Dermatology Residency Guide: Physician Salary by Specialty Explained

Understanding Physician Salary by Specialty: Where Dermatology Fits

When you’re aiming for a dermatology residency, you’re stepping into one of the most competitive and frequently discussed fields in terms of income and lifestyle. Applicants often hear that dermatology sits among the highest paid specialties, but the reality is nuanced. Compensation varies dramatically depending on:

• Your exact dermatology subspecialty
• Practice setting (academic vs. private practice vs. corporate)
• Geography and market saturation
• How your compensation is structured (salary, productivity, bonuses, partnership)

This guide breaks down how physician salary by specialty works, where dermatology falls on the income spectrum, and what that means for your derm match strategy and long‑term career planning.

You’ll get:

• A clear overview of how doctor salary by specialty is typically structured
• Concrete dermatology salary ranges across different practice types
• Comparisons with other high‑earning specialties
• Practical advice to factor compensation into your residency and career decisions

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How Physician Salary by Specialty Is Determined

Before drilling into dermatology, it helps to understand the broader forces behind physician pay. While survey numbers change every year, the same underlying drivers tend to shape physician salary by specialty.

1. Supply, Demand, and Case Complexity

Specialties with high procedural complexity, longer training, and fewer physicians often command higher pay. Classic examples among the highest paid specialties include:

• Orthopedic surgery
• Neurosurgery
• Cardiology (especially interventional)
• Gastroenterology
• Radiology
• Dermatology (especially procedural or cosmetic-focused practices)

Dermatology is interesting because it’s not a “high-acuity” field like neurosurgery, yet it sits near the top of many doctor salary by specialty surveys. Why?

• There is sustained demand for both medical and cosmetic skin care
• Cosmetic services are largely cash-pay and not limited by insurance reimbursement
• Efficient outpatient workflows make high productivity possible

2. Outpatient vs. Inpatient Work

Outpatient specialties with high throughput and procedure-based revenue can do very well, sometimes rivaling or exceeding the pay in heavy-call, inpatient specialties.

Dermatology is:

• Predominantly outpatient
• High-volume but often predictable
• Flexible in scheduling, with the option to layer in cosmetic procedures, patch testing, or procedural clinics

In contrast, hospital-based or call-heavy specialties (e.g., emergency medicine, critical care, trauma surgery) may earn high salaries but often with more nights, weekends, and shift work trade-offs.

3. Practice Type and Ownership

The same specialty can earn very different incomes based purely on practice model. This is particularly true in dermatology.

Common categories:

• Academic / Teaching Hospitals

  • Lower base salary
  • Stronger benefits, stability, and protected teaching/research time
  • Access to complex cases, subspecialty clinics, and leadership roles

• Hospital-Employed or Integrated Health Systems

  • Competitive starting salaries with predictable income
  • Less administrative burden than private practice
  • Limited upside compared to partnership/private equity models

• Traditional Private Practice (Physician-Owned)

  • Often a modest starting salary with ramp-up period
  • Partnership track with substantial income growth after buy-in
  • Potential to be well above national average among highest paid specialties

• Private Equity / Corporate Dermatology Groups

  • High guaranteed salaries or RVU-based compensation
  • Potential bonuses tied to productivity
  • Less autonomy over scheduling, staffing, and business decisions

Dermatology offers viable paths in each of these, which makes it one of the more flexible specialties for tailoring your career to your priorities.

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Dermatology in the Physician Salary Landscape

Now to the core question: where does dermatology sit in the broader conversation about doctor salary by specialty?

National Context: Salary Tiers

While exact numbers vary year-to-year and by data source, surveys from organizations like Medscape, MGMA, and Doximity typically show a pattern:

• Top income tier (often $500,000+ median)

  • Orthopedic surgery
  • Plastic surgery
  • Cardiology (especially interventional)
  • Gastroenterology
  • Radiology
  • Urology

• Upper-mid tier (commonly $400,000–$500,000 range)

  • Dermatology
  • Anesthesiology
  • Emergency medicine
  • General surgery
  • Oncology
  • Ophthalmology

• Mid tier (commonly $300,000–$400,000)

  • Internal medicine subspecialties (endocrinology typically lower, heme/onc higher)
  • OB/GYN
  • Neurology
  • Psychiatry (in some markets)

• Lower tier (commonly below $300,000)

  • Pediatrics (particularly general pediatrics)
  • Family medicine
  • General internal medicine
  • Some academic-heavy subspecialties

Dermatology consistently lands in the upper-mid or even top tier, especially when you consider private, procedure‑heavy, or cosmetic practices.

