Resident Pay — The Real Hourly Wage

Same stipend. Different hours. Wildly different hourly wages. Within any given hospital, PGY-1 residents earn the same salary regardless of specialty — but general surgery residents average 83.1 hours/week while psychiatry residents average 49.5 hours. That turns the same $68,166 stipend into $15.77/hour on one end and $26.48/hour on the other — a 68% gap for the same paycheck.

Effective Hourly Wage by Specialty

Based on AAMC PGY-1 stipend of $68,166÷ (specialty hours × 52 weeks). Hours from Panacea Financial 2025 Residents & Fellows Survey.

Hours source: Panacea Financial 2025 Residents & Fellows Survey Report (page 30, “Workload By Specialty”). n=479 U.S. residents and fellows, ±3.8% sampling error at 95% CI, field period Jan 15 – Feb 28 2025. Hours include on-call duties (per the survey question wording). Stipend source: AAMC Survey of Resident/Fellow Stipends and Benefits 2025, Table 1. Single commercial hours survey — treat per-specialty values as directional, not a national audit.

Don't See Your Specialty?

Panacea's 2025 survey covered the 12 specialties above. For the others (Plastics, Neurosurgery, Vascular, CT Surgery, Urology, Dermatology, Rad Oncology, IR, Ophthalmology, Neurology, ENT), map your typical weekly hours onto one of these bands — same PGY-1 stipend math.

The 80-hour cap is cited from ACGME Common Program Requirements VI.F.1 (averaged over 4 weeks). The 50/60/70 anchors are common reference bands, not published per-specialty means for the un-surveyed specialties.

PGY-1 Stipend by Region

Weighted mean PGY-1 stipend by region (weighted by number of residents at each institution; n=26,173 residents nationwide). National all-region average: $70,684.

Source: AAMC Survey of Resident/Fellow Stipends and Benefits 2025, Table 4. Northeast and Western pay above the national average; Central and Southern below. The $12,573 spread between the highest and lowest regions is real money — but so is the cost-of-living differential in NYC / SF vs. most Southern metros, so don't pick a region for PGY-1 pay alone.

Stipend Progression by PGY Year

Mean unweighted stipend with quartile spread. The spread is real: at PGY-1, the 25th percentile is $62,830 and the 75th is $71,657 — an $8,827 gap depending on which institution you match into.

Source: AAMC Survey of Resident/Fellow Stipends and Benefits 2025, Table 1 (unweighted means — each institution counted equally so larger programs don't dominate). 345 institutions reporting for PGY-1, declining to 127 for PGY-8.

The Raise That Wasn't

Nominal stipends have risen every year. Real purchasing power hasn't kept up.

Between 2020 and 2025, PGY-1 stipends rose $9,245 (+15.7%) in nominal dollars — but CPI rose faster. Adjusted for inflation, today's residents earn $599 LESS per year in real purchasing power than residents did at the 2020 peak.

Source: AAMC Survey of Resident/Fellow Stipends and Benefits 2025, Table 2 (CPI-U adjusted to constant 1969 dollars). The 1969 baseline is AAMC's reference year — the historical first year of the survey.

When Were Stipends Last Raised?

Pay raises aren't automatic. AAMC asked each of 349 institutions when they last adjusted resident stipends.

That means 28.1% of programs did NOT raise stipends in 2025. At those institutions, residents are earning last year's stipend (or older) while groceries, rent, and loan interest keep climbing.

Source: AAMC Survey of Resident/Fellow Stipends and Benefits 2025, Table 11.

Total Stipend Earned Over Residency

Gross stipend across training. Does NOT account for loan interest accruing on ~$223,130 of average medical school debt at 7.5%.

The Debt Residents Are Carrying

* 7.5% is a midpoint estimate — most current residents have loans at multiple rates (5–7% from earlier years, 7.94–8.94% for 2025–26 borrowing, rising to 8.07–9.07% for 2026–27). Your actual blended rate may be lower or higher.

Source: AAMC Class of 2025 Debt, Costs, and Loan Repayment Fact Card

For Context — Other Jobs' Hourly Rates

Source: federal & state minimum wages (2026) | Target & Starbucks company minimums

A Note on Methodology

Stipends vary by institution and region — the AAMC tables on this page show the spread directly (PGY-1 25th-percentile $62,830 to 75th-percentile $71,657; Southern region $65,076 to Western region $77,649). All PGY stipend figures (PGY-1 through PGY-8), the regional breakdown, the inflation-adjusted history, the 96.9%-same-stipend statistic, and the stipend-adjustment cadence come from the AAMC Survey of Resident/Fellow Stipends and Benefits 2025 (Tables 1, 2, 4, 10a, and 11; 350 ACGME-sponsoring institutions surveyed). Per-specialty weekly hours come from the Panacea Financial 2025 Residents & Fellows Survey Report (n=479, ±3.8% at 95% CI, field period Jan 15 – Feb 28 2025; self-reported, includes on-call duties). The 80-hour weekly cap shown in the “Don't see your specialty” section is from ACGME Common Program Requirements VI.F.1 (averaged over 4 weeks). Hourly wages are computed as the AAMC PGY-1 stipend ÷ (weekly hours × 52). We use the flat PGY-1 anchor (not Panacea's per-specialty salary numbers) because within any given hospital all PGY-1s earn the same stipend regardless of specialty (96.9% per AAMC Table 10a) — so the comparison isolates the hours difference. Real hourly wages are likely lower once pre-round prep, charting, and educational time are counted. Treat the per-specialty hours values as directional — a single commercial survey, not a national audit. Finally, these figures are cash stipend only: they exclude health insurance, retirement contributions, and meal or housing allowances, and most residency years count toward PSLF (Public Service Loan Forgiveness) — real value the paycheck alone doesn't capture.