Yes, you get paid in residency. It’s a job. You sign a contract, you get a W-2, and money shows up twice a month. Getting to that contract is the hard part for IMGs, though, and small errors cost interviews, our guide to the ERAS mistakes IMGs make covers the ones that quietly do the most damage. The number is just lower than most people expect.
The number is just lower than most people expect. The AAMC’s 2025 stipend survey puts the average first-year resident at $68,166. That’s for work weeks that often run past 70 hours.
What you actually earn depends on your PGY year, where the program sits, and which hospital signs the check. Specialty matters far less than people assume, which we’ll get to. Pay does climb every July as you move up a year.
Below is what residents earn at each stage, what moves the number, and what’s left after taxes.
You’re an employee of the hospital, health system, or university that sponsors the program. Not the department, not the specialty. That’s who pays you.
The money is usually called a stipend, but it works like any salary. Direct deposit, withholding, the whole thing.
Benefits come with it almost everywhere. Health insurance is standard. So is malpractice coverage. Most programs throw in paid time off and some kind of education allowance, though the size of that allowance swings wildly.
The amount is the part that varies. Two residents doing identical work in the same specialty can be several thousand dollars apart because one matched in Boston and the other in Alabama.
Do you get paid for residency? Yes, residents in the US receive an annual salary throughout training.
Do doctors get paid during residency? Yes. You’re a licensed physician doing postgraduate training, and you’re paid for it.
There’s no single national salary, because every sponsoring institution writes its own pay scale. So the real answer is a range.
The AAMC’s annual stipend survey is the source worth trusting here. Its 2025 edition covers pay as of July 1, 2025, pulled from data on more than 100,000 residents and fellows. Average PGY-1 stipend: $68,166. That’s about $5,680 a month before anything comes out.
Averages hide a lot, though. At PGY-1, the 25th percentile sits at $62,830 and the 75th at $71,657. Nearly $9,000 separates a low-paying program from a high-paying one in the exact same training year.
| Training Level | Average Annual Stipend (AAMC 2025) | Approx. Monthly Gross |
| PGY-1 | $68,166 | $5,680 |
| PGY-2 | $70,499 | $5,875 |
| PGY-3 | $73,301 | $6,108 |
| PGY-4 | $77,593 | $6,466 |
| PGY-5 | $81,807 | $6,817 |
| PGY-6 | $84,744 | $7,062 |
| PGY-7 | $89,187 | $7,432 |
| PGY-8 | $94,215 | $7,851 |
These are unweighted averages, so each institution counts once no matter how big its program is. Use them as a benchmark. The number that matters for you is on the GME page of whatever program you’re ranking, and it’s usually published.
Resident pay works like a ladder. You go up a rung every July, automatically.
PGY-1 means post-graduate year one. Intern year. First year out of medical school, bottom of every pay scale in the country.
Average is $68,166, roughly $5,680 monthly before deductions. Most programs land between $62,000 and $72,000.
Why the lowest pay? Because scales reward years completed, not hours worked. Interns frequently put in the longest weeks in the building and earn the least while doing it. It’s a known sore point and it doesn’t change until July.
Second years average $70,499 per the same AAMC data. Compared to intern year that’s about $2,300 more, or roughly $195 extra a month.
Nobody negotiates this. It isn’t tied to your evaluations or your performance. The raise was written into the contract you signed before you started.
PGY-3 averages $73,301, around $6,108 a month. For internal medicine, family medicine, and pediatrics, that’s your last year of training.
Longer programs keep going. PGY-4 averages $77,593, PGY-5 averages $81,807. Chiefs usually earn above the standard scale for their year, since about 71% of institutions pay a separate chief stipend.
PGY is a post-graduate year. It counts years finished since medical school, nothing else.
One catch trips people up. Your PGY number doesn’t always match your year inside a program. Do a prelim or transitional year first and you enter your categorical program as a PGY-2. Fellows keep counting upward too, so a first-year nephrology fellow coming out of internal medicine is a PGY-4, not a PGY-1 again.
This is where most applicants have it backward. Your specialty barely touches your residency salary.
In the AAMC’s 2025 data, 96.9% of multi-specialty institutions paid every resident at a given PGY level the same base stipend, regardless of specialty. The ortho intern and the psych intern at the same hospital are almost always on identical paychecks.
