Most U.S. first-year residents earn about $68,000 per year in salary, with benefits and paid time off that raise total compensation.
If you’re asking how much do 1st year residents make?, you’re not alone. Intern year hits fast. You’re learning new systems, new teams, new call rooms, and new limits on sleep. Money worries shouldn’t be one more mystery. You can plan your money before day one starts.
This guide breaks down what a PGY-1 salary usually looks like, what adds to it, and what can cut it down. You’ll leave with a simple way to estimate take-home pay and compare offers without guesswork.
What PGY-1 Compensation Usually Includes
A residency offer is more than a single salary number. Most programs package pay, insurance, time off, and small stipends together. Those add-ons can swing your day-to-day cash flow, even when base pay looks close across programs.
| Pay Item | What It Pays For | What To Check In Your Offer |
|---|---|---|
| Base salary (stipend) | Your fixed annual pay for PGY-1 | Start date, pay schedule, and any mid-year raises |
| Health plan cost | Medical, dental, vision pricing and deductibles | Employee share per paycheck and family plan pricing |
| Retirement match | Employer contributions to a 401(k) or 403(b) | Match rate, vesting rules, and when eligibility starts |
| Meal allowance | Cafeteria credits, night meal funds, call-room snacks | Monthly amount, rollover rules, and where it works |
| Parking or transit | Garage access, bus pass, subway subsidy | Fees you must pay and whether nights differ |
| Books and CME funds | Boards resources, conference fees, learning materials | Annual cap, reimbursement steps, and eligible purchases |
| Relocation or start bonus | One-time help with moving or start costs | Tax treatment, pay date, and repayment clauses |
| Moonlighting options | Extra paid shifts when permitted and licensed | Policy, rate, limits, and approval steps |
| Extra shift or call pay | Pick-up shifts, extra shifts, added call | When it applies and how it’s tracked |
How Much First-Year Residents Make By Region And Program Type
Across the United States, most PGY-1 stipends land in the mid-$60,000s to low-$70,000s. A national snapshot from Medscape’s 2025 Resident Salary and Debt Report, reported by The DO, lists an average first-year salary of $68,000.
That single number hides local swings. Housing costs, union contracts, hospital budgets, and state taxes all move your net pay. A program in a high-cost metro may pay more, yet your rent can climb faster.
Academic Hospitals Vs. Non-Academic Hospitals
Large teaching centers often bundle more benefits, plus access to wider specialty services and larger teaching teams. Smaller hospitals sometimes keep the package simpler. Either model can pay well. The difference is more about the full deal than the logo on the badge.
Why Cost Of Living Matters More Than A Small Raise
A $3,000 bump sounds nice until you price apartments near the hospital and add parking. Run the full monthly math: rent, utilities, commuting, food, insurance deductions, and loan payments. That’s the only way to see which offer feels lighter week to week.
How Much Do 1St Year Residents Make?
When people ask this question, they usually mean: “What hits my bank account?” The gap between gross salary and net pay surprises many interns. Taxes, retirement, health plan costs, and other deductions happen before you see the money.
A Realistic Paycheck Starting Point
The AAMC published a sample budget using a projected 2025 PGY-1 stipend of $67,400 and a monthly net paycheck of $4,400 at a teaching hospital. You can view the AAMC sample monthly budget for a PGY-1 resident and use it as a scale check for your own numbers.
In plain terms, if your base salary is in the high-$60,000s and you’re paid twice a month, your gross check might look like a little over $2,800. After deductions, your deposit can land closer to the low-$2,000s, depending on state tax and benefit choices.
Quick Math For Your Own Estimate
Use this simple method:
- Start with annual salary.
- Divide by pay periods (24 for semi-monthly, 26 for biweekly).
- Subtract pre-tax items you choose (health plan cost, retirement).
- Expect payroll taxes and income tax to take a chunk that varies by state and filing status.
If you want a clean first pass, assume 25% to 35% of gross pay goes to taxes and mandatory payroll deductions, then adjust once you know your local rates and your benefit pricing.
Benefits That Change The Real Value Of An Offer
Two programs can post the same stipend and still feel different. Benefits are where that difference shows up. Check costs you’d pay anyway and see which program pays more of them.
Health Plan Pricing And Out-Of-Pocket Costs
Low per-check costs can hide high deductibles. Higher per-check costs can buy a plan that pays for more visits and meds. If you take regular prescriptions or plan care, run the numbers with your own use pattern.
