Become a Pediatrician, Get Rich

I love being a pediatrician. Our patients are cute and hilarious; we see a huge range of physiology and development, and I wear a cool dinosaur sticker on my ID badge. You, as a non-pediatrician, could also wear a cool dinosaur sticker on your ID badge, but your patients wouldn’t respect you more for it. Mine do.

Pediatricians are generally a pretty cheerful bunch. The only time I second-guess my career choice is when I’m around a bunch of really high-earning physicians. I’m married to a urologist, so I have no right to complain. And I know first-hand the effort that goes into becoming and practicing as a highly paid specialist. I don’t begrudge you your starting salaries, your fat RVU conversion rates, or your lake houses. I do wish that pediatrics paid better (the 2026 Medscape survey said we earn an average of $266,000), because I think what we do is valuable to our patients and to society.

(I also wish our healthcare system prioritized children’s health, but this is not the place for that rant.)

I really, really wish that the low salaries in peds and primary care weren’t a barrier to entry for medical students. The order of operations should NOT be “Get rich, then you can become a pediatrician.”

So, one night when I was particularly disgruntled, I looked at the reasons pediatricians have a steep financial climb—and then the advantages we have along the way. For “pediatrician,” you could substitute “primary care” or “part-time physician.” I’m sticking with peds because I am speaking to and for my people.

Here's what makes it hard for pediatricians to get rich:

Low Salary

We are consistently among the lowest- or the lowest-paid physicians. What’s even worse is that most peds specialties pay the same or less than general peds. You do an extra three years of training, spend your days literally saving children’s lives, and get paid the same as those of us who stopped after residency. It’s not surprising that peds specialty fellowships often go unfilled.

Just to put some numbers on the problem: I am salaried at 0.8 FTE for $220,000, which equates to a full-time salary of $275,000, on par for my region (Northeast) according to MGMA. For 2025, I had a productivity bonus of $6,500, which was the max possible. Of course, there is a huge range of salaries and bonuses out there. According to the comment section on a 2024 WCI article, the range went up as high as $800,000 for partners with real estate interests. That $800,000 is an outlier, and it included partnership and real estate income—most of us will fall in the $200,000-$300,000 range.

Let’s say you make an average-ish pediatrician salary of $240,000. If you max your 403(b)/401(k)/TSP of $24,500 [2026 — visit our annual numbers page to get the most up-to-date figures], do a backdoor Roth contribution/conversion ($7,500), contribute to an HSA ($4,400 for a single earner), you’ll have saved $36,400 by the end of the year—most of it pre-tax. This gives you a savings rate of 15%, not quite the goal of 20% or more. Hopefully, you have access to other tax-advantaged retirement accounts, such as a 457(b) ($24,500) to bring you up to $60,900 and a 25.2% savings rate. If not, you will have to contribute after-tax money to get where you need to be. This leaves you $179,100 (pre-tax) to live on. It’s amazing that LA and New York City have any primary care pediatricians.

The American Urology Association dedicates an entire section of its journal to personal and practice finance. The American Academy of Pediatrics says cutesy things like, “Are pediatricians well paid? Look at this cool dinosaur sticker!” I am proud to be part of an organization that has an advocacy mission, and bewildered because we won’t advocate for ourselves. Which brings me to the second major disadvantage of pediatrics.

• Here’s How Much We Make, Save, and Spend as ‘Moderate Earners’
• The Moderate-Income Physician

The Nobility Myth

The AAP thinks that talking about money is beneath us, and many pediatricians seem to agree. If I hear one more colleague say, “We don’t do it for the money, am I right?” I will snap and open a cash-only Adderall clinic.

This learned helplessness is nonsense. We can be noble, we can spend our lives caring for the most vulnerable in society, and we can still end up wealthy. These things are not mutually exclusive. Happily, I have met many pediatricians and peds residents who are interested in setting themselves up financially. It's N of some small number, but it gives me hope.

Now that I’ve gotten that out of my system, here are some of the advantages pediatricians have in building wealth:

Short Residency, Long Career

If you get after it, you can be a pediatric attending in your early 30s when many other docs are still getting a resident salary. Start saving and watch compound interest work its magic. This system works at any salary. We have access to the same investments and tax-sheltered accounts as everyone else.

