Highest and Lowest Paying Specialties

The Highest & Lowest Paying Specialties to Match Into

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Med students consider a lot of different factors when deciding which specialty they want to pursue. One of the factors that they may consider is compensation. Of course, most people go into medicine for reasons beyond just money. In fact, when you consider the extreme effort and long hours involved in becoming a doctor, choosing medicine purely for the money wouldn’t really make sense. At the same time, med students may want to ensure that they get a good return on all of the time and energy that they spent on becoming a doctor – and they do have to pay back some rather considerable student loans.

So what are the highest-paying medical specialties – and what are the lowest-paying ones? How much can you really expect to make as a doctor, anyway?

What are the top 10 highest-paying medical specialties?

In order to figure out how much doctors in different specialties earn, we first need to get some data. The physician networking company Doximity has a huge database, with over 70% of physicians belonging to their network. They do a comprehensive survey on physician compensation and publish the results each year. This gives us an excellent data set to draw from when determining what type of compensation various specialties can achieve.

According to the 2021 Doximity report on physician compensation, these are the top 5 highest-paying medical specialties:

  • Neurosurgery ($773,201)
  • Thoracic Surgery ($684,663)
  • Orthopedic Surgery ($663,620)
  • Plastic Surgery ($556,698)
  • Vascular Surgery ($552,313)

So far, we can see that the top 5 are all surgical subspecialties. However, if we look at the next 5 in order to round out the top 10, we get a slightly more complete picture:

  • Oral & Maxillofacial Surgery ($545,471)
  • Radiation Oncology ($544,313)
  • Cardiology ($537,777)
  • Urology ($514,922)
  • Gastroenterology ($500,400)

Now we’re starting to see some medical specialties showing up on the list. However, notice that these specialties are quite procedure-heavy – although they may not be surgeons, doctors in these specialties generally perform quite a few procedures. For example, gastroenterologists do endoscopies and colonoscopies, while cardiologists do angioplasties and catheterizations.

In general, the medical compensation system favors procedures over clinic visits – in other words, it favors doing things over thinking about things. You can easily see that reflected in the compensation patterns across different specialties. The more things you do as a doctor (meaning surgeries or procedures), the more money you’ll end up taking home. All 10 of the highest-paid specialties are very heavy on doing things.

Rounding out the top 20 are:

  • Otolaryngology (ENT) ($497,157)
  • Radiology ($495,451)
  • Dermatology ($476,263)
  • Anesthesiology ($457,867)
  • Ophthalmology ($454,997)
  • General Surgery ($451,151)
  • Oncology ($447,112)
  • Colon & Rectal Surgery ($445,730)
  • Nuclear Medicine ($398,544)
  • Pulmonology ($385,602)

What are the 10 lowest-paying medical specialties?

To gain a complete understanding, let’s take a look at the lowest-paying specialties as well. Here are the 10 lowest-paying specialties, according to the 2021 Doximity Compensation Survey:

  • Pediatric Infectious Diseases ($210,844)
  • Pediatric Rheumatology ($216,969)
  • Pediatric Endocrinology ($220,358)
  • Pediatric Hematology & Oncology ($238,783)
  • Pediatric Nephrology ($247,861)
  • Pediatrics ($251,657)
  • Medical Genetics ($254,128)
  • Pediatric Pulmonology ($263,106)
  • Medicine/Pediatrics ($264,254)
  • Preventative Medicine ($264,539)

Here we see that the lowest-paying specialties are all medical rather than surgical. Furthermore, pediatric subspecialists seem to be among the very lowest-paid doctors. If you continue on up the list to round out the bottom 20, you’ll find that it includes the adult equivalents of the same medical subspecialties, along with primary care doctors of all kinds.

  • Geriatrics ($268,861)
  • Endocrinology ($270,116)
  • Family Medicine ($273,865)
  • Child Neurology ($276,420)
  • Pediatric Emergency Medicine ($280,373)
  • Infectious Disease ($294,768)
  • Internal Medicine ($295,607)
  • Pediatric Gastroenterology ($295,751)
  • Rheumatology ($303,511)
  • Occupational Medicine ($310,934)

You probably noticed this in the numbers yourself, but we wanted to call attention to it anyway. Doctors in the very lowest-paid medical specialty still took home over $200k a year. As a doctor, no matter what specialty you choose, you’re not likely to find yourself struggling to make ends meet. Yes, there are significant discrepancies in pay between doctors in different specialties. But in general, all doctors are doing pretty well financially. One reason that physicians choose lower pay is to maintain a good work-life balance.

Read: The Top 5 Specialties for Work-Life Balance

Many factors influence physician income

It’s very important to note that a physician’s specialty is only one of the factors that determine their income. Factors like geographical area, the type of practice they’re part of (a private group or solo practice, hospital, HMO, academic center, etc.), how many hours they choose to work, and more can all have a significant influence on how much a doctor makes. So if having a high income is important to you, then choosing a high-paying specialty alone won’t be enough to ensure that you make the highest possible income. You’ll want to pay attention to these other factors as well. And even if you choose a lower-paying specialty, you could still earn more than the average if you decide to make this a priority.

In this article, we’ve only touched on a few highlights, in terms of the various factors that affect physician compensation. If you’d like to dig deeper into the report, you can find it here.

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