Pediatrics — Specialty Profile

Exploratory, not prescriptive. This profile blends hard data (pay, match rates, burnout, demographics — each sourced and dated) with generalizations and synthesized online opinion about culture and "who fits." It's here to help you get curious and go find out for yourself — not to tell you who to become. Numbers marked ⟳ verify change every year; check the linked source before you quote one. Last reviewed: 2026-07-25.

Also called: peds, general pediatrics. Base residency you enter straight from medical school. Patient population: humans from birth through adolescence (and, for some chronic patients, into young adulthood).

The 30-second version

Pediatrics is the specialty of the whole child, organized around an age rather than an organ or a disease. You do well-child checks and vaccines, catch developmental delays, manage asthma and diabetes and the growing tide of adolescent mental-health, reassure anxious parents, and always treat the family as much as the patient. It is widely regarded as one of the most meaningful jobs in medicine and one of the lowest-paid. That single tension is the whole personality of pediatrics: deep purpose against the smallest paycheck in the field, off the exact same training length as everyone else. It is the thing a premed most needs to understand before falling in love with it.12

Quick dashboard (details and sources below)
Training after med school 3 years
Total from college start ~11 years (4 undergrad + 4 med school + 3 residency)
Competitiveness Low-to-moderate — and unusually accessible right now, but softening ⟳
Typical full-time pay ~$265,000 total comp — the lowest or near-lowest of any specialty ⟳
Pay range (structure) BLS state means ~$144k (DC) → ~$354k (LA); rough working spread ~$200k–$330k+ ⟳
Lifestyle Generally humane, esp. outpatient — but dense, high-volume, admin-heavy
Burnout ~51% (Medscape 2024) — around 4th highest, at/above the physician average ⟳
% women ~66.7% practicing · ~75% of residents — the most female specialty in medicine ⟳
DO / IMG accessibility Unusually open to IMGs, ordinary for DOs — 30.4% IMG of filled positions against a 25.2% all-PGY-1 baseline, and 21.1% DO against 21.5% (2026) ⟳

What they actually do

General pediatricians care for people from birth through adolescence, and the job is far broader than the "colds and ear infections" stereotype. On any given clinic day you move between well-child visits and vaccines (the preventive core of the field), acute minor illness, developmental and behavioral screening, chronic-disease management (asthma, diabetes, obesity), and a growing load of adolescent mental-health concerns. The defining skill is longitudinal, family-centered generalism rather than a single procedure: reading a child who can't always tell you what's wrong, catching the subtle deviation from a normal growth or developmental curve, and managing the parent's anxiety as deliberately as the child's illness.1

Pediatrics is also not one job. The setting changes the work almost entirely: outpatient/clinic general peds is high-continuity, high-volume, and lightest on call; inpatient/hospitalist work is shift-based with more nights, weekends, and acuity; the newborn nursery adds deliveries and early feeding/jaundice management; and the subspecialty ICUs (NICU, PICU) are high-acuity, procedure-adjacent, and emotionally intense.3

Representative work and procedures: well-child exams and anticipatory guidance · immunizations · growth and developmental surveillance · newborn resuscitation and nursery care · lumbar puncture · management of acute pediatric illness (dehydration, asthma exacerbation, febrile infant) · chronic-disease and behavioral-health management · (in inpatient/ICU settings) intubation, lines, and advanced resuscitation of children.3

A day in the life (outpatient general peds): a schedule packed with well-child checks and sick visits, ~40–50 hours a week, relatively light call, but dense: short visits, high volume, a Medicaid-heavy panel, and an EHR in-basket that fills faster than you can empty it. You build relationships with families over years, which is the part pediatricians say they love; you also carry the administrative and reimbursement weight that makes "good hours" feel heavier than the clock suggests.34

The training path & time to completion

Medical school (4 yrs) → pediatrics residency (3 yrs) → board-eligible with ABP. No fellowship is required to practice as a general pediatrician. You finish a 3-year residency, sit the American Board of Pediatrics General Pediatrics Certifying Exam, and can practice as a full attending.5

  • Residency: a standard 3-year categorical program (PGY-1 through PGY-3) after medical school.5
  • Board: the American Board of Pediatrics (ABP), which administers the General Pediatrics Certifying Exam and Maintenance of Certification.5
  • Total from the start of college: ~11 years (4 undergrad + 4 med school + 3 residency), i.e. ~7 years post-college to general board eligibility. Subspecialists add a fellowship (below).5
  • Fellowships are mostly 3 years, so a subspecialist is roughly ~10 years post-college (7 + 3). There are ~15 primary ABP subspecialties, nearly all 3-year, plus co-sponsored fellowships of variable length.56

How competitive is it?

Pediatrics is, right now, one of the more instructive match stories in medicine, a field that used to fill reliably and has recently, visibly, softened.

For years categorical pediatrics filled at ~97%+, 97.2% in 2022 and 97.1% in 2023. Then it dropped: in 2024 the categorical fill rate fell to 91.8%, with 252 unfilled positions of 3,078 offered, the largest single-year applicant decline in a decade, and the share filled by US-MD seniors fell to 47.6%, down 7.2 points. The AMA flagged pediatrics as that year's "surprise." It recovered part of the way in 2025, to 95.3% with 147 unfilled of 3,135 offered, and then slipped again in 2026, to 94.4% with 175 unfilled of 3,126 offered. Two cycles on, what looked like a rebound is a plateau: pediatrics no longer fills at its historical near-full level, and it now routinely leaves 150 to 250 categorical spots to the SOAP.78910

What that means for you today:

  • Not supply-constrained. Matched applicants roughly track available positions and the field does not fully fill, so the effective applicant-to-position ratio is near/just above 1.0. (NRMP doesn't publish a single clean ratio for peds; derive it from Results & Data Table 1.)9 ⟳
  • Matched US-MD seniors: mean USMLE Step 2 CK 247 (2024 cycle; DO seniors 241, US-IMG 233, non-US-IMG 240).11 ⟳
  • The entering class is diverse by school type: of the 2026 categorical cohort, roughly US-MD ~49%, US-DO ~21%, US-IMG ~7%, and non-US-IMG ~23%. The openness is one-sided, and it is worth being precise about which door is wide. Pediatrics took 30.4% of its filled positions from international graduates against 25.2% across all PGY-1 positions, which is genuinely one of the wider IMG doors among desirable fields; its 21.1% DO share sits at the 21.5% all-specialty average. The international share is also the piece that keeps rising, from 28% of the filled class in 2025 to 30% in 2026.1012 ⟳

The honest read: pediatrics is very reachable right now, a realistic target even without an elite research pedigree, but the same softening that opened the door is a real signal about how premeds and students are weighing the field's pay against its debt (see Compensation and the FLI angle). Sentiment is genuinely split between "this is a warning sign for the specialty" and "this makes it a humane, attainable path."4

Compensation — the robust version

This is the section that matters most for pediatrics: general pediatrics is consistently among the lowest-paid physician specialties in the United States, and frequently the single lowest-paid in the major survey rankings. This is a durable, structural pattern across Medscape, Doximity, and BLS rather than a bad year or a rounding artifact. A note on sources first: total-comp surveys (Medscape, Doximity) run higher than BLS (which captures W-2 wages only), and crowdsourced sites (SalaryDr) run higher still by self-selection.1213

National number. Depending on source and definition, general pediatrics lands from ~$222,987 (BLS payroll mean, May 2024) to ~$265,230 (Doximity 2025, 2024 data) to ~$266,000 (Medscape 2026, 2025 data). The defensible "typical full-time" figure to cite is ≈ $265,000 total compensation (2024–2025), the lowest or near-lowest of any specialty. SalaryDr's crowdsourced ~$310,000 median skews high and small-sample; treat it with caution.1213 ⟳

Where it sits in the ranking, and the proof. In Medscape's 2026 report (2025 data), pediatrics is #29 of 29 specialties (dead last) at ~$266K, below public health ($277K), infectious diseases ($282K), rheumatology and endocrinology ($284K), family medicine ($288K), and internal medicine ($307K). For scale, the top specialty (orthopedics, $611K) earns roughly 2.3× pediatrics. Doximity's 2025 report ranks it 47th of 51 specialties. Even within primary care pediatrics is the floor: on Doximity 2025, family medicine is $318,959 against peds $265,230, so FM pays roughly 20% more.21314 ⟳

The spread (structure). Clean national percentile bands for general-peds total comp sit behind paywalls (MGMA, SullivanCotter show no public numbers). Public anchors: BLS state means run from $143,880 in DC, likely academic-skewed, to $354,060 in Louisiana; W-2 employed hourly mean ≈ $107/hr. No locum tenens rate is quoted here: the published pediatric locum bands come from the staffing agencies that broker the placements, and a seller's own price is not evidence of a market rate.15 FastRVU's 2026 productivity benchmark, an aggregator's own compilation rather than a licensed survey, puts pediatrics wRVU percentiles at 25th 3,500 · median 4,600 · 75th 5,800 · 90th 7,200, though it publishes no dollars-per-wRVU rate for peds. A rough working spread to cite: most general pediatricians fall ~$200K (25th/early-career/part-time) to ~$330K+ (75th–90th/high-productivity/partner), median ~$265K, with endpoints approximate; verify against MGMA or SullivanCotter.131516 ⟳

Starting against experienced, a flat ramp. New-grad offers average ~$244,000 (Merritt Hawkins recruiter data, 2024); overall median ~$265,000; experienced private-practice partner/owner ~$320,000. The starting-to-experienced climb is relatively flat compared with procedural fields, and the biggest lever for experienced earnings is practice ownership or partnership rather than seniority. Incentive bonuses are small: Medscape put the average pediatric incentive bonus near ~$26,000, close to the bottom (vs. ~$116,000 for orthopedics).151718 ⟳

Academic vs. private/community. Academic ~$244,000 · private-practice employee ~$250,000 (only ~$6k over academic) · blended private ~$278,000 · private partner/owner ~$320,000 (31% over academic). The academic discount for employed pediatricians is small ($6k); the real money is in ownership. Academic peds trades cash for research/teaching time and (sometimes) loan-forgiveness eligibility.17 ⟳

Employment models. Straight salary (common in hospital-employed/academic; predictable, lower ceiling) · salary + wRVU productivity (increasingly standard) · pure productivity / eat-what-you-kill (private partners; highest ceiling but most exposed to payer mix). Across all models the structural anchor on pay is the same: about 37% of US children are covered by Medicaid or CHIP, which reimburses below cost of care (roughly two-thirds of Medicare rates), and pediatrics has few high-RVU procedures.141719 ⟳

Geography. Higher-paying markets skew lower-cost, non-coastal, or supply-constrained (Louisiana, Alaska, upper Midwest on top by BLS state means); prestigious academic-dense high-cost metros often pay less nominally and far less after cost of living. Rural/underserved markets generally pay more to attract pediatricians (sign-on and loan-repayment incentives common), though a single clean national urban-vs-rural dollar delta for peds wasn't found. Doximity's 2025 metro figures (e.g., Rochester MN ~$495k, Charlotte ~$448k) run far above the national median and likely reflect small samples or a different comp basis, so treat them as suspect.1315 ⟳

The trend that colors all of it. Pediatrics pay is falling in real terms. Doximity: pediatricians earned $14,590 less in inflation-adjusted 2024 dollars than in 2017, a −6.7% real decline, and 2024→2025 nominal growth was only ~+2.2% against +3.7% for physicians overall. Pediatricians know it: only ~45% feel fairly compensated (Medscape 2026); 87% told Doximity their pay is unfair relative to work complexity and hampers debt repayment, 69% have considered a career change, and 65% have made practice changes (more volume, less staff) to cope. The physician gender pay gap (~26% in 2024) compounds this in a majority-women field.132021 ⟳

