Highest earning medical specialities
Here's a quick overview based on my training knowledge:
Top-earning medical specialties (US, roughly ranked):
- Neurosurgery (~$700k-$900k+)
- Thoracic Surgery (~$600k-$800k)
- Orthopedic Surgery (~$600k-$750k)
- Plastic Surgery (~$550k-$700k)
- Oral & Maxillofacial Surgery (~$500k-$650k)
- Vascular Surgery (~$500k-$600k)
- Cardiology (~$500k-$600k)
- Radiation Oncology (~$450k-$550k)
- Dermatology (~$400k-$500k)
- Gastroenterology (~$400k-$500k)
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highest earning medical specialties 2025 2026 average salary
Here is an up-to-date breakdown of the highest-earning medical specialties in the US, based on the Doximity Physician Compensation Report 2025 and Medscape Physician Compensation Report 2026:
Highest Earning Medical Specialties (US, 2026)
| Rank | Specialty | Avg. Annual Salary |
|---|---|---|
| 1 | Neurosurgery | $700,000 - $800,000+ |
| 2 | Thoracic Surgery | $650,000 - $800,000 |
| 3 | Orthopedic Surgery | $550,000 - $680,000 |
| 4 | Plastic Surgery | $550,000 - $650,000 |
| 5 | Cardiology | $480,000 - $620,000 |
| 6 | Gastroenterology | $450,000 - $600,000 |
| 7 | Oncology | $480,000 - $570,000 |
| 8 | Radiology | $500,000 - $550,000 |
| 9 | Urology | $500,000 - $550,000 |
| 10 | Dermatology | $470,000 - $540,000 |
| 11 | Anesthesiology | $450,000 - $500,000 |
| 12 | Otolaryngology (ENT) | $460,000 - $500,000 |
| 13 | Ophthalmology | $430,000 - $500,000 |
| 14 | Critical Care | $400,000 - $470,000 |
| 15 | OB/GYN | $360,000 - $420,000 |
Source: Sermo Physician Salary 2026 and TAG MedStaffing 2026
Key Takeaways
- Neurosurgery consistently tops the list at ~$749,140 average (Doximity 2025). It requires the longest training path - 7 to 8 years of residency.
- Surgical specialties dominate the top slots. The combination of procedural complexity, liability, and long training drives compensation up.
- The overall US physician average is ~$463,387/year (Marit 2026), with specialists averaging ~$404,000 and primary care at ~$287,000.
- Radiology and Dermatology offer strong pay relative to lifestyle, making them highly competitive for residency spots.
- Cardiology and Gastroenterology earn well partly due to high-volume procedural work (catheterizations, endoscopies).
What Drives High Pay?
- Procedural volume - surgeons and interventionalists bill more per encounter
- Training length & scarcity - fewer specialists = higher demand
- Liability/malpractice risk - OB/GYN and neurosurgery carry high insurance costs
- Geographic location - rural/underserved areas often pay 20-30% more
- Employment model - private practice typically outearns hospital employment
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