Training length is what actually changes total earnings. Five years in surgery means five years climbing the scale instead of three.
| Specialty | Typical Residency Length | Salary Considerations |
| Internal Medicine | 3 years | Institutional PGY scale |
| Family Medicine | 3 years | Institutional PGY scale |
| Pediatrics | 3 years | Institutional PGY scale |
| General Surgery | 5 years | Same scale, two extra years of raises |
| Emergency Medicine | 3–4 years | Institutional PGY scale |
| Psychiatry | 4 years | Institutional PGY scale |
| Anesthesiology | 4 years plus intern year | Institutional PGY scale |
| OB/GYN | 4 years | Institutional PGY scale |
Residency pay and attending pay are separate conversations. The field that pays best after training isn’t the field that pays best during it. Picking a specialty off resident salary makes no sense at all, because you’re chasing a few thousand dollars now and giving up a difference of hundreds of thousands later.
Surgical interns are PGY-1s, so they start on the same rung as everyone else. Around $68,166 nationally, or whatever that specific institution pays its first years.
General surgery runs five years, so surgical residents climb higher up the scale than most. A PGY-5 chief averages roughly $81,807 under the 2025 figures.
The difference isn’t the money. It’s the hours. Surgery consistently reports some of the longest weeks in graduate medical education, and the paycheck doesn’t adjust for that. Same stipend, far more time in the hospital, much lower effective hourly rate.
Yes, essentially everywhere. Nearly all institutions run a PGY-based scale, so you advance automatically:
PGY-1 → PGY-2 → PGY-3 → PGY-4 → PGY-5
The bump usually runs 3% to 5%, which adds somewhere around $2,000 to $4,000 a year.
Worth keeping in perspective, though. Resident pay rose 2.2% from 2024 to 2025, the slowest growth since 2021, and that trailed inflation. Adjusted for CPI, real resident pay actually dipped slightly. So an annual raise mostly keeps you level rather than getting you ahead.
Some programs add cost-of-living adjustments, chief stipends, sign-on or education bonuses, and moonlighting once you’re license-eligible.
Benefits are worth real money, and they’re where programs differ most:
None of this is standardized. Two programs advertising the same stipend can be $10,000 apart in real value once you compare retirement matching, insurance premiums, and education money. Ask about it on interview day, knowing which questions to ask is part of what our residency interview preparation covers. The GME benefits page usually spells out more than the recruiter will.
Your stipend isn’t your paycheck. Here’s one month of a PGY-1 salary, line by line.
The setup: $68,166 a year, single filer, no dependents, living in a state with no income tax like Texas or Florida. Health insurance premium of $150 a month, taken out before taxes. No retirement contributions yet.
| Line | Monthly |
| Gross pay | $5,680 |
| Health insurance premium (pre-tax) | −$150 |
| Federal income tax | −$482 |
| Social Security (6.2%) | −$343 |
| Medicare (1.45%) | −$80 |
| Take-home | ≈ $4,625 |
So roughly $1,055 a month disappears. That’s about 18.6% of the gross.
The federal number surprises people because it’s lower than they expect. After the $16,100 standard deduction and the pre-tax premium, taxable income lands at $50,266, which keeps almost all of it inside the 12% bracket. Residents pay a fairly light federal rate. Payroll taxes are the part nobody can avoid.
Three things move that $4,625 in either direction:
State income tax: New York would take around $250 more a month at this salary. Live in New York City and city tax adds roughly $175 on top of that. California sits somewhere in between. Texas, Florida, Tennessee, and a handful of others take nothing.
Retirement contributions: Put 5% into a 403(b) and you lose about $284 a month, but you get $34 of it back in lower federal tax. Net effect is around $250, dropping take-home to roughly $4,375. Worth doing if your program matches.
Family coverage: Adding a spouse or kids to your insurance can double or triple that $150 premium line.
Stack the realistic worst case, high-tax city, family plan, retirement contributions, and a PGY-1 can land closer to $3,700. Same stipend, very different month.
These are estimates, not tax advice. Run your own numbers against your program’s actual stipend and your state before you sign a lease.
People ask this constantly and the answer disappoints them. It’s the hospital, not the specialty.
Because nearly every institution pays one rate per PGY level across all departments, no specialty pays more during training. The best-paying residency spots are simply the ones at expensive, well-funded institutions, and for IMGs, whether a program takes international graduates at all matters far more than its stipend, our list of top IMG-friendly programs with visa sponsorship is the place to start. Rent usually eats the regional difference anyway.
