OB/GYN in Residency: Four Years and the Clock Is Running

The jump at the end of training is the largest raise of your career. It arrives on a date you already know. Training runs four years, and no general resident salary figure anchors this chart, on purpose: this page prices only what the surveys price. The attending anchor is the average starting salary of $374,000 (AMN Healthcare, 2026 Review). Above it sit the specialty averages: $390,000 on Medscape, $410,241 self reported on Marit Health, and $420,859 on Doximity. Everything on this page is about being ready for that jump: coverage placed before it, a loan count already running into it, and habits that survive the bigger number.

Read the chart as a planning tool, not a promise. Residency runs four years, and every one of those years can carry a qualifying loan payment and a year of Roth space. The attending years then repay the patience quickly, which is exactly why the mistakes of this stage are not income mistakes. They are window mistakes: a disability window left to close, a forgiveness count started late, a Roth year left empty.

Worked math: how much cash a resident should keep and whether to open the Roth IRA in residency.

Buy your individual own occupation disability policy in training. It is the single most valuable purchase of residency. OB/GYN pays a body to do physical work on a call schedule: lifting and positioning patients, standing through long cases, and operating at night, year after year. An injury to a hand, a back, or a shoulder does not reduce that income gradually. It ends the call work, and the call work is the income. The policy is what stands between that injury and the end of the pay, and training is when it is cheapest to place and easiest to qualify for.

This section is built around Jimmy Turner, MD, the physician behind Money Meets Medicine and the disability voice this site trusts. His standing point is the one residents miss: you are not buying the small benefit a resident salary supports today. You are buying the guaranteed right to increase that benefit to attending income later, without a new medical exam, at rates set by the healthy person you are now. Group coverage through a program is a starting point, not a plan: it is sized to a fraction of income, written to the group definition of disability, and gone when the job is. Carriers in total issue coverage replacing up to 60 to 70 percent of pre disability income (Medical Economics), and the resident policy is how you lock your place inside that math while the underwriting is easy. Read Jimmy and the assessment path at the Jimmy Turner page, and the definition itself at own occupation disability.

One window deserves its own warning. Some training programs and institutions offer guaranteed issue coverage: a policy you can place without a medical exam, inside a window that is open during training and closed after it. If your program has one, the window is a deadline, not an advertisement. The red flags block below names what happens when a resident carries group only coverage out of training, and that gap is the first thing this page exists to close.

Worked math: what disability insurance an OB/GYN resident should buy and how much disability insurance an OB/GYN needs.

OB/GYN training is four years, and in this specialty the count usually runs. Every one of them can carry a qualifying payment. Public Service Loan Forgiveness asks for 120 qualifying monthly payments while you work full time for a government or 501(c)(3) nonprofit employer, and training payments count on exactly the same terms as attending payments (Federal Student Aid). Academic medical centers and nonprofit hospital systems run most OB/GYN residencies and employ many attendings, so a resident who starts in the first year can finish residency 48 payments into the count. A resident who waits starts attending life at zero, with the biggest payments still ahead. The median graduate carries $200,000 of education debt (AAMC, class of 2025), which is why the count matters more than the payment size at this stage.

The proof sits one stage ahead. Heidi, the new attending in the Financial Health Assessment case library, has 24 of her 120 payments made. Her count ran because she was on a plan at a qualifying employer, not because she paid extra. That is the whole training strategy: minimums on the plan, certification on time, not a dollar beyond what the plan asks.

The rule underneath it is worth learning before you sign anything: forgiveness follows the employer that pays you, not the building you work in. Eligibility follows the employer of record, the entity on your paycheck, confirmed by its employer identification number on the yearly certification. File the first certification early, in the first year, so any problem surfaces while it is cheap to fix. One narrow exception, effective July 1, 2023: where state law bars the nonprofit hospital from employing physicians directly, California and Texas are the named examples, the physician certifies with the nonprofit facility employer identification number instead.

Two more training rules. Never a dollar extra toward the loans while forgiveness is live. Every extra dollar is a dollar you pay that the program was going to forgive. And recertify on time, every year: the payment during the first attending year is set by the income you last certified, which is a legal discount on the most expensive year of the count, and it evaporates the moment you recertify late or early. The full strategy lives on the student loans topic page.

Worked math: when to file the first PSLF employment certification, paying during residency against waiting, and whether PSLF is realistic at a nonprofit hospital system.

After the coverage and the loan plan, the Roth IRA is the resident move. Training may be the lowest tax years of your life. The 2026 IRA limit is $7,500 (IRS Notice 2025-67), sized almost exactly for a resident budget, and contributions made at a trainee tax rate come out tax free in retirement at an attending tax rate. The space never comes back once the year closes. Capture the full employer match first if your program offers one, and nothing past it: the match is the only guaranteed return in finance. Then build one month of reserves at your current lifestyle and take any credit cards to zero and hold them there, because card interest outruns any investment return a resident can reasonably expect.

