By Dr. Rob Anderson, Guest WriterAs an anesthesiologist and clinical leader, I have your typical mix of responsibilities, including clinical loan, scheduling, and hospital committee work. I am also the lead recruiter of our group, which has given me a firsthand look at how physicians approach their first job offers—and how awkward and uncomfortable salary discussions can be in medicine.
I still recall a negotiating experience from a few years ago with an anesthesiology resident. Unlike most others who are excited to land their first big paycheck job out of residency, he came in fully prepared to negotiate. He first tried negotiating his base and bonus, but an adjustment like that would mean changing comp across our entire group. So, he moved on to his signing bonus and then to relocation expenses. He tried to negotiate his package wherever possible, and ultimately, he got much more than what was customary. I was genuinely impressed by how well he advocated for himself.
That incident has stuck with me—not because of how persistent he was but because of how prepared he was. He had data. He knew what to ask for. He had worked hard to get all the information, and it reminded me how little salary transparency there is in medicine and what’s possible when you have the information and the confidence to advocate for yourself.
This is why I started Marit—a community-powered anonymous salary-sharing site built for medicine. Using real, anonymized salary submissions from thousands of physicians around the country, we've compiled detailed compensation data for all of medicine, where you can see all the averages and, more importantly, the details that matter—from comp model to bonuses to schedule and shifts, benefits, etc.
Most salary benchmarks typically publish averages across all career levels—whether you are fresh out of residency or 15 years into your attending career. That’s not particularly helpful for new grads, so in this post, we'll present a unique view of data, specifically filtered for new attendings (i.e., those with less than two years of experience). If you’re preparing to negotiate your first offer, this should give you a clearer sense of what might be possible.
Core Components of an Offer
When reviewing a new attending offer, it’s easy to focus on the base salary—but that’s only one part of the picture. Most offers include a guaranteed base, but multiple bonuses are often layered on top, tied to things like productivity, quality metrics, etc. Depending on the role, you may also have additional income opportunities, such as overtime or extra shifts.
In the benchmarks below, we’ll focus on total compensation, including all of these components. In addition, there will be one-time payments like sign-on bonuses, relocation support, residency stipends, student loan assistance, and a range of benefits that can vary widely.
More information here:
28 Things You Can Negotiate Besides Salary
12 Negotiation Techniques You Need to Know
How Much Do New Grads Make for Each Specialty?
Here are the average starting salaries for new attending physicians across all specialties, based on the physician salary data on Marit. In addition to salary, we’ve included typical weekly hours worked and a pay satisfaction score. This score is based on a 5-point scale, with 1 representing Very Dissatisfied with Compensation and 5 representing Very Satisfied with Compensation. The average across all specialties is 3.6 stars.
Why the Highest Paying Specialties Stand Out
At the top of the list are neurosurgery ($805,000), cardiology ($575,000), and orthopedic surgery ($571,000). These specialties continue to be consistently among the highest-paying specialties, owing to their heavy procedural volumes and higher reimbursement rates associated with them. On the other end, podiatry ($227,000), pediatrics ($234,000), and nephrology ($265,000) sit at the lower end of the pay scale. These specialties typically generate modest wRVU volumes, and their codes tend to have lower reimbursement rates
More information here:
There Was No Golden Age of Medicine (at Least for Physician Incomes)
‘What Are Your Salary Expectations?’ Here’s Why You Should Stop Evading This Question
Academic vs. Non-Academic Salaries
Keep in mind that these figures represent averages, and there are huge variances depending on factors like practice type, location, compensation structure, and work schedule. One major factor affecting starting salaries is whether you're joining an academic institution or a private hospital/medical group. Here’s how new attending salaries compare between academic and non-academic settings:
Allergy & immunology shows the largest gap, with non-academic salaries averaging 53% higher. Other specialties with large differences include hematology oncology (40%), physical medicine & rehab (34%), ophthalmology (33%), and pathology (32%). There are many drivers of these differences, but one of the biggest tends to be the amount of clinical workload in each setting. Academic physicians often tend to see fewer patients as they split their team between clinical and non-clinical responsibilities.
