As the physician shortage increases, signing bonuses are becoming a larger part of the incentive package often offered to doctors during physician contract negotiations. As such, they are often discussed within our physician communities as graduating residents and fellows approach their first job search as well as by physicians looking for a career change.
In our 2024 Physician Side Gigs Physician Salary and Negotiation database, we’ve seen the average signing bonus go up across specialties when compared to previous versions of our database. In this article, we cover average sign on bonuses for doctors by specialty. As we see below, specialty can play a huge role in sign on bonuses, so it’s important to make sure you’re comparing relevant data as you approach your contract negotiations.
Disclaimers/Disclosures: This information is derived from our physician salary and compensation databases, but is subject to self-reporting errors and availability of relevant data points from our online communities. This information is provided for educational purposes only, and is aimed at advocating for individual physicians. It is not intended to be used for collective bargaining; please see additional disclosures and disclaimers on the physician salary data pages. Please also do your own research before making any decisions based on the information provided. We are not formal financial, legal, or tax professionals and do not provide individualized advice. You should consult these as appropriate. We highly recommend having your physician employment agreement reviewed by a physician contract review attorney to ensure you have the most up to date and relevant information for your specific situation.
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How Signing Bonus Aggregate Stats Were Determined
Data used to determine the average physician sign on bonus below was collected from mid-2023 to mid-2024 through our physician salary and compensation negotiation database, a free resource to all members of our online physician community, which consists of over 6,000 data points.
Many members contribute their current salary and compensation structure information every year, and many have been at their jobs for several years. The averages below are aggregates across all current data submitted. As such, that doesn’t mean these are completely representative of the going rates for this specific season.
We recommend you explore the physicians salary and compensation database, which allows members to also see how long physicians have been in their current position, giving the most accurate and up-to-date comparison. A good contract review attorney can also help you assess current trends for your specialty and market.
The averages presented below are for the subset of our respondents that reported some sort of signing bonuses. Contributions of $0 were removed before assessing averages. To give you an idea of overall responses:
12% of physicians across all specialties mentioned specifically that they did not receive any sign on bonus.
47% of physicians did not respond; they may have left it blank because they didn’t receive one, they couldn’t remember what it was, or they simply chose not to respond.
41% of physicians reported receiving some sort of signing bonus.
These aggregate numbers may differ slightly from reported averages in our how much doctors make by specialty breakout articles, depending on when articles were published and last updated, as our salary and compensation database is continually updated.
How Doctor Sign On Bonuses Are Structured
While we were compiling the data for this article, we noticed several different bonus structures mentioned.
Many sign on bonuses were structured as advances or zero interest forgivable loans; these were more retention bonuses versus straight signing bonuses. These tended to be the higher reported amounts.
Some physicians were paid a set amount per year for X number of years (often 1-3 years) that they remain with the group or institution as another retention bonus style versus a larger lump sum up front.
Others were paid out up front but their bonus wasn’t “forgiven” or earned out completely until X years of employment, so part of their sign on bonus would have to be paid back if they left before the end of the agreement.
Some were given an initial signing bonus plus a smaller retention bonus for the next X years.
Others got a stipend from when they committed to the job to when they officially started the role to finish out their residency or fellowship.
Learn more about sign on bonuses and physician contract negotiations.
Overall Physician Signing Bonuses
The average sign on bonus for doctors across all specialties was $30,395, with a median reported bonus of $20,000. The range of signing bonuses can help explain this large gap between the average and median, as reported bonuses ranged anywhere from $1,000 all the way to $300,000. As noted above, some of these are a mix of a sign on bonus and a retention bonus. Higher signing bonuses often had some sort of long-term commitment attached to earn out the entire bonus.
As we’ve seen in our how much doctors make by specialty series, average signing bonuses can vary significantly by specialty, so we also looked at sign on bonuses by each specialty.