Back to our prototypical low-earning pediatrician: if you max a Roth IRA during your three years of residency, you will graduate with $22,500. Then you live like a resident for the first two years and sock away the aforementioned $60,900 each year, for a total nest egg of $144,300 (not including any interest earned since starting residency). If you decrease your savings rate to only $1,000 monthly, you will still have $1.22 million in 20 years at the average stock market historical return of 8%. Maybe you can keep your savings rate as high as $2,000 per month, which will net you $1.77 million, or $3,000, which will net $2.32 million. Now we’re talking—and you are only in your mid-50s, plenty of runway left.

Pediatrics is not nearly as physically demanding as other fields, and you can still practice if your knees give out. It doesn't have the overnight shenanigans that wear out OBs and ER docs. (An aside: my dear friend is an OB. She ruptured a flexor tendon in her finger resolving a scary shoulder dystocia. Y’all are built different.) You might not be able to retire early on a pediatrician salary, but you also might not need to retire early.

Loan Forgiveness Options

We qualify for just about every student loan repayment option out there, including the military. Loan forgiveness can be a huge advantage, coming as it does early in a career when you have a long investment timeline. It’s true that your life will be constrained by the payment program requirements while you are in it, but guess what: everyone’s life is constrained until their loans are paid off.

Career Flexibility

The downside to being highly specialized that no one talks about is that specialists are often tied to large population centers or tertiary care hospitals. Career flexibility contributes to financial success because you can change things up to stay interested, to take advantage of geographic arbitrage, and to accommodate life and family changes.

Pediatricians are in demand in every part of the country and in every practice setting. You can choose academics, private practice, or concierge medicine in the city, country, or in between. You can do more than one of those in your long career. You can have your pick of low-stress locums jobs. My locums job in Alaska pays 50% more than my day job, plus travel and housing. I should go more often.

And there’s nothing keeping us from the other wealth-building activities available to other physicians. We can invest in low-cost index funds and insure ourselves appropriately. We can build private practices (with low medical malpractice insurance rates), we can own the buildings we practice in, and we can start our own businesses. We can spend intentionally and in line with our values.

• How to Be a Part-Time Physician
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• Should I Feel Bad About Taking Time Off?

Low Divorce Rate

On my first day of residency, during the hospital-wide orientation for all the residents, one of our instructors said, “If you get the chance, marry a pediatrician. They are so nice.” It was a little awkward since he was there to talk about EKGs, but maybe he was on to something.

Pediatricians have among the lowest divorce rates for physicians. (According to Google, psychiatrists have the highest. Anyone care to comment?) Divorce is incredibly expensive, so being fortunate enough to get married and stay married is in your favor.

We Are Good at Basic Math

Why are the rest of you so scared of a little weight-based dosing?

Maybe you don't do all of these things. You get started late, you can’t use geographic arbitrage to your advantage, you get divorced. So, control what you can. Having a big income makes it easier to end up wealthy, but it’s no guarantee. My husband and I have the huge advantage of two physician salaries, but we got where we are by the money decisions we made. If we had kept our money with our old money manager, our net worth would be two-thirds what it is today, and if we hadn’t sent the kids to private school, it would be almost double. Like I said, I have no right to complain.

There you have it: the reasons why it’s hard for pediatricians to build wealth, and why we can do it anyway. I’ll leave you with the poem William Shakespeare would have written if he were in my shoes:

“When, in disgrace with fortune and men’s eyes hospital accountants,
I all alone beweep my outcast state salary
And trouble deaf heaven with my bootless cries,
And look upon myself and curse my fate,
Wishing me like to one more rich in hope money
. . .

With what I most enjoy contented least;
Yet in these thoughts myself job almost despising,
Haply I think on thee my cute patients and then my state,
(Like to the lark at break of day arising
From sullen earth) sings hymns at heaven’s gate;
For thy sweet love remembered being a pediatrician such wealth brings
That then I scorn to change my state with kings radiologists.”

Are you a pediatrician who's gotten wealthy? How have you done it? What other advice do you have for moderate-income earners?