Which are the Highest Medical Specialties?

August 17

Table of Contents

Nobody has ever said that becoming a doctor is simple. Medical school is expensive, demanding, and competitive. 

Suppose you will put in the time, money, and effort to get an MD or DO. In that case, you want your medical career to be lucrative enough to justify your actions monetarily and in other ways.

The training requires perseverance, and the work-life balance remains difficult and taxing. 

Doctors and surgeons frequently have unpredictable, extended work weeks. They might also do call-in jobs. The effort pays off with a lucrative career and the chance to bring hope and healing to patients of all ages.

Although medicine is considered profitable, salaries can vary significantly from one specialty to the next, even within the same business.

This article gives you thorough listings of the highest-paid medical specializations. We will also go into detail about the complex system that doctors use to receive payment and the variables that affect doctors' earnings.

How Do Doctors Get Paid? 

This is a very challenging question. Understanding and explaining how doctors are compensated in the U.S. is complicated. Their pay depends on a variety of circumstances, including work position, state of practice, and of course, specialty.

With the introduction of new bills, rules, and institutional reforms like the Affordable Care Act, the healthcare landscape in the United States is also continually changing.

The several elements that affect a doctor's income are listed below.

Private Practice vs. Employed

The AMA (American Medical Association)  reported that the primary distinction in how much money doctors make depends on whether they are hired or have a private practice. The difference is not in revenue per se but in how doctors create a living.

For instance, doctors working in hospitals, clinics, and other organizations of a similar nature typically list their salaries as their primary form of payment. Private professionals can also receive compensation, but significantly fewer self-employed doctors do. 

Private physicians' pay frequently depends on their own performance. This is not to suggest that employed physicians' salary is not influenced by productivity but to a considerably lesser extent than that of their private counterparts. 

Only a small percentage of practice owners said their income was solely based on financial performance, which is lower than the expected percentage for private physicians. 

A self-employed doctor's income can be calculated after all other business-related costs and expenses have been paid, just like any other private business owner. 

The physician's office sees patients, records their visits, bills them or their insurance providers, and collects money.

Suppose a medical practitioner earned USD 350,000 in a single year. The business's operating expenses total USD 200,000 USD (rent, employee wages, leases, supplies, etc.). As a result, the practice's owner or owners are left with a USD 150,000 revenue, which they divide equally. 

Serving as many patients as possible each day is preferable for private practices. Their daily patient and bill volume have a significant impact on their income. Simply put, a personal doctor's office's income decreases as the number of patients increases.  

It is challenging to think that the U.S. healthcare system will stop paying physicians based on the number of patients they see. 

Currently, several healthcare systems in the U.S. are attempting to restructure their pay structures to comply with specific Medicare standards.

However, quality and efficiency are also receiving a lot of attention. Thus, the value of care delivery will also consider other factors in addition to patient volume. 

Finding this balance is incredibly tough. Pay in the healthcare industry is mainly based on productivity, just like in many other business models. 

However, the change in healthcare compensation aims to align pure production and care quality.

Income Difference by State

The state of practice also impacts the revenue of doctors. 

The highest salaries for doctors would be expected in states with the most people, yet this is not the case.

It is interesting to note that places like New York and California do not even make the list of the top 10 states where doctors are paid the most. There could be several causes for this. Patients have many alternatives when it comes to selecting their healthcare provider. 

Thanks to the number of healthcare options offered by large and economically developed states like New York and California. 

This indicates that there are often fewer patients per doctor. The U.S. healthcare system is designed around payments depending on the number of patients serviced. As a result, states with huge populations and plenty of healthcare options have lower average physician incomes. 

Income Difference by Specialty

So why does a doctor's compensation depend on their specialty? Simply put, some professions demand more training and skill than others. 

Some of the highest-paid doctors in the U.S. work in the surgical disciplines of orthopedics, cardiology, radiology, and plastic surgery.

These procedure-based specialties need an additional 5 or 6 years of residency training after medical school. Additionally, these specialties frequently necessitate post-residency subspecialty study, such as fellowships. Therefore, these experts are paid more. 

Less training is needed for primary care specialties, including family medicine, internal medicine, pediatrics, etc. 

After completing six years of medical school (4 years of medical school and two years of residency), one can start working as a family doctor.

As a result, doctors who practice in these specializations make less money. The benefit is that they spend less time and money on specialized training, which allows them to enter the workforce more quickly and with less student debt. Because they may start paying off their debt earlier, they also incur less debt.  

Demand in the healthcare industry should be considered while choosing a specialty. A specialty-based pay raise or increase in earnings frequently portends a scarcity in that field.  

