OB/GYN

Most specialties negotiate a salary. OB/GYN negotiates coverage too. Everything about its money follows from that one fact. A hospital or group that carries your premium is paying you a benefit that never appears in the salary line, and a practice that hands the premium back to you has cut your pay by the same amount while calling it independence. In Florida, an OB/GYN premium of $243,988 sits next to an internal medicine premium of $59,736 in the same Miami Dade market (AMA). The obstetrician coverage costs about four times the internist coverage, because claims in obstetrics involve newborns and can arrive until the child turns 18 in many states.

The structure runs through every decision in this hub. Contracts: call paid as its own line against call folded into salary compounds across a term, and the laborist model deletes call from home entirely. Loans: many OB/GYNs work for nonprofit systems, so forgiveness is often the default plan rather than the exception. Ownership: buying into a practice means buying into its malpractice history, including claims not yet filed. Retirement: partner incomes spread widely, and the group plan has to fit the spread. And the career curve bends: obstetrics first, then a gynecology only second phase, priced before it is forced.

Three surveys land within about thirty thousand dollars of each other. The spread inside the specialty, by region and by model, dwarfs the spread between them. Medscape puts average compensation at $390,000. Doximity puts average total compensation at $420,859. Marit Health, across self reported salaries, puts the average at $410,241. AMN Healthcare puts the average starting salary at $374,000, and its regional offer averages run from $350,000 in the West to $446,333 in the Southwest.

Read the table the way this specialty actually works. OB/GYN was the top paying specialty among female physicians in the Medscape Women in Medicine report, at an average of $370,000. The regional spread inside the AMN offers is $96,333, because $446,333 minus $350,000 is $96,333, and that gap is geography and model, not skill. Then hold every figure next to the premium in the malpractice topic below, because in this specialty the salary is only half of the pay stub. Coverage is the other half.

1. Contracts and income

The contract is the deepest topic in this specialty. It decides what call is worth, who carries the premium, and who pays the tail. Call paid as its own line against call folded into salary, employed work against private group work against laborist shifts: read the structure before the salary, at every stage. The worked math: how to compare a contract that pays for call against one that folds call into salary and laborist pay by the shift against private practice over a career. Read the contracts and income topic page →

2. Student loans

Forgiveness follows the employer that pays you, not the building you work in. Public Service Loan Forgiveness cancels the remaining federal balance after 120 qualifying monthly payments made while working full time for a government or 501(c)(3) nonprofit employer. Many OB/GYNs work for nonprofit hospital systems, which puts much of this specialty on the forgiveness road. In states such as California and Texas that bar hospitals from employing physicians directly, a rule effective July 1, 2023 lets physicians certify using the nonprofit facility's employer identification number. The median graduate carries $200,000 of education debt into that fork. The worked math: forgiveness at the nonprofit hospital against paying the loans off fast and whether PSLF is realistic at a nonprofit hospital system. Read the student loans topic page →

3. Insurance

One injury can end physical call work, and with it the income. Coverage here is built for a physical job and a long liability shadow. Disability sized to the income it protects, on an own occupation definition, with group coverage treated as a floor and never the plan. Term life and umbrella sit in the same stack, in that order. The worked math: how much disability insurance an OB/GYN needs and occurrence against claims made malpractice, and which policy form you have. Read the insurance topic page →

4. Retirement

The funding order is the same discipline at every stage. Capture the full employer match, and nothing past it. Fill the tax advantaged space in order: the HSA first inside the max retirement tier, then the 401(k) or 403(b), then a governmental 457(b) where the job offers one, then the mega backdoor last. The taxable account opens only when the reserve is finished. The 2026 elective deferral limit is $24,500 for a 401(k), a 403(b), and a governmental 457(b), and the IRA limit is $7,500. The worked math: the order an OB/GYN should fund retirement accounts and stacking a 403(b) and a 457(b) at a hospital job. Read the retirement topic page →

5. Ownership

Buying into a practice means buying into its malpractice history. A buy in purchases a share of income, voting rights, and the claims exposure of the years before you arrived, filed and unfiled alike. The stake gets priced on the patient panel, the payer mix, and the coverage structure together, never on the income line alone. Entity choice runs through state professional practice law first, because many states route physicians through a professional corporation or a professional limited liability company. The worked math: what it costs to buy into a practice with its own malpractice history and how to exit or sell a share of a practice. Read the ownership topic page →

6. Estate planning

The documents are the plan the law does not write for you. A will, powers of attorney, a health care directive, and guardians named for minor children. In a specialty where households carry practice interests, partnership shares, and long liability exposure, the titling and beneficiary layer matters as much as the documents themselves, and the plan gets rebuilt when the career changes phase. The worked math: the documents a new attending needs and the documents an established OB/GYN needs. Read the estate planning topic page →

7. Malpractice and tail coverage

This is the specialty defining topic, and it prices every other one. Premiums for a $1M/$3M policy run from $49,804 in Los Angeles and Orange County to $243,988 in Miami Dade (AMA), and liability premiums rose for the seventh consecutive year. Tail coverage commonly costs 150 to 200 percent of the mature annual premium, due in one lump sum when the policy ends. Shown arithmetic: the Florida premium times 1.5 is $365,982, and times 2 is $487,976. The California premium times 1.5 is $74,706, and times 2 is $99,608. In many states the malpractice clock for a child does not start running until the patient turns 18, so a delivery can become a claim nearly two decades later. The worked math: what the tail actually costs when your policy says you pay it and what a patient compensation fund is and how it changes your cost. Read the malpractice and tail coverage topic page →

Medscape Physician Compensation Report 2026 (OB/GYN average compensation of $390,000, accessed October 2026)

Doximity Physician Compensation Report 2026 (OB/GYN average total compensation of $420,859, accessed October 2026)

Marit Health, self reported salaries (OB/GYN self reported average of $410,241, accessed October 2026)

AMN Healthcare, 2026 Review of Physician and Advanced Practitioner Recruiting Incentives (OB/GYN average starting salary of $374,000 and regional offer averages, accessed October 2026)

Medscape Women in Medicine Report 2026 (OB/GYN average of $370,000 among female physicians, the top paying specialty for women, accessed October 2026)

American Medical Association, Policy Research Perspectives, medical liability premiums (reported $1M/$3M premiums for obstetrics and gynecology by market, Medical Liability Monitor data through 2025, accessed October 2026)

Physician Side Gigs, malpractice tail insurance coverage (tail coverage commonly costs 150 to 200 percent of the mature annual premium, payable in a single lump sum at policy termination, accessed October 2026)

Association of American Medical Colleges (median education debt of $200,000 for the class of 2025, accessed October 2026)

Ryan Inman is a retired financial planner who worked with about 500 physician families. He created the Financial Residency podcast (about 3 million downloads) and is no longer affiliated with it. Financial Fellowship is his sole focus. This guide is educational. Last updated October 2026.