Paid Leave Rules And Protected Time
Time off is part of pay. The ACGME requires sponsoring institutions to provide at least six weeks of paid medical, parental, and caregiver leave for qualifying reasons, plus at least one week of paid time off outside that leave. The ACGME leave policy guidance spells out the baseline, while each hospital sets its own details.
Meals, Parking, And Small Stipends
These line items can feel minor, then you start paying $12 a day for parking or buying meals on night float. A monthly meal allowance or free garage access can save cash over a year.
Hourly Pay Reality Check
Intern pay is usually a salary, not hourly. Still, it can help to translate it into an hourly rate so you can spot stress points in your budget. Say your program pays $68,000 and you average 65 hours a week over the year. That’s about $20 an hour before taxes. If your weeks run closer to the 80-hour cap at times, the number drops. This isn’t a complaint; it’s a planning tool. It tells you how hard a surprise expense can hit when time is scarce.
Table Of Take-Home Pay Scenarios
Use the table below as a fast comparison tool. It assumes a single filer and a blended deduction rate that lumps taxes and payroll items together. Your results will differ. Treat it as a starting sketch, then run your own numbers once you know your benefits and local tax rules.
| Gross PGY-1 Pay | Ballpark Monthly Take-Home | What Moves It Most |
|---|---|---|
| $62,000 | $3,600 to $4,000 | State tax, health plan cost, retirement contributions |
| $67,400 | $4,100 to $4,500 | Benefit pricing and withholding choices |
| $68,000 | $4,100 to $4,600 | Local tax rates and pre-tax deductions |
| $72,000 | $4,300 to $4,900 | Plan choice trade-offs and city taxes |
| $75,000 | $4,500 to $5,200 | Local taxes, union dues, retirement deferrals |
Ways Residents Add Income Without Burning Out
Base salary is fixed for most programs, yet there are a few legit ways residents can add income. The trick is to protect your training time and your sleep.
Moonlighting When Your Program Allows It
Some residents can moonlight after they meet licensing and program rules. Rates vary widely. Ask about limits, malpractice arrangements, and whether shifts count toward duty hours.
Extra Shifts And Added Pay
Programs sometimes pay for extra clinic shifts, holiday shifts, or short-staffed call slots. If you pick these up, track the paperwork. If it isn’t logged, it can vanish.
Reimbursement You Should Claim
Many residents leave money on the table by skipping reimbursements. Common ones include:
- Licensing and DEA fee reimbursement, when offered
- Board review materials paid from CME funds
- Required travel reimbursed for away rotations
Common Pay Traps That Shrink Your Net
Pay traps are rarely dramatic. They’re small cuts that add up.
Benefit Costs You Didn’t Notice
Scan the offer for per-paycheck costs, parking fees, and any mandatory payroll deductions. If you’re moving with a partner or kids, family plan pricing can change the math fast.
Moving Costs And Upfront Deposits
July starts come with deposits, utility setup fees, and sometimes a gap between moving in and your first check. Build a short runway if you can: a month of basic expenses keeps stress down during orientation.
Tax Withholding Guesswork
If you set withholding too low, you can get hit with a big tax bill. If you set it too high, your paychecks feel tight all year. Use your employer’s payroll tools and update them after any major change like marriage or a second job.
How To Compare Two Offers In 15 Minutes
If you have two programs on the table, don’t stare at the salary line and call it done. Run this quick comparison:
- Write the base salary for each program.
- List monthly fixed costs: rent, commuting, parking, health plan cost.
- Add cash-like benefits: meal credits, transit subsidy, start bonus.
- Check leave and paid time off rules.
- Estimate take-home pay with the same tax assumption for both.
Then ask one question that clears the fog: “What’s the total annual compensation value after benefits?” Many GME offices can share a summary sheet.
A Practical Checklist For Intern-Year Money
Here’s a tight list you can use before your first paycheck lands:
- Pick a health plan after you price the deductible and your usual care.
- Set retirement contributions at a level you can keep all year.
- Build a simple monthly budget: rent, utilities, food, transit, loan payment, phone.
- Track reimbursements in one folder so you submit them on time.
- Plan for one-time costs in July: scrubs, badges, licenses, deposits.
And if you’re still wondering, how much do 1st year residents make? Start with the stipend, then zoom out. The full package, taxes, and local costs decide how it feels in day-to-day life.