We all know that some specialties make more money than others, but are they actually making
more money per hour? Or are they just working more hours? Let’s dive into the data and
find out. Dr. Jubbal, MedSchoolInsiders.com
When discussing which specialties make the most money, the conversation usually starts
and ends with annual salaries. Although this is a good place to start, it overlooks one
crucial component: the time that it takes to make that salary.
We took the average salary for each specialty in 2021 and divided it by the average number
of hours worked per week, multiplied by the number of weeks worked in a year, to give
us the average hourly wage. We’ll also discuss factors like competitiveness,
on-call responsibilities, and length of training to give you a better understanding of the
price you pay to earn that higher hourly wage. Number one on our list is plastic surgery
which focuses on the repair, reconstruction, replacement, and alteration of soft tissue.
This should come as no surprise as plastic surgery is known for being one of the more
lucrative specialties. It is often in the top 3 for highest-paid specialties. Plastic
surgeons have an average annual salary of $526,000 and work an average of 52 hours/week,
giving us an hourly wage of approximately $202 per hour.
It is important to note that this number includes both reconstructive and aesthetic plastic
surgeons. Plastic surgeons working in aesthetics will, in general, make more than their reconstructive
colleagues. That being said, to achieve this compensation
you will first have to match into plastic surgery which is no easy feat. It is currently
ranked #2 on the MSI competitiveness index, neck and neck with dermatology in first. You
will have to commit a great deal of time and effort during medical school to be competitive
for plastics, and even then there is no guarantee that you will match.
The training to become a plastic surgeon is also longer than most specialties at 6-8 years
depending on the pathway you take. So while many of your peers during medical school are
already receiving an attending’s salary, you will still be completing your training.
Once you begin practicing as a plastic surgeon, however, the lifestyle is often pretty good.
Plastic surgeons work an average of 52 hours per week which is less than many of the other
surgical specialties but middle of the pack when looking at all specialties.
Most surgeries are also non-urgent so call typically isn’t terrible. Keep in mind though
that if you choose to do microsurgery or handle face trauma, your call obligations can be
more taxing. Number two is orthopedic surgery which focuses
on the surgical management of the musculoskeletal system including the extremities, spine, and
associated structures. Orthopedic surgeons have an average annual
salary of $511,000 and work an average of 57 hours per week, yielding an average hourly
wage of $179 per hour. Much like plastic surgery, orthopedic surgery
is consistently in the top 3 highest-paid specialties, right in the mix with plastics
and neurosurgery. Similarly, it is also one of the more competitive
specialties to match into as your USMLE Step 1 score and 1 rep max on bench press will
have to exceed 500, which can be a big barrier to entry for prospective applicants. All jokes
aside, it is ranked #4 on the MSI competitiveness index which means more time and effort spent
during medical school to make yourself a competitive applicant.
Ortho residency is 5 years, which is standard for most surgical specialties, but longer
than many non-surgical specialties. Longer residency programs do exist which include
additional research experience. Orthopedic surgeons work an average of 57
hours a week, which is in line with many other surgical specialties but on the higher end
compared to all specialties. On-call obligations will vary depending on
your choice of subspecialty. If you choose to subspecialize in trauma, for instance,
be prepared for a heavier call schedule. Number three is dermatology which focuses
on the management of diseases involving the skin, hair, and nails.
Dermatologists have an average annual salary of $394,000 per year and work an average of
45 hours per week, averaging $175 per hour. Dermatology is currently ranked #1 on the
MSI competitiveness index as it is known to have a great lifestyle, and is the only specialty
in the top 5 that is non-surgical. To become a dermatologist you will have to
complete a 1 year internship followed by 3 years of dermatology residency for a total
of 4 years in training after medical school which puts dermatology in the middle of the
pack when it comes to length of training. Dermatologists work 45 hours per week which
is towards the lower end of all specialties. Given the outpatient nature, low acuity of
medical conditions, limited call, and flexible workdays, dermatology is known for having
a “cush” lifestyle relative to other medical specialties.
Number four is cardiology which focuses on diseases of the heart and the blood vessels.
Cardiologists have an average salary of $459,000 per year and work an average of 58 hours per
week, yielding an average hourly wage of $158 per hour.
Cardiology is the first specialty on our list that does not have a dedicated residency.
