Medscape just released the results of their annual survey of 7,000 US practising physicians across 29+ specialties about a number of topics, including compensation.

Nelson J. How much green comes with the white coat? Medscape Millennial Physician Compensation Report 2024. Medscape. September 27, 2024.

Overall, pay is up—but not for everyone

For the 2024 compensation report, Medscape defined millennial respondents as those under the age of 40. Compensation for doctors in this generation was up 4% overall in 2023 compared with 2022. This increase was greater for primary care physicians than it was for specialists, who saw little change. Based on place of employment, average compensation was highest for single-specialty private practice at $358K, with hospital at $339K and outpatient clinic at $278K.

While these numbers look good for PCPs, some primary care respondents noted that they are paid less and/or unfairly compared to specialists. “Very little value is placed on primary care,” one said. Additionally, gender pay gaps persist for all physicians, as was noted in Medscape’s 2023 and 2022 reports. A 24% gender pay gap, favouring men, was calculated for millennial physician respondents. 

The Midwest pays best; the Northeast falls below

The location also plays a role in millennial physicians’ compensation. In the Midwest, the highest-paycheck region, millennial respondents earn an average of $343K. Meanwhile, the lowest-paid millennials are in the Northeast, with average compensation of $300K.

Despite these increased average incomes, 51% of millennial physicians reported that they don’t feel fairly paid for their work. This is a slight increase from the 2022 report, where 46% of this group felt underpaid. These numbers were similar for older physicians: over 50% of respondents ages 50-54 and 55-59 reported that they felt underpaid as well.

When it comes to specialities, certain areas had higher rates than others of compensation satisfaction. 

Millennials' chief complaints

Millennial respondents spoke up on specific issues with their work and compensation. One referred to their job responsibilities as “an assembly line,” while others referenced burnout.

School debt was also cited as a source of dissatisfaction. The specialities with the highest occurrence of student debt, all over 50%, were family medicine, OB/GYN, orthopaedics, and internal medicine. “The average minimum monthly payment doctors make is $2,275,” the report said.

Chief complaints haven’t changed recently—in the past 3 years’ reports, millennials cite difficult patients and long hours as the most challenging parts of their work. “Dealing with managing relationships of all types: difficult patients, difficult staff, difficult community partners, and hospital admin,” said one respondent. 

Is pay the most important factor? Maybe not

Millennial physicians named helping others as one of the most rewarding aspects of the job. “The opportunity to profoundly impact individuals’ lives through compassionate care and evidence-based treatments is immensely fulfilling,” said Sham Singh, MD, a millennial holistic psychiatrist at WINIT Clinic in Santa Monica, California.

Despite compensation complaints, 68% of millennial respondents would choose a career in medicine again. This number has decreased somewhat in recent years, from 76% in the 2021 report.

Millennials were more likely to be satisfied with their speciality than with their place of work. In this group, 84% said that they would choose the same speciality, while only 32% responded that they would choose the same practice setting.

Moonlighting and new technologies present intriguing opportunities for millennial physicians. “Technologies like telemedicine and virtual assistants also enable young doctors to find newer models of moonlighting than previous generations had,” the report states.