Typical Dermatology Salary Ranges

Again, figures vary by region and year, but a realistic rough breakdown for attending dermatologists might look like this:

• Academic Dermatology Attending

  • Early career: ~$220,000–$320,000
  • Mid-career: ~$280,000–$380,000+ (with leadership roles, research funding, or administrative stipends)

• Hospital-Employed / Large Group Dermatologist

  • Early career: ~$300,000–$400,000 salary or salary + RVU
  • Mid-career: ~$350,000–$500,000+ with productivity bonuses

• Private Practice, Non-Owner (Associate)

  • Early career: ~$300,000–$450,000
  • Mid-career: ~$350,000–$550,000+

• Private Practice Partner / Owner

  • Income often ranges from ~$450,000–$800,000+
  • High-performing cosmetic or surgical dermatologists in affluent markets may exceed this

• Cosmetic-Focused Dermatologist

  • Highly variable; a busy cosmetic practice in the right market can significantly outperform traditional medical dermatology
  • Income often depends on practice reputation, self-pay volume, and entrepreneurial skill

These are broad directional ranges for planning purposes, not guaranteed offers. But they help frame dermatology as a specialty with strong lifetime earnings capacity, particularly once you move past early attending years.

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Subspecialties Within Dermatology: Does Specialty Affect Salary?

Dermatology is often treated as a single category in salary surveys, but subspecialization can influence your eventual compensation and job market niche.

Mohs Surgery

Mohs micrographic surgery is one of the best-known dermatology subspecialties and is often associated with higher income.

• What you do: Precise excision of skin cancers with immediate microscopic margin evaluation; often combined with reconstruction
• Training: Dermatology residency plus a fellowship (typically 1 year)
• Income pattern:
  • Mohs surgeons often earn more than general dermatologists due to high procedural volume and specific reimbursement codes
  • Many Mohs-heavy practices see total income shift into the higher end of dermatology compensation ranges

If your goal is maximizing income within dermatology while remaining primarily in a clinical, outpatient setting, Mohs is worth exploring.

Cosmetic Dermatology

Cosmetic dermatology is not always a formal fellowship – many dermatologists build cosmetic practices through:

• Additional training courses
• Mentorship during residency and early career
• Industry-sponsored workshops and device/company relationships

Income features:

• Cash-based revenue from cosmetic procedures (fillers, Botox, lasers, resurfacing, body contouring)
• Reduced dependence on insurance reimbursement and prior authorizations
• High return per unit time if the practice is well-marketed and efficiently run

A cosmetic-heavy practice in a high-income area can place you among the highest paid specialties in practice, even though “cosmetic dermatology” may not appear as a separate line in salary surveys.

Pediatric Dermatology

Pediatric dermatology, especially in academic centers, may be at the lower end of the dermatology pay spectrum, often closer to:

• Academic ranges (e.g., ~$220,000–$350,000) depending on institution
• Heavy teaching/research responsibilities in tertiary children’s hospitals

However, pediatric dermatologists are in demand, particularly in large children’s hospitals and underserved regions. The trade-offs often include:

• Lower income compared with high-volume private adult derm or Mohs
• Stronger alignment with academic missions, teaching, and complex care
• High patient and family impact, often with rare or challenging conditions

Dermatopathology

Dermatopathologists split time between clinical dermatology and pathology, or focus primarily on skin biopsies in a lab setting.

• Training: Fellowship in dermatopathology after dermatology or pathology residency
• Income:
  • Integrated academic roles may mirror other subspecialty academic salaries
  • Private dermpath labs or partnerships can increase income, depending on volume and ownership

Ultimately, subspecialization can shift your income up or down within a fairly high baseline for dermatology as a whole. Your interests, tolerance for procedures, and desired practice mix should drive the decision more than salary alone.

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How Dermatology Compares With Other High-Paid Specialties

If you’re aiming for a derm match, you may also be considering other competitive or high-earning specialties. Understanding lifestyle and income together helps clarify whether dermatology is the right fit.

Lifestyle vs. Income: Dermatology’s Sweet Spot

Dermatology is frequently cited as one of the “best lifestyle” fields:

• Predictable daytime clinic hours
• Limited or no inpatient responsibilities for many jobs
• Minimal overnight and weekend call in most practices
• Ability to choose between part-time, full-time, or job-sharing arrangements

Income-wise, while dermatology is often slightly below ultra-high earners like orthopedic surgeons or interventional cardiologists, it typically outperforms many outpatient primary care fields while offering:

• Significantly more schedule control than many surgical fields
• Lower malpractice risk compared with OB/GYN or neurosurgery
• Less physical strain than some OR-heavy specialties

This combination explains why dermatology residency is highly competitive despite a relatively small number of positions.

Rough Comparison Example

To illustrate physician salary by specialty across a few options (again, using approximate ranges):

• Orthopedic Surgery:

  • Often $600,000–$900,000+ (partner or high-volume surgeon)
  • Heavy OR schedule, trauma call, and long operating days

• Interventional Cardiology:

  • Frequently $500,000–$800,000+
  • Intense call, night emergencies, catheterizations, and procedural risk

• Gastroenterology:

  • Commonly $450,000–$700,000+ with procedural emphasis
  • Mix of clinic and endoscopy, often call responsibilities

• Dermatology:

  • Generally $350,000–$600,000+ for general derm and non-owner roles
  • $450,000–$800,000+ for high-volume partners or cosmetic/Mohs-focused practices
  • Lighter call, mostly outpatient

• Family Medicine / General Internal Medicine:

  • Often $230,000–$320,000, depending on location
  • Significant documentation load, panel management, hospital shifts in some settings

Dermatology doesn’t always top the raw income charts, but when you normalize for work hours, call burden, and burnout risk, it becomes one of the most appealing specialties for many applicants.

