If you are in medical school or starting residency, you have probably heard conflicting information about what residents actually earn. Some sources say $60,000. Others say $80,000. The truth depends on your year, specialty, and location. Here is the breakdown.
Resident Salary by Year
Most residency programs follow a standard pay scale that increases slightly each year. Here is what you can expect in 2026:
| Year | Typical Salary Range | Notes |
|---|---|---|
| PGY-1 | $64,000 - $74,000 | Starting salary, varies by program |
| PGY-2 | $66,000 - $76,000 | Typical 3-5% increase |
| PGY-3 | $68,000 - $79,000 | Final year of many categorical programs |
| PGY-4+ | $70,000 - $85,000 | Chief residents earn more |
| Fellowship | $74,000 - $95,000 | Depends on specialty and year of fellowship |
What Affects Your Resident Salary
Several factors determine where you fall within these ranges:
Geographic Location
Cost of living adjustments add significantly to your base salary. Programs in high-cost cities like New York, San Francisco, Los Angeles, and Boston typically offer $5,000-$15,000 more than the national average. Some programs call this a "geographic adjustment" or "cost of living supplement."
Employer Type
Academic medical centers often pay slightly less than community programs or hospital-employed positions. However, academic centers may offer better benefits, loan forgiveness programs, or access to research opportunities. Military residencies provide a salary plus housing and other allowances.
Specialty
Most specialties follow the same pay scale within a program, but some surgical subspecialties offer small differentials. Fellowships generally pay more than residency, with competitive fields like interventional radiology or transplant hepatology at the higher end.
What Is Actually in Your Paycheck
Your gross salary is only part of the picture. Here is what to expect:
Typical Deductions
- Taxes: Federal, state, and FICA take roughly 25-30%
- Health insurance: $100-$300/month for family coverage
- Retirement: Some programs offer 403(b) matching
- Disability insurance: Often mandatory, $50-$100/month
Typical Take-Home
After deductions, most PGY-1 residents take home approximately $3,500-$4,500 per month. This varies significantly by location and tax situation.
Additional Compensation
Beyond your base salary, you may receive:
Moonlighting
Internal moonlighting (working extra shifts at your own institution) is allowed in most programs and typically pays $80-$150 per hour depending on the work. External moonlining requires program approval and typically is limited to PGY-3 and above.
Meal Stipends
Many programs provide $50-$150 per month for meals while on call. Some give a set number of meal tickets rather than cash.
Educational Allowances
Some programs provide $500-$2,000 annually for conferences, books, or board review courses. This may be a separate check or loaded onto a debit card.
Chief Resident Stipend
If you become chief resident, expect an additional $5,000-$15,000 per year on top of your base salary.
The Hidden Costs of Residency
Your salary does not reflect the full financial picture during training:
- Delayed earnings: You lose 3-7 years of attending salary, which could be $500,000-$1,500,000 in lost income
- Student loans: Interest accrues during residency, adding $50,000-$100,000 to total debt for many physicians
- Board exams: USMLE Step 2 and 3, plus specialty boards cost $3,000-$10,000 total
- Interview costs: Traveling to 10-20 interviews costs $5,000-$15,000
- Moving expenses: Relocating for residency or fellowship costs $3,000-$8,000
Fellowship Salary
If you pursue fellowship after residency, your salary increases but varies more widely:
| Fellowship Type | Typical Salary Range |
|---|---|
| Internal Medicine Subspecialties | $74,000 - $85,000 |
| Surgical Subspecialties | $78,000 - $95,000 |
| Competitive Fields (Interventional, etc.) | $85,000 - $110,000 |
The Bottom Line
As a resident in 2026, you will earn approximately $64,000-$85,000 per year depending on your year, specialty, and location. This is enough to live on, but it will not make a significant dent in the $200,000-$400,000 in student loans most physicians carry.
The real money comes after training. An attending physician earns 3-5 times what a resident earns, which is why understanding your future compensation potential matters. Knowing what you will earn helps you plan for loan repayment, choose practice settings strategically, and negotiate your first contract from a position of knowledge.
Track your RVUs from day one of attendinghood. Understanding your productivity and compensation structure is the single best way to maximize your earning potential.
Ready to maximize your physician income?
Start tracking your RVUs from your first day as an attending. Know exactly what you are earning and what you are worth.
Try RVU Tracker FreeNeed to look up RVU values for procedures? Use our free RVU Calculator.
Questions about resident salary or compensation? Email us at support@rvutrackerapp.com.