Physician Salary in OB GYN: A Comprehensive Guide for Residents

Understanding Physician Salary by Specialty Within OB GYN

Physician salary by specialty is often discussed in terms of broad fields—surgery vs primary care, highest paid specialties vs lowest paid. But for someone pursuing an OB GYN residency, the more relevant question is: How much do different subspecialties and practice types within obstetrics & gynecology actually earn, and why?

OB GYN sits at an interesting intersection. It’s a surgical specialty with 24/7 coverage demands and operative skills, yet it also has a strong longitudinal primary-care-like component. This hybrid nature shapes both the obstetrics match process and eventual compensation opportunities.

This guide breaks down:

• How OB GYN compares to other specialties
• Salary ranges across OB GYN subspecialties
• Academic vs private practice vs employed models
• Geographic variation and lifestyle trade‑offs
• Practical advice for residents and applicants

All salary ranges below are approximate, derived from large national compensation surveys (MGMA, Doximity, Medscape, AMGA) through 2024, plus reported contract data. Actual numbers vary by region, productivity, and practice type, but the ranges will help you understand the big picture.

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1. Where OB GYN Fits in the Physician Salary Landscape

When people search “doctor salary by specialty” or “highest paid specialties,” OB GYN is rarely at the extreme top or bottom. It typically falls in the upper-middle tier of overall physician compensation.

1.1 OB GYN vs Other Major Specialties

Typical recent median total compensation (pre-tax, including bonuses but excluding benefits) for full‑time attendings:

• Primary care
  • Family medicine: ~$240k–$280k
  • Internal medicine (general): ~$250k–$300k
• Core surgical/procedural specialties
  • General surgery: ~$400k–$550k
  • Anesthesiology: ~$420k–$550k
  • Emergency medicine: ~$350k–$425k (wide regional range)
• Subspecialty / highest paid specialties
  • Orthopedic surgery: ~$600k–$800k+
  • Interventional cardiology: ~$650k–$800k+
  • Neurosurgery: ~$700k–$900k+

Obstetrics & Gynecology (generalists):

• Community/private or hospital-employed: commonly $320k–$450k
• Academic: often $260k–$350k for junior faculty, higher for senior/leadership

So, in the landscape of physician salary by specialty:

• OB GYN earns significantly more than most primary care physicians.
• OB GYN earns less than many high-intensity surgical subspecialties, but still in the upper-middle tier.
• Within OB GYN, certain subspecialties approach or overlap some of the traditionally highest paid specialties.

For residency applicants, the key takeaway: OB GYN is a solidly compensated field, but income varies dramatically inside the specialty depending on how you practice.

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2. Salary by Subspecialty Within Obstetrics & Gynecology

Within OB GYN, your ultimate “specialty” is often your fellowship choice or practice niche. Here’s how compensation typically breaks down.

2.1 Generalist OB GYN

Most OB GYN residents graduate into general practice—delivering babies, performing gynecologic surgery, and providing outpatient care.

Typical compensation ranges:

• Academic medical centers

  • Assistant professor: ~$260k–$340k
  • Associate/full professor: ~$320k–$450k (highly variable, leadership supplements possible)

• Hospital-employed or large health system

  • Commonly $320k–$450k in base + incentive
  • Sign-on bonuses: $20k–$75k+ in high-need regions
  • Loan repayment: $20k–$100k structured across several years

• Private practice (traditional partnership track)

  • Early years as associate: often $280k–$380k
  • Established partner: $400k–$600k+, depending on volume, call, and ownership/share of ancillaries (e.g., ultrasound, surgery center)

Key drivers of generalist OB GYN income:

• Call burden and L&D coverage: Practices requiring frequent overnight call or in-house labor & delivery presence generally pay more.
• Surgical volume: Higher procedural productivity (C-sections, hysterectomies, minimally invasive surgery) correlates with higher income under RVU or production models.
• Outpatient volume and case mix: High-volume clinics, complex gynecologic care, and in‑office procedures (IUDs, endometrial ablations, colposcopies) can significantly increase compensation.