After training, everything flips. Medscape’s 2026 Physician Compensation Report put average physician pay at $386,000, primary care at $298,000, and specialists at $417,000. Eight specialties cleared $500,000, and if you’re curious which fields top the list, see our breakdown of the highest-paid doctors in the US. Specialty choice drives your income, just not yet.
Before salary matters, you have to match. We help IMGs build a program list around visa support, IMG-friendliness, and the factors that actually decide the Match.
| Stage | Typical Compensation |
| Medical student | No salary |
| PGY-1 | ~$68,166 |
| PGY-2 / PGY-3 | ~$70,499 to $73,301 |
| Fellow (PGY-4 and up) | ~$77,593 to $94,215 |
| Attending physician | ~$386,000 average |
That last row is the biggest single income jump in a physician’s career. An internal medicine resident finishing PGY-3 goes from about $73,000 to a starting attending salary several times higher. For IMGs, the path to that jump runs through the Match, and hands-on US clinical experience is one of the biggest levers on getting there. Just don’t blend the two datasets.
After training, everything flips.
The biggest one by far. Every completed year moves you up.
Cost of living explains most of the regional spread. Northeast and West pay more, and then charge you for it in rent.
Academic centers, community hospitals, and health systems all set their own scales. Two programs in one city can be thousands apart.
Longer specialties mean more years on the scale. Prelim and transitional years change where you enter it.
Retirement matching, premiums, and education allowances can swing total value by five figures even when the stipend looks identical on paper.
For IMGs, that last one deserves the most attention. A slightly lower stipend with strong benefits and cheap housing beats a bigger number in an expensive city almost every time, and visa support matters just as much, our guide on J-1 vs H-1B visas for IMG residency explains which programs sponsor what.
Book a free call with mentors who matched as IMGs. We’ll help you weigh visa sponsorship, benefits, and rent, not just the headline number, when you rank programs.
Yes. Residents are paid employees and receive a salary throughout training.
Roughly $68,166 at PGY-1 up to $94,215 at PGY-8, based on AAMC 2025 data. Your actual figure depends on the institution.
About $68,166 annually, or around $5,680 a month before deductions.
The same as everyone else at their institution and PGY level. They just spend more years on the scale and work more hours for it.
Yes. Residency is paid postgraduate training.
Most PGY-1s take home about $3,800 to $4,500 a month, depending on state taxes, filing status, and benefit choices.
In nearly all programs, yes. Increases usually run 3% to 5%.
The average US physician earned about $386,000 in 2025 per Medscape’s 2026 report. Primary care averaged $298,000, specialists $417,000.
Residency pays, just not much compared to what comes after. The salary climbs on a fixed scale each year, and the actual number comes down to the institution, the region, and what’s bundled into the contract. Specialty has almost nothing to do with it during training and almost everything to do with it afterward.
If you’re applying as an IMG, look past the headline figure. Compare insurance costs, retirement matching, education and licensing allowances, visa support, and local rent. A program paying $2,000 less on paper can leave you better off by June. Follow IMG Helping Hands blogs if you found this helpful as we are determined to guide you through every step of your journey.
The resident stipend is a bridge, and the far bigger income is on the other side of a successful Match. That’s the part we help IMGs get right. Here’s how:
1. AMA “Resident physician pay still rising, but growth trails inflation”
https://www.ama-assn.org/medical-residents/residency-life/resident-physician-pay-still-rising-growth-trails-inflation
2. AAMC Survey of Resident/Fellow Stipends and Benefits
https://www.aamc.org/data-reports/students-residents/report/aamc-survey-resident/fellow-stipends-and-benefits
3. Medscape Physician Compensation Report 2026
https://www.medscape.com/p11/return-normalization-medscape-physician-compensation-report-2026a10009um
4. Advisory Board “The current state of physician compensation, in 6 charts”
https://www.advisory.com/daily-briefing/2026/06/04/physician-compensation
5. Tax Foundation “2026 Tax Brackets and Federal Income Tax Rates”
https://taxfoundation.org/data/all/federal/2026-tax-brackets/
6. Congressional Research Service (via Congress.gov) RL34498
https://www.congress.gov/crs-product/RL34498
Articles published by IMG Helping Hands are prepared by our team using information from direct experience, publicly available resources, and educational references. AI tools may be used to assist with drafting, proofreading, and formatting; however, all content undergoes review and approval before publication.
The information provided is intended for educational purposes only. Requirements, policies, and processes may change over time. Readers should consult official sources for the most current information.
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