Medical Specialties by Salary: 2026 Complete Rankings

22 min read
SalaryDr Research Team
Physician Compensation Research
Table of Contents

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Frequently Asked Questions

What is the highest-paying medical specialty in 2026?
Neurosurgery is the highest-paying medical specialty with a median total compensation of approximately $810,000. Orthopedic surgery ($700,000) and cardiothoracic surgery ($690,000) follow closely. However, when adjusting for hours worked, dermatology and ophthalmology rank among the highest-paying specialties on a per-hour basis.
What is the lowest-paying medical specialty?
Pediatrics and family medicine are the lowest-paying physician specialties, with median total compensation of approximately $260,000 and $265,000 respectively. Preventive medicine and geriatrics also rank in the lower tier at $255,000 to $275,000. However, these specialties often offer better work-life balance and more predictable schedules.
Is training length correlated with higher physician salary?
Generally yes, but the correlation is imperfect. Neurosurgery (7 years of training) and orthopedic surgery (5-6 years) are among the highest-paid. However, dermatology (4 years) pays exceptionally well relative to its training length, while pediatric surgery (7 years) pays less than many shorter-training surgical specialties. The strongest predictor of compensation is procedural volume, not training length.
Which specialties have the best salary per hour worked?
Dermatology, ophthalmology, and psychiatry consistently rank highest in compensation per hour worked. Dermatologists working 40-45 hours per week at $455,000 earn approximately $195-$220 per hour. By contrast, general surgeons working 55-65 hours at $435,000 earn approximately $130-$150 per hour. Surgical specialties with heavy call reduce effective hourly rates further.
How often do physician salary rankings change?
The top and bottom of the physician salary rankings are remarkably stable year over year. Neurosurgery, orthopedic surgery, and cardiology have been top-5 for over a decade. The middle tier sees more movement — psychiatry, for example, has risen significantly in recent years due to demand-supply imbalances. Major shifts typically take 5-10 years and are driven by changes in reimbursement, demand, or supply.