What Do Doctors Actually Make? The Real, Granular Version

Part of The Money the Job Makes. Nobody really told me this stuff when I was starting out, not honestly and not with the details. I'm a hospitalist, and the plain truth is that physicians barely know what each other make. Two doctors with the exact same title, ten miles apart, can earn double one another and never find out. If it's a black box to us, it's even more of one to an 18-year-old trying to figure out whether this is worth it. So here it is, in case it helps. I wish I'd had it.

A note on the numbers: every figure below is footnoted to its source at the bottom of the page, because I'd rather you not take my word for any of it. Compensation data also disagrees between surveys and changes every year, so treat these as a map of how the system works, not a promise of any single number.

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First, a memory

When I was a medical student, I had no income. None. I remember sitting in a restaurant looking at the menu, doing real math in my head. How do I get the most food out of this one chicken sandwich for the least money? That was the budget.

Around that same time, a friend of mine, 24 years old, was at Netflix making over half a million dollars a year, and he never once looked at a price. He told me later he was surprised watching me calculate my order down to the dollar. Same age, roughly the same starting line. Completely different worlds.

I tell you that because when you say "I want to be a doctor," a lot of people, maybe your parents, hear "I want to be rich." And the honest relationship between those two things is far stranger and more variable than anyone will tell you. So let me actually tell you.

The number you've seen, and why it's almost a lie

If you look this up, you'll find a clean, confident figure. As of the 2026 reports, the average physician earns around $386,000 a year. Primary care sits closer to $298,000. Specialists average about $417,000.¹

And that average is nearly useless. Not wrong, useless. It's the average of a distribution so wide that almost nobody actually sits at the average. Telling a premed "doctors make $386k" is like telling someone "the weather on Earth is 57°F." Technically true. Utterly unhelpful for deciding what to pack.

You'll even find that the two most-cited surveys, Medscape and Doximity, disagree with each other by $100,000 or more for the very same specialty, because they survey different doctors in different ways.¹² That disagreement is the lesson: the label doesn't set the number. Something else does. Several something-elses, actually.

The number that reframes everything

Look at emergency medicine, which publishes better data on itself than almost any other field. In ACEP's 2025 salary survey, an EM physician at the 25th percentile earned about $248,400 and one at the 75th earned about $432,000. Same specialty, same residency, same board exam.³

That quartile band is the conservative version, because it deliberately cuts off both tails. ACEP does not publish a true 10th or 90th percentile, but it does publish the whole distribution, and the ends sit well outside the quartiles: 4% of respondents reported under $100,000, 14% reported under $200,000, and 13% reported $500,000 or more. So the observed range inside this one specialty runs from under $100,000 to past $500,000.³

One finding in the same survey runs backwards. Compensation moves inversely with patient volume. Physicians at departments seeing fewer than 30,000 patients a year reported a median of $360,000, and those at departments seeing 70,000 or more reported $305,000. Academic and faculty roles sat at $249,100, against $360,000 for a clinical emergency physician.³

The survey also names the lever. Split the same specialty by employment model and you get an employed physician at about $310,000, a contractor at about $406,000, and a partner in a democratic group at about $431,000 — roughly 39% more for the partner than the employee, in the same job.³

Stop on that last set of numbers. Nothing about the training, the years, or the work differs across it the way it would between a pediatrician and a plastic surgeon. Both sides are the same doctor, the same residency, the same shifts, and $121,000 a year of difference that comes from how the job is structured rather than from what the job is.

Specialty matters. The second set of decisions, made after the specialty is settled, moves six figures on its own, and for most people it gets made by default, because the levers were never named.

For scale: on 2026 survey data the distance between the average pediatrician and the average plastic surgeon is around $290,000.¹ The employment-model gap inside emergency medicine is a little over 40% of that, on top of whatever specialty you chose, and it is available to you without eleven more years of training.

So the biggest financial decision of your career is probably still what specialty. The second biggest is a set of levers, and it is the one you can still change. Here they are.

