Yes, medical interns in the United States get paid. First-year residents (called PGY-1, for “postgraduate year one”) typically earn between $56,000 and $66,000 per year, depending on the program and location. Some programs in high cost-of-living cities like San Francisco or New York pay nominally higher salaries in the $70,000–$78,000 range, though that extra pay often doesn’t keep up with local expenses.
How Much Interns Actually Earn
The term “intern” in medicine refers specifically to a doctor in their first year of residency training after graduating from medical school. Unlike unpaid internships in other fields, medical internships are salaried positions. Most major academic medical centers pay PGY-1 residents in the $58,000–$65,000 range, while community and regional programs typically fall between $56,000 and $62,000.
That salary rises modestly each year of residency. Expect roughly a $2,000–$3,000 bump per postgraduate year. So a third-year resident might earn $62,000–$70,000, depending on the program. These aren’t negotiable figures in most cases. Your residency program sets the pay scale, and everyone at the same training level earns the same amount.
What That Looks Like Per Hour
The raw salary sounds reasonable until you factor in the hours. The Accreditation Council for Graduate Medical Education (ACGME) caps resident work hours at 80 per week, with individual shifts not exceeding 30 hours. In practice, the majority of residents work 60 or more hours per week, and nearly one in five report working at or near the 80-hour maximum.
At 60 hours per week, a $60,000 salary works out to roughly $19 per hour. At 70 hours, it drops to about $16.50. At the 80-hour cap, you’re looking at around $14.40 per hour. For context, that’s in the range of many entry-level jobs that require no advanced degree, let alone a decade of higher education. This math is a big part of why resident compensation is a persistent source of frustration in medicine.
Where Your Dollar Goes Furthest
Location makes a dramatic difference in how far your intern salary stretches. Programs in smaller Midwestern and Southern cities consistently offer the best purchasing power, even when their nominal salaries look modest on paper.
A resident in Indianapolis earning $62,000 has the equivalent of roughly $68,900 in purchasing power compared to the national average. Columbus, Ohio and Omaha, Nebraska offer similar real-dollar advantages in the $67,000–$68,000 range. Birmingham, Alabama and Greenville, South Carolina community programs paying $58,000 nominally translate to roughly $65,900–$66,600 in real spending power because housing and daily costs are so low.
Contrast that with high-profile coastal programs. A San Francisco academic program might pay $78,000, but after adjusting for the Bay Area’s extreme cost of living, the real value drops to about $50,300. New York and Boston programs tell a similar story, with real purchasing power typically landing between $50,000 and $58,000. In other words, multiple Midwest programs effectively pay $15,000–$18,000 more in real dollars than prestigious coastal institutions.
Benefits Beyond the Paycheck
Most residency programs supplement the base salary with benefits that meaningfully offset daily expenses. Health insurance is standard. Many programs offer meal subsidies for residents who are on call, free parking, and access to institutional credit unions that provide housing loans tailored to residents. Relocation stipends, though not universal, are common at larger academic centers.
One of the most financially significant benefits is access to employer-sponsored retirement plans. Even small contributions during residency benefit from years of compound growth. Some programs offer matching contributions, which is essentially free money on top of your salary.
Student Loans During Internship
The average medical school graduate carries over $200,000 in student debt, which makes the intern salary feel even thinner. The good news is that residency years can count toward Public Service Loan Forgiveness (PSLF) if your hospital qualifies as a nonprofit or government employer, which many teaching hospitals do. PSLF forgives your remaining federal loan balance after 120 qualifying monthly payments (10 years) made while working for an eligible employer.
To make this work, you need to be on an income-driven repayment plan and submit qualifying employment certification. Each month of residency counts as one of those 120 payments, so starting during intern year means three to seven years of residency payments are already banked toward forgiveness by the time you finish training. This is one of the most impactful financial decisions an intern can make, and missing the window to enroll costs real money over the long term.
Moonlighting Restrictions
If you’re wondering whether you can pick up extra shifts to supplement your income, the answer during intern year is almost always no. ACGME rules and most institutional policies prohibit PGY-1 residents from moonlighting. The rationale is straightforward: interns are already working long hours while adjusting to clinical medicine, and additional work raises safety concerns for both the doctor and patients.
After intern year, some programs allow moonlighting with approval. Any moonlighting hours still count toward the 80-hour weekly cap, so the opportunity is limited even when it’s permitted. Internal moonlighting (extra shifts at your own hospital) is more commonly allowed than external moonlighting at outside facilities.
How Pay Compares Internationally
Medical intern pay varies widely by country. In the United Kingdom, Foundation Year 1 doctors (the equivalent of interns) earn a base salary of £36,616 in England, £34,500 in Scotland, £33,307 in Wales, and £29,566 in Northern Ireland. These figures translate to roughly $46,000–$47,000 USD for England, though direct comparisons are complicated by differences in work hours, benefits, and the fact that UK doctors graduate with far less student debt than their American counterparts.
The Role of Unions
Resident unions have gained traction in recent years, and unionized programs tend to negotiate better pay and working conditions. The Committee of Interns and Residents (CIR-SEIU), the largest resident union in the U.S., has secured notable gains at several institutions. University of California residents, for example, recently negotiated a 3.2% base salary increase plus a 1.8% transitional pay adjustment, with retroactive lump-sum payments of $1,000. These incremental gains add up, and unionized programs often also secure better call meal stipends, housing allowances, and parental leave policies.
Only about 20% of U.S. residents are currently unionized, but that number is growing. Programs at large public university hospitals are the most likely to have union representation.