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In the U.S., the national average salary for PGY-1 medical residents is $68,166 annually, according to the Association of American Medical Colleges (AAMC) 2025 Survey of Resident/Fellow Stipends and Benefits. Averaged across eight years of training, residents earn a salary of $79,939 in the U.S.
Here’s a look at how the average resident salary varies by year of training.
Disclaimer: Unweighted salary averages give each institution equal weight regardless of how many residents it trains. The approach keeps larger programs from skewing the average, so the figures reflect the typical institution rather than the typical resident.
The pay increase from PGY-1 to PGY-8 is $26,049. Annual raises typically fall in the 3% to 5% range, adding roughly $2,000 to $4,000 per year. The exact increase depends on your program and the number of years your specialty requires. Shorter residencies, such as family medicine (three years), acquire less of that growth than longer tracks, such as neurosurgery (seven years).
The gap between the 25th and 75th percentiles gets bigger as you advance, from about $8,800 at PGY-1 to nearly $13,800 at PGY-8. Where you train matters more with each year, so a senior resident at a top-paying program can out-earn a peer at a lower-paying one by far more than a first-year resident ever would.
Here’s a look at how resident salaries have changed over the last six years.
Disclaimer: Unweighted salary averages give each institution equal weight regardless of how many residents it trains. The approach keeps larger programs from skewing the average, so the figures reflect the typical institution rather than the typical resident.
Resident pay rose 15.7% over five years, but inflation accounted for most of that increase. PGY-1 stipends climbed from $58,921 in 2020 to $68,166 in 2025. The raises look good on paper until you set them against the cost of living. Treat a 3% to 5% annual raise as a salary that keeps pace with the cost of living, not one that increases your buying power. When you weigh program offers, measure each stipend against local rent and grocery prices rather than against last year's number.
To match into your top residency for the best chance of a high-paying salary, get residency application support from our counselors.
These are the average annual salaries for medical residents by region, according to AAMC data.
Disclaimer: Weighted salary averages give each resident equal weight rather than each institution. Larger programs carry more pull on the average because they train more residents, so the figures reflect what the typical resident earns rather than what the typical program pays.
Western and Northeast consistently run well above the national average across all PGY levels, and they converge by PGY-8. The South is the only region that falls meaningfully below average, and the gap widens at higher PGY levels. Central starts close to the national average but drifts increasingly below it from PGY-4 onward.
As a medical resident, your specialty not only dictates the focus of your training but also significantly impacts your potential salary. Here are the average salaries of residents by specialty.
Residency pay varies by more than just your year of training. Several structural factors determine where your stipend falls within the national range. Understanding those factors helps you see what your actual take-home compensation will look like.
Where you train matters more than most applicants realize. Programs in high-cost-of-living cities like New York, San Francisco, and Boston typically offer higher stipends to offset housing and transportation costs.
However, "higher" does not always mean "enough." A PGY-1 earning $72,000 in Manhattan has significantly less purchasing power than a PGY-1 earning $65,000 in Omaha. Look at stipend data alongside local cost-of-living indexes rather than comparing raw dollar amounts across programs.
Academic medical centers, community hospitals, and VA-affiliated programs all structure compensation differently. Large academic institutions tend to offer stipends on the higher end of the AAMC range because they receive more substantial Medicare Graduate Medical Education (GME) funding.
Community-based programs may compensate with fewer call hours, better scheduling flexibility, or additional stipend bonuses. VA programs follow a federal pay scale that operates independently from the hospital's own GME budget.
Larger health systems with multiple teaching sites and higher patient volumes generally pay more than smaller independent programs. Multi-hospital networks spread administrative costs across a larger revenue base, which frees up more funding for resident compensation.
A resident at a major urban academic center affiliated with a large health system will often out-earn a peer at a smaller community hospital at the same PGY level. Larger systems also tend to offer more valuable benefits packages, including better insurance options, more generous education allowances, and stronger retirement plan matching.
Your specialty doesn’t always directly affect your residency stipend. A PGY-2 in family medicine and a PGY-2 in general surgery at the same institution sometimes earn the same base pay. The difference shows up in total years of training.
A family medicine resident completes three years of training, while an orthopedic surgery resident completes five years. Subspecialty fellows in cardiology or gastroenterology add another two to three years on top of that.
Each additional year brings incremental raises (typically 3% to 5% annually). But every extra year of training is also a year spent earning a fraction of attending-level income.
Residency stipends increase with each postgraduate year. The mean PGY-1 stipend is $68,166, rising to $94,215 by PGY-8. Annual raises typically fall in the 3% to 5% range, adding roughly $2,000 to $4,000 per year.
These increases are automatic and built into the program's pay scale rather than tied to performance reviews. That means a seven-year surgical resident will earn approximately $25,000 more in their final year than in their first.
Most residency programs offer a benefits package that adds $10,000 to $20,000 in value beyond your base stipend. Knowing what to look for helps you evaluate total compensation rather than fixating on salary alone.
