Yes, medical internships are paid. In the United States, first-year medical residents (called interns) earn a national average salary of about $68,166 per year. That figure comes from the 2025 AAMC survey of training institutions nationwide. While this is a real salary with benefits, it’s modest relative to the hours worked and the debt most new doctors carry, which is why compensation remains a hot-button issue in medicine.
How Much Interns Actually Earn
The term “medical intern” refers to a doctor in their first year of residency training, known as PGY-1 (postgraduate year one). Unlike unpaid internships in other fields, medical internships are salaried positions with benefits. The nationwide average for PGY-1 sits at $68,166, but pay varies significantly by institution and location. Programs in high cost-of-living cities pay considerably more. At UCLA, for example, first-year residents earned $89,261 as of July 2024, with a scheduled increase to $93,777 in late 2025.
Pay rises modestly each year of training. The national averages by year, according to the AAMC’s 2025 survey, look like this:
- Year 1: $68,166
- Year 2: $70,499
- Year 3: $73,301
- Year 4: $77,593
- Year 5: $81,807
- Year 6: $84,744
- Year 7: $89,187
- Year 8: $94,215
From intern year to the final years of fellowship, total compensation grows by more than $25,000. That sounds like meaningful growth, but spread across seven or eight years, the annual bumps are small.
Why the Pay Feels Low
The raw salary numbers don’t tell the full story until you factor in hours. The Accreditation Council for Graduate Medical Education (ACGME) caps resident work hours at 80 per week, averaged over a four-week period. That ceiling includes all clinical duties, educational activities, and even clinical work done from home. Many programs schedule residents close to that maximum.
At 80 hours per week, a PGY-1 earning the national average of $68,166 makes roughly $16.39 per hour. That’s below the minimum wage in several states when you account for the level of responsibility involved. It’s no surprise that Medscape’s 2025 Resident Salary and Debt Report found 73% of residents felt underpaid when asked to consider their salary and benefits together.
The hours are also front-loaded in intensity. Intern year is widely considered the most grueling stretch of training, with frequent overnight call shifts, weekend coverage, and minimal schedule flexibility. The combination of high hours and entry-level pay creates a financial squeeze, especially for those managing six-figure medical school debt.
Where the Money Comes From
Resident salaries in the U.S. are largely funded through Medicare. The federal government pays teaching hospitals for the cost of training residents through a program called Direct Graduate Medical Education, or DGME. Each hospital receives a per-resident payment amount based on its historical training costs, the number of residents it employs, and its share of Medicare patients. This system has been in place since 1985.
Because funding is tied to Medicare reimbursement formulas rather than market forces, resident pay has historically grown slowly. The American Medical Association has noted that while resident pay continues to rise, the growth trails inflation. Hospitals receive a set amount per resident and have limited incentive to raise salaries beyond what’s needed to fill their programs, since residency positions are highly sought after regardless of pay.
Benefits Beyond the Paycheck
Most residency programs offer a benefits package on top of the base salary. Health insurance is standard and typically covers dental and vision as well. Many programs provide additional perks like meal stipends during on-call shifts, relocation allowances for incoming residents, and access to retirement plans. Some institutions in expensive cities offer subsidized housing or housing stipends to offset local costs. The specifics vary widely by program, so the total compensation gap between a program paying $65,000 in a low-cost city and one paying $89,000 in Los Angeles may be narrower than it appears, or wider, depending on what’s included.
How Pay Compares Internationally
Medical interns in other countries are also paid, though the amounts differ. In England, Foundation Year 1 doctors (the equivalent of U.S. interns) earn a base salary of £38,831 under the 2016 contract, which works out to roughly $49,000 USD. In British Columbia, Canada, first-year residents earn about $65,332 CAD annually, or approximately $47,000 USD. Both countries have publicly funded healthcare systems, and their junior doctor pay reflects different cost structures, tax benefits, and debt loads. Canadian and British medical graduates typically carry far less educational debt than their American counterparts, which changes how that salary feels in practice.
Unionization and Recent Pay Gains
One of the biggest shifts in recent years is the growth of resident unions pushing for higher pay. Across the country, residents at major academic medical centers have organized and negotiated contracts with meaningful salary increases. In New York City, a 2024 tentative agreement between the city and the Doctors Council SEIU secured compounded wage increases of 3% annually over four years, plus 3.25% in the fifth year, along with a $3,000 ratification bonus.
UCLA’s resident union contract, running through mid-2025, pushed first-year salaries well above the national average. These gains reflect a broader trend: as the cost of living rises and student debt grows, residents are increasingly leveraging collective bargaining to close the gap. Programs at unionized hospitals tend to offer higher base pay than the national median, and the movement is expanding to institutions that previously had no union presence.
What This Means for Your Finances
If you’re heading into residency, the salary is enough to cover basic living expenses in most cities, but it requires careful budgeting, particularly if you’re carrying student loans. Most federal loan borrowers enroll in income-driven repayment plans during residency, which keep monthly payments manageable based on your resident salary. The trade-off is that interest continues to accumulate.
The financial picture improves substantially after training. The jump from a final-year resident salary of around $90,000 to an attending physician salary, which ranges from $250,000 to over $400,000 depending on specialty, is one of the steepest income increases in any profession. The intern year paycheck is real and it covers your bills, but for most doctors, it represents the financial low point of their career.