Average physician signing bonus jumps 29% to nearly $50,000 as competition for specialists intensifies

DALLAS, Oct. 19, 2026 /PRNewswire/ — Gastroenterologists are now offered the highest average starting salary of any physician, at $654,000, according to AMN Healthcare’s annual review of physician recruiting incentives. They displace orthopedic surgeons, who had topped the list in each of the previous four years and whose average starting salary fell 12% year over year, to $507,000.

The 2026 Review of Physician and Advanced Practitioner Recruiting Incentives, now in its 33rd year, tracks the starting salaries and other incentives that hospitals, medical groups and other facilities offer to physicians and advanced practice professionals. The report finds that the average starting salary for all physicians is $419,000, up from $403,000 last year.

Signing bonuses are also climbing sharply with the average signing bonus offered to physicians reaching $49,306, up 29% from $38,215 last year. Signing bonuses were offered in 87% of the search engagements AMN Healthcare conducted, up from 74% the prior year.

“An aging population is driving demand for specialists faster than the supply of physicians in procedural fields like gastroenterology, cardiology and urology can keep up,” said Robin Johnson, Group President of Nursing, Allied & Physician Solutions at AMN Healthcare.  “Hospitals and medical groups are responding by competing harder for every candidate and signing bonuses have become one of the most effective ways to stand out when a physician is weighing multiple offers.”

Specialists Command the Top Salaries
Specialists account for every position in the top 10 of the report’s starting salaries. After gastroenterology, the highest average starting salaries are: 

• Interventional cardiology at $650,000
• Urology at $638,000
• Otolaryngology at $575,000
• Radiology at $571,000
• Non-invasive cardiology at $568,000 

Urologists saw the largest year-over-year gain, a 22.5% increase. Non-invasive cardiologists followed with 20.9%, and gastroenterologists with 18.5%.

Primary care physicians continue to be offered far less. Family medicine physicians are offered an average of $291,000, a 5.8% increase. Internal medicine physicians are offered $289,000, down 1.2%. Pediatricians are at the low end of the scale at $231,000, down 10.6%. 

Specialists made up 84% of the physician searches AMN Healthcare conducted, compared with 16% for primary care.

Academic Positions Pay Less
Practice setting significantly affects pay. Physicians in academic positions are offered an average starting salary of $362,000, compared with $452,000 for non-academic positions. Academic medical centers accounted for 30% of AMN Healthcare’s search engagements, and 90% of those were for clinical faculty. That is the highest share in the report’s history.

NPs Remain Most Requested for Sixth Straight Year
Nurse practitioners were again AMN Healthcare’s most requested search engagement; the sixth consecutive year they have led the list. NP starting salaries held steady at an average of $180,000.

“Organizations increasingly see nurse practitioners as a core part of their workforce strategy, not a stopgap. NPs are expanding access in primary care, supporting specialty practices and meeting rising demand for behavioral health and telehealth services,” Johnson said.

Contract Structures Shifting
Most contracts (68%) offered a salary plus a production bonus. Bonuses were most often tied to RVUs (relative value units), which measure the volume and complexity of the services a physician provides. The report also notes a growing shift among physicians toward 1099 independent contractor arrangements. It also finds that telehealth has become a permanent practice setting.

The full report is available at: https://online.flippingbook.com/view/1007051548/.

Methodology
AMN Healthcare’s 2026 Review of Physician and Advanced Practitioner Recruiting Incentives is based on a representative sample of the 1,293 permanent physician and advanced practitioner search engagements the company conducted or had ongoing from April 1, 2025, to March 31, 2026. 

About AMN Healthcare
AMN Healthcare is the leader and innovator in total talent solutions for health care, bringing together the people, processes and technology to deliver better care. Through a steadfast partnership approach, we solve the most pressing workforce challenges to enable better clinical outcomes and access to care. In 2025, our health care professionals reached more than 13 million patients at more than 2,300 health care systems, including 93% of the top health care systems nationwide. We provide a comprehensive network of quality health care professionals and deliver a fully integrated and customizable suite of workforce technologies.

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SOURCE AMN Healthcare Services, Inc.