How does OB/GYN pay differ by practice model?

By who carries the costs underneath the salary, because each model pays a different person for the work between the patient and the paycheck. The surveys set the level; the model decides what is left. Three sources set the level for the specialty as a whole. Average compensation is $390,000 in the Medscape Physician Compensation Report 2026. Average total compensation is $420,859 in the Doximity Physician Compensation Report 2026. The self reported average is $410,241 at Marit Health. No model ranking can be read off those three figures, because none of them splits the specialty by model. What can be priced is the structure: average starting salary is $374,000 in the AMN Healthcare 2026 review, regional offers run from $350,000 in the West to $446,333 in the Southwest in that same review, and two named laborist postings show the shift model priced in the open. Read the model by what it carries for you and what it hands back to you, starting with the malpractice premium, because in this specialty that single line can run from $49,804 to $243,988 a year depending on the state.

Part of the OB/GYN hub.

The anchors, stated exactly

Hold the three averages apart, because they measure different things. Medscape reports average compensation of $390,000. Doximity reports average total compensation of $420,859, from nearly 23,000 full time physicians across specialties, on 2025 data, published August 25, 2026. Marit Health reports a self reported average of $410,241. Marit is a rolling, self reported figure, so read it as a snapshot.

The AMN review adds the entry point: average starting salary of $374,000, across 1,293 permanent searches from April 1, 2025 to March 31, 2026, with signing bonuses offered in 87 percent of all physician searches in that review, averaging $49,306 across specialties. Regional starting offers in the same review run Southwest $446,333, Midwest $408,200, Northeast $371,262, Southeast $362,400, and West $350,000. The regional spread alone is $446,333 minus $350,000, which is $96,333, wider than many physicians expect a model change to be worth.

Employed: the package underneath the salary

Hospital and system employment is the model most new OB/GYNs enter, and its salary line is only part of the offer. The system carries the malpractice premium, and in employed terms the tail is usually carried by the employer as well, as it is for Heidi in this hub's case file, where the policy is claims made and the tail is covered by the employer. The system also carries health cover, group disability and life, paid leave, and a retirement plan that can hold a 403(b) and, at a public system, a governmental 457(b) beside it, each with its own $24,500 deferral limit for 2026.

Private group: the surplus, and the premium, shared

A private group bills for its own work and shares what remains after expenses. The same structure that lets partner income run above an employed salary also makes the group responsible for one of the largest overhead lines in the specialty. In California, Los Angeles and Orange, the AMA exhibit prices a $1M/$3M obstetrics and gynecology premium at $49,804. In Florida, Miami Dade, the same exhibit prices it at $243,988. The Florida figure divided by Medscape average compensation is $243,988 divided by $390,000, about 63 percent of an average year of pay, spent before rent, staff, or supplies. The California figure is about 13 percent on the same division. A group in a high premium state is a different business from a group in a low premium state at the same revenue, and a buy in buys a share of that business, premium history included.

Laborist: pay by the shift, priced as postings

The laborist model pays for shifts in the hospital, with obstetric cover as the job itself and no call from home in the pattern these postings describe. Two employer postings, stated here as postings and never as survey data, show the model priced. Vanderbilt University Medical Center posted a laborist role at a $370,000 base salary, fourteen 12 hour shifts a month, no call, and Public Service Loan Forgiveness eligible, in a DocCafe posting accessed October 2026. Sutter Medical Group in Davis, California posted an OB/GYN hospitalist role at $429,000 at 1.0 FTE of 24 hour shifts, in a Health eCareers posting accessed October 2026. The gap between the two postings is $429,000 minus $370,000, which is $59,000, for different shift shapes in different markets. Two postings are not a national average, and none should be inferred from them.

What the model carries is clear in both postings: the hospital carries the malpractice premium and the tail, because the work is the hospital's work on the hospital's shifts. What the model gives up is also clear: no practice to own, no panel that compounds, and income that stops when shifts stop. For a physician carrying loans on a forgiveness track, a posting that is forgiveness eligible at $370,000 can be worth more in outcome than a higher salary that ends the count.

Follow up questions

Which model pays the most in the first attending year?

On starting terms, the AMN review puts the average starting salary at $374,000, with regional offers up to $446,333 in the Southwest. The comparison that matters prices the premium, the tail, the benefits, and the loan outcome beside the salary, because a first year physician has not yet felt the cost of the missing layers.

Does the model change my student loan outcome?

Yes, completely. Forgiveness after 120 qualifying monthly payments requires full time work for a qualifying employer, a government organization or a 501(c)(3) nonprofit, per Federal Student Aid. A private group paycheck does not qualify, even when the work happens inside a nonprofit hospital, with a narrow exception where state law bars the hospital from employing physicians directly, with California and Texas as the named examples. The same deliveries can carry a live forgiveness count or no count at all, depending on whose name is on the paycheck.

Related questions

• Should I take a hospital employed OB/GYN job or join a private group?
• How does laborist shift pay compare with private practice over a career?
• Is OB/GYN worth it financially?

Sources

• Medscape Physician Compensation Report 2026, which establishes average OB/GYN compensation of $390,000, accessed October 2026.
• Doximity Physician Compensation Report 2026, which establishes average total compensation of $420,859, accessed October 2026.
• Marit Health, self reported salaries, which establishes the self reported average of $410,241, accessed October 2026.
• AMN Healthcare, 2026 Review of Physician and Advanced Practitioner Recruiting Incentives, which establishes average starting salary of $374,000 and the regional offers, accessed October 2026.
• AMA Policy Research Perspectives, Medical Liability Monitor premium exhibit, which establishes the $1M/$3M premiums of $243,988 in Florida, Miami Dade, and $49,804 in California, accessed October 2026.

Takeaways

• The level: Medscape average $390,000, Doximity average total $420,859, and the Marit self reported average $410,241, stated as an average only.
• The entry point: AMN average starting salary $374,000, with regional offers from $350,000 in the West to $446,333 in the Southwest, a $96,333 spread.
• The model decides who carries the premium and the tail: the system in employed work, the group and its partners in private practice, and the hospital in laborist work.
• The laborist postings are postings: Vanderbilt at $370,000 for fourteen 12 hour shifts a month with no call, and Sutter at $429,000 at 1.0 FTE of 24 hour shifts.