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Lever 1: Geography, and the paradox that trips people up

"Geography" is really two different levers stacked together: the region you're in, and whether you're urban or rural within it. Both matter, and they don't always point the same way.

Region

Physicians tend to earn more in the Midwest and South, and less in expensive coastal metros like Boston, New York, DC, San Francisco, and Seattle. Take my own field. By region, hospitalist pay looks like this:⁴

Region	Avg hospitalist comp
Midwest	~$384,000
South	~$352,000
Mountain	~$343,000
Southwest	~$335,000
Pacific	~$327,000
Northeast	~$322,000

The Midwest pays roughly $62,000 more (about +19%) than the Northeast for the same job.⁴

Urban vs. rural (this may matter even more)

Now layer on the second axis: rural and small-town jobs pay more than urban ones, often a lot more. This is separate from region. A rural hospital in a "low-paying" state can out-pay an urban academic center in a "high-paying" one.

Why? Simple supply and demand. Everyone wants to live in the city. Far fewer doctors want to move to a small town three hours from an airport. So rural and "critical-access" hospitals, chronically short-staffed, have to compete for you: higher salaries, bigger signing bonuses, loan repayment. Urban centers, drowning in applicants, don't. Look at typical first-year offers for the same specialties:⁵

Specialty	Urban academic	Rural / small-town
Family medicine	~$210,000 + $10k sign-on	~$260,000–$280,000 + $40k sign-on
General internal medicine	~$220,000 + $10k	~$280,000–$300,000 + $50k sign-on
Hospitalist (7-on/7-off)	~$260,000–$280,000	~$300,000–$330,000

At the far end, a hospitalist at a true rural or critical-access hospital can reach $350,000–$450,000 on AMN's and MedMoneyGuide's figures.⁶ That's the same work I do, for potentially $100,000+ more a year. The trade is simply where you live.

And then cost of living makes the gap even wider

The urban coastal doctor doesn't just earn less on paper. That smaller paycheck also buys far less. Adjusted for cost of living, the worst places in the country to be a physician financially are Boston, DC, Seattle, San Francisco, and Denver. The best are places like Rochester (Minnesota, home of the Mayo Clinic), St. Louis, Oklahoma City, and Omaha.² To make it concrete: $350,000 in Oklahoma City can leave you roughly twice the monthly discretionary income of that same $350,000 in San Francisco, once you pay taxes and rent.¹ Same salary, double the life.

So the doctor quietly building wealth isn't the one in the penthouse over Central Park. It's often the one in a small city you've never thought about, with a paid-off house and a ten-minute commute.

(One honest note: you'll hear people say "a New York hospitalist makes under $200k while one in Kansas makes $400k." The truth is a bit more precise. The regional average on the coast is around $320k, not $200k. That sub-$250k figure is real, but it's specifically the urban academic job, a prestigious teaching hospital in an expensive city, the single lowest-paying combination that exists. So the honest, still-striking version: an urban academic hospitalist might earn $220,000–$250,000 while a rural Midwest hospitalist earns $400,000+ for the same clinical work. That's a $150,000-plus swing driven entirely by geography and setting, not by how good a doctor you are.)

Bottom line

Region and urban-versus-rural are two levers, and here they point in opposite directions: the same Midwest that pays best overall contains the metro postings at the bottom of this chart.

Lever 2: Setting, which moves the number more than the specialty does

Where you work, the type of employer, may move your income more than your specialty does.

Roughly, from lowest-paying to highest: academic medical centers pay the least, hospital-employed jobs sit in the middle, and private practice (especially as an owner) pays the most. Some real numbers:

• In cardiology, the private-practice median runs around $575,000 vs. about $484,000 in academics, a ~$90k gap.⁷ In gastroenterology, it's roughly $679,000 private vs. $468,000 academic, over $200,000 for the same specialty, decided purely by setting.⁷
• In my world, the academic hospitalist discount is about $50,000–$75,000 a year versus a community hospital.⁴

Academic medicine pays less for concrete reasons: your time is split with teaching and research (less of your day is billable), these centers see more Medicaid and uninsured patients (which reimburse less), and the prestige and mission are treated as part of the pay. People accept less to be at a big-name university hospital. That's a real, legitimate choice. I just want you to know you're making it, and roughly what it costs.