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Using Salary Information Strategically in Your Derm Match Journey

Understanding doctor salary by specialty is helpful, but it should support—not dictate—your career choices. Here’s how to use compensation insight effectively as you navigate dermatology residency and beyond.

1. Choosing Dermatology for the Right Reasons

If your sole priority is the highest possible income, you may find even higher ceilings in orthopedic surgery, neurosurgery, or interventional cardiology. But dermatology offers:

• High earnings with more flexible, predictable hours
• Intellectual variety (medical, surgical, cosmetic, oncologic, pediatric)
• Long-term sustainability, with lower burnout in many surveys

When deciding whether to pursue dermatology residency, focus first on:

• Genuine interest in skin disease, procedures, and outpatient care
• Comfort with high patient volume and visual diagnosis
• Enjoyment of longitudinal patient relationships and cosmetic counseling

Then use salary data to confirm that your long-term financial goals are feasible in this field—which they almost certainly are.

2. Interpreting Salary Offers After Residency

As a graduating resident or fellow, you’ll start encountering real contracts. Keep these principles in mind:

• Know your market: Research median dermatology salary in the region and practice type you’re considering. Regional cost of living matters.

• Look beyond the base: Evaluate:

  • RVU or productivity bonuses
  • Partnership track and buy-in requirements
  • Non-clinical expectations (teaching, research, administrative)
  • Benefits (retirement match, health insurance, malpractice coverage, CME funds)

• Consider trajectory, not just year one:

  • A lower first-year salary with a clear path to partnership and significantly higher income by year 3–5 may be more valuable than a high guaranteed salary with no growth.

• Protect your flexibility: Look for non-compete clauses, restrictive covenants, and call requirements that may affect your future options or lifestyle.

3. Balancing Debt, Lifestyle, and Location

Dermatology’s earning potential can dramatically help with medical school debt, but optimization is still important:

• High-debt graduates: Early years in a hospital-employed or large group practice with a strong base salary and help with loans can build a solid financial foundation.
• Geographic flexibility: Rural or semi-rural areas may offer higher salaries and aggressive signing bonuses due to undersupply of dermatologists.
• Lifestyle choices: Part-time or 4-day work weeks are more common in dermatology than in many high-pay surgical specialties. This flexibility may moderate your income but can improve life satisfaction.

4. Thinking Long-Term: Equity and Ownership

Many of the highest earning dermatologists gain income not only through clinical work but also through:

• Practice ownership and partnership
• Ancillary services (in-house pathology lab, cosmetic retail, medspa services)
• Real estate ownership (owning the building where the practice operates)
• Speaking, consulting, or industry roles

You don’t need to plan all of this during residency, but understanding that the top of the dermatology income curve often includes business/ownership elements can help you look for mentorship and training in practice management along the way.

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FAQs: Physician Salary by Specialty in Dermatology

1. Is dermatology really one of the highest paid specialties?

Dermatology is consistently in the upper tier of physician salary by specialty. It may not always beat fields like orthopedic surgery or interventional cardiology on raw income, but when you factor in more favorable hours, less call, and outpatient-focused practice, it ranks among the most attractive combinations of salary and lifestyle.

2. How much do dermatology residents get paid?

Dermatology residents are typically paid like other residents at their institution, based on PGY year rather than specialty. Most U.S. residents earn roughly $60,000–$75,000 annually, varying by region and cost-of-living adjustments. The major salary jump comes when you transition from resident to attending, not between specialties during residency.

3. Do cosmetic dermatologists make more than general dermatologists?

Often, yes. Cosmetic dermatology leans heavily on self-pay procedures, which are not limited by insurance reimbursement. A busy cosmetic-focused dermatologist in a strong market can out-earn many general dermatologists. However, income is highly dependent on patient base, location, marketing, and business acumen. It’s also a more entrepreneurial pathway with higher variability.

4. Should I choose dermatology mainly because of the high doctor salary by specialty?

Choosing any specialty primarily for salary is risky. While dermatology offers excellent earning potential, it is also highly competitive and requires genuine interest in the day-to-day work: skin exams, rashes, biopsies, minor procedures, chronic disease management, and sometimes cosmetic counseling. If you enjoy these aspects and want a high-income, outpatient-focused career, dermatology is a strong choice. Salary should be a supporting factor, not the only one.

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By understanding how physician salary by specialty works—and how dermatology in particular fits into the broader income landscape—you can make more informed decisions about your derm match strategy, fellowship interests, and early career choices. With thoughtful planning, dermatology offers not only strong financial rewards but also a sustainable, flexible, and intellectually engaging career.