Yes, resident doctors get paid a salary during their training. First-year residents earn an average of $68,000 per year as of 2025, with pay increasing modestly each year of residency. It’s a real paycheck with benefits, but given the hours residents work, the effective hourly rate is lower than many people expect.
How Much Residents Earn by Year
Resident pay is structured around your Post-Graduate Year, or PGY level, which simply means how many years you’ve been in residency. The 2025 national averages break down like this:
- First year (PGY-1): $68,000
- Second year (PGY-2): $68,000
- Third year (PGY-3): $72,000
- Fourth through eighth year (PGY-4 to PGY-8): $79,000
The jumps between years are small. A resident in their final year of a seven-year surgical program earns only about $11,000 more than a first-year intern. This flat pay structure is one of the biggest frustrations in graduate medical education, since a senior resident carries far more responsibility and clinical skill than someone who just started.
What That Salary Looks Like Per Hour
The salary numbers look more modest once you factor in how many hours residents actually work. The national accreditation body caps resident work weeks at 80 hours, and many residents regularly hit that limit. Some specialties, particularly surgical ones, push right up against it.
At 80 hours per week for 50 working weeks, a first-year resident earning $68,000 makes roughly $17 per hour. That’s less than many jobs requiring far less training. Even a senior resident at $79,000 comes out to about $20 per hour under the same calculation. For comparison, the federal minimum wage is $7.25, but many entry-level office jobs in major cities pay $20 to $25 an hour without requiring a decade of higher education.
Shifts can last up to 24 hours, sometimes with an additional 6 hours tacked on for handoffs. Residents are required to have at least 10 hours off between shifts. These limits were introduced in 2003 after concerns about burnout and patient safety, and research has generally confirmed that working beyond 80 hours per week is associated with worse outcomes for both residents and patients.
Benefits Beyond the Paycheck
Residency programs include a benefits package on top of salary. The specifics vary by institution, but most programs offer comprehensive health insurance, disability insurance, life insurance, and some form of retirement savings plan. Many also provide meal stipends or free meals when you’re on call, which adds up when you’re regularly in the hospital for 12 to 28 hours at a stretch.
Some programs in expensive cities offer housing support. UCLA, for example, provides residents a $1,000 monthly housing stipend and access to dedicated university-owned apartments in West Los Angeles. Not every program is this generous, but cost-of-living adjustments and housing assistance are becoming more common as institutions compete to attract applicants in high-cost areas.
Continuing medical education allowances are another standard perk. These cover conference fees, textbooks, and exam costs that residents need for board certification. The dollar amount varies widely, from a few hundred to a few thousand per year depending on the program.
How Location and Unions Affect Pay
Where you train matters. Residency salaries in New York City, San Francisco, and other expensive metro areas tend to be higher on paper, though cost of living often eats the difference. The more meaningful shift in recent years has come from unionization.
Resident physicians in several major cities have organized through unions, and the results are tangible. In New York City, a 2024 contract agreement between the city’s public hospital system and the resident union secured compounded wage increases totaling 16.21 percent over the contract term. Under that deal, the starting salary for residents will rise from $66,247 to $81,238 by December 2025. That’s a significant jump, and it’s pushed other institutions in the region to raise their pay to stay competitive.
Unionized programs have also negotiated for better non-salary benefits: improved parental leave, stronger meal stipends, and caps on out-of-pocket healthcare costs. The union movement among residents is still growing, and programs in cities like Los Angeles, Boston, and Philadelphia have followed similar paths.
The Student Debt Problem
Resident pay can’t be understood without the context of medical school debt. The median educational debt for medical students who graduated in 2025 was $215,000 nationwide, according to the Association of American Medical Colleges. Many graduates carry significantly more.
On a resident salary of $68,000, the standard repayment on $215,000 in loans would consume a huge portion of take-home pay. Most residents enroll in income-driven repayment plans that cap monthly payments at a percentage of discretionary income, keeping payments manageable during training. Some pursue Public Service Loan Forgiveness, which erases remaining federal loan balances after 10 years of qualifying payments while working for a nonprofit employer. Since most teaching hospitals qualify, residency years count toward that timeline.
Still, interest accrues during residency, and many residents see their loan balances grow even as they make payments. A three-year residency might add $30,000 or more in capitalized interest to the original balance. This is the financial reality that makes residency feel underpaid even when the salary itself would be comfortable in another context.
Moonlighting for Extra Income
Some residents supplement their income by moonlighting, which means picking up extra clinical shifts outside their regular training schedule. Moonlighting pay rates are typically much higher than the resident hourly equivalent, often ranging from $75 to $150 per hour depending on the specialty and setting.
There are restrictions, though. Any moonlighting hours count toward the 80-hour weekly cap, so you can only moonlight if your regular schedule leaves room. Some programs prohibit moonlighting entirely, especially in the intern year when the learning curve is steepest. Programs that allow it usually require approval from the program director and proof that the extra work isn’t affecting your performance or well-being.
How Pay Changes After Residency
The steep pay gap between residency and independent practice is what makes the training years financially tolerable for most physicians. A primary care doctor finishing a three-year residency can expect a starting salary in the range of $230,000 to $280,000. Specialists who complete longer residencies and fellowships often start above $350,000, with some surgical and procedural specialties exceeding $500,000.
That jump typically happens overnight. You finish residency in June, start your attending position in July or August, and your monthly paycheck roughly triples or quadruples. For many physicians, this is when aggressive loan repayment begins in earnest, and most can pay off even large balances within five to ten years if they maintain a resident-level lifestyle for a while after training.