And then there's ownership, the real multiplier. When you're a partner in a private practice, you don't just earn a salary. You earn a share of everything the practice owns: the in-house imaging, the labs, the surgery center, the physical therapy. For some private specialists, ancillary income like that is 50–60% of what they take home.³ It's the difference between being paid for your hands and being paid for the whole business your hands run.

This is where the "cardiologist who made a million dollars" story comes from. A private interventional cardiologist who owns a piece of the cath lab genuinely can clear $750,000 to over $1 million.⁸ A salaried general cardiologist at a university hospital in a big city might be at a fraction of that. Same word on the door, "cardiologist," but radically different economics: one is an owner running procedures, the other an employee on a salary line.

One trend is reshaping all of this: private practice is disappearing. In 2012, about 60% of physicians were in private practice. By 2024 it was down to roughly 42%.⁹ More of us are employed by hospitals or, increasingly, by private-equity-owned groups. Generally more stability, less of that ownership upside. The road to the $1M private-practice number is narrowing.

Bottom line

Gastroenterology's setting gap is larger than the entire distance between the average pediatrician and the average emergency physician. It is decided after the specialty is chosen.

Lever 3: How you're actually paid, whether salary, RVUs, or shifts

This is the machinery under the hood. There isn't one system. There are several, and which one you're on changes everything.

Salary. Plenty of physicians, many hospitalists and most academics among them, are simply paid a flat annual salary. They show up, do the work, and the number doesn't move with how many patients they see. I'm one of them: I'm salaried, and I've never counted an RVU in my life. Predictable, no volume pressure, often a lower ceiling. This model is far more common than premed forums make it sound.

Productivity (the RVU model). Every service you provide is assigned points, "work relative value units," or wRVUs, by Medicare. A quick 15-minute visit might be ~1.3 points, a complex visit ~2.8, a cataract surgery ~10.3.¹⁰ At year's end your points get multiplied by a dollar rate, commonly $50–$62 per point, varying by specialty and employer.¹⁰ Two consequences fall out of this, and they explain a lot about medicine:

• Volume is money. A doctor seeing 30 patients a day generates more points, and more income, than an identical doctor seeing 18. Busier means more pay.
• Procedures beat conversations. The point system rewards doing things to people (surgeries, scopes, injections) far more per minute than thinking and talking with people (diagnosing, counseling, managing chronic disease). This is why a proceduralist can out-earn, per hour, a primary care doctor working the same hours. It's part of what people mean when they say the incentives in medicine are a little broken.

Shift-based / hybrid. Many hospitalists are paid per shift, or a base plus a small per-patient or per-RVU bonus above a threshold. Signing bonuses (averaging ~$31,000) and student-loan repayment (averaging ~$117,000 when offered, but only in ~17% of jobs, usually rural) ride on top.¹¹

Two doctors, same specialty, same city, one salaried and one on a high-volume RVU deal, can be $200k apart, and neither of them is "wrong." They chose different machines.

Lever 4: Specialty and sub-specialty, where the labels mislead

Yes, specialty matters. Here's the rough ladder (2025–2026 data, and remember, surveys disagree, so treat these as ranges):¹²

Tier	Specialties	Ballpark average
Top	Neurosurgery, orthopedic surgery, cardiothoracic surgery	$650,000–$750,000+
High	Cardiology, radiology, plastics, urology, GI, anesthesiology, ENT	$500,000–$600,000
Middle	Dermatology, general surgery, oncology, ophthalmology, EM, critical care	$420,000–$510,000
Lower	OB-GYN, psychiatry, neurology, PM&R, nephrology	$330,000–$395,000
Bottom	Internal medicine, family medicine, endocrinology, infectious disease, pediatrics	$265,000–$310,000

But more training does not always mean more money. We're trained to assume a fellowship, extra years of specialization after residency, is always a step up. It isn't.

