Acute care specialty
Emergency Medicine: Salary, Residency & Career Guide
Undifferentiated acute illness, trauma and time-sensitive emergency care.
Typical Training
3–4 years
Programs are typically 3 or 4 years
Attending Compensation
$423,723
Average Total Compensation
Employment outlook
+3%
Projected Job Growth
Relative Competitiveness Index
36 / 100
Lower
Start in Medical School
M1 to M4 Preparation
Practical experience, projects and rotation planning.
See the Medical School RoadmapAttending Compensation and State Wages
U.S. Attending Compensation
$423,723
Average Total Compensation
BLS State Median Wages (Separate Data Series)
Highest published state medians. Select another state above for its figure.
Resident Pay by Institution
Programs are typically 3 or 4 years.
2026–27 salaries, five published training-institution examples.
Selected institution
University of Michigan, Ann Arbor, MI
$77,049/ year
Pay varies by institution and postgraduate year.
Schedules and Work Setting
Schedule and Call
Shift work means you may leave without carrying a patient panel, but night shifts, circadian disruption, weekends and holidays are part of the package. Twelve night shifts are not equivalent to twelve daytime clinic shifts.
Practice Settings
Emergency departments and urgent or emergency care systems.
Procedures and Clinical Work
- Resuscitation
- Intubation
- Procedural sedation
- Laceration repair and ultrasound
Fellowship Training
Fellowship Expectation Index
1 / 5
Fellowship Options
Common Fellowship Duration: 1–2 year(s) beyond residency. Ultrasound and EMS are commonly shorter tracks; medical toxicology typically takes two years.
Most physicians can enter general emergency-department practice directly after EM residency. Fellowships chiefly support specific niches; critical care, toxicology, pediatric EM, EMS or academic ultrasound; not core ED eligibility.
Direct Practice
General emergency physician in community or academic EDs.
Specialized Practice
A dedicated subspecialty credential or specialized academic role may require additional training; pediatric EM and critical care have distinct pathways.
Choosing a Path
If you want shift-based adult ED practice, assess residency acuity and procedures before worrying about fellowship. If you want pediatric-only EM or ICU practice, trace that route early.
Potential Fellowship Pathways
- Medical toxicology
- Pediatric emergency medicine
- Emergency medical services
- Critical care medicine
Fellowship Careers From This Residency
Choose a subspecialty to see its training requirements, clinical work and preparation pathway.
Preparing in M1 Through M4
Emergency physicians make disposition decisions with incomplete information. Follow a shift from triage through reassessment and discharge, including patients who never need a procedure.
Research or QI
A quality project in sepsis pathway timing, safe discharge instructions, ED crowding or ultrasound documentation is naturally relevant.
Common Mistake
Treating the ED as only trauma and intubation. Programs also watch communication, handoffs, shift stamina, accepting feedback and reassessing uncertain patients.
Preparation by Year
- 1Shadow a full shift from triage to discharge, including low-acuity and complex disposition cases. Ask how the team decides who can safely go home.
- 2Read the CORD/EMRA advising guide early to understand how specialty evaluation letters are produced; identify institutions with EM residency-based clerkships.
Ask a resident this: How many patients does a senior resident carry at once, and what backup exists during night surges or boarding crises?
MD vs DO Match Outcomes
1,246 of 1,272 matched to their preferred specialty
981 of 1,018 matched to their preferred specialty
MD vs DO difference: 1.6 percentage points
Applicant Considerations
Historical MD and DO preferred-specialty match rates for EM were both high, so a DO student should focus less on pedigree anxiety and more on access to timely, substantive eSLOEs and rotations.
DO Application Strategy
Arrange an EM rotation at a residency-bearing site that can author the appropriate SLOE; check that the evaluation will arrive by program deadlines. School affiliation is less useful than documented on-shift performance.
Job Outlook
+3%
Projected Employment Growth
2025 to 2035, BLS occupational projection
Regional hiring depends on employers, workforce supply and patient demand.
AI and the Specialty
Potential Workflow Changes
Decision support, triage assistance and documentation may change workflows, but bedside stabilization and procedures remain central.
Sources & Data Notes
Reviewed . National attending compensation uses Doximity's 2026 specialty survey (2025 pay) where available, then verified specialty-specific Medscape, Marit or Salary.com estimates. Doximity, Medscape and Marit report total compensation; Salary.com models base salary. Survey averages, modeled salaries and BLS wage medians measure different populations and must not be interpreted as identical metrics. BLS May 2025 state wages are shown separately and exclude self-employed physicians. The ophthalmology BLS category excludes pediatric ophthalmologists. State figures may be missing, top-coded, or suppressed. Job outlook uses BLS 2025–2035 occupational projections; it is not a local vacancy forecast. Resident stipend examples reflect published institutional scales for 2026 to 2027, by postgraduate year, not specialty. Stanford includes housing in its reported base salary; other institutions handle allowances differently.
The Relative Competitiveness Index uses a fixed score of 25 plus 1.75 times the 2024 U.S. MD preferred-specialty unmatched percentage, rounded, then applies the same 1.225 multiplier to every specialty. Neurological Surgery is 98/100; the score is not the applicant's chance of matching. It is not a 2026 estimate or DO-specific score. The MD and DO percentages compare different unadjusted applicant cohorts who ranked that specialty first. They do not account for application strategy, program selection, scores, or geography. Ophthalmology and urology have separate specialty match processes; other pathways may lack suitable NRMP cohorts.
The 1–5 Fellowship Expectation Index is an editorial assessment of customary career paths, not a measured participation rate or requirement. For residency profiles, compact training labels put specialty years before the clinical base or preliminary year; e.g. 3+1 means three specialty years and one clinical base year, even though the clinical year comes first. Fellowship-defined careers are presented in the separate fellowship explorer. Schedules, procedural scope, preparation suggestions, and potential AI effects depend on the program and practice setting; they are qualitative descriptions, not guaranteed outcomes or forecasts of physician replacement.
For Emergency Medicine: Doximity 2026, Average Total Compensation, reported under “Emergency Medicine.” The national estimate must not be treated as a state-specific compensation figure.
Emergency Medicine: ABEM 2025–26 training report documents a growing fellowship landscape but does not imply a fellowship is routine for all graduates. Specialty-specific roadmaps describe illustrative activities, not mandatory publication, shadowing-hour, rotation, or skill requirements. Common fellowship routes: Ultrasound and EMS are commonly shorter tracks; medical toxicology typically takes two years.