Overview
US residents are employed by their hospital or health system. Pay is set by the programme and varies by specialty, region and year of training. Student loan debt is a major financial consideration for most US medical graduates.
Resident Physician Salaries
$58k
Average PGY-1 salary
$75k
Average PGY-5+ salary
~$1k
Increase per PGY year
Resident salaries in the US are set by each programme. The national average PGY-1 salary is approximately $58,000–62,000. This increases modestly with each year of training. High-cost-of-living cities (NYC, San Francisco, Boston) may pay more but living costs significantly offset this.
Salary by Specialty (approximate PGY-1)
| Specialty | Average PGY-1 | Notes |
|---|---|---|
| Internal Medicine | $58,000–$65,000 | Varies significantly by region |
| General Surgery | $58,000–$68,000 | Some programmes offer more |
| Radiology | $60,000–$72,000 | After PGY-1 preliminary year |
| Family Medicine | $55,000–$65,000 | Community programmes may vary |
| Emergency Medicine | $60,000–$75,000 | Some community EDs pay more |
Moonlighting
Moonlighting refers to clinical work outside of residency training. Rules vary by programme:
- Internal moonlighting: Within your own programme/hospital — programme director permission required
- External moonlighting: At a different facility — requires full state medical licence (unrestricted) in most states
- Rates: typically $100–200/hour depending on specialty and location
- Income is taxable; consider quarterly estimated tax payments
- Ensure malpractice coverage — confirm your hospital or personal policy extends to moonlighting
Student Loan Repayment
The average US medical school debt is over $200,000. Key strategies during residency:
- Income-Driven Repayment (IDR): SAVE, IBR, PAYE, or ICR plans — payments based on income; important for PSLF
- Public Service Loan Forgiveness (PSLF): After 10 years of qualifying payments at a non-profit employer (most residency programmes qualify) — remaining balance forgiven
- During residency: Enrol in an IDR plan immediately; certify PSLF eligibility annually
- Private refinancing: Consider only if not pursuing PSLF; eliminates federal protections
Retirement Accounts
- 403(b) / 401(k): Contribute at least enough to capture any employer match
- Roth IRA: Consider contributing during residency when income and tax rate are lower (<$7,000/year limit for 2024)
- Resident income bracket: 22% federal rate typical — Roth is often better than Traditional during training
Financial Planning Tips
- Build a 3-month emergency fund before aggressively investing
- Disability insurance is essential — purchase own-occupation disability insurance early (cheaper when young)
- Term life insurance if you have dependants
- The White Coat Investor (whitecoatinvestor.com) — excellent physician-specific financial resource