The fellowship penalty — pediatrics' signature pay quirk

Here's the counterintuitive, important, honest point premeds almost never hear: completing a 3-year pediatric fellowship, three more years of low-paid training and often more debt, frequently yields the same or LESS than staying a general pediatrician. This is documented directly in Doximity's own numbers.214

Pediatric subspecialties paying below general peds ($265,230, Doximity 2025 / 2024 data): Endocrinology $230,426 · Rheumatology $231,574 · Infectious Disease $248,322 · Hematology-Oncology $255,733 · Nephrology $263,013 (essentially equal). So five counted subspecialties pay less than general peds and nephrology is a rounding error away. Only procedural/acute subspecialties clearly out-earn general peds: pulmonology ~$282K, child neurology ~$290K, GI ~$298K, pediatric EM ~$312K.214 Doximity's own commentary flags seven outpatient, non-procedural peds fields that earn below general peds, under the mnemonic "READING": Rheumatology, Endocrinology, Adolescent medicine, Developmental-behavioral, Infectious disease, Nephrology, Genetics. An assistant professor of pediatric ID has a base quoted at $147K–$158K, less than a new computer-science bachelor's grad's ~$160K starting salary.20

And even the subspecialties that do out-earn general peds get paid far less than their adult counterparts doing similar work: adult oncology earns ~96% more than pediatric, GI ~80% more, cardiology ~67% more, hematology ~65% more, pulmonology ~51% more, nephrology ~40% more, endocrinology ~26% more.13 The consequence is a real workforce crisis. In the 2026 match, pediatric infectious disease filled 44 of 86 positions and pediatric rheumatology 24 of 44, each leaving about half its seats empty, and developmental-behavioral peds is described as facing "recruitment collapse."202223 A per-subspecialty net-present-value figure for that penalty does exist. Catenaccio, Rochlin and Simon priced the lifetime return on fellowship for all 15 pediatric subspecialties in Pediatrics (2021), and most of the 15 came out negative. Read the dollar figure for a given field there.24

Lifestyle & the humane-but-dense bargain

The most-cited pro of general pediatrics: relative to surgical and high-acuity fields, the hours are humane and the schedule reasonably controllable, and outpatient and clinic pediatricians commonly work ~40–50 hours a week with relatively light call, one reason the field draws people wanting family-compatible careers. Shift-based hospitalist work adds predictability.3

The most-cited con is the texture underneath those hours: clinic economics (short visits, high volume, Medicaid-heavy panels) make the "good hours" feel dense and administratively heavy, and the EHR in-basket is a recurring grievance. And pediatrics is not monolithic. Newborn nursery, inpatient and hospitalist work, and especially NICU and PICU carry real overnight and weekend burden and high acuity, while outpatient subspecialties (endocrine, rheum, developmental-behavioral) are lighter.3

Lifestyle rating: 4/5. Genuinely more controllable than most of medicine in the outpatient setting, docked because the volume, in-basket load, and reimbursement pressure make it less relaxed than the raw hours suggest.

Wellbeing — the part to take seriously

Burnout: at or a bit above the physician average, rather than a low-burnout field. In Medscape's 2024 Burnout & Depression Report, pediatricians reported roughly 51% burnout, around 4th highest of all specialties (behind emergency medicine, OB/GYN, and oncology). The AMA's Organizational Biopsy (2022 data) put pediatrician burnout at 55%, with 48% feeling undervalued. Named drivers: EHR/in-basket message volume, feeling disconnected from leadership, reimbursement pressure, and under-preparation for the surging pediatric mental-health load. The humane hours do not buy a pass on burnout.2526 ⟳

Meaning and satisfaction, the headline strength. This is where pediatrics shines. Pediatricians repeatedly rank their work among the most meaningful in medicine; their top sources of gratification are "gratitude from / relationship with patients" and "being good at what I do," not money (only ~8% named financial reward as their most gratifying element). "Would choose the specialty again" lands mid-pack, and the tension is specific and consistent: high satisfaction with the work and patients, low satisfaction with pay (~42% satisfied with compensation; ~58% feel not paid fairly, 2024 Medscape data). A 2025 Doximity summary captured the paradox precisely: 87% of pediatricians felt inadequately compensated and 69% had considered leaving, yet 74% remained, describing it as a calling.42713 ⟳

Stress & career longevity. General-peds stress is more emotional than physical: anxious parents, social-determinant complexity, the mental-health surge in kids and teens, with genuinely high-acuity stress concentrated in the NICU, the PICU, and heme-onc. Pediatrics is generally a long-career specialty, especially outpatient; the threat to longevity is less physical burnout-from-hours than economic and moral attrition, the feeling of being squeezed by reimbursement and administrative load. That "69% have considered leaving" figure is the warning light.4

Who's in the field (demographics)

  • Women: 66.7% of practicing pediatricians (2024 data, the highest share of any specialty, ahead of OB/GYN at 64.1%) and 74.8% of residents (AY2024-25), one of the most female specialties in medicine and getting more so.2829 ⟳
  • DO: ~21% of the 2026 categorical match cohort (623 DO seniors and graduates of 2,951 filled), so pediatrics is comparatively DO-friendly, and DO seniors also have among the highest peds match-success rates.10 ⟳
  • IMG: ~30% of the 2026 cohort (897 of 2,951, US and non-US IMG combined), a substantial and growing entry point.10 ⟳
  • Subspecialties skew even more female (2024–25 trainees): developmental-behavioral ~87%, pediatric hospital medicine ~82%.29 ⟳
  • URiM: no clean single pediatrics URiM figure was located in primary press releases; overall MD-resident race/ethnicity (2023, all specialties) was ~47.2% White, 23.3% Asian, 8.9% Hispanic, 6.9% Black, with URiM physicians underrepresented relative to the child population. Pediatrics-specific URiM share: limited data, verify via AAMC specialty tables.30 ⟳