M.D. vs. D.O. Salary

When practicing in the same specialty, D.O. and M.D., doctors make equivalent amounts of money. 

However, D.O. doctors have fewer specialization possibilities. While there is still a disparity in the numbers, you should be aware that D.O. representation in surgical, competitive specialties has significantly increased. 

The modifications in residency program accreditation are mostly to blame for this. In the past, the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME) were the organizations that granted accreditation to both osteopathic and allopathic residencies, respectively.

Osteopathic residency programs now have the same status and prospects as allopathic programs because the ACGME has accredited both D.O. and M.D. programs. 

The same accreditation system also permits participation by D.O.s in M.D. programs (under the condition that they satisfy all requirements, including passing the United States Medical Licensing Exam and participation by M.D.s in programs designated as having "Osteopathic Recognition" (again under the condition that they satisfy all requirements, which vary by program).

The D.O. vs. M.D. residency division is decreasing thanks to the unified accreditation system. The population gap between D.O. and M.D. inhabitants will decrease over time. 

But remember what D.O. stands for—remember that D.O.s hold a particular ideology that motivates them to pursue primary, non-intrusive medical care specialties.

Although DOs can absolutely become surgeons, their beliefs still influence the specialties they choose to practice in and the locations where they do so. This suggests that the pay gap between D.O. and M.D. may still exist.  

Top 10 Highest Medical Specialties

Americans are well aware that doctors often earn some of the highest salaries in the nation. Less widely recognized are the medical specialties that pay the highest salaries. 

These top-paying medical specialties may interest you if you are considering becoming a doctor, and money is a major deciding factor.


  • Average Annual Salary: USD 524,827
  • Average Work Hours Per Week: 58 hours

The first specialty on our list without a specific residency is cardiology

Alternatively, you must finish six years of training following medical school, including three years of internal medicine residency, three years of cardiology fellowship, and three years of internship.

One of the most difficult internal medicine fellowships to get into is cardiology. 

However, it is difficult to compare the competitiveness of cardiology to other specialties on our list because it is a fellowship rather than a residency.

Compared to most other non-surgical specialties, cardiologists work 58 hours per week (on average), which is on the higher end of the spectrum. The clinic, cath lab, performing procedures, daily rounds, and research are divided up during this period. 

Your sub-specialization will determine your specific on-call obligations. For example, you should anticipate many calls and long days in the cardiac catheterization lab if you opt to subspecialize in interventional cardiology.

Pediatric Surgeons 

  • Average Annual Salary: USD 485,989
  • Average Work Hours Per Week: 46 hours

Pediatric surgeons care for kids from birth through late adolescence. They make pediatric care the focal point of their medical practice. Advanced training and practical experience teach one how to treat youngsters medically and surgically.

Children-specific tools and spaces are used by pediatric surgeons. They have also received substantial training and experience in providing for the needs of youngsters. This involves caring for particular and perhaps uncommon surgical conditions that affect kids.


  • Average Annual Salary: USD 448,190
  • Average Work Hours Per Week: 48 hours

Radiologists diagnose and occasionally treat medical problems, syndromes, and illnesses using medical imaging technologies. They are medical professionals who focus on using medical imaging (radiology) procedures (exams/tests) like X-rays, computed tomography (C.T.), nuclear medicine, magnetic resonance imaging (MRI), ultrasound, and positron emission tomography (PET) to diagnose and treat illnesses and injuries.

Medical school, a four-year residency, and, most frequently, an extra one- or two-year fellowship of highly specialized training, such as radiation oncology, pediatric radiography, or interventional radiology, are all required of radiologists as part of their minimum 13 years of study.

They must adhere to strict guidelines for continuing medical education during their years of practice to maintain their American Board of Radiology certification.


  • Average Annual Salary: USD 425,800
  • Average Work Hours Per Week: 40 hours  

A surgeon is a medical professional who diagnoses and treats diseases that may call for physical alterations to the human body or surgery. Surgery can be used to treat an injury or identify a condition. 

Surgeons oversee nurses and other medical professionals in the OR (operating room) to ensure an operation goes smoothly.

A modern surgeon received the same medical training as physicians before specializing in surgery, is a licensed physician, or both, even though there are distinct traditions in different eras and countries.

In addition, some surgeons practice veterinary, dental, and podiatric medicine. An estimated 310 million surgical procedures are carried out annually worldwide by surgeons.