Nearly every accredited residency program provides employer-sponsored health insurance, and most cover a significant portion of the premium. According to Medscape's 2025 Residents Salary and Debt Report, 90% of residents have access to health insurance through their program. Dental and vision coverage are common additions.
Coverage typically extends to spouses and dependents, though you may pay a higher premium for family plans. Even with employer contributions, plan quality varies. Review copays, deductibles, and network restrictions before assuming all insurance packages are equal.
Most programs offer 15 to 25 days of paid time off per year, which combines vacation, sick leave, and personal days into a single unit. Some programs separate vacation from sick time, while others use a combined paid time off (PTO) model.
Keep in mind that "days off" in residency rarely mean full disconnection. Many residents schedule their PTO around lighter rotations because taking leave during a demanding surgical or ICU block can create coverage gaps that affect the entire team.
Parental leave policies have expanded in recent years, but coverage remains inconsistent. Some programs offer six to eight weeks of paid parental leave, while others require residents to exhaust their PTO first.
Check whether your program's leave policy aligns with ACGME requirements for medical, parental, and caregiver leave, which now allow up to six weeks of approved absence without automatically extending training.
Programs typically provide an annual education stipend ranging from $1,000 to $5,000. You can use these funds for:
Some programs also cover licensing exam fees, USMLE Step 3 costs, or specialty board application fees separately. Ask during interview season exactly what the education fund covers. Definitions vary widely.
A program advertising a "$3,000 education allowance" might exclude conference travel, while another offering "$1,500" might cover everything, including flights and hotel.
Free meals during overnight call shifts are standard at most teaching hospitals. Some programs go further, offering daily meal stipends, subsidized cafeteria access, or monthly-loaded meal cards.
The value seems small in isolation. But free food during 70-hour work weeks adds up quickly. Residents working 15 to 20 call shifts per month can save $200 to $400 monthly, depending on the benefit amount.
Programs in urban centers often provide free parking or subsidized transit passes. In high-cost-of-living cities like New York, Boston, or San Francisco, some institutions offer subsidized housing or housing stipends to offset rent.
A handful of programs provide relocation allowances for incoming residents, typically ranging from $500 to $2,000. These benefits rarely appear in headline compensation numbers but can meaningfully reduce your monthly expenses.
Many teaching hospitals offer 403(b) or 401(k) retirement plans with employer matching contributions, though match rates for residents are typically pretty low. Starting retirement contributions during residency, even at small amounts, builds a habit that compounds over a 30-year career.
Most programs also provide short-term and long-term disability insurance at no additional cost. Given that your earning potential as an attending physician represents your most valuable financial asset, disability coverage during training is one of the most underappreciated benefits in any residency package.
The highest-paying states for medical residents overall are Washington ($309,153), followed by the District of Columbia ($308,451), New York ($298,627), and Massachusetts ($298,105), according to Ziprecruiter. Resident pay in high-salary states often comes with equally high costs of living that offset the difference. Evaluate stipend amounts against local housing, transportation, and tax burdens rather than ranking states by gross pay alone.
Most medical residents work between 50 and 80 hours per week, depending on specialty, rotation, and program structure. The ACGME caps clinical and educational work hours at 80 per week, averaged over a four-week period. Surgical specialties and ICU rotations tend to push closer to the cap, while outpatient-heavy blocks may fall in the 50- to 60-hour range. Night float rotations, weekend call, and home call shifts all count toward the weekly total.
No, medical residents are classified as salaried exempt employees and do not receive overtime pay. The annual stipend covers all scheduled hours regardless of whether a resident works 50 or 80 hours in a given week. Some programs allow moonlighting at hourly rates ranging from $75 to $150, which functions as the closest equivalent to overtime compensation. All moonlighting hours still count toward the ACGME's 80-hour weekly limit.
Most residency programs do not offer housing stipends. According to 2025 Residents Salary and Debt Report, only about 9% of residents report receiving a housing allowance. Programs in high-cost-of-living cities like New York and San Francisco are more likely to offer subsidized housing or housing assistance, but these remain the exception rather than the norm. Some programs provide a one-time relocation allowance of $500 to $2,000 for incoming residents, which helps with moving costs but doesn’t offset ongoing rent.
In Canada, the average salary for a PGY-1 resident is $63,779. This number is the average of 10 PGY-1 salaries in the different provinces in Canada. In the U.S., the average salary for a PGY-1 resident is $68,166. At face value, U.S. residents appear to earn more, but the comparison requires more context.
U.S. residents earn higher gross salaries, but Canadian residents face lower tuition, less educational debt, and fewer out-of-pocket healthcare expenses. Depending on your debt load and where you train, a Canadian resident's financial position during training may be comparable to or even better than that of their American counterpart.
European residents' salaries vary dramatically by country, but nearly all fall below U.S. levels in absolute terms. In Europe, first-year equivalents range from roughly $30,800 USD in Spain to over $127,500 USD in Switzerland, with most countries landing somewhere in between. A German resident earning $60,000 for 48-hour weeks takes home a higher effective hourly rate than a U.S. resident earning $68,000 for 60- to 70-hour weeks. Fewer hours also mean more time for rest, study, and personal well-being during training.
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