Culture, personality & the online stereotypes

Who gravitates here: people who genuinely like kids and their parents; warm, patient, relationship-oriented personalities; those comfortable managing the caregiver as much as the child; people tolerant of ambiguity and anxious parents; and mission-driven types drawn to prevention, development, advocacy, and underserved/community care. The field self-selects for empathy and communication over procedural machismo. As always, plenty of people in the field do not fit any single mold.3

The stereotypes. community caricatures, not facts. Several are unfair:

  • "The nicest doctors in the hospital." Widespread and mostly affectionate, but it flattens a field that includes hard-charging NICU, PICU, and heme-onc physicians and skips the real intellectual difficulty of pediatric diagnosis.
  • "Underpaid martyrs / do it for love, not money." Rooted in a real pay gap, but the "martyr" framing is unfair. Pediatricians are among the most vocal about reimbursement inequity rather than naive about it.
  • "It's just colds, ear infections, and vaccines." A dismissive stereotype that ignores developmental-behavioral work, chronic and complex disease, adolescent mental health, congenital conditions, and the entire subspecialty universe.
  • "You have to treat the parents too." Literally true (family-centered care) and often meant as a knock, but experienced pediatricians reframe it as a core skill rather than a burden.

What people say online (synthesized and paraphrased, not quotes): Across trainee and physician forums the dominant thread is the pay-versus-meaning tension, and residents and attendings describe loving the actual work and the patients while openly worrying the salary doesn't square with modern debt loads. It's the single most consistent theme. Match-softening anxiety is discussed candidly after the 2024 fill-rate drop, split between "warning sign for the field" and "this makes it humane and attainable." Recurring frustrations: Medicaid reimbursement, the EHR inbox burden, and subspecialty pay sometimes being lower than general peds despite years of extra training. Recurring positives: the joy of the work, kids' resilience, long continuity relationships, and a collegial, less-cutthroat culture than many specialties.4

Voices from the field. Paraphrased from public writing, with links to the originals:

  • Abraham Kim, writing in Doximity's Op-Med, documents the paradox in numbers: pediatricians averaged ~$265K in 2024 (+2.2%) yet lost ~$14.6K in real purchasing power since 2017, are the lowest-paid primary-care group, and trail their adult subspecialty counterparts by 24%+, quoting AAP president Susan Kressly that new grad-loan caps could make the lifetime math "financially unfeasible" for many, even as 74% stay out of calling.13
  • Dr. Satyan Lakshminrusimha (Chair of Pediatrics, UC Davis), in Doximity Op-Med, argues that non-procedural outpatient peds subspecialties pay so little, with pediatric ID starting near $147K–$158K, that they're losing trainees despite 10+ years of extra training, threatening the children's-health workforce.20
  • Marc Zarefsky, reporting for the AMA, describes ~55% pediatrician burnout (2022 data) driven by EHR message overload, disconnection from leadership, and unpreparedness for kids' mental-health needs, and system-level fixes like message limits and wellness committees that measurably helped.26
  • AAMC News attributes the 2024 match dip to the pay gap (peds ~$260K vs. OB/GYN ~$352K vs. cardiology/ortho $500K+), ~$200K median debt, limited early exposure, and Medicaid reliance.31

Why people choose it / why people leave

Why choose it: the work is unusually meaningful, and you help kids grow up healthy and walk with families over years · relatively humane hours and good schedule control in outpatient settings · broad range of settings and subspecialties, so you can find your acuity level · collegial, warm, less-cutthroat culture · mission-rich (prevention, advocacy, underserved and community care) · more accessible to match into than it once was · short training with no required fellowship.

Why leave or avoid it: pay is the lowest tier in medicine and has lost ground to inflation, a serious concern against modern debt · burnout at/above the physician average despite decent hours (EHR load, reimbursement squeeze) · subspecialty training can lower your pay relative to general peds, which is a demoralizing quirk · heavy Medicaid dependence exposes you to state reimbursement politics · emotionally hard cases (abuse, chronic/terminal illness, anxious parents) are constant.

Best fit if: you genuinely enjoy kids and their parents and communicate warmly · you define career success by impact and relationships more than income · you want humane, sustainable outpatient hours or predictable shift work · you're mission-driven, especially toward underserved communities.

Not for you if: you need or want a high income to feel secure or to service large debt fast · you dislike managing anxious caregivers or repetitive well-child/acute visits · you want a highly procedural or high-prestige-competitive specialty · reimbursement/administrative frustration would erode your sense of purpose.

The FLI angle — Pediatrics for first-gen, low-income & immigrant students

Pediatrics is the specialty where the FLI calculus is sharpest and most two-sided, so read both halves squarely.

Where pediatrics fits FLI realities well:

  • Mission alignment is unusually direct. For students who came from underserved communities and want to serve kids and families like the ones they grew up with, pediatrics is one of the most naturally aligned specialties in medicine, through prevention, advocacy, and long-term relationships. Community health centers, Medicaid-heavy clinics, and school/adolescent health are core pediatric turf.
  • The match is genuinely accessible. Pediatrics takes a much larger share of international graduates than the average specialty and an ordinary share of DOs, and its recent softening means it is attainable from either school type, so an FLI student without an elite pedigree or research machine behind them has a realistic path in. That accessibility is a real FLI advantage, not a footnote.
  • Loan-forgiveness fit is strong, with one limit that changes the arithmetic. Because so many pediatricians work at non-profit hospitals, academic centers, and community health centers, pediatrics is unusually well-suited to PSLF: ten years of qualifying payments on an income-driven plan, then tax-free forgiveness, and it is the single biggest lever available to a high-debt FLI pediatrician. NHSC and state loan-repayment programs add sizable repayment for serving in shortage areas, a natural fit for FLI students who want to serve those communities anyway. But PSLF forgives federal loans. Since July 2026 federal borrowing stops at $200,000, and medical school costs more than that at almost every school, so a student starting now graduates with a private loan sitting beside the federal one and no program forgives that half. A private loan sets its payment from the balance rather than from your income, which means it does not shrink to fit the lowest salary in medicine. That is the same loan cap the AAP warning below is about, seen from the other end.