Some of the smallest gaps, or no gaps at all, appear in orthopedic surgery, OB/GYN, and family medicine, where academic and non-academic roles both involve heavy clinical loads.
Sign-On Bonuses and Relocation Allowances
Most new attending offers include a sign-on bonus, and this is often one of the more negotiable parts of the package. That said, it’s essential to read the fine print. These bonuses usually come with conditions, such as a requirement to stay with the employer for a certain period (often around three years). If you leave early, you may be required to repay some or all of the bonus.
Based on Marit's dataset, there’s a strong correlation between total compensation and the size of the sign-on bonus. The overall trend is roughly approximated by the following formula:
Sign-on bonus ≈ $5,700 + 7.1% of total compensation.
For example, a new attending earning $400,000 in total comp might expect a signing bonus of roughly $34,100 ($5,700 + 0.071 * $400,000). Keep in mind that actual signing bonuses vary by specialty, employer type, and region, and they tend to be higher for harder-to-fill positions. Still, this can be a helpful benchmark when reviewing or negotiating your offer.
Relocation allowances are more standardized, and they do not vary by specialty as much. The average relocation bonus on Marit is ~$13,000.
More information here:
The Best and Worst Metro Areas for Physician Salaries
Future Growth Prospects
Let’s talk about what happens after that first contract. For most physicians, compensation increases steadily in the early years of practice. Beyond that, salary growth will depend heavily on the choices you make: how much you work, the type of schedule you prefer, your productivity, and the kind of practice you join.
But growth isn’t the same across the board. Some specialties see faster increases than others, driven by factors like how your productivity increases with experience, demand within the specialty, shifts in reimbursement, and broader changes in the healthcare landscape. Below is the specialty-specific growth in compensation we see on Marit, so you can get a better sense of what your earning trajectory might look like over time.
Specialties that have a significant mix of private practice models or rely heavily on productivity-based models—like ENT (+49%), ophthalmology (+47%), orthopedic surgery (+42%), podiatry (+60%)—tend to show the most significant percentage increases. These physicians often start in salaried roles at a larger health system and may transition into a private practice or a productivity-based model, where earnings are more directly tied to volume, collections, or shared group profits. Compensation tends to accelerate as they ramp up productivity or gain access to equity or partnership tracks.
By contrast, specialties with more salary-based structures—such as hospital medicine, emergency medicine, and anesthesiology—have flatter growth curves (all under 10%). These roles often have standardized pay across years of experience, especially in hospital-employed settings, leaving less room for significant increases over time.
We hope this overview was helpful. While salary averages can offer useful benchmarks, every contract is different and shaped by various factors. You can explore the full dataset on Marit for a more detailed view, including real, anonymized salary data broken down by compensation models, locations, hours, benefits, and more.
These deep dives are only possible because of the physicians who have already shared their data. If you found this post valuable, consider submitting your salary anonymously and sharing Marit with a colleague who might benefit.
What's the most important aspect of a new attending's contract: base salary, bonuses, or other kinds of benefits? How much negotiating have you done in your own salary discussions? Are you satisfied with how much you made or currently make as an early-career doctor?
In the table with breakdown of total comp by years of experience, is there a typo for mid career compensation for rheumatology? Seems like all the other specialities have increase in compensation with time but rheumatology has a decrease. If this is accurate, is there a reason for this?
Yes – we noticed that as well. We don’t believe there is an actual decrease in compensation over time for rheumatology, but more that our current dataset for that specialty is still relatively small. As more data comes in, we should be able to reflect the actual pattern, as seen in other specialties.
For a first year attending, is the signing bonus, student loan payment, and relocation included in total comp?
No. It is not included. Total Comp includes base, bonuses (productivity, quality), and any other additional income (e.g., partnership income). Signing bonuses, relocation, loan payments are reported separately
Why did you include podiatrists in this? Every specialty here goes through MD/DO school. Podiatry is a separate school and separate residency. If you’re including non physicians why not include oral surgeons and CRNAs?
