With a new emphasis—both in medicine and in society—on well-being, anti-burnout strategies such as taking adequate and protected time off, fostering hobbies and nourishing mind and body have real tradeoffs in terms of the income a physician can generate.
And as residents plan their careers in practice, they will ask themselves at some point: “How much time do we trade in for the money?” said Anna Yap, MD, an emergency physician and assistant professor in Sacramento, California.
Dr. Yap also serves as chair-elect of the AMA Young Physicians Section Governing Council and has years of experience mentoring physicians. Her tips for navigating the balancing act of well-being and finances—everything from picking a practice setting to deciding how much to work—can be boiled down to two simple words: Know thyself.
Know that burnout is real
With intense time demands, modest compensation and a barrage of novel experiences, residency and fellowship training often stretch physicians to their limits. It’s important to know that feelings of stress or overwork are common.
“I was pretty burnt out in residency,” Dr. Yap acknowledged. “For med school and residency and—for a lot of us, even going through college before that—I think we're constantly running, are constantly on this set of train tracks. And then when we get to the end of it after residency, we're like: Wait, now what?”
And the data shows that Dr. Yap and her colleagues were not alone. Physician burnout continues to be a challenge, despite recent improvement. AMA-exclusive data showed residents in 2024 reporting lower burnout compared with prior years, and burnout rates for practicing physicians also have fallen from high-water marks seen during the COVID-19 public health emergency. But the battle isn’t won.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine®.
Know your options
Coming out of that high-pressure time, residents need to assess what their futures will look like in terms of time investments and the income they can expect. Different physician specialties present their own challenges and opportunities. Dr. Yap said that in emergency medicine, “a big dividing point” is the decision between academic and nonacademic medicine, considering that, “generally speaking, academics will pay less.”
But there are ways to supplement one’s income. If your specialty offers them, feel free to take advantage.
“The beauty of being in emergency medicine is we can pick up those extra shifts and do the extra moonlighting, so we have some more flexibility and being able to fill in the gaps where it's needed,” she said. “That's been very helpful for me in my career.”
Learn more about the AMA Resident and Fellow Section, which gives voice to—and advocates on—issues that affect resident and fellow physicians.
Know your lifestyle
Selecting a practice setting will have implications for the income a physician can generate. The decision was complicated for Dr. Yap, but her advice is to make the decision about more than the money.
“I don't come from a family with generational wealth, and I was really struggling with the idea of making less. But ultimately, when I sat down and figured out what my true priorities were—what would result in practice satisfaction and a long-term career—I realized that I really love mentoring and teaching and getting people involved in advocacy and health policy,” she said. “So, really, academics was the track for me, and so I just had to come to terms with that.”
Residents also need to ask themselves: How much control do I want over my job? An employed physician might have less autonomy but may see a more consistent income stream.
“Some people like being able to go and do locum tenens so that you have a lot more flexibility. To some people, stability is much more important to them and so the W-2 sort of job and knowing what your salary's going to be monthly, that’s really important to them. To some people, independence is really important—maybe going out and doing private practice,” Dr. Yap said. “In general, in academics, you’re going to be doing a W-2. So that was the other consideration: Did I want to be a contractor versus a W2 employee? I was OK with being a W-2 employee.”
Dive deeper with this AMA issue brief (PDF) on the campaign to support the health and well-being of medical students, residents and physicians.
Know your limits
A rule of thumb Dr. Yap said she often heard was to initially keep work hours stable.
“Many times, folks say if you can swing it after residency, try to work about as much time as you did as a resident, or maybe go down just a little bit so you can make as much money on the front end. And I will say that I definitely did do that my first two years out of residency and fellowship,” she said.
But that path may not be feasible for everyone. For some, doing it could have a big downside of dampening the joy they find in practicing medicine. “The biggest shame is going through all this training in med school and residency, and then coming out and not doing it anymore because you're too burnt out,” she said. “That's why it's OK to give yourself permission to take a bit of a break to then regroup.”
Learn some ways to evaluate potential employers’ commitment to preventing and treating burnout among physicians. Residents looking for their first physician jobs can use tools like the AMA STEPS Forward® toolkits to prepare for interviews, finding questions to ask health care organizations and learning about where the trouble spots often lie.
Know your priorities
Now that you will have more income as a practicing physician, where do you want to spend your money? For Dr. Yap, it was about meeting her desires to put down roots.
“In trying to figure out how to balance and how much money to make, it came down to figuring out what are the things that I truly wanted and valued,” Dr. Yap said. “For me, having a home and somewhere that I'm really comfortable was really important to me and my husband.”
Once you’ve made your decisions, feel confident that you chose a path that’s more likely to be long and fulfilling.
“If you can work as much as a resident for your first few years to make more money, that's great. But that's not going to be the case for everybody. And don't feel bad about it if you don't, because ultimately it is OK to give yourself permission to take a break, to regroup, to ‘unburn’ yourself out so that you can then make something you like” out of your career.
If you’re in the search for your first physician job after residency, get your cheat sheet from the AMA now.
Explore further with the AMA STEPS Forward® toolkit, “What to Look for in Your First or Next Practice: Evaluate the Practice Environment to Match Your Priorities.” It is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit ™.
Learn more about AMA CME accreditation.