The honest concern, not sugarcoated:

  • You would be choosing the lowest-paid specialty. For an FLI student carrying ~$200K+ in loans with no family financial safety net, this is a material risk, not just a values choice. You may be simultaneously supporting family, unable to lean on parents in an emergency, and servicing large debt on a ~$260–265K salary, while pay loses ground to inflation. This is the one place where "follow your heart" advice can be genuinely costly.
  • The fellowship penalty hits FLI students hardest. Three extra low-paid years for the same or lower pay is a much harder trade when you have no cushion and are already carrying debt.
  • The AAP itself has warned that new caps on graduate/education loans could make pediatrics' lifetime earnings "financially unfeasible" for some entrants, a caution that lands hardest on FLI students.

Bottom line: pediatrics can be a beautiful mission fit and a realistic match for an FLI student, but go in with eyes open about the pay, build the PSLF / loan-repayment plan before you commit, price the private slice the federal cap leaves behind, and run the actual debt math as seriously as the calling. Both things are true at once.

Subspecialties & fellowships

All require completing the 3-year pediatrics residency; most fellowships add ~3 years, and as flagged above, many pay the same as or less than general peds. None is required to practice general pediatrics.632

  • Neonatal-Perinatal Medicine (NICU / neonatology). High-acuity care of premature and critically ill newborns; heavy call; better-paid.
  • Pediatric Critical Care (PICU). ICU management of the sickest kids; intense, procedural, high call.
  • Pediatric Cardiology. Congenital and acquired heart disease; procedural/imaging-heavy; among the better-compensated peds fields.
  • Pediatric Hematology-Oncology. Childhood cancers and blood disorders; emotionally intense, long relationships.
  • Pediatric Emergency Medicine. Acute/emergency care of kids; shift-based; entered via peds or EM.
  • Pediatric Gastroenterology. GI/liver/nutrition; procedural (endoscopy); relatively better-paid.
  • Pediatric Pulmonology. Asthma, cystic fibrosis, chronic lung disease.
  • Pediatric Endocrinology. Diabetes, growth, thyroid, puberty; outpatient; notably underpaid relative to training.
  • Pediatric Nephrology. Kidney disease, dialysis, transplant; outpatient-heavy; lower-paid.
  • Pediatric Infectious Disease. Complex infections; academic; one of the lowest-paid despite long training.
  • Pediatric Rheumatology. Autoimmune/inflammatory disease; outpatient; workforce shortage; lower-paid.
  • Developmental-Behavioral Pediatrics. Autism, ADHD, developmental delay; outpatient; underpaid, high demand.
  • Adolescent Medicine. Teen health, reproductive/behavioral/mental health; outpatient; lower-paid.
  • Genetics & Metabolism. Inherited/metabolic disease and diagnosis; academic; lower-paid.
  • Pediatric Hospital Medicine (PHM). Inpatient generalist; shift-based; board-certifiable since 2019, with the fellowship commonly cited as 2 years, though the exact duration varies by pathway.
  • Child Abuse Pediatrics. Forensic evaluation and protection; small, mission-heavy field.
  • Co-sponsored / niche (variable length): Hospice & Palliative Medicine, Medical Toxicology, Sleep Medicine, Sports Medicine, Transplant Hepatology, and pediatric components of medical genetics.

Fun facts

  • Pediatricians routinely score among the most meaning-driven physicians while sitting among the lowest-paid, the sharpest meaning-versus-money split in medicine.
  • In a 2025 survey, ~69% of pediatricians had considered leaving the field, yet ~74% stayed, describing it as a calling.
  • Some pediatric subspecialists, after 3 extra years of fellowship, earn less than general pediatricians, one of medicine's strangest pay inversions ("READING": rheum, endo, adolescent, developmental-behavioral, ID, nephro, genetics).
  • A well-child visit is arguably one of the most cost-effective encounters in all of medicine, yet a payment system that rewards procedures over prevention structurally underpays it.
  • Pediatrics' categorical fill rate fell from ~97% to 91.8% in 2024, recovered to 95.3% in 2025, then slipped again to 94.4% in 2026, a real-time story of a specialty's pay and prestige wobbling.
  • Pediatrics is the most female specialty in medicine (66.7% practicing, ~75% of residents) and one of the more IMG-accessible desirable paths, though its DO share is only average.

Sources

Footnotes

  1. General pediatrics as consistently lowest/near-lowest-paid; ~$265K–$266K total comp; ~25% less than adult medicine for identical training; Medicaid/procedure structural drivers. Medscape Pediatrician Compensation Report 2026 (via Nuaxia summary, 2026) (https://www.nuaxia.com/post/medscape-pediatrician-compensation-report-2026); Chartis, "Match Day 2024… potential future shortage, pediatrics" (2024) (https://www.chartis.com/insights/match-day-2024-sees-record-numbers-reveals-potential-future-shortage-pediatrics). ↩ ↩2 ↩3 ↩4

  2. Doximity 2025 Physician Compensation Report (2024 data) — general peds $265,230, rank 47/51; subspecialty comp table. (2025) https://www.doximity.com/reports/physician-compensation-report/2025 ↩ ↩2 ↩3 ↩4 ↩5 ↩6

  3. What pediatricians do; settings (outpatient/inpatient/nursery/NICU-PICU/subspecialty); hours ~40–50/wk, call, schedule control. Pediatrics life/lifestyle research compilation (mid-2026), drawing on Medscape 2024 Lifestyle (https://www.medscape.com/sites/public/lifestyle/2024) and workforce reporting. ↩ ↩2 ↩3 ↩4 ↩5 ↩6

