How Much Do Doctors Make a Year? Salary Calculator
Estimate a physician's annual pay and hourly equivalent by specialty, experience, region, and employment model. The defaults are common 2026 benchmarks, but every input is fully adjustable.
Physician pay in 2026 spans an enormous range. A pediatrician in academic medicine may earn around $230,000, while an orthopedic surgeon in private practice can clear $700,000. The biggest single driver is specialty: procedural fields (orthopedics, cardiology, dermatology, plastic surgery) typically pay 1.7x to 2.3x what primary care pays. Location matters next — rural and high-demand markets often add 8–12% to base, while major coastal cities can pay 3–5% below the national average because supply is dense. This calculator combines those factors so you can model realistic scenarios instead of relying on a single headline average.
Experience and employment model finish the picture. A first-year attending generally earns 70–80% of the mid-career number; by year 15, partners in private practice can exceed the specialty median by 15–25%. Employment type matters too: academic medicine usually pays 10–20% less than hospital-employed roles, while locum tenens can add 15–25% but without benefits. The example numbers shown (such as a $300,000 baseline) are defaults only — you can plug in any specialty, region, or experience level to get a personalized 2026 estimate, including monthly and hourly equivalents based on a typical 2,400-hour clinical year.
How it works: Pick a specialty, enter years of experience, choose region, and select employment type. The tool multiplies a specialty base by experience, location, and employment factors to estimate annual pay and an hourly equivalent.
Estimates are educational. Real offers depend on RVU productivity, call burden, bonus structures, and local market dynamics not captured here.
Physician Pay in 2026: What Drives the Number
Doctor compensation in 2026 reflects four big levers — specialty, experience, geography, and employment model. Understanding each helps you negotiate, plan a career path, or compare offers realistically.
2026 estimated mid-career annual salary by specialty
| Specialty | Base estimate | Typical range | Hours/week |
|---|---|---|---|
| Pediatrics | $250,000 | $210k – $300k | 40–50 |
| Family Medicine | $265,000 | $225k – $315k | 40–50 |
| Internal Medicine | $275,000 | $235k – $330k | 45–55 |
| Psychiatry | $310,000 | $260k – $380k | 35–45 |
| OB/GYN | $340,000 | $285k – $430k | 50–60 |
| Emergency Medicine | $380,000 | $320k – $450k | 36–48 |
| General Surgery | $450,000 | $380k – $560k | 55–65 |
| Anesthesiology | $460,000 | $395k – $560k | 50–60 |
| Dermatology | $470,000 | $390k – $620k | 36–44 |
| Cardiology (invasive) | $510,000 | $430k – $680k | 55–65 |
| Plastic Surgery | $575,000 | $450k – $850k | 50–60 |
| Orthopedic Surgery | $580,000 | $470k – $760k | 55–65 |
Pay adjustments by region and employment model
| Factor | Adjustment | Why it moves pay | Example |
|---|---|---|---|
| Rural / underserved | +10% to +15% | Loan repayment, sign-on, retention bonuses | Family med $300k vs $265k |
| Major urban (NYC/LA/SF) | -3% to -6% | High physician density; lifestyle premium | IM $260k vs $275k base |
| Private practice partner | +15% to +25% | Ancillary income and ownership distributions | GI $650k vs $510k employed |
| Academic medicine | -12% to -20% | Protected research time, prestige tradeoff | Cards $410k vs $510k |
| Locum tenens | +18% to +28% | No benefits; covers gaps and travel | EM $260/hr equivalent |
| Government / VA | -15% to -20% | Pension, schedule stability, federal scale | Psych $250k vs $310k |
Specialty is the single biggest factor
The gap between the lowest- and highest-paid specialties in 2026 is more than 2.3x. Procedural fields (orthopedics, cardiology, dermatology, plastic surgery, gastroenterology) bill more per unit of time because of RVU-heavy procedures and ancillary revenue. Cognitive specialties (pediatrics, family medicine, psychiatry, endocrinology) generate lower RVUs and depend more on volume. A useful rule of thumb: if a specialty includes a high share of OR or cath-lab procedures, expect compensation 1.7–2.3x family medicine. Sub-specialization typically adds 15–35%, with interventional cardiology and spine surgery at the high end.
Experience curve: residents to senior partners
First-year attendings typically earn 70–80% of the mid-career median because they are still building patient panels, procedure volumes, or partnership equity. By years 6–10 they reach the median, and senior physicians in years 15–25 often earn 110–120% of the median. Partner-track private practice doctors can see a step-function jump at year 2–3 when they buy in and start receiving distributions — often a $100,000+ annual increase overnight. Rule of thumb: budget for 75% of your specialty median in year one, with 8–12% raises annually for the first five years.
Geography pays — but not where you'd think
Counter to most other professions, doctors often earn more in rural and small-town markets, not major cities. Hospitals in underserved areas use sign-on bonuses ($30k–$100k), loan repayment ($25k–$50k/yr), and elevated base pay (10–15% premium) to attract physicians. By contrast, Boston, San Francisco, and Manhattan pay roughly 3–6% below national medians because supply is saturated and brand-name systems attract candidates anyway. A common guideline: every step down in population density adds 2–4% to base pay, with the biggest jumps in towns under 50,000 residents.
Employment model and total compensation
Hospital-employed physicians (about 75% of U.S. doctors in 2026) get steady salary plus RVU bonuses, full benefits, and malpractice coverage. Private practice owners earn more per year but absorb overhead (40–60% of collections), staffing risk, and a buy-in cost of $100k–$500k. Academic medicine pays 12–20% less but offers protected time, tenure, and prestige. Locum tenens jobs pay top hourly rates ($180–$400/hr depending on specialty) but exclude health insurance, retirement match, malpractice tail, and PTO — usually worth 20–28% of base.