We do cover Oral Maxillofacial Surgery as well. It isn’t reported above as the data-set is still very small. CRNAs are covered too and under APPs. We began with MD/DO and APPs, and then expanded to Podiatrists as there was a lot of interest. We may expand to others in the future, but for now – we are trying to focus largely on improving the product for existing core segments.
I find this question of inclusion of podiatry in the list to be an example of the continuation of the old turf war of MD’s trying to exclude podiatry when they do the same work as ortho-pod MDs despite podiatry having more training in the work they perform. Yes some podiatry schools are separate but others are a part of the same school that produce MDs and DOs where the podiatry students are taking the same classes along with the MDs and DOs. Sometimes the MD students do better, sometimes the podiatry students do better. Graduated podiatrists go through a 3 year residency just like MDs and DOs and some podiatrists do fellowships after that. Ortho pods generally only do one year podiatry fellowship after their 3 year general residency making their overall training in dealing with the feet less than any podiatrist graduating today. Our country really needs to stop focusing on titles that someone has and start focusing on the quality of work we can perform. Just with any specialty, there are those that have been terribly trained and those that are truly skilled. I would never ask a MD cardiologist to work on my foot just as I would never ask a podiatrist or ortho-pod to work on my heart. As an aside, many MD or DO orthopedics don’t want to work on the feet because reimbursement vs the time to treat is less than them working on any other part of the body. That is why podiatry even exists. There was a need in our country for all those that have feet issues that MDs weren’t meeting and are still not meeting today. I’m sure if foot issues paid physicians more then more MDs and DOs would treat the foot. As you can see from the chart, Podiatry is one of the lowest paying specialties. Just like MDs and DOs, podiatry is a doctorate program and requires 3 years residency training.
Ortho is 5 years. Before fellowship. And there is probably a selection bias. It’s a little harder to get into MD/OD school than podiatry school and ortho is still a pretty competitive residency.
But otherwise I agree with your comments and refer to podiatry all the time.
Their definitely a selection bias as there is a huge shortage of residency programs in our country vs number of students the schools are producing. Comparing how hard to get into podiatry school vs MD/DO is tricky as those that go intro Podiaty may never have applied to MD/DO schools just as those that get MD/DO never applied to podiatry. I think there is now 11 podiatry schools (some part of MD/DO schools) in our country. On top of that, some MDs went to schools in the Caribbean that are definitely easier to get into than Podiatry schools. That isn’t to disparage those schools as some great physicians come from there. Just not every student is willing to go to school there being separated from family and friends and their communities they know. It really wasn’t that long ago where there was a turf war between MDs and DOs where MDs were trying to exclude DOs. MDs got over that for the most part and our our county’s healthcare is stronger for it. I do appreciate the correction on the 5 year residency for orthos. General MD/DO residency is still 3 years. 5 years for podiatry would be overkill as they are mostly training in just the foot where ortho is training many parts of the skeleton
There is no “general” MD residency. My EM residency was 3 years. Some EM residencies are 4. OB is 4. Gen surg is 5. Peds is 3. FM and IM are three. Add on a 1-3 year fellowship for subspecialties. It’s just highly variable.
I don’t think the data has ever supported the idea that podiatry school is just as hard to get into as medical school. A quick Google search suggests podiatry applicants have an average MCAT of 494 and a GPA of 3.3 and medical school matriculants have far higher MCAT/GPAS. https://www.shemmassianconsulting.com/blog/average-gpa-and-mcat-score-for-every-medical-school
Here’s an even more worrisome take from a podiatry dropout: https://www.reddit.com/r/podiatryschool/comments/runuvz/my_experience_in_podiatry_practically_negative/
I don’t think one can argue with a straight face that podiatry school is just as hard to get into as medical school. How much that matters later can certainly be debated of course.