  4. Online sentiment (pay-vs-meaning, match-softening, EHR/Medicaid, subspecialty pay inversion), would-choose-again mid-pack, 74% stay/69% considered leaving; culture/who-gravitates. Synthesized from r/Pediatrics, r/medicalschool, SDN, and Doximity Op-Med, Abraham Kim (2025) (https://opmed.doximity.com/articles/despite-a-small-bump-in-pay-pediatric-care-continues-to-feel-the-strain). ↩ ↩2 ↩3 ↩4 ↩5

  5. Residency length (3-yr categorical), ABP board certification, ~7 yrs post-college to general certification, ~15 subspecialties mostly 3-yr. American Board of Pediatrics, "Certification | General Pediatrics" (accessed 2026) (https://www.abp.org/pediatrics); ABP "Guide to Board Certification / Booklet of Information" (https://www.abp.org/sites/abp/files/pdf/certboi.pdf). ↩ ↩2 ↩3 ↩4 ↩5

  6. Pediatric subspecialty fellowship list and 3-year lengths; co-sponsored subspecialties. ABP, "Subspecialty Certifications and Admission Requirements" (accessed 2026). https://www.abp.org/subspecialties/subspecialty-certification-and-admission-requirements ↩ ↩2

  7. 2023 categorical fill rate 97.1%; 2024 softening (fill ~91.8%, 252 unfilled of 3,139; US-MD seniors 47.6%, −7.2 pts); AMA "surprise." AMA, "Inside Match Day 2024" (2024). https://www.ama-assn.org/medical-students/preparing-residency/inside-match-day-2024-nearly-39000-matches-and-some-surprises ↩

  8. Corroborating NRMP primary data (2024). NRMP, "Results and Data: 2024 Main Residency Match" (June 2024). https://www.nrmp.org/wp-content/uploads/2024/06/2024-Main-Match-Results-and-Data-Final.pdf ↩

  9. 2025 partial recovery: 3,193 categorical/primary positions offered, ~150 unfilled, 95.3% fill; near-1.0 applicant:position. NRMP, "2025 Main Residency Match Results" press release (March 2025) (https://www.nrmp.org/about/news/2025/03/national-resident-matching-program-releases-the-2025-main-residency-match-results-celebrates-the-next-generation-of-physicians/); independent tabulation (categorical: 3,135 offered / 2,988 filled / 147 unfilled), The Match Guy, "2025 NRMP Match Results" (2025) (https://www.nrmp.org/wp-content/uploads/2025/05/Main_Match_Results_and_Data_20250529_FINAL.pdf). ↩ ↩2

  10. The 2026 cycle. NRMP, Results and Data: 2026 Main Residency Match, May 2026 — categorical pediatrics: 250 programs, 3,126 positions offered, 2,951 filled, 175 unfilled, a 94.4% fill rate. The report's own five-year row for the specialty runs 97.2% (2022) · 97.1% (2023) · 91.8% (2024) · 95.3% (2025) · 94.4% (2026), on 2,942 / 2,986 / 3,078 / 3,135 / 3,126 positions offered. Table 2 gives the 2026 composition: MD seniors 1,407 and MD graduates 23, DO seniors 615 and DO graduates 8, US IMGs 213, non-US IMGs 684, and one in the "others" column. As shares of the 2,951 filled, that is MD 48.5%, DO 21.1%, US IMG 7.2%, non-US IMG 23.2%, and 30.4% IMG combined. https://www.nrmp.org/wp-content/uploads/2026/05/Main_Match_Results_and_Data-2026.pdf Corrected 2026-08-17: this page read the 2025 cycle as a rebound and wrote the whole section in the present tense. The rebound did not hold. The fill rate fell again, unfilled positions went from 147 to 175, and the combined IMG share went from 28% to 30.4%. The 2024 denominator here was wrong as well: 3,139 counts categorical plus primary pediatrics, and the categorical figure that the 91.8% and the 252 unfilled belong to is 3,078. ⟳ ↩ ↩2 ↩3 ↩4

  11. USMLE Step 2 CK of applicants who matched pediatrics, 2024 cycle, from NRMP's three Charting Outcomes in the Match editions, each Table PD-1. US MD seniors, mean 247 (matched n=1,216; unmatched 233): https://www.nrmp.org/wp-content/uploads/2024/08/Charting_Outcomes_MD_Seniors_2024-2.pdf . US DO seniors, mean 241 (matched n=454), alongside a mean COMLEX-USA Level 2-CE of 534: https://www.nrmp.org/wp-content/uploads/2024/08/Charting_Outcomes_DO_Seniors_2024-2.pdf . US IMGs, mean 233 (matched n=165) and non-US IMGs, mean 240 (matched n=363): https://www.nrmp.org/wp-content/uploads/2024/08/Charting_Outcomes_IMG_2024-1.pdf . Corrected 2026-08-17: this note called all four figures medians and named a single primary, the MD Seniors edition, with an instruction to "verify exact peds median." That edition covers US MD seniors only and so cannot carry three of the four, and it publishes Step 2 CK as a mean in Table PD-1 and as a histogram in Chart PD-4, so no median for pediatrics can be read off it. All four values verify exactly against the three editions above, as means. The secondary they were taken from, Inspira Advantage, "USMLE Step 2 Average Scores by Specialty" (https://www.inspiraadvantage.com/blog/usmle-scores-by-specialty), is no longer needed and has been dropped. ↩

