Highest Paid Medical Specialties in 2026

The highest-paid physicians in the US earn nearly four times as much as the lowest-paid. Here are the 10 highest-paid medical specialties in 2026, all earning over $600,000 annually, based on the most recent Doximity physician compensation report.

#10 | Vascular Surgery: $600,520

Vascular surgeons earn an average of $600,520 annually and specialize in diseases of the arteries and veins throughout the body, excluding the brain and heart.

They treat conditions such as aortic aneurysms, carotid artery disease, and blood clots. While compensation is strong, the lifestyle is demanding, with frequent call and unpredictable hours.

Training lasts 5 years if matched directly into vascular surgery, or 6 to 7 years if pursued after a general surgery residency.

#9 | Cardiology: $604,635

Cardiology is the highest-paid internal medicine subspecialty, with average compensation around $604,635.

Cardiologists treat diseases of the heart and vascular system, including heart failure, hypertension, and heart attacks. Demand remains high, as cardiovascular disease continues to be the leading cause of death in the United States.

Lifestyle varies depending on subspecialty. Procedural cardiologists often take emergency call, while those working in heart failure or electrophysiology clinics tend to have more predictable schedules.

Training includes 3 years of internal medicine residency followed by a 3-year cardiology fellowship, with many physicians subspecializing further.

Heart disease is, unfortunately, the leading cause of death in the US, despite often being preventable. 

#8 | Diagnostic Radiology: $609,684

Diagnostic radiology ranks 8th, with an average annual compensation of $609,684.

Radiology can be broken down into two distinct tracks: diagnostic radiology and interventional radiology.

Diagnostic radiologists interpret imaging studies such as X-rays, CT scans, and MRIs to help diagnose disease. While the pay is high, radiology is best known for its relatively strong work-life balance. Most diagnostic radiologists work predictable hours with limited emergency call.

Training requires a 5-year residency. Compensation varies widely depending on subspecialization, practice setting, and workload. 

#7 | Radiation Oncology: $613,837

Radiation oncologists earn approximately $613,837 per year and treat cancer using radiation therapy.

They work closely with medical and surgical oncologists as part of multidisciplinary cancer teams. Despite the seriousness of the work, radiation oncology is known for one of the better lifestyle-to-income ratios in medicine.

Most radiation oncologists work 45 to 50 hours per week with minimal call. Training consists of a 5-year residency.

#6 | Plastic Surgery: $625,757

Plastic surgeons earn an average of $625,757 annually and practice in both reconstructive and aesthetic surgery.

Aesthetic plastic surgeons typically earn more than those focused on reconstruction alone. While the lifestyle is generally manageable compared to other surgical fields, plastic surgery is consistently one of the most competitive specialties to match into.

There are two main training pathways:

• Integrated: 6 years directly after medical school
• Independent: 5 years of general surgery followed by 3 additional years of plastic surgery training

If you’re targeting a high-paying, high-competition specialty like plastic surgery, preparation needs to begin early. Strong Step 2 scores, research output, and standout letters of recommendation matter.

To explore competitiveness data across specialties, visit SpecialtyRank.com, which provides free access to NRMP match statistics.

#5 | Pediatric (General) Surgery: $627,126

Pediatric surgery appears on this list due to expanded compensation reporting in recent years.

Pediatric surgeons operate on infants, children, and adolescents, treating congenital anomalies, tumors, and traumatic injuries. The work is high-stakes, and the lifestyle reflects that intensity.

Training requires a 5-year general surgery residency followed by a 2-year pediatric surgery fellowship, totaling at least 7 years after medical school.

Despite similar training demands, pediatric specialists often earn significantly less than their adult counterparts, highlighting one of the largest pay gaps in medicine.

#4 | Interventional Radiology: $634,658

Well ahead of diagnostic radiology, interventional radiologists earn an average of $634,658 per year.

Interventional radiologists use imaging guidance to perform minimally invasive procedures that actively treat patients, rather than only diagnosing conditions. This procedural role comes with longer training, typically 6 to 7 years, and more demanding call responsibilities.

The key tradeoff is lifestyle: diagnostic radiology prioritizes predictability, while interventional radiology trades longer hours and call for hands-on procedural work. 

#3 | Orthopedic Surgery: $696,852

In the bronze medal position is orthopedic surgery at $696,852.

Orthopedic surgeons use both surgical and nonsurgical treatments to manage musculoskeletal conditions. They treat conditions like trauma, tumors, infections, degenerative diseases, congenital disorders, spine diseases, and sports injuries.

Although the paycheck is certainly substantial, depending on the subtype of orthopedic surgery you practice, it may come with long hours and poor work-life balance.

To get into orthopedic surgery, which consistently ranks in the top 5 most competitive specialties, you’ll have to complete a 5-year orthopedic surgery residency.