• A hospitalist (no fellowship) can earn $300,000–$350,000. An endocrinologist or infectious-disease doctor, who did two extra years of fellowship, often earns less than that hospitalist.¹² They trained longer to earn less.
• Pediatrics is the starkest case. General pediatrics averages about $265,000. Several pediatric sub-specialties, after a three-year fellowship, pay below that: pediatric endocrinology ($230k), pediatric rheumatology ($232k), pediatric infectious disease (~$248k).¹³ You do three more years of grueling training to make roughly $30,000 less. (Adult versions of these same fields pay far more, an adult hematologist earns nearly double a pediatric one, mostly because of how the work gets billed, not how hard it is.)¹³

So "I'm going to be a doctor," or even "I'm going into peds," tells you shockingly little about what someone will earn. The sub-specialty, and every other lever, matters more.

And if you care about life, not just salary, look at pay per hour instead of per year. Dermatology earns less per year than cardiology but more per hour, because dermatologists work ~10 fewer hours a week with almost no nights or call. Orthopedic surgery and family practice work nearly the same hours, but ortho pays roughly twice as much per hour.³ The number on the offer letter and the number your life actually feels are two different numbers.

Lever 5: Schedule and employment type

The last of the big five is the shape of the work itself.

• Night work pays a premium. A nocturnist, a hospitalist who works only nights, earns roughly 8–12% more than a day hospitalist (in hot markets, FastRVU's 2026 guide says up to 25%), often while working fewer shifts.¹⁴ You trade your circadian rhythm for money and time. (Wrinkle: nocturnists often get smaller bonuses, taking the premium in base pay instead.)⁴
• The schedule itself is compensation. Hospitalists famously work 7 days on, 7 days off, roughly half the year. Long, hard shifts, including nights and weekends. But that structure is a real reason people choose the field, and it never shows up on a salary chart.
• Locum tenens (temp/traveling work) pays a higher hourly rate. A hospitalist locum might make $140–$200/hour, annualizing to $380k–$430k, but you're a 1099 contractor with no benefits, no retirement match, no paid time off, and your own taxes and malpractice to handle.¹⁵ The big gross number shrinks once real life is subtracted, and by how much is Two Offers, Same Number, Different Jobs.

One more lever: negotiation

This lever isn't on any salary survey, and for a first-generation student it might be the most important one: a huge amount of what you'll earn comes down to whether, and how well, you negotiate.

Two doctors get identical offers. One signs it. The other counters, on base, on the signing bonus, on the RVU rate, on how many shifts, on loan repayment, on start date, and walks away with tens of thousands more per year, every year, compounding for a career. Nothing about their medical skill differs. One just knew that the first offer is a starting point, not a verdict.

This is pure hidden curriculum. Kids from professional families often grow up knowing everything is negotiable. If you grew up like I did, where a price was a price and you were grateful for the job at all, nobody tells you that you're allowed to ask for more, and not asking can quietly cost you a fortune.

Leverage isn't equal everywhere, though, and some employers genuinely won't budge. Large academic and hospital systems often run on rigid, pre-set salary bands, and sometimes "that's the number" really is the number. No amount of skillful asking will move it. But private practices, community hospitals, and especially short-staffed rural groups often have enormous room, on base, signing bonus, loan repayment, start date, number of shifts. So the skill is knowing where you actually have leverage and pushing hard there, and not talking yourself out of asking in the places where the answer could easily have been yes. The first offer is a starting point until you've confirmed it isn't.

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A worked example: what a hospitalist actually makes

Let me put it all together with my own field, honestly.

A typical full-time adult hospitalist in 2024 earned around $330,000–$355,000 in total compensation. Call it ~$348,000 as a solid anchor, including an average bonus of about $43,000.⁴ Now watch what the levers do to that one number:

• Take it to a rural, short-staffed Midwest hospital: $400,000+.⁶
• Take it to a prestigious urban academic center in an expensive city: $220,000–$250,000.⁴
• Look at urban hospitalist jobs in a big city: even in the "high-paying" Midwest, postings in a major metro can run just $210,000–$240,000. The region is supposedly one of the best-paying in the country, but the urban location, and the oversupply of doctors who want to live there, drag the number well below what a rural hospital two hours down the highway would pay. Region and urban-vs-rural are two different levers, and right here they point in opposite directions.
• Do it as a locum: maybe $380,000 gross, minus the benefits you now buy yourself.¹⁵
• Stay 15 years vs. start fresh: surprisingly little difference. Hospitalist pay is fairly flat across experience (only ~4% from entry to senior).⁴ In my field, experience barely moves the number. The levers above do almost all the work.