Highest Average Physician Sign On Bonuses
Below, we dig deeper into signing bonuses by each specialty, but here are the highest average sign on bonuses by specialty.
Please note that specialties without enough data to assess an average were omitted, but additional information on sign on bonuses, such as the range of bonuses reported, are still included below.
Lowest Average Physician Signing Bonuses
Along with the highest average signing bonuses, we looked at the lowest average sign on bonuses as well.
We noted that specialties with the lowest average signing bonuses also tended to be the specialties with the lowest average salaries reported. Similarly above, the specialties with the highest average signing bonuses also tended to have higher average salaries.
Average Physician Sign On Bonus By Specialty
Average Signing Bonus for Addiction Medicine
We don’t have enough data points to confidently assess an average, but signing bonuses for addiction medicine doctors ranged from $10,000 - $60,000.
Average Sign On Bonus for Allergy and Immunology Doctors
The average sign on bonus for allergists and immunologists was $18,000, with a median signing bonus of $15,000.
Bonuses ranged from $5,000 to $40,000. Three of the top signing bonus amounts were all from physicians who negotiated their bonuses within the last year, while three of the lowest signing bonuses were from physicians who have been at their positions for several years. This suggests that signing bonuses are increasing for allergy and immunology doctors.
Average Signing Bonus for Anesthesiologists
The average signing bonus for anesthesiologists was $39,000, with a median signing bonus of $30,000. Signing bonuses ranged anywhere from $1,000 to $300,000, which was the highest of all sign on bonuses reported across all specialties.
Learn more about the average salary and compensation package for anesthesiologists.
Average Sign On Bonus for Cardiologists
The average signing bonus for cardiologists was $41,000, with a median of $35,000. Signing bonuses ranged from $1,000 to $150,000.
All of the higher signing bonuses in cardiology were reported by physicians who signed on for the position within the past few years, so we are seeing a trend with increasing signing bonuses in this specialty as well. It’s important to note, however, that this doesn’t guarantee a higher sign on bonus, as some of the lower reported bonuses were also from recent hires.
This highlights the importance of contract negotiations when you are assessing a new position. Working with a contract review attorney can also help you understand current local trends to better negotiate your sign on bonus and other aspects of your contract.
Learn more about the average salary and compensation package for cardiologists.
Average Signing Bonus for Critical Care Medicine Physicians
The average signing bonus for intensivists was $32,000, with a median of $29,000. Sign on bonuses in critical care medicine ranged from $10,000 to $100,000.
Learn more about the average salary and compensation package for intensivists.
Average Sign On Bonus for Dermatologists
The average sign on bonus for dermatologists was $37,000, with a median of $25,000. Signing bonuses ranged from $3,000 all the way up to $150,000.
As with many of the other specialties, we saw a trend in dermatology where the highest reported signing bonuses are from physicians who recently negotiated their physician employment agreement within the last year or so.
Learn more about the average salary and compensation package for dermatologists.
Average Signing Bonus for Emergency Medicine Doctors
The average signing bonus for emergency medicine physicians was $36,000, with a median of $30,000. Bonuses ranged from $3,000 to $150,000.
The majority of the higher sign on bonuses were reported by EM physicians who negotiated their agreements in the past year.
Learn more about the average salary and compensation package for emergency medicine doctors.
Average Sign On Bonus for Endocrinologists
The average sign on bonus for endocrinologists was $22,000, with a median of $20,000. Signing bonuses ranged from $10,000 to $100,000.
Learn more about the average salary and compensation package for endocrinologists.
Average Signing Bonus for Family Medicine Physicians
The average signing bonus for family medicine physicians was $35,000, with a median of $25,000. Sign on bonuses ranged anywhere from $2,000 to $250,000.
Signing bonuses in family medicine were scattered depending on how long the physician had been in a position, but many of the top reported bonuses were from the least year. Retention bonuses might also come into play, with physicians happy to stay in their current positions able to earn additional incentives over time.
