Top 5 Highest Paying Physician Assistant Specialties for New Graduates

So let’s face it, you’re a soon-to-be new grad with 6 figures of student debt and want to know when this degree will finally pay off. I promise it will! Between being a student and precepting students years later, I’ve come across a fair amount of students that have multiple interests in medicine that had difficulty narrowing down their search for an area of medicine they would like to work in. While I hope it goes without saying that money should not be the only goal when choosing a career or a specific job, it is obviously a big factor so hopefully this helps.

  1. Cardiothoracic Surgery – $115,000

Okay great, now that you know what is the best paying specialty for new grads you can stop reading and only plan on applying to CT surg jobs. Not so fast. This is a very demanding specialty with a culture of perfectionists. While every job is different, it has a reputation for having surgeons that are very particular and expect you to not only round on patients in the morning but also scrub in for often lengthy surgeries. If you are interested in surgery, and also caring for using very medically complex patients while making a great salary, this specialty may be for you. Just don’t be surprised if you are expected to work more than your typical 40-hour work week and have to either live or commute to a major city as these jobs are rare in more rural settings.

  1. Occupational Medicine – $109,500

Have you ever dreamed of evaluating patient’s workman compensation claim in your hospital’s employee health office? If so, occupational medicine may be for you. It never struck me as the most exciting specialty, but I would expect a fairly normal 9-5 type schedule without weekends or holidays which can be hard to come by with some of the higher-paying specialties.

  1. General Surgery – $106,000

Do you have a general interest in surgery? Well here you go, that’s it.

Okay, there’s way more to say about surgery than that but chances are if you’re reading this you’ve already been through a general surgery rotation and have a decent idea of whether or not you could see yourself working in surgery. This may be a great first job if you’re interested in or would like to further develop your surgical procedural skillset as it will translate well if you market those skills to a job in a surgical sub-specialty you are interested in.

  1. Surgical Sub-Specialties (Vascular Surgery, Urology, Orthopedics) – $105,000

Most surgical positions are going to have similar starting salaries. Vascular surgery appears to have a fairly high ceiling with experience. You are paid in direct proportion to the complexity of the problems you solve and how rare and valuable your skills are. Let’s face it, as a new grad PA your skills are fairly similar to most other new grads. As you develop those skills and gain experience in a specialty that is fairly specific, even if your starting salary isn’t as good as some others, you may have significantly more bargaining power when negotiating when compared to your generalist counterparts. With that being said, if you choose a surgical sub-specialty, I would recommend you keep in mind that it may be difficult to transition out of that specialty. Family, internal, and emergency medicine PAs I would argue are the most capable of switching specialties as they use a little bit of everything in their day-to-day work. An orthopedic surgery PA that decides after 5 years that they would like to work in inpatient Cardiology may have a bit of a tougher transition.

  1. Emergency Medicine/ Urgent Care – $103,000

I have included these together as their salaries are very similar and positions will often overlap. One of my first job offers was a hybrid of urgent and ER shifts and both require you to maintain a knowledge base of all areas of medicine and know the difference between sick and not sick and how to treat accordingly. Although the lowest on the list, I would argue that emergency medicine and urgent care have the highest overall income potential given that they are shift work primarily and often have fewer days worked overall with 3 and 4-day weeks of 10 or 12-hour shifts being very common. A cardiothoracic or neurosurgical PA working 50 hours a week 5 days a week with the occasional weekend call may not have many additional opportunities for more pay on top of their salary however if let’s say your job requires 12 shifts a month of 12 hours each(which is very common) at a rate $60 an hour (national average for a new grad as of 2022) x 12 hours x 12 shifts a month = $103,680 annually. Most jobs should pay a “bonus rate” for extra shifts which I have seen as low as $15 above your normal hourly rate and as high as 1.5X your base rate. So if 2 additional shifts were picked up per month at $80 an hour(either bonus shifts at your job or another per diem job) that would be an extra $1920 monthly, or $23,040 annually making an overall compensation of $126,720 very attainable in year one working 168 hours a month(roughly the same amount the 40 hours a week PAs are working).