That's easily a $150,000+ swing on the identical job title, driven by geography, urban-vs-rural, setting, schedule, pay model, and how you negotiated. Not by talent, not by seniority, and not by how good a doctor you are.

Bottom line

Fifteen years of experience moves this number by about 4%. Three of the four rows above move it by more than ten times that.

So what does this mean for you?

A few things I'd want a younger version of me to take from all this:

Don't pick a specialty off the average. The average lies, and the levers matter more. A well-positioned family physician who owns their practice in a low-cost small city can out-earn, and out-live, a salaried subspecialist in an expensive one.

Geography, urban-vs-rural, and setting may shape your finances more than specialty does. These are choices, and they're yours. You can build real wealth as a doctor in a "boring" town.

Learn to negotiate, and know which pay model you're signing up for. These are the hidden levers students leave on the table by accident. Don't.

The money is real. It's just slow, variable, and never automatic. Being a physician gives you something rare: a genuine shot at financial security no matter where you came from. But it isn't a lottery ticket that pays everyone the same. What you earn is built, from the choices in these levers.

And I have to say it, and I mean it: please don't choose your specialty for the money. Choose it because you can see yourself doing it at 3am when it's hard. The pay differences are real, but they're smaller than the difference between a career you love and one you endure. Do the thing you'd be proud to be great at. Then use what's here to make sure you're not leaving your future, and your family's, on the table by accident.

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Compensation figures change every year and vary enormously by individual situation, so treat this as a map of how the system works, not a promise of any specific number, and always verify current figures before making decisions. This is educational information, not financial advice. — Last reviewed: 2026-08-06

References

A transparency note: the most authoritative percentile-level datasets (MGMA's Provider Compensation report and the Society of Hospital Medicine's State of Hospital Medicine) sit behind industry paywalls; where their figures appear here, they're cited via reputable secondary reporting. For a public resource, this page is worth re-checking annually as new reports come out.

Footnotes

1. Medscape Physician Compensation Report 2026. Overall average ~$386k; primary care ~$298k; specialists ~$417k; the per-specialty table behind the pediatrician-to-plastic-surgeon gap (pediatrics ~$266k, plastic surgery ~$554k). Reported via The DO, What physicians are getting paid in 2026: https://thedo.osteopathic.org/2026/07/what-physicians-are-getting-paid-in-2026/ and White Coat Investor, How Much Do Doctors Make? [Salary by Specialty]: https://www.whitecoatinvestor.com/how-much-do-doctors-make/. The San Francisco vs. Oklahoma City discretionary-income line is an illustration computed from tax and housing costs on the same salary, pointing the same direction as the cost-of-living-adjusted metro data in footnote 2; no public survey publishes that exact figure. ↩ ↩² ↩³ ↩⁴ ↩⁵

2. Doximity 2025 Physician Compensation Report — nominal and cost-of-living-adjusted metro rankings; best/worst metros for real physician pay; documents the survey-to-survey disagreement. https://www.doximity.com/reports/physician-compensation-report/2025 ↩ ↩² ↩³

