Reflecting the very high level of qualifications of specialist doctors and the high workload of many of them, specialist doctors earn much more than the average national wage of all workers in all countries. Salaried medical specialists earn between two and five times more than the average worker, while self-employed specialists typically make around three to five times more. In Korea this difference is nearly seven times more (Figure 8.11; left panel). In nearly all countries where self-employed specialists coexist with salaried specialists, the self-employed earn much more than the salaried. The Netherlands is an exception, but this merely reflects the growing number of self-employed specialists practicing under a “director-shareholder business” status that provides an incentive to report low “usual wages” for tax reasons.
When comparing the remuneration of specialists in absolute terms based on a common currency (US dollars), and adjusted for differences in purchasing power and inflation, salaried specialists earn most in Ireland, where the new contracts for consultants that forgo the right to see private patients – effective in 2024 ‑ led to an average income of more than USD 250 000 (Figure 8.11; right panel). Among the self-employed specialists, the highest earners are in Germany, Korea and Austria, making close to or more than USD 300 000. On the other hand, salaried specialists in Bulgaria take home the least among OECD and accession countries, and salaries for specialists in Mexico, Colombia, Greece and Costa Rica are also comparatively low (between USD 65 000‑75 000). It is worth noting that while Mexican salaried specialists rank last based on this measure, their remuneration is above the OECD average when relating it to the existing average national wage in the country (Figure 8.11, left panel).
The level of income and how this differs across categories of doctors can be a criterion in deciding whether to pursue a career in general practice or in one of the various medical specialities. On average across OECD countries and specialties, specialists earn around 40% more than GPs. In Korea, the income of self-employed specialists was at least double that of self-employed GPs. In Switzerland, the difference between self-employed specialists and GPs was much smaller, at around 6%. Among salaried doctors, income of specialists is double that of GPs in Türkiye, Israel and Korea.
Calculating a generic average of the many different medical specialities hides important differences in the earning potential across the various disciplines, which can influence the career decisions of young doctors in training. While there are differences across OECD countries, some recurring patterns exist. On average, radiologists, anaesthesiologists and ophthalmologists are the highest earning specialists across OECD countries, earning around 60‑80% more than GPs (Figure 8.12). On the other hand, income of paediatricians is typically either slightly below or above the level of GPs.
There are significant income gaps across specialties in some countries such as in Canada, where ophthalmologists on average make over three times more than GPs and over 75% more than general surgeons, while radiologists in Germany earn over two times more than GPs and paediatricians. In Israel, anaesthesiologists earn almost three times more than GPs. The gap is narrower in countries such as Portugal, where radiologists and ophthalmologists have incomes similar to those of GPs, while surgeons and anaesthesiologists make about 10% more than GPs.
Various factors can contribute to explain the variation in levels of remuneration across countries and specialties, such as remuneration methods in general (such as salaries or fee‑for-service for self-employed doctors), specific hourly or monthly wages, or fees for services paid and differences in workload (number of working hours).