2.2 Maternal-Fetal Medicine (MFM)

MFM physicians focus on high-risk obstetrics: complicated pregnancies, fetal anomalies, consultative perinatal care.

Typical ranges:

• Academic: $325k–$450k
• Hospital-employed / large groups: $350k–$550k
• High-demand or under-resourced markets: $450k–$600k+

Compared to general OB GYN:

• Base compensation is often higher or at least at the upper end of generalist ranges.
• MFMs may take less in-house call and do fewer deliveries themselves, often focusing on consultations, ultrasounds, procedures (e.g., amniocentesis), and system leadership.
• Productivity may be driven by consults and imaging services rather than sheer delivery volume.

Why MFM can pay more:

• Highly specialized skills and relatively limited supply of fellowship-trained MFM physicians.
• Critical role in risk management for hospitals and health systems.
• Revenue from advanced imaging and procedures.

2.3 Gynecologic Oncology

Gyn onc combines complex pelvic surgery, chemotherapy administration, and longitudinal cancer care.

Typical ranges:

• Academic centers: $375k–$550k
• Large hospital systems / cancer centers: $450k–$700k+
• High-volume or leadership roles: often >$600k

Gyn onc is among the highest paid OB GYN subspecialties, approaching compensation levels of other surgical oncology fields.

Contributors to higher income:

• High RVU generation from major oncologic operations and complex inpatient care.
• Management of chemo and advanced therapies (depending on state/regulations).
• Significant call and acuity, often covering large referral regions.

Trade‑offs:

• Very intense hours, longer OR days, and emotionally challenging oncologic care.
• Typically academic or large-tertiary-care-based, which may come with more research and teaching expectations.

2.4 Reproductive Endocrinology & Infertility (REI)

REI physicians focus on infertility, assisted reproductive technology (ART), fertility preservation, and complex endocrine issues.

Typical ranges:

• Early-career in established fertility centers: $300k–$450k
• Experienced partners in high-volume practices: $500k–$800k+

Some REI physicians are among the highest compensated physicians within OB GYN, especially in private, cash-pay–heavy fertility practices and metro markets.

Why compensation can be high:

• High demand and out-of-pocket, non-insurance-covered services (IVF cycles, egg freezing, donor programs).
• Substantial revenue from procedure fees, lab services, and ancillary business lines.
• High patient volume in urban centers and destination fertility clinics.

Trade‑offs:

• Many REI physicians have minimal obstetric call, more controllable schedules, and office-based procedures.
• Entry into top-paying practices can be competitive; some new graduates start in lower-paying roles before building a patient base.

2.5 Female Pelvic Medicine and Reconstructive Surgery (FPMRS / Urogynecology)

Urogynecologists specialize in pelvic floor disorders, incontinence, and reconstructive procedures.

Typical ranges:

• Academic: $325k–$450k
• Private or hospital-employed: $350k–$550k+

Compensation drivers:

• High surgical case mix, with minimally invasive and robotic procedures.
• Demographic trends (aging population, increasing attention to pelvic floor health).
• Potential for building a regional referral practice.

2.6 Complex Family Planning and Other Fellowship Paths

Other pathways (e.g., complex family planning, minimally invasive gynecologic surgery fellowships) often boost surgical skill and marketability but may not radically change salary compared to a strong generalist practice—unless you use them to build a high-volume surgical niche.

• Many such fellowship-trained physicians in academics: $280k–$380k early career, with upside in leadership roles.
• In private practice, added skills can justify higher productivity and income, especially for complex minimally invasive surgery.

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3. Practice Setting, Contracts, and Real-World Earning Power

Within any OB GYN specialty, how and where you practice often affects your income as much as what letters follow your name.

3.1 Academic Medicine

Pros:

• Strong emphasis on teaching and research
• Collegial environment, subspecialty colleagues easily accessible
• Often more structured schedules and institutional support
• Prestige, opportunities for leadership and academic promotion

Cons (financially):

• OB GYN academic salaries are frequently 15–30% lower than comparable community/hospital-employed roles.
• Incentive structures may be modest; some faculty have RVU bonuses, but others are largely salaried.