3. ACEP 2025 Salary Survey Findings (published 2025, data collected late 2024) — emergency-medicine percentiles (25th $248,400 · median $330,000 · 75th $432,000); the note that true 10th and 90th percentiles are not published, alongside the full distribution histogram (4% under $100,000 · 14% under $200,000 · 13% at $500,000 or more); the inverse relationship between total clinical compensation and patient visits (under 30,000 visits $360,000 · 70,000+ visits $305,000); median by primary role (emergency physician $360,000 · EM academic/faculty $249,100); and the employment-model spread (W2 employee ~$310,000 · 1099 contractor ~$406,000 · democratic-group partner ~$431,000). https://www.acep.org/siteassets/sites/acep/media/compensation-report/2025-salary-survey-findings.pdf Replaced a 2015 figure on 2026-08-04. The previous $213k/$510k pair came from a White Coat Investor page reproducing an unnamed 2015 survey that its own source described as outdated, and the article claimed no better published percentile pair existed outside a paywall. That was no longer true: ACEP publishes one free, and this site's own emergency medicine profile was already citing it. Corrected again 2026-08-18. The footnote and the sentence it supports had placed low-volume roles at the bottom of the range and locums-heavy, high-shift practices at the top. The survey reports the opposite relationship with volume, so the low-volume attribution ran backwards; it publishes no compensation breakout for locum tenens work, which is 2% of respondents, and no dollar figure above $500,000 appears in it. The $240,000s belong to academic and faculty roles, at $249,100. Urban respondents' median is $297,700, $91,800 below rural. ⟳ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

4. Today's Hospitalist 2024 Compensation Survey — hospitalist pay by region; academic vs. community discount; nocturnist premium and bonus differential; shift differentials; the flat experience curve; the ~$348k average and ~$43k average bonus. Survey overview ($348,231 average, ~$43k in bonuses, academic $303,624 vs. nonacademic $355,307, and the ~$15k entry-to-senior spread): https://todayshospitalist.com/factors-affecting-hospitalist-pay-bonuses-experience-patient-volume-location/; regional table: https://todayshospitalist.com/hospitalist-pay-region-which-part-country-pays-most/; nocturnist bonus differential (2022 survey): https://todayshospitalist.com/nocturnists-paid-more-but-dont-get-all-perks/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

5. Urban-academic vs. rural/small-town first-year offer table, compiled from physician-recruiting listings; treat the specific cell values as directional rather than surveyed. The direction and rough magnitudes match AMN Healthcare's 2024 Review of Physician and Advanced Practitioner Recruiting Incentives, which reports academic vs. non-academic starting salaries (family medicine: $249,000 academic average, $211,000 academic low, vs. $274,000 non-academic average with a $460,000 high; internal medicine: $236,000 academic vs. $276,000 non-academic) and average signing bonuses near $30,000 for family and internal medicine. https://www.amnhealthcare.com/siteassets/amn-insights/physician/incentive-review-2024-final.pdf ↩

6. AMN Healthcare hospitalist salary guide and MedMoneyGuide — rural and critical-access hospitalist compensation reaching $350,000–$450,000. Corrected 2026-08-17: both hosts are now named in the sentence that prints the range, because an aggregator figure stays where it is the only figure there is and puts the host where the reader meets the number. The recap bullet later in the piece ("$400,000+") restates the same claim and is left as it reads. ↩ ↩²

7. Physician Side Gigs, private-practice vs. academic compensation by specialty — cardiology (~$575k vs. $484k), gastroenterology ($679k vs. ~$468k), and others. Both figures are on the page, which describes them as self-reported member salary data from mid-2023 to mid-2025: https://www.physiciansidegigs.com/private-practice-vs-academic-physician-compensation-by-specialty (MaritHealth publishes similar comparisons but its site refuses automated fetching, so it is not linked here). On Marit Health: it publishes a panel of self-reported physician salaries, and displays MGMA and AMGA benchmarks beside them that are masked unless you create an account. The figure quoted here comes from the self-reported panel, not from either benchmark. Read it as crowd data: unweighted, of unstated sample size, and directional. ↩ ↩²

8. MedAxiom / Cardiovascular Business cardiology compensation survey — general vs. interventional vs. electrophysiology; private-practice/ownership economics and the $750k–$1M+ interventional range. MedAxiom's 2023 survey medians, summarized by TCTMD: invasive $775,000, interventional $755,840, and electrophysiology $746,444 in integrated practices, with private equity now owning about half of private cardiology groups: https://www.tctmd.com/news/private-equity-firms-own-half-cardiology-practices-medaxiom-survey. The seven-figure upper tail is percentile data behind the MedAxiom and MGMA paywalls; Cardiovascular Business's own coverage refuses automated fetching and is not linked. ↩