The Double Up Rule is waiting at the end of this stage, not running during it. Its terms, set now so the jump never surprises you: as a new attending you live on double your resident net, and every dollar above it flows the waterfall until the taxable account opens. A resident net of $65,000 becomes a $130,000 lifestyle, and the raise above it does the heavy lifting of the first attending years.

Worked math: opening a Roth IRA as an OB/GYN resident and how much cash to keep in training.

Choose the fellowship that fulfills you. This section only prices the choice, in attending pay, so you make it with open eyes. OB/GYN residency runs four years, and a subspecialty fellowship adds roughly three more years at trainee pay, training as a fellow of maternal fetal medicine, gynecologic oncology, reproductive endocrinology and infertility, urogynecology, or minimally invasive gynecologic surgery. The financial fact is timing: each fellowship year is a year at the attending anchor, $374,000 on the AMN starting average, that is not earned in that year. Fellow pay offsets part of that, and this chart counts attending pay only, across the first six years after residency, so read it as the size of the trade, never as a verdict on the training.

The other side of the ledger is real, and it is yours to weigh: the work you want to do for thirty years, the patients you want to treat, and the schedule and practice shape the subspecialty buys you later. A fellowship that changes the call burden or the premium class of a long career can be worth attending dollars on any honest accounting. Our job is the arithmetic. Yours is the choice. This section informs the decision. It never steers it.

Worked math: whether an OB/GYN fellowship is worth it financially and comparing first attending offers as a resident.

The last year of training carries the highest leverage decision of this stage. It is not the salary negotiation. In OB/GYN it is the coverage structure the salary hides, and policy form and tail awareness start here, in training. Ask every offer the same questions. Is the policy occurrence or claims made? Who carries the premium, and is any of it billed back through compensation offsets? If the policy is claims made, who pays the tail on each kind of exit: resignation, termination, retirement, disability? Tail coverage commonly costs 150 to 200 percent of the mature annual premium, due in one lump sum, so the answer is a real price, not a clause. Is call paid as its own line, or folded into the salary? And is the employer the nonprofit system itself, so your forgiveness count keeps running?

Early money belongs in the same read. A residency stipend or an early sign on payment is a loan in friendly clothing until you read the repayment terms: what triggers repayment, and what happens if you never start the job. Signing bonuses were offered in 87 percent of all physician searches in the AMN review, averaging $49,306 across specialties, and the terms matter more than the size. Claims from training belong in the read too: what happens to a claim filed after you graduate depends on the policy form the program carried. The depth lives on the contracts and income topic page and the malpractice and tail coverage topic page, and the new attending page picks up where the signature lands.

Worked math: comparing first attending offers, the stipend or early sign on read, and what happens to malpractice claims from residency after graduation.

The gaps that follow OB/GYNs out of training are visible in the attending files. Heidi entered attending life with real strengths, and the residue of her training years still cost her points. One: group only disability carried out of training. Her protection was the group policy and nothing else, sized to a fraction of income, written to a group definition, and gone when the job is. The individual policy this page puts first was never placed while her health and rates were at their best. Two: a will only. No power of attorney and no health care directive beside it, so the documents stop exactly where a crisis starts. Three: a loan count that was running because the defaults ran it. Her 24 banked payments arrived by enrollment and employment rather than by a plan she chose and checked each year. A count that runs on defaults can also stop on defaults, silently.

One more window sits behind all three. Some programs open a guaranteed issue window in training: coverage placed without a medical exam, on terms that close at graduation. A resident who lets that window pass buys later at attending scrutiny, if the health record still allows it. Check whether your program has one in your first year, not your last.

Worked math: the resident disability purchase and the resident reserve.

A partner who is not your spouse: the law gives a partner no default rights, so the estate documents are the entire plan. Start with the documents named in the red flags block above, and do not let a will only stand as the whole build.

Training at a program whose paycheck is not qualifying: the forgiveness count may not be running at all. Verify the employer of record with the first certification.

Planning a fellowship: you will train as a fellow of the subspecialty, never as a fellow of OB/GYN, and the fork section above prices the added years before you apply.

Carrying private loans beside federal loans: forgiveness never touches the private balance, so the private loans run on their own plan in parallel while the federal count runs. The loan section above covers the federal side.

Federal Student Aid, Public Service Loan Forgiveness (120 qualifying payments, full time employment with a qualifying employer, forgiveness follows the employer, and the July 1, 2023 exception for states that bar direct hospital employment of physicians, accessed October 2026)

AMN Healthcare, 2026 Review of Physician and Advanced Practitioner Recruiting Incentives (OB/GYN average starting salary of $374,000; signing bonuses offered in 87 percent of all physician searches, averaging $49,306 across specialties, accessed October 2026)

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)

Internal Revenue Service, Notice 2025-67 (2026 IRA limit of $7,500, accessed October 2026)

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

Medical Economics (disability carriers issue coverage totaling about 60 to 70 percent of pre disability income, accessed October 2026)

Physician Side Gigs, malpractice tail insurance coverage (tail coverage commonly costs 150 to 200 percent of the mature annual premium, 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.