Instead, you must first complete 3 years of internal medicine residency followed by 3
years of cardiology fellowship, for a total of 6 years of training after medical school.
Although it is difficult to compare the competitiveness of cardiology to other specialties on our
list due to the fact that it is a fellowship and not a residency, it should be noted that
cardiology is one of the most competitive internal medicine fellowships to get into.
Cardiologists work an average of 58 hours per week, which is towards the higher end
when compared to most other non-surgical specialties. This time is split between clinic, cath lab,
performing procedures, general rounds, and research. Of note, 30-40% of emergency room
admissions are cardiac-related, so there is certainly no shortage of work if you’re
a cardiologist. On-call responsibilities will vary depending
on your subspecialization. If you choose to subspecialize in interventional cardiology,
for instance, you can expect lots of call with long days in the cardiac cath lab.
Number five is otorhinolaryngology, or ear, nose, and throat, which focuses on the surgical
management of diseases of the head and neck region.
Ear nose and throat doctors, or ENTs, have an average salary of $417,000 per year and
work an average of 53 hours per week, averaging $157 per hour.
ENT is a highly competitive specialty, consistently ranking #5 on the MSI competitiveness index
right after dermatology, plastic surgery, neurosurgery, and orthopedic surgery.
ENT residency is 5 years, which is the standard for most surgical specialties, but longer
than many non-surgical specialties. Longer residency programs do exist which include
additional research experience. ENT’s will work an average of 53 hours per
week which is middle of the pack when looking at all specialties. Work is typically split
between surgery and clinic with clinic days generally having regular 9 to 5 hours, and
OR days being half days or full 12 hour days depending on the complexity of the cases.
Given the greater proportion of time in the clinic coupled with the fact that ENT typically
splits face call with plastics and OMFS, on-call obligations are typically less than other
surgical specialties. This can vary though depending on the hospital or institution you
work for. Number six is emergency medicine which focuses
on the treatment of acutely ill patients with urgent healthcare needs.
Emergency medicine physicians have an average salary of $354,000 and work an average of
46 hours per week, averaging out to $154 per hour.
In terms of competitiveness, emergency medicine is at the lower end of the MSI competitiveness
index at #17. It is also at the shorter end of residency
lengths at just 3 to 4 years of training after medical school.
Emergency medicine physicians will work on average 46 hours per week, which is towards
the lower end of all specialties. They are also unique in that they do shift work, meaning
that they clock in and clock out and don’t take work home with them - which is something
you can’t say about many medical specialties. Emergency medicine is not without its downsides
though. Although many people view shift work as a positive, it also means that you might
end up working irregular hours depending on your shifts, so a regular circadian rhythm
can be hard to come by. Emergencies don’t take days off either so
it is not uncommon to miss important events or holidays, particularly during training
or when you are a freshly minted attending. EM physicians also experience some of the
highest rates of burnout despite working fewer hours than most other medical specialties
which can be attributed to working on the front line, consistent high intensity and
stress, unpredictability, increasing charting demands, and irregular circadian rhythms.
As you can see, even the highest-earning specialties are not without their downsides. This is why
money, although important, should not be the only factor when choosing a specialty. It
is much more important to find a specialty that is a good fit and you enjoy doing.
If you have your eyes set on a particular specialty but find yourself getting discouraged
because it’s highly competitive, don’t fall into the trap I’ve seen many succumb
to. I’ve come across many who wanted to do a different specialty, but ultimately decided
they weren’t competitive enough for the specialty that they truly desired.
If you think you’re not the smartest and that you’re doomed, stop right there. Your
ability to crush your MCAT, USMLE, and have dozens of research articles is less a function
of your intelligence and more a function of working smarter at sufficient intensity. Having
a stellar medical school or residency application and crushing the interviews is no different,
even if you don’t consider yourself a natural “people person” or gifted writer.
At Med School Insiders, our mission is to empower a generation of happier, healthier,
and more effective future doctors. From medical school or residency application help to crushing
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See for yourself and learn more at MedSchoolInsiders.com. Thank you all so much for watching! If you
enjoyed this video, check out the Top 10 Highest Paid Doctor Specialties or my video going
over the Best Doctor Lifestyle Specialties. Much love and I’ll see you guys there.