Osteopathic doctors (DOs) earned an average of $374,000 per year in 2024, a figure that rose about 2.9% from the previous year. That number varies widely depending on specialty, work setting, and years of experience, with some DOs earning well under $300,000 and others clearing half a million.
Average Salary in 2024
The $374,000 average comes from a report covering all physician compensation, both MDs and DOs. Once fully trained and practicing, osteopathic doctors earn on the same pay scales as their MD counterparts in the same specialty and setting. Your degree type matters far less than what kind of medicine you practice and where you practice it.
That said, DOs as a group tend to earn less on average than MDs for a structural reason: osteopathic graduates disproportionately enter primary care fields like family medicine, internal medicine, and pediatrics, which sit at the lower end of the physician pay scale. Research published in 2025 found a negative correlation between specialty salary and how competitive that specialty is for osteopathic graduates, suggesting DOs are channeled toward lower-paying specialties rather than the highest-compensated surgical subspecialties. A DO who matches into orthopedic surgery or cardiology earns the same as an MD in that field. The gap is about specialty distribution, not degree discrimination.
How Specialty Shapes Earnings
Specialty choice is the single biggest factor in how much any physician earns. The spread is enormous. Primary care physicians typically fall in the $250,000 to $300,000 range, while procedural and surgical specialists can earn $500,000 or more. Here’s a rough breakdown of where different fields land:
- Lower range ($230,000–$300,000): Family medicine, pediatrics, internal medicine, psychiatry, endocrinology
- Mid range ($300,000–$400,000): Emergency medicine, hospitalist medicine, physical medicine and rehabilitation, neurology, rheumatology
- Upper range ($400,000–$600,000+): Orthopedic surgery, cardiology, gastroenterology, urology, plastic surgery, dermatology
Since roughly 40% of practicing DOs work in primary care, the “typical” osteopathic doctor earns closer to the lower end of the overall average. But a DO in gastroenterology or orthopedics is pulling in the same high-six-figure salary as any other physician in those fields.
What You Earn During Training
Before reaching attending-level pay, every DO spends three to seven years in residency earning a fraction of their eventual salary. The average medical resident earns around $64,000 per year. First-year residents start at roughly $57,500, while those in their sixth through eighth years of training (common in surgical subspecialties) average about $70,300. These stipends are essentially flat across MD and DO programs and across specialties, so a surgery resident and a family medicine resident earn nearly the same during training.
The financial jump from residency to attending physician is dramatic. A family medicine resident making $62,000 might sign a contract for $260,000 the following year. Surgical subspecialists see an even larger leap, sometimes going from $68,000 to $450,000 or more in a single year. That transition usually happens between ages 30 and 35 for most DOs, depending on the length of their training.
Private Practice vs. Hospital Employment
Where you work changes your earning potential and your financial risk. Physicians in private practice have historically earned more than their hospital-employed peers. Private practice doctors average around $301,000, compared to $278,000 for those in inpatient hospital settings and roughly $228,000 at nonprofit hospitals. Those figures reflect all physicians, including those early in their careers, so they run lower than the 2024 specialty-level averages.
The tradeoff is predictability. Hospital employment comes with a steady paycheck that doesn’t fluctuate month to month. Your employer handles billing, staffing, and overhead. In private practice, your income is tied directly to patient volume and the revenue you generate after covering staff salaries, rent, malpractice insurance, and other business costs. A good year can mean significantly higher earnings. A slow quarter, or a surprise expense, cuts directly into your take-home pay.
The trend over the past decade has been toward employment. More DOs now work for hospital systems or large medical groups than run independent practices, especially among younger graduates who prefer income stability and less administrative burden.
Signing Bonuses and Loan Repayment
Total compensation for DOs often extends beyond base salary. Signing bonuses of $10,000 to $50,000 are common, particularly for primary care physicians willing to work in underserved or rural areas. Relocation stipends, productivity bonuses, and retirement contributions can add tens of thousands more annually.
Federal loan repayment programs are especially relevant for DOs, given that many enter primary care. The National Health Service Corps offers up to $75,000 in loan repayment for primary care clinicians who commit to two years of full-time work in a health professional shortage area. Students in their final year of medical school can apply for up to $120,000 through the Students to Service program in exchange for a three-year commitment. Rural-focused programs offer up to $100,000, and specialized substance use disorder programs go as high as $250,000 for a six-year commitment. These programs can effectively raise a DO’s total compensation by $25,000 to $40,000 per year during the repayment period.
Job Outlook Through 2034
Employment for physicians and surgeons is projected to grow 3% from 2024 to 2034, which matches the average growth rate across all occupations. That modest percentage still translates to steady demand because the physician workforce is large, retirements are accelerating, and the U.S. population continues to age. DOs now make up more than 11% of all active physicians in the country, and that share is growing as osteopathic medical schools expand enrollment. Primary care DOs in particular face strong demand, since shortages in family medicine and internal medicine persist in most states.