Learn more about the average salary and compensation package for family medicine doctors.
Average Sign On Bonus for Gastroenterologists
The average sign on bonus for gastroenterologists was $40,000, with a median of $25,000. Bonuses ranged anywhere from $5,000 to $250,000. The 7 highest signing bonuses were all reported by physicians who negotiated new positions in the past year or so.
Learn more about the average salary and compensation package for gastroenterologists.
Average Signing Bonus for Geriatric Medicine Physicians
The average signing bonus in geriatrics was $24,000, with a median of $20,000. Bonuses ranged from $4,000 to $60,000.
This is one of the smaller datasets we have across the different specialties, so we’d love to reassess when we have additional information. If you haven’t already, please contribute your anonymous physician salary and compensation data today to help us update this in the future.
Average Sign On Bonus for Hematologist Oncologists
The average sign on bonus for hematologist oncologists was $30,000, with a median of $25,000. Bonuses ranged from $10,000 to $100,000.
As we’ve seen in a few other specialties so far, while some of the highest signing bonuses have been by physicians who changed jobs in the past year, so are some of the lowest signing bonuses reported. Physicians specifically mentioned in their contributions that they were able to negotiate signing bonuses significantly higher, so it can be worth the consideration in your contract negotiations strategy.
Learn more about the average salary and compensation package for hematologist oncologists.
Average Signing Bonus for Hospice and Palliative Care Physicians
The average signing bonus for hospice and palliative care physicians was $18,000, with a median of $20,000. Bonuses ranged from $5,000 to $50,000.
We would love to look at hospice and palliative care separately in the future, but don’t currently have enough data points to split the specializations.
Like hematologist oncologists, we see a mix of trends in sign on bonuses with the current dataset.
Learn more about the average salary and compensation package for hospice and palliative care doctors.
Average Sign On Bonus for Hospitalists
The average sign on bonus for hospitalists was $25,000, with a median of $20,000. Bonuses ranged anywhere from $2,500 to $200,000.
Internal medicine hospitalists reported a higher average signing bonus amount ($26,000) than family medicine hospitalists ($21,000). Internal medicine hospitalists also reported the 8 highest signing bonuses overall. The highest reported sign on bonus amount for family medicine hospitalists was $50,000.
We also look at OB/GYN hospitalists and pediatric hospitalists below.
For hospitalists, we noticed that the majority of the higher signing bonuses amounts were reported by recent hires, suggesting that sign on bonuses are on the rise for hospitalists who can effectively negotiate for them.
Learn more about the average salary and compensation package for hospitalists.
Average Signing Bonus for Infectious Disease Physicians
The average signing bonuses for infectious diseases doctors was $27,000, with a median of $27,500. Bonuses ranged from $10,000 to $50,000.
Average Sign On Bonus for Internal Medicine Physicians
The average sign on bonus for internal medicine physicians was $25,000, with a median of $20,000. Bonuses ranged anywhere from $5,000 to $100,000.
Similar to family medicine, we saw a trend of a mix of new hires and physicians who have been in their positions for a few years, which may signal that internal medicine physicians are negotiating signing bonuses with retention components as well.
Make sure your bonus structure is clearly laid out in your physician employment agreement when you are negotiating your employment agreement.
Learn more about the average salary and compensation package for internal medicine doctors.
Average Signing Bonus for Nephrologists
The average signing bonus for nephrologists was $25,000 with a median of $20,000. Bonuses ranged from $10,000 to $50,000.
Average Sign On Bonus for Neurologists
The average sign on bonus for neurologists was $29,000, with a median of $25,000. Bonuses ranged from $5,000 to $100,000.
Signing bonuses for neurologists seemed a little scattered with our current dataset, making it difficult to track overall trends in bonuses being negotiated. We look forward to investigating this again in the future with additional contributions.
Learn more about the average salary and compensation package for neurologists.