Hours, call burden, and the real hourly rate
Headline salaries hide enormous schedule differences. An orthopedic surgeon making $580,000 working 60 hours/week earns about $193/hr; a dermatologist at $470,000 working 38 hours/week earns about $238/hr. Emergency physicians work fewer total hours (around 1,500–1,800 clinically) but with intense night and weekend coverage. A practical rule: divide annual pay by (hours/week × working weeks) to get a true hourly equivalent. Most physicians work 46–50 weeks per year after vacation, CME, and parental or sick leave.
Benefits, bonuses, and the W-2 vs 1099 question
Total compensation usually adds 18–25% on top of base salary for employed physicians: health insurance ($15k–$25k), retirement match ($15k–$45k including 401(k)/403(b) plus cash balance plans), malpractice ($8k–$30k), CME stipend ($3k–$5k), and PTO. A locum 1099 contract paying $250/hr looks great until you subtract self-employed taxes, health insurance, retirement, and downtime — the effective equivalent W-2 rate is roughly $190–$200/hr. Sign-on bonuses ($25k–$100k) and retention bonuses are common but usually have 2–4 year clawback clauses.
Taxes, student loans, and take-home reality
A $350,000 attending salary lands in roughly the 32–37% federal bracket, with state tax adding 0–13%. Effective total tax (federal + state + payroll) typically falls between 30% and 42% for physicians, leaving $200k–$245k in take-home on $350k gross. Student loans further compress early-career income: an average $230k debt at 7% costs about $2,650/month on a 10-year plan. PSLF, REPAYE, or refinancing can change that significantly. Rule of thumb: in your first five attending years, plan to live on 50–60% of gross.
How to use these estimates when negotiating
Bring three numbers to any contract conversation: the specialty median (MGMA or Doximity), the regional adjustment, and the employment-model multiplier. If your offer falls below specialty median × regional factor × 0.95, you have negotiating room. Common levers beyond base salary: sign-on bonus, relocation, CME budget, PTO weeks, RVU thresholds and per-RVU rate above target, call pay ($800–$1,500/24h), and student loan repayment. A useful guideline: ask for 5% above the offer in base, plus one structural concession — many employers will trade $10k of base for an extra PTO week or higher RVU rate.
How This Calculator Works: Methodology & Parameter Explanations
Core formula: annual_salary = specialty_base × experience_multiplier × location_multiplier × employment_multiplier; hourly_equivalent = annual_salary ÷ (clinical_hours_per_week × working_weeks_per_year)
Parameter explanations
| Input | What it means | Impact on results |
|---|---|---|
| Specialty | The clinical field the physician practices, which sets the mid-career base salary benchmark used in 2026 modeling. | Largest single driver. Switching from family medicine to orthopedic surgery roughly 2.2x the base; even within surgery, sub-specialty shifts of 15–30% are common. |
| Years as an attending | Years of independent practice after residency or fellowship. Drives an experience multiplier from 0.75 (year 0) to 1.18 (20+ years). | Moves annual pay by roughly +3–8% per year early on, plateauing after year 10. A year-1 attending earns about 75% of mid-career; year-20 earns about 118%. |
| Region / market type | Geographic and market category, ranging from major urban (lower) to rural/underserved (higher), reflecting supply-demand for physicians. | Adjusts pay between -6% and +12%. Rural premiums and sign-on incentives push the largest gains; saturated coastal metros reduce base. |
| Employment type | How the physician is paid: hospital-employed, private practice, academic, government, locum, or telehealth. | Swings pay -18% to +22%. Private practice partners and locums see the biggest gains; academic and government roles trade pay for stability, mission, or research time. |
| Clinical hours per week & weeks per year | Total clinical workload, used to convert annual pay to an hourly equivalent. | Does not change annual pay, but a 60-hour week vs 40-hour week roughly cuts the hourly equivalent by one-third for the same salary. |
Assumptions
Specialty base salaries reflect 2026 mid-career (years 5–10) U.S. medians blended from public MGMA/Doximity/AMGA reporting.
The $300,000 or any specific salary figure shown in the calculator defaults is only an example; the math accepts any specialty, region, and experience combination.
Experience multiplier is tiered (0.75/0.88/1.00/1.12/1.18) rather than continuous to mirror how compensation steps with seniority.
Estimates are pre-tax gross W-2 equivalent; locum/1099 figures do not subtract self-employment taxes or benefit gaps.
Hourly equivalent uses user-entered clinical hours × weeks, so call hours not counted as clinical time will inflate effective hourly rate.
Likely range is computed as 85–118% of the midpoint to reflect normal variance in offers and bonus realization.
Parameter meanings
| Input | What it means | Impact on results |
|---|---|---|
| Specialty | Clinical field setting the mid-career base ($250k–$580k in 2026) | Largest factor; 2.0–2.3x spread between lowest and highest |
| Years as attending | Independent practice years after training | Multiplier 0.75 → 1.18; biggest gains in years 1–10 |
| Region / market | Urban vs rural vs regional market | -6% to +12% adjustment to base salary |
| Employment type | Hospital, private, academic, government, locum, telehealth | -18% to +22% adjustment; locum has highest gross but no benefits |
| Clinical hours/week | Patient-care hours per week | Adjusts hourly equivalent inversely; no effect on annual |
| Working weeks/year | Weeks worked after PTO/CME | Adjusts hourly and weekly equivalents; no effect on annual |