Typical expectation:
Academic faculty trade some income for teaching, research, job security, and a more predictable path for leadership.

3.2 Hospital-Employed / Health System Roles

The fastest-growing employment model in OB GYN:

• Base salary (often $300k–$450k for generalists, more for subspecialties)
• RVU-based incentives for productivity above a threshold
• Benefits: health, retirement, CME stipend, malpractice with tail coverage

Advantages:

• Lower administrative burden compared with private practice
• Guaranteed income and sign-on bonuses
• Potential for hospital-paid loan repayment

Considerations:

• Less control over staffing, schedule templates, and operational decisions.
• Productivity pressure: RVU targets may be aggressive in some systems.
• Caps on upside: you might earn less than a similarly busy private partner.

3.3 Private Practice and Partnership Models

OB GYN private practices come in many flavors:

• Small 3–10 physician groups
• Large multispecialty groups
• OB GYN super-groups with shared call and ancillaries

Associate phase:

• Contracted salary plus bonus (e.g., $280k–$380k)
• Buy-in or partnership discussion after 2–5 years
• Sometimes a percentage of collections above a certain threshold

Partner phase:

• Income tied to practice profits and sometimes ownership in assets (imaging, surgery centers, office buildings).
• Top earners can exceed $500k–$700k+, especially with high productivity and efficient operations.

Risks and trade-offs:

• Greater exposure to business risk and overhead fluctuations.
• More responsibility for running the practice (HR, compliance, billing) unless contracted out.
• Financial upside is high, but so is the time and cognitive load of practice management.

3.4 Locum Tenens and Nontraditional Paths

Locum tenens (temporary contracted work) for OB GYN can pay $1,800–$3,000+ per 24‑hour call shift, sometimes more in critical shortage areas. Full-time locums OB GYN physicians can earn $400k–$600k+ depending on schedule intensity.

Pros:

• Flexibility and the ability to choose when and where you work
• Premium pay for hard-to-fill roles and locations

Cons:

• Variable benefits; you typically handle your own retirement, health insurance, and time off.
• Less continuity with patients and teams.
• Income stability may be lower between contracts.

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4. Geography, Lifestyle, and Call: Why the Same Specialty Can Pay Very Differently

Two OB GYN generalists with identical training can have dramatically different salaries based on where they live, how much they work, and how call is structured.

4.1 Geographic Trends

In general:

• Rural and smaller cities:

  • Higher salaries, larger sign-on bonuses, loan repayment.
  • General OB GYN: $380k–$500k+ is common.
  • Trade-offs: fewer subspecialists, heavier call, limited amenities.

• Suburban/medium metro areas:

  • Balanced lifestyle and income.
  • General OB GYN: $320k–$450k, often with good call-sharing groups.

• Major coastal metros & highly saturated markets (NYC, SF, Boston, LA):

  • Lower salary ranges: sometimes $280k–$380k for generalists.
  • High cost of living; compensation may lag relative to expenses.
  • Some REI and concierge practices are exceptions, earning far more.

When evaluating an offer, think beyond the absolute number:

• Cost of living (housing, childcare, taxes)
• Loan repayment or sign-on bonuses
• Spouse/partner career opportunities
• Access to family support and quality of schools

4.2 Call Structure and L&D Models

Call is a major driver of both lifestyle and physician salary by specialty within OB GYN.

Common models:

• Traditional call:

  • Your practice covers its own L&D patients.
  • Call frequency often 1:4 to 1:8.
  • Higher intensity but stronger continuity.

• Laborist or OB hospitalist model:

  • Dedicated hospitalist physicians manage inpatients and L&D.
  • Generalists in clinic may have fewer overnight responsibilities, potentially lower burnout.
  • Laborists commonly earn $300k–$450k, sometimes paid per shift.

The more frequent and intense the call, the higher the typical compensation. But higher pay often comes at a cost to sleep, family time, and longevity in the role.

