Becoming an Internal Medicine (IM) resident is a critical step for doctors pursuing specialization in adult medicine. Understanding the salary expectations in 2026 can help medical professionals plan their careers, manage finances, and set realistic goals. This guide covers average salaries, factors affecting earnings, experience-based pay, benefits, job trends, and comparisons with related medical specialties.
What Do Internal Medicine Residents Do?
Internal Medicine residents are doctors in postgraduate training, managing adult patients with a variety of acute and chronic illnesses. Their work typically includes:
- Diagnosing and treating complex medical conditions
- Coordinating patient care with specialists
- Conducting medical procedures such as lumbar punctures or central line insertions
- Participating in rounds, research, and academic teaching
- Engaging in hospital and outpatient care
IM residency is demanding, requiring long hours and commitment, but it lays the foundation for specialized careers like cardiology, gastroenterology, or endocrinology.
Average IM Residents Salary in 2026
Resident salaries vary depending on location, hospital funding, and level of training. In 2026, IM residents can expect competitive compensation reflecting their crucial role in healthcare.
Average Annual Salary Range
| Region | Average Salary |
|---|---|
| United States | $63,000 – $75,000 |
| Canada | $55,000 – $70,000 CAD |
| United Kingdom | £33,000 – £42,000 |
| Australia | AUD 60,000 – AUD 75,000 |
| Asia (Developed Markets) | $25,000 – $45,000 |
Salaries are often supplemented by stipends for on-call duties or night shifts.
Salary by Year of Residency
Experience and residency year strongly influence pay. IM residency programs usually last 3 years, with incremental increases each year.
| Residency Year | Typical Salary Range (USD) | Notes |
|---|---|---|
| PGY-1 | $60,000 – $65,000 | Entry-level, supervised patient care |
| PGY-2 | $63,000 – $70,000 | Increased responsibility and procedures |
| PGY-3 | $68,000 – $75,000 | Senior residents often lead rounds and mentor juniors |
Some hospitals or states offer additional bonuses for night shifts, research, or teaching responsibilities.
Factors That Influence IM Resident Salary
Several factors impact how much an IM resident earns:
1. Location and Cost of Living
- Higher salaries in major cities or regions with higher living costs
- Rural hospitals may offer slightly lower base pay but with other incentives
2. Hospital Type
- Teaching hospitals vs. private hospitals
- University-affiliated programs often provide higher stipends
3. Additional Duties
- Night shifts, weekend coverage, and call hours often come with stipends
- Research projects or administrative roles can increase total compensation
4. Education & Previous Experience
- Graduates from prestigious medical schools may have leverage for better programs
- Prior clinical experience may lead to modest pay differences
5. Union or Program Negotiations
- Some hospitals have resident unions that negotiate salaries and benefits
Benefits Beyond Salary
IM residency comes with several perks that complement salary:
- Health insurance and disability coverage
- Meal allowances and housing stipends
- Paid vacation (varies by program)
- Access to conferences and educational resources
- Professional networking and mentorship opportunities
These benefits can significantly enhance the overall value of residency compensation.
Job Market Trends in 2026
Internal Medicine remains one of the most essential medical specialties globally. Trends in 2026 indicate:
- Steady demand for internal medicine physicians
- Growing need in aging populations and chronic disease management
- Expansion of hospitalist roles, improving residency opportunities
- Telemedicine integration increasing remote training and exposure
While residency positions are competitive, IM remains a high-demand specialty with solid long-term prospects.
Education & Certifications That Affect Salary
Required Education
- Medical degree (MD or DO)
- USMLE or equivalent licensing exams
Optional Certifications
- ACLS (Advanced Cardiac Life Support)
- PALS (Pediatric Advanced Life Support, if working with young adults)
- Board preparation for eventual specialty can improve post-residency opportunities
Certifications and exam performance may not drastically increase resident pay but can influence program placement and future salary potential.
IM Residents vs Related Medical Fields (Salary Comparison)
| Specialty | Average Resident Salary (2026) | Notes |
|---|---|---|
| Internal Medicine | $63,000 – $75,000 | Core adult medicine residency |
| Family Medicine | $60,000 – $72,000 | Slightly lower but broad scope |
| Surgery | $65,000 – $80,000 | More intensive hours and responsibilities |
| Pediatrics | $58,000 – $70,000 | Focused on children, slightly lower pay |
| Anesthesiology | $65,000 – $78,000 | Higher procedural complexity, similar hours |
IM residency salaries are competitive, balancing workload, educational value, and long-term career growth.
Job Outlook After Residency
After completing residency, IM physicians can expect:
- Entry-level attending salaries of $180,000 – $250,000+ depending on location and subspecialty
- Opportunities in hospitalist medicine, primary care, or subspecialties like cardiology
- Strong employment stability due to ongoing need for adult medicine practitioners
Residency provides essential experience and credibility that drives higher compensation in post-residency practice.
Is Internal Medicine Residency Worth It in 2026?
IM residency is challenging but offers a rewarding path to a stable and well-compensated medical career. Benefits extend beyond immediate salary, including professional development, long-term earnings potential, and opportunities to specialize in high-demand medical fields.
Final Thoughts
The IM residents salary in 2026 reflects a balance between rigorous training and fair compensation. Earnings depend on residency year, location, hospital type, and extra responsibilities. Combined with valuable benefits and a strong job market, IM residency remains a lucrative and respected step for aspiring physicians.