Average Signing Bonus for OB/GYN Physicians
The average signing bonus for OB/GYN physicians was $29,000, with a median of $25,000. Bonuses ranged anywhere from $3,000 to $170,000. The highest reported sign on bonuses were for OB/GYNs in general OB/GYN and gynecology only.
Signing bonuses for physicians negotiating agreements in the past year are a little scattered among OB/GYNs, but many of the higher reported bonuses are for recent hires.
Sign On Bonus for OB/GYN Hospitalists
The average sign on bonus for OB/GYN hospitalists was $26,000, with a median of $25,000. This is similar to what we saw above for internal medicine hospitalists, and above the average for family medicine hospitalists.
Learn more about the average salary and compensation package for OB/GYNs.
Average Signing Bonus for Occupational Medicine Physicians
While we don’t have enough data points to assess an average yet for occupational medicine, current reported salaries ranged from $15,000 to $100,000.
Average Sign On Bonus for Ophthalmologists
The average sign on bonus for ophthalmologists was $33,000, with a median of $20,000. Bonuses ranged anywhere from $5,000 to $150,000.
Learn more about the average salary and compensation package for ophthalmologists.
Average Signing Bonus for Orthopedic Surgeons
The average signing bonus for orthopedic surgeons was $41,000, with a median of $25,000. Bonuses ranged from $10,000 to $125,000.
Average Sign On Bonus for Otolaryngologists (ENTs)
The average sign on bonus for otolaryngologists was $28,000, with a median of $22,500. Bonuses ranged from $10,000 to $80,000.
We see a general increasing trend in signing bonus amounts for ENTs, as well as a higher percentage of physicians who have recently accepted new positions reporting some signing bonus.
Learn more about the average salary and compensation package for ENTs.
Average Signing Bonus for Pain Management Doctors
The average signing bonus for pain management physicians was $28,000. Bonuses ranged anywhere from $5,000 up to $75,000.
Learn more about the average salary and compensation package for pain management doctors.
Average Sign On Bonus for Pathologists
The average sign on bonus for pathologists was $27,000, with a median of $15,000. This large difference between the two shows the large range of bonuses, from $5,000 to $150,000. While there were a few 6-figure salaries, the majority reported bonuses fell within the $10,000 to $30,000 range.
Learn more about the average salary and compensation package for pathologists.
Average Signing Bonus for Pediatricians
The average signing bonus for pediatricians was $20,000, with a median of $15,000. Bonuses ranged anywhere from $1,200 to $200,000.
The highest reported sign on bonuses were for pediatricians specializing in:
Gastroenterology
Neonatology
Neurology
As we’ve seen above, specialty can factor into average signing bonuses, so we also looked at the data for general pediatricians separately and assessed averages for pediatric specialties where we had enough data.
If you would like to see your specialty included below, please contribute to our physician salary and compensation data to help us with future updates.
The average sign on bonus for general pediatricians was $19,000, with a median of $15,000. Bonuses ranged from $2,000 to $150,000.
Average Signing Bonus for Neonatologists
The average signing bonus for neonatologists was $20,000, with a median of $20,000. Bonuses ranged from $5,000 to $100,000.
Average Sign On Bonus for Pediatric Hospitalists
A large subset of our pediatric specialists practice hospital medicine. The average sign on bonus for pediatric hospitalists was $18,000, with a median of $20,000. Bonuses ranged from $5,000 to $60,000. This is significantly less than internal medicine hospitalists and OB/GYN hospitalists, who averaged $26,000, and less than family medicine hospitalists, who averaged $21,000.
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Average Signing Bonus for Psychiatrists
The average signing bonus for psychiatrists was $29,000, with a median of $20,000. Bonuses ranged anywhere from $1,000 to $210,000.