9. AMA Physician Practice Benchmark Survey 2024 — physicians in private practice falling from ~60% (2012) to ~42% (2024); rise of hospital and private-equity employment. The AMA's own summary puts it at 60.1% in 2012 and 42.2% in 2024, with hospital-owned practices rising from 23.4% to 34.5%: https://www.ama-assn.org/practice-management/private-practices/smaller-share-doctors-private-practice-ever ↩

10. MaritHealth / RVU compensation references — what a wRVU is, sample point values (CPT codes), and typical conversion factors of ~$50–$62 per wRVU. On Marit Health: it publishes a panel of self-reported physician salaries, and displays MGMA and AMGA benchmarks beside them that are masked unless you create an account. The figure quoted here comes from the self-reported panel, not from either benchmark. Read it as crowd data: unweighted, of unstated sample size, and directional. ↩ ↩²

11. AMN Healthcare 2024 Physician Recruiting Incentives Review — average signing bonus ($31k), relocation, and student-loan repayment ($117k, offered in ~17% of searches). The report itself: average signing bonus $31,473, average relocation allowance $11,284, and educational loan forgiveness averaging $117,217 where offered, in 17% of searches. https://www.amnhealthcare.com/siteassets/amn-insights/physician/incentive-review-2024-final.pdf ↩

12. Medscape Physician Compensation Report 2026 puts diabetes and endocrinology at about $284,000 and infectious disease at about $282,000 (per-specialty table via The DO: https://thedo.osteopathic.org/2026/07/what-physicians-are-getting-paid-in-2026/), while Today's Hospitalist's 2024 survey puts the average hospitalist at about $348,000 (https://todayshospitalist.com/factors-affecting-hospitalist-pay-bonuses-experience-patient-volume-location/). Across both surveys, the two fellowship-trained specialties sit below the no-fellowship hospitalist. ↩

13. Doximity 2025 report and Doximity Op-Med, The Salary Problem in Pediatric Subspecialties — pediatric endocrinology, rheumatology, and infectious disease averaging below general pediatrics; adult-vs-pediatric same-field pay gaps. The report carries the figures (pediatric endocrinology $230,426, pediatric rheumatology $231,574, pediatric infectious disease $248,322, general pediatrics $265,230, and adult hematology-oncology 93% above pediatric): https://www.doximity.com/reports/physician-compensation-report/2025. The Op-Med essay is the narrative companion: https://opmed.doximity.com/articles/the-salary-problem-in-pediatric-subspecialties ↩ ↩²

14. Today's Hospitalist (2022 survey) and fastrvu/medmoneyguide — nocturnist premium of ~8–12% (up to ~25% in some markets), shift/pay-model structures. The 2022 survey found nocturnists earning 8.5% more per year and 12% more per hour than day hospitalists: https://todayshospitalist.com/nocturnists-paid-more-but-dont-get-all-perks/. FastRVU's 2026 guide states a 15 to 25% premium in current postings: https://fastrvu.com/articles/hospitalist-nocturnist-compensation Corrected 2026-08-17: the 8–12% is Today's Hospitalist's survey and the body sentence carried the 25% ceiling unattributed, so FastRVU is now named for that half. MedMoneyGuide is cited here for shift and pay-model structure and supplies no figure the body prints. ↩

15. Locumstory (CHG), Barton Associates, and Weatherby — locum tenens hospitalist hourly rates (~$140–$200/hr) and the 1099 trade-offs (no benefits, self-employment tax, own malpractice). Barton's hospitalist guide states $140 to $200 per hour and annualizes a full locum year at $175/hr to roughly $382,000: https://www.bartonassociates.com/internist-salary-guide/. Locumstory covers how 1099 pay, quarterly taxes, and agency-provided malpractice work: https://locumstory.com/spotlight/locum-tenens-pay ↩ ↩²