  12. Categorical cohort composition by applicant type. NRMP, Results and Data: 2026 Main Residency Match, Table 2 — Pediatrics (Categorical): 3,126 positions offered, 2,951 filled; MD senior 1,407, MD graduate 23, DO senior 615, DO graduate 8, US IMG 213, non-US IMG 684, other 1. Of the positions filled, DOs took 623 (21.1%) and IMGs 897 (30.4%). https://www.nrmp.org/wp-content/uploads/2026/05/Main_Match_Results_and_Data-2026.pdf . The 2025 cycle for the trend line: US-MD 1,476 / US-DO 640 / US-IMG 251 / non-US-IMG 590, an IMG share of 28.4%. https://www.nrmp.org/wp-content/uploads/2025/05/Main_Match_Results_and_Data_20250529_FINAL.pdf Swept 2026-08-17: DO 21.1% and IMG 30.4%, both over positions filled (2,951), against all-PGY-1 baselines of 21.5% DO and 25.2% IMG over 38,354 filled positions, from Table 2 of the same report. Pediatrics is well above the baseline on IMG and at it on DO, so the page no longer calls the field open on both axes. This footnote previously gave the 2025 composition while the body described the 2026 cohort, and attributed the figures to a private match-advice blog rather than to the NRMP report the link actually points at. ↩

  13. Real-income decline (−$14,590 / −6.7% vs 2017), +2.2% YoY vs +3.7% all MDs; FM ~$319K vs peds ~$265K; pediatric vs adult subspecialty gaps (onc 96%, GI 80%, cards 67%, heme 65%, pulm 51%, nephro 40%, endo 26%); 87% feel undercompensated, 69% considered leaving, 74% stay; gender pay gap. Doximity Op-Med, Abraham Kim, "Despite a Small Bump in Pay, Pediatric Care Continues to Feel the Strain" (2025). https://opmed.doximity.com/articles/despite-a-small-bump-in-pay-pediatric-care-continues-to-feel-the-strain Corrected 2026-08-17: the FLI section called PSLF "arguably the single biggest lever for a high-debt FLI pediatrician" and, two bullets later, reported the AAP's warning that new graduate-loan caps could make pediatrics' lifetime earnings "financially unfeasible" for some entrants, without connecting the two. They are the same mechanism from opposite ends: the capped slice becomes private debt whose payment is set by balance rather than income, on the lowest salary in medicine. The PSLF bullet now says so. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9

  14. Medscape 2026 ranking #29/29 (~$266K) with lowest-paid tail and orthopedics ~$611K top; subspecialty comp figures. Becker's Hospital Review, "29 physician specialties ranked by annual compensation (Medscape)" (2026) (https://www.beckershospitalreview.com/compensation-issues/29-physician-specialties-ranked-by-annual-compensation-medscape/); Becker's ASC, "Physician pay in 2026: 20 stats" (https://www.beckersasc.com/asc-coding-billing-and-collections/physician-pay-in-2026-20-stats/). ↩ ↩2 ↩3 ↩4

  15. BLS mean $222,987; state means $143,880 (DC)–$354,060 (LA); hourly ~$107/hr; starting ~$244K (Merritt Hawkins); SalaryDr ~$310K (crowdsourced). Barton Associates, "Pediatrician Salary Guide" (2026, citing BLS OES May 2024 & Merritt Hawkins). https://www.bartonassociates.com/pediatrician-salary-guide-2/ Corrected 2026-08-17: this page also carried a locum tenens band of $93–$130/hr, annualizing to ~$239,000, from the same Barton page. Barton Associates is a locum tenens staffing agency and that band is the price of the service Barton brokers, which is the case the price rule governs: the qualifying property of a price is that whoever publishes it is not the one selling the service. The band is removed rather than re-sourced, because no non-broker publisher of pediatric locum rates was found. The BLS figures in this footnote are a different matter and stay — there Barton is relaying a federal primary, named and dated, rather than quoting its own book of business. SalaryDr does not publish a panel size for the page cited here (its blog and career-guide pages omit the n that its per-specialty pages carry), so the panel-size caveat this site attaches to a self-selected panel cannot be quantified for this figure. Treat it as a self-selected panel of unknown size. ↩ ↩2 ↩3 ↩4

  16. Pediatrics wRVU productivity percentiles (25th 3,500 / median 4,600 / 75th 5,800 / 90th 7,200); $/wRVU and MGMA/SullivanCotter total-comp percentiles paywalled. FastRVU, "Physician Productivity Benchmarks" (June 2026) (https://fastrvu.com/articles/physician-productivity-benchmarks); MGMA pediatrician salary page (paywalled) (https://www.mgma.com/pediatriciansalary) — verify. Corrected 2026-08-17: a figure of this kind stays with the host named rather than being removed, so the spread paragraph now names FastRVU where it previously said only "2026 benchmark." MGMA and SullivanCotter keep their pediatric total-comp percentiles behind a paywall, which is why an aggregator's compilation is the only public productivity ladder on this page, and the reader should be told that at the point they read it. ↩

  17. Academic $244K / private employee $250K / blended $278K / partner-owner $320K; ownership as the real lever; incentive bonus ~$26K; Medicaid/procedure structural driver. Physicians Side Gigs, "Private Practice vs Academic Physician Compensation by Specialty" (2024/2025) (https://www.physiciansidegigs.com/private-practice-vs-academic-physician-compensation-by-specialty); incentive-bonus figure via Physicians Weekly (2021). ↩ ↩2 ↩3

  18. Historical/trend context: Medscape 2021 peds $221K (down from $232K); 82% low-to-high gap; ~82% would choose peds again (historical); starting ~$244K. Physicians Weekly, "Pediatricians Continue to be Lowest Paid…" (2021). https://www.physiciansweekly.com/post/pediatricians-continue-to-be-lowest-paid-physicians-is-the-specialty-in-peril ↩

  19. Medicaid and CHIP covered 37.4% of US children aged 0–18 in 2024, roughly 28.2 million children in Medicaid plus 1.5 million in other public coverage; the share has run between 37% and 39% across 2018–2024. KFF, "Health Insurance Coverage of Children 0-18," https://www.kff.org/state-health-policy-data/state-indicator/children-0-18/. Corrected 2026-08-13: this page said more than half of US children are on Medicaid, which is above the top of the published range. ↩

