisfaction with their compensation frequently cited that it did not adequately reflect the extensive hours they worked and was not comparable to the salaries of other medical staff with less training and responsibility.
Implications for Future Doctors
While fully licensed physicians in the US achieve a substantial and stable income in the low to mid six-figure range, the path to reach this point is lengthy and demanding. Furthermore, specialties with higher earning potential often require longer residency periods.
For individuals considering medicine primarily for financial reasons, it’s essential to recognize that while the earning potential is significant, it requires a substantial investment of time and carries a considerable opportunity cost. Becoming a practicing physician involves nearly a decade of education and training, incurring hundreds of thousands of dollars in expenses. Furthermore, achieving a six-figure salary typically occurs after residency, which is 7-12 years later than individuals who choose alternative career paths like engineering, coding, finance, or entrepreneurship, who can reach similar or higher income levels much sooner.
For those seeking more information about physician salaries or strategies for managing medical school debt, resources are available: Why Are So Many Doctors Broke? Is It Worth the Debt? and How Much Do Doctors Make? (Specialty Breakdown).
Med School Insiders offers guidance for aspiring residents seeking to create compelling residency applications. A range of Residency Admissions Consulting Services are available, including ERAS application editing, residency personal statement editing, one-on-one advising, and interview preparation. Regardless of your chosen specialty, these services aim to help you effectively present your qualifications and attract the attention of your preferred residency programs.