  • Average Annual Salary: USD 420,196
  • Average Work Hours Per Week: 50 hours 

The medical professionals in charge of keeping patients unconscious, sedated, or pain-free during surgical procedures are known as anesthesiologists

As per the Bureau of Labor and Statistics, the vital position has a high earning potential of more than USD 300,000 annually. 

Anesthesiologists work primarily with patients undergoing surgery while not being surgeons themselves. Giving patients anesthetics or painkillers prepares them for painful or difficult diagnostic procedures and operations. 

Anesthesiologists monitor the patient's respiration, body temperature, pulse, blood pressure, and other vital signs throughout surgery to look for discomfort or stress and alter the patient's pain medication as necessary. They assist in postoperative care by monitoring patients following surgery.

Additionally, anesthesiologists provide effective and secure pain treatment to patients with chronic pain, those in the intensive care unit (ICU), and mothers giving birth.

Oral and Maxillofacial Surgeons

  • Average Annual Salary: USD 390,357
  • Average Work Hours Per Week: 40 hours 

Face, head, neck, and jaw reconstruction surgeries are the specialty of oral and maxillofacial surgeons. Complex dental operations involving the jawbone and facial reconstruction following traumatic traumas are examples of this surgery. 

Depending on the country's legal system, oral and maxillofacial surgery may call for a degree in either medicine, dentistry, or both.

Emergency Medicine Physicians

  • Average Annual Salary: USD 361,200
  • Average Work Hours Per Week: 46 hours 

Emergency medicine physicians are distinctive in that they work shifts, which is something you cannot say about many medical professions. This means they clock in and out and do not bring work home.

There are drawbacks to emergency medicine, though. Even though shift work is often viewed positively, maintaining a regular circadian rhythm might make it difficult because you might end yourself working irregular hours depending on your shifts.

Emergency situations do not observe holidays or important events. Therefore, it is customary to miss them, especially when you are in training or have just started working as an attendee.

Although they work fewer hours than most other medical specialties, E.M. doctors have some of the highest rates of burnout. This is because they are on the front lines, are constantly under stress and high intensity, are unpredictable, have increasing charting requirements, and have irregular circadian rhythms.


  • Average Annual Salary: USD 374,400
  • Average Work Hours Per Week: 45 hours 

The only non-surgical specialty on this list, dermatologists also have a reputation for having a pleasant lifestyle.

After graduating from medical school, the training required to become a dermatologist includes a 1-year internship, followed by 3-years of dermatology residency, for a total of 4-years of training. This places dermatology in the middle of the pack regarding training duration.

In contrast to other medical disciplines, dermatology is known for having a "cush" lifestyle because of the outpatient nature of the field, the common understanding of medical issues, the typical call volume, and the flexible weekday schedule.

Orthopedic Surgeons (Except Pediatric)

  • Average Annual Salary: USD 317,772
  • Average Work Hours Per Week: 57 hours

Orthopedic surgery consistently ranks among the top highest-paid specialties. It is also one of the more difficult specialties to match into because your USMLE Step 1 score and 1 rep maximum on the bench press must be higher than 500, which can be a significant hurdle for potential applicants.

The orthopedic residency lasts five years, longer than many non-surgical specialties but regular for most surgical specialties. There are also more extended residency programs available that offer more research training.

Depending on the subspecialty you choose, you may have different on-call responsibilities. Be ready for a busier call schedule, for example, if you decide to subspecialize in trauma.

Obstetricians and Gynecologists

  • Average Work Hours Per Week: 57 hours
  • Average Work Hours Per Week: 52 hours 

Obstetrics and gynecology are the two subspecialties of obstetrics that deal with the health of the female reproductive system. Although many physicians go on to develop subspecialty interests in one or the other field, postgraduate training programs for both areas are typically combined, preparing the practicing obstetrician-gynecologist to be skilled at both the care of female reproductive organs' health and the management of pregnancy.

Additional FAQs – Which are the Highest Paying Medical Specialties?

What Affects a Doctor's Income?

The primary determinant of a doctor's income in the U.S. is their job status, whether they work for themselves or a hospital or other medical facility. 

The specialty of a doctor also significantly affects their pay. A doctor's income is influenced by their state of practice as well.

Are There Differences in the Salaries of DO and MD Doctors?

The average salary for doctors in the US who are DOs and MDs does differ. 

DO physicians in the US make an average of USD 165,000 per year, compared to M.D. physicians, who make an average of USD 220,000 annually. These averages are determined by considering DO and MD doctors from all fields.

But because fewer DOs are working in profitable surgical specialties, their projected average pay is lower than MDs'. When practicing the same specialties, DOs and MDs make comparable salaries.

You're no longer alone on your journey to becoming a physician

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