#2 | Thoracic Surgery: $749,707

In the silver medal spot, we make a huge jump in pay. Thoracic surgeons earn an average of $747,707 a year.

Thoracic surgery, also known as cardiothoracic surgery or CT for short, is the surgical treatment of organs within the thorax (chest cavity), such as the heart, lungs, aorta, esophagus, and diaphragm. These surgeons perform lung and heart transplants, valve replacements, coronary artery bypass grafts, and lung resections to remove lung cancer.

This specialty can be broken down into cardiac, thoracic, or cardiothoracic surgery. After completing their CT surgery training, physicians can choose to specialize in cardiac surgery, focusing on the heart and aorta, or thoracic surgery, focusing on the lung, esophagus, ribs, and other structures in the thorax. If the surgeon chooses to remain generalized, they can operate in both cardiac and thoracic domains.

Unfortunately, this is a specialty with a very difficult lifestyle. Coronary artery bypass grafts, or CABG for short, can last anywhere from 4 to 8 hours, and if complications arise, it could take up to 12 hours. There’s not much of a work-life balance in CT surgery.

Depending on the path, it can take anywhere from 5 to 7 years to become a CT surgeon.

There are 3 pathways to becoming a CT surgeon. The independent pathway is the most common and requires a 5-year general surgery residency followed by an additional 2-year cardiothoracic residency.

The integrated pathway is only 5 or 6 years, where you match directly into a CT residency program after medical school.

The combined pathway requires 4 years of general surgery and 3 years of CT surgery at a single program. These physicians are certified in both general and CT surgery.

#1 | Neurosurgery: $829,161

Finally, in the gold-medal spot is neurosurgery, with a whopping salary of approximately $829,161 per year.

Neurosurgery involves the surgical treatment of disorders affecting the central nervous system, including the brain and spinal cord. It also includes the peripheral nervous system, which comprises the neuromuscular junctions, peripheral nerves, spinal nerves, and their roots and branches.

There are two categories in neurosurgery: elective and non-elective (emergent) surgery. Generally, elective surgeries treat conditions that are not immediately life-threatening. Emergent surgery includes traumatic injuries to both the cranium and spine.

While compensation often correlates with competitiveness, it’s not a perfect science, just like neurosurgery. Neurosurgeons have the longest training of any residency program, but it’s not the most competitive. It ranked 2nd in 2024 and was the 5th most competitive in 2026. This has a lot to do with lifestyle.

Neurosurgeons are known for having one of the most challenging lifestyles among physicians. In addition to scheduled cases, they are required to take neurosurgery trauma call. It’s often said that neurosurgeons make the most money, but they don’t have any time to enjoy it.

Neurosurgery also comes with a massive 7-year residency following medical school, and 7 years is a very long time to earn only a resident’s salary, which is about $75,000. 

Is the Money Important?

While money should absolutely not be a primary reason to go into medicine, it is an important factor. After all, we wouldn’t pursue becoming a doctor if it only paid $50,000 per year and came with hundreds of thousands of dollars in debt. That’s just not a smart move.

Learning how to choose a medical specialty that aligns with your interests and lifestyle matters far more than compensation alone.

It doesn’t matter how much money you make if you don’t enjoy the operating room.

Factors Contributing to High Salaries

So what do neurosurgery, orthopedics, and thoracic surgery have in common that results in such high salaries? It comes down to procedures. In the current US healthcare system, procedures are compensated quite handsomely. On the flip side, you’ll notice that the 5 lowest compensated specialties aren’t procedurally focused.

Does that mean you should pursue a specialty that is procedure-heavy? Not based on salary alone. I personally love working with my hands and precise, meticulous attention to detail, which is why I matched into plastic surgery. But if you don’t love working with your hands, you’d be miserable doing any form of surgery.

There are several other factors beyond specialty choice that can significantly affect a doctor’s average compensation.

1 | Location

It’s a matter of supply and demand. Lots of doctors want to live in California, and therefore, there’s relatively more supply of doctors than demand. As a result, hospitals can pay doctors less than they would in, say, Wisconsin. Because fewer doctors are eager to work in less-populated areas like Wisconsin or Oklahoma, hospitals need to offer higher salaries to attract talent there. It’s simple economics at play.

2 | Practice Type

Self-employed physicians, meaning private practice doctors, on average, make substantially more than employed physicians. This has held true for decades, although private practice is less appealing than it was 10 years ago.

Again, your decision shouldn’t be based on just the money. Private practice usually comes with the significant added headache of handling the business side of things, and you can expect to be working harder hours than if you were employed.

If you’re an aspiring physician but don’t know which specialty you’d like to pursue, our So You Want to Be series will help you understand the pros and cons of every medical path to help you choose the one that’s best for you.

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