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5. Strategic Career Planning: Balancing Income, Passion, and Sustainability

If you’re in the obstetrics match pipeline or early in residency, it can be tempting to think purely in terms of “highest paid specialties.” Yet career satisfaction in OB GYN is deeply tied to fit, not just numbers.

5.1 Questions to Ask Yourself

1. How much do you enjoy obstetrics vs surgery vs longitudinal clinic?

   • Love complex pregnancies and systems-level thinking? Consider MFM.
   • Love high acuity oncology and long OR days? Gyn onc may fit.
   • Enjoy procedural outpatient work and control over schedule? REI or urogynecology can be appealing.

2. How much control do you want over your schedule?

   • Intensely procedural subspecialties may have high incomes but long days and calls.
   • REI and some FPMRS practices may offer more predictable hours.

3. What type of team environment energizes you?

   • Academic centers with trainees and research opportunities
   • Tight-knit private practice groups
   • Large systems with robust support services

4. How important is maximum income versus quality of life?

   • You can craft high-earning but more intense roles (heavy call, partner in a high-volume practice).
   • Or choose slightly lower income in exchange for reduced call, part-time options, or academic protected time.

5.2 Practical Steps for Residents and Applicants

• During residency:

  • Seek exposure to all subspecialties. Rotate with MFM, REI, gyn onc, and FPMRS physicians and ask about their typical week.
  • Track which days feel most fulfilling vs most draining.
  • Attend departmental or GME talks on contracts and physician compensation.

• When exploring fellowship:

  • Look beyond “how much do they make” and consider your tolerance for acuity and emotional load.
  • Ask fellows and junior attendings about actual work hours, call schedule, and burnout.

• Before signing your first contract:

  • Obtain benchmarks for OB GYN in your region (MGMA, Doximity, specialty societies, mentors).
  • Understand the comp model: base vs RVU, collections percentage, quality bonuses, call stipends.
  • Negotiate extras: sign-on, relocation, loan repayments, CME funds, and tail coverage for malpractice.

• Think long-term:

  • Maximize early-career earnings and savings by:
    • Avoiding rapid lifestyle inflation
    • Refinancing high-interest loans when appropriate
    • Contributing early to retirement accounts (401(k), 403(b), backdoor Roth IRA if allowed)
  • Financial stability can give you more freedom later to cut back hours, move, or pursue leadership roles.

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FAQs: OB GYN Physician Salary by Specialty

1. Is OB GYN considered one of the highest paid specialties?

No. Compared to the absolute highest paid specialties like orthopedic surgery, neurosurgery, and interventional cardiology, OB GYN as a whole sits a tier below. However, within OB GYN, certain subspecialties—especially REI and gyn onc in high-volume practices—can earn incomes comparable to many top-paying procedural fields.

2. Do OB GYN subspecialists always make more than generalists?

Not always. On average, MFM, gyn onc, REI, and FPMRS tend to have higher median compensation than general OB GYN. But a high-volume, efficient generalist in a well-run private practice or underserved area can out-earn many subspecialists. The business model and productivity matter as much as the fellowship title.

3. How much does location really affect OB GYN salary?

Location can shift OB GYN compensation by $100k–$200k+ for similar work. Rural and smaller-city positions often offer significantly higher salaries and bonuses, while major coastal metros tend to pay less relative to the cost of living. When comparing offers, always factor in housing costs, taxes, childcare, and loan repayment.

4. Is academic OB GYN “not worth it” financially?

Academic OB GYN generally pays less than community or private practice, especially early on. However, it can still provide a comfortable income, particularly as you move into mid-career leadership roles. Many physicians value academics for teaching, research, prestige, and intellectual environment, and feel that the trade-off is worthwhile. The best choice depends on your priorities, not just the raw physician salary numbers.

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By understanding physician salary by specialty within obstetrics & gynecology—across subspecialties, practice settings, and regions—you’ll be better equipped to navigate the obstetrics match, choose training paths intentionally, and design a sustainable, rewarding career that fits both your professional passion and your financial goals.