While we’ve seen large ranges of bonuses across specialties, this is one of the largest and a reminder of the importance of negotiating when assessing a new job opportunity. While a higher salary provides a higher income for every year you’re with a group or institution, a large signing bonus, especially with a retention bonus, can also highly increase your earnings.
While signing bonuses are a little scattered within psychiatry, there does appear to be a trend of increasing bonus amounts for recent hires, as well as a smaller percentage reporting they did not receive any signing bonus amount.
Learn more about the average salary and compensation package for psychiatrists.
Average Sign On Bonus for Pulmonologists
The average sign on bonus for pulmonologists was $31,000, with a median of $30,000. Bonuses ranged from $5,000 to $110,000. It appears as if the percentage of pulmonologists who receive some sort of signing bonus is increasing over time.
Average Signing Bonus for Radiation Oncologists
While we don’t have enough data to assess an average yet, reported signing bonuses for radiation oncologists ranged from $10,000 to $100,000, with the majority being between $10,000 and $50,000.
Average Sign On Bonus for Radiologists
The average sign on bonus for radiologists was $37,000, with a median of $25,000. Bonuses ranged anywhere from $7,500 to $250,000.
The percentage of radiologists who receive some sort of signing bonuses seems to be increasing over time.
Learn more about the average salary and compensation package for radiologists.
Average Signing Bonus for Rheumatologists
The average signing bonus for rheumatologists was $35,000, with a median of $25,000. Bonuses ranged from $10,000 to $100,000.
Average Sign On Bonus for Sleep Medicine Physicians
While we don’t have enough data to assess an average yet, current contributions for sign on bonuses in sleep medicine ranged from $10,000 - $35,000.
Average Signing Bonus for Sports Medicine Doctors
We also don’t have enough data to assess an average for sports medicine, but signing bonuses ranged from $10,000 to $50,000.
Average Sign On Bonus for Surgeons
As we’ve seen above, compensation packages can vary significantly by specialty, so we wanted to look closer at different surgeon specialties. These are smaller datasets, so we didn’t have averages for all, but included ranges where applicable.
Bariatric surgeons: Signing bonuses range from $5,000 to $55,000
Breast surgeons: Signing bonuses range anywhere from $2,000 to $300,000
Colon and rectal surgeons: Signing bonuses ranged from $25,000 to $50,000
Neurosurgeons: Signing bonuses ranged from $25,000 to $210,000
Oncology surgeons: Signing bonuses ranged from $10,000 to $100,000
Plastic and reconstructive surgeons: Signing bonuses ranged from $20,000 to $75,000
Trauma surgeons: Signing bonuses ranged from $12,500 to $35,000
Vascular surgeons: Signing bonuses ranged from $10,000 to $75,000
The average sign on bonus for a general surgeon was $32,000, with a median of $25,000. Bonuses ranged from $10,000 to $110,000.
If you would like to see your specialty expanded, please contribute your anonymous physician salary and compensation data to help support future updates.
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Average Signing Bonus for Urologists
The average signing bonus for urologists was $45,000, with a median of $35,000. Bonuses ranged anywhere from $10,000 to $180,000.
It appears that sign on bonuses are becoming more common in urology, as we had a higher percentage of physicians report receiving signing bonuses for recent job changes.
Conclusion
A sign on bonus can be a great additional incentive as part of your overall employment agreement, especially if you are considering multiple opportunities that are a great potential fit. While not all employers offer signing bonuses to all hires, there are certainly opportunities out there for significant bonuses, which you won’t always know about unless you ask. The more leverage you have in the negotiations, the more you may be able to negotiate a nice bonus as part of your agreement. Always remember your worth as you approach contract negotiations.
Bonuses are often taxed differently than salaries, and as noted above, there are different structures to signing bonuses and retention bonuses. It’s important to discuss and define ahead of time how bonuses will be paid out, and ensure that you understand the tax implications of bonuses as well.
Learn more about sign on bonuses in overall physician contract negotiations.
Additional Salary and Career Resources for Physicians
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