I never said podiatry is harder. Nor can we say getting into MD/DO school is harder for many confounding factors. To refute your one point about MCAT and GPA, every MD, DO and podiatry school admissions committee out there will tell you that a students acceptance is more about the student being well rounded student looking at all facets of the applicant. Admission is not based solely on MCAT and GPA. All schools reject applicants. An applicant can also get into some MD/DO schools and not others just like podiatry. There are definitely some MD/DO schools that have lower requirements than some podiatry schools. For your “worrisome take”, I read your referenced Reddit post of a podiatry school dropout and the comments to that post. As the comments to that post said, you can have disgruntled podiatry students just as well as MD/DO students. Experiences between schools are different just as they are within each school between students. This does digress from the point of the article but the fact is that there are very smart and talented people in all fields of medicine, there is a great need for podiatry care in our country like other fields of medicine, the truly talented individuals will end up at the top of their field, and we should not put down others who have answered the call in caring for others health that have made great personal and financial sacrifices for this calling.
To also add, my comment on general residency is factoring in what is the most common length of residency programs for all graduating MD DO students that go onto residencies. I admit perhaps the number would be 4 but it doesn’t change my point that 3 years of residency for podiatry is training on the foot. (“General” was not referring to any type of program like general surgery). While not fact checked here is likely a good source for length of residency programs if anyone reading is interested : https://residency.wustl.edu/residencies/length-of-residencies/
This of course should be correct today but this was not always the case and may change in the future.
If we are not going to worry about titles, then just train any old high school graduate to operate on feet. I am certain this could be done successfully with on the job training alone. However, titles do matter. Degrees do matter. That underlying knowledge is very helpful when you are seeing patients, especially the curve balls. It would be foolish to equate a podiatrist with an orthopaedic surgeon. I work with podiatrists all the time, and I think they are great, but they are not MD/DO, just like NP/PA’s are not physicians and should not be functioning like physicians. We should move back towards the time when titles did matter.
The hard part isn’t usually the operation, it’s knowing when to operate, which operation to do, how to manage post op issues etc.
Would love to see the hours worked for mid career compensation as well if that was available. Having that for new graduates is very helpful and interesting. Also, if hours worked a year (ie, vacation, paid or not) that would also help put everything in context. Thanks for all the work on this project — important for all of us.
That’s a great suggestion. We’ll include that in a future update
I know it’s a small data set but seems weird to me
IM is higher than hosptial medicine on day one
~3 years ago when my classes mates were looking most pcp jobs had low salary first two years and then production based after that (which was presumably significantly higher)
vs hospital medicine was just sorta whatever the salary is (but usually higher starting)
thank you for doing this. I think it’ll help people a lot going forward
Yes – you are right. IM has a few fellowships grouped into it so it skews the numbers. If we just look at IM – General, it starts off lower at $295k for new grads and mid-career average is $315k
I signed up.
My specialty (PMR) isn’t broken down by fellowship, which is unfortunate; it’s like lumping Internal Medicine (Interventional Cardiology) and Internal Medicine (Primary Care) in the same group. Sadly, most surveys do the same, despite those with a pain fellowship making probably 25-100% more. It throws the average way off.
Anyone know of surveys that split this out? Or perhaps that functionality could be added to the Marit data.
Thanks for signing up and the feedback. We do cover the following fellowships within PMR –
Sports, Spinal Cord Injury, Pain Management, Pediatric and Neuromuscular.
These are all grouped under PMR in the table above, but you can see them broken out individually on Marit. PS: Some of them don’t have sufficient data, but we break out the ones with sufficient data here
https://www.marithealth.com/o/-/neuromuscular-medicine-physician/salary/trends
I’d be interested to learn more about sign-on bonuses and correlation with job satisfaction. I’m Emergency Medicine in rural Maine, and there’s a nearby hospital offering $120k for 3 years, while a similar one is offering $15k for 3 years. I chose the worse sign-on bonus, and my job satisfaction is way higher than people getting the higher bonus. Just my n of 1
As you’ve demonstrated, there is a lot more to a job than the sign-on bonus, or even total compensation.
Does “total compensation” for this data include benefits like health insurance and retirement contributions or just salary? Looking at IM and hospitalist jobs there is quite a bit of variability in the value of benefits. Some have almost no benefits while others seem worth as much as 100k.
Yea, it’s important to compare apples to apples. Total compensation does usually include at least some benefits and obviously should include all benefits but I’m not sure it always does.