  20. The "fellowship penalty" / "READING" mnemonic; peds ID base $147K–$158K; ID fellowship 51.9% unfilled (2023). Doximity Op-Med, Dr. Satyan Lakshminrusimha, "The Salary Problem in Pediatric Subspecialties" (2024/2025). https://opmed.doximity.com/articles/the-salary-problem-in-pediatric-subspecialties ↩ ↩2 ↩3 ↩4

  21. Pediatrician pay sentiment (Medscape 2026): 45% feel fairly paid, 60% think physicians underpaid, 39% income falls short, raise/flat/cut outlook. Nuaxia/Medscape Pediatrician Compensation Report 2026. https://www.nuaxia.com/post/medscape-pediatrician-compensation-report-2026 ↩

  22. Pediatric rheumatology <half of positions filled; developmental-behavioral "recruitment collapse"; subspecialty-workforce crisis framing. MDedge/The Hospitalist, pediatric rheumatology match (https://community.the-hospitalist.org/content/rheumatology-match-less-half-pediatric-positions-filled-worsening-existing-trend); KevinMD (Dec 2025) (https://kevinmd.com/2025/12/why-developmental-and-behavioral-pediatrics-faces-a-recruitment-collapse.html); Lucile Packard Foundation (2024) (https://lpfch.org/wp-content/uploads/2024/02/FINALM_1.pdf). ↩

  23. NRMP, Results and Data: Specialties Matching Service, 2026 Appointment Year (Feb 2026), Table 1A — Pediatric Infectious Diseases: 86 positions offered, 44 filled (51.2%), 33 programs left unfilled. Pediatric Rheumatology: 44 offered, 24 filled (54.5%), 19 programs unfilled. https://www.nrmp.org/wp-content/uploads/2026/02/SMS_Results_and_Data_Report2026.pdf ↩

  24. Per-subspecialty net present value of fellowship: Catenaccio E, Rochlin JM, Simon HK, "Differences in Lifetime Earning Potential for Pediatric Subspecialists," Pediatrics 2021 (PMID 33685988), DOI: 10.1542/peds.2020-027771 — the paper's table carries a dollar figure for each of the 15 subspecialties. Pediatric–adult academic subspecialty comp gap paper (specific figures require journal access); ABP educational-debt data. AAP Pediatrics, "Changes in the Pediatric–Adult Academic Subspecialists Compensation Gap" (2026) (https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2026-076566/207286/Changes-in-the-Pediatric-Adult-Academic); ABP debt data (https://www.abp.org/publications/educational-debt-and-subspecialty-fellowship-type) — verify. ↩

  25. Burnout ~51%, ~4th highest (Medscape 2024). Healthgrades summary of Medscape Physician Burnout & Depression Report 2024. https://resources.healthgrades.com/pro/the-most-and-least-burned-out-physicians-by-specialty ↩

  26. Pediatrician burnout ~55% (AMA 2022 data), 48% feel undervalued; EHR/leadership/mental-health drivers and fixes. AMA, Marc Zarefsky, "Most pediatricians have burnout. Here's what it takes to fix that" (2024). https://www.ama-assn.org/practice-management/physician-health/most-pediatricians-have-burnout-here-s-what-it-takes-fix ↩ ↩2

  27. Comp satisfaction ~42%; ~58% feel not paid fairly; ~8% cite money as most gratifying; ~$260K, 2nd-from-bottom. Weatherby Healthcare, "2024 pediatrician salary report" (summarizing Medscape comp data) (2024). https://weatherbyhealthcare.com/blog/pediatrician-salary-2024 ↩

  28. Women 66.7% of active pediatricians, the highest share of any specialty, ahead of obstetrics and gynecology at 64.1% (2024 data). AAMC, 2025 Key Findings, https://www.aamc.org/data-reports/data/2025-key-findings. Corrected 2026-08-13: this page carried 64.3% from 2019 and called pediatrics second-highest; it is first. Corrected 2026-08-17: that correction reached one bullet in Who's in the field and stopped there. The Quick dashboard and the Fun facts still printed ~64%, which is now OB/GYN's figure rather than this specialty's. ↩

  29. Women 75.4% of pediatric residents (2024–25); subspecialties even more female (DBP ~87%, PHM ~82%). AMA, "These physician specialties have the biggest gender imbalances" (citing AMA/AAMC National GME Census, JAMA, 2024–25 data). https://www.ama-assn.org/medical-students/preparing-residency/these-physician-specialties-have-biggest-gender-imbalances ↩ ↩2

  30. No clean peds URiM figure; overall MD-resident race/ethnicity (2023). AAMC, "2024 Report on Residents Executive Summary" (https://www.aamc.org/data-reports/students-residents/data/report-residents/2024/executive-summary); peds-specific URiM figures live in the AAMC specialty tables (https://www.aamc.org/data-reports/students-residents/data/report-residents/2024/table-b3-number-active-residents-type-medical-school-gme-specialty-and-gender). ↩

  31. 2024 match dip drivers: pay gap (peds ~$260K vs OB/GYN ~$352K vs cards/ortho $500K+), ~$200K median debt, limited exposure, Medicaid reliance. AAMC News, "Why are fewer U.S. MD graduates choosing pediatrics?" (2024). https://www.aamc.org/news/why-are-fewer-us-md-graduates-choosing-pediatrics ↩

  32. Subspecialty descriptions and pathways. Council of Pediatric Subspecialties, "Subspecialty Descriptions" (https://www.pedsubs.org/about-cops/subspecialty-descriptions/); NRMP Medicine and Pediatric Specialties Match (https://www.nrmp.org/fellowship-applicants/participating-fellowships/medicine-and-pediatric-specialties-match/). ↩

Researched with AI assistance and reviewed by hand. How this site is made