2024 Pay Raise Not Enough, Many Residents Feel Underpaid

Medical resident salaries and stipends increased for 2024, but the majority of those surveyed say they still feel underpaid, according to Medscape Resident Salary & Debt Report 2024.

Over the last 9 years, resident earnings have increased by just a combined 27%, considered slow growth given the rising cost of living. In 2015, residents earned an average of $55,000, while today’s compensation sits at an average of about $70,000.

As a result, almost three quarters of residents said they are underpaid relative to their workload. First- and 2nd-year residents earn an average of $65,000, with incremental increases each year following. 

“There’s no need to provide slave labor in order to learn a trade,” a 3rd-year plastic surgery resident said.

The majority of residents (60%) in Medscape Medical News‘s survey worked in hospital environments, where the pace is fast and the hours are long. Dayna Isaacs, MD, MPH, a hematology/oncology fellow, said many residents contend with 28-hour calls, shifting schedules, and work responsibilities on off-days. Despite this workload, residents are treated like students, Isaacs said.

The reality has some residents in a grim mood: One told Medscape Medical News that they are “barely surviving,” and that they “carry more responsibility and provide more care for patients, see more patients, and [are] more active in their care than most mid-level providers are.”

What would it take for residents to feel they are being paid fairly? For 10% of residents, a pay bump of at least double. Ian Motie, MD, an internal medicine chief resident and chair of the American College of Physicians council of residents/fellow members, said he could understand why some residents want a pay boost, especially those at resident-run hospitals where they are worked “like a dog.” 

Another 37% believed they should earn 26%-50% more, while a quarter would be happy with 11%-25% more.

Motie also noted that residents who do not have a living or education stipend, especially those in cities where the cost of living is higher, have it hard. 

Workplace benefits can significantly impact residents. For example, most residents said they can access health insurance and paid time-off. Sixty percent reported that they have meal allowances, and 59% have travel allowances. However, only 12% of residents said they have housing allowances, while 5% have access to childcare help.

The most popular specialty choices among residents surveyed included internal medicine (13%) and family medicine (11%).

Isaacs told Medscape Medical News that choosing a specialty based on passion and enthusiasm is important, but so is their future potential salary — especially for those carrying the burden of education debt. Over half of residents surveyed said they manage at least $150,000 in medical school debt, with 19% owing over $300,000 and 14% owing between $200,000 and $250,000.

Some residents said debt load may mean the difference between deciding to work in a private or academic practice or in affluent areas vs in underserved populations. One resident even said, “Debt dominates my thought process.”

Even though earnings clearly did matter, money was not everything for those surveyed. Thirty-six percent of residents said a workplace that offered work-life balance was a key factor in guiding their first post-residency position. Starting pay was a key factor for only 19% of residents, while a supportive organizational and practice environment came close at 17%.