A doctor for people in their eighties and nineties, where the hard part is fewer pills, not more.
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What you earn and what it costs to get there.
Typical
$244,180
Part-time or early
$76,830
Top of the range
$428,550
The federal wage survey has no separate line for geriatricians. It counts them with Family Medicine Physicians, where the national median is $244,180 a year and the bottom tenth sit near $76,830. The survey only measures physicians who are employees, so doctors who own part of a practice are missing from it. Geriatricians usually land at or a little below the middle of that band.
About $70,000 to $85,000
Resident and fellow pay, rising each year
Residents and fellows are salaried hospital employees. The figure depends on the city and the hospital system, and it does not go up much for the extra geriatrics year.
Little or no bump
For the extra year of geriatrics training
Most specialties pay more after a fellowship. This one usually does not, because the income comes from Medicare office visits rather than procedures. People choose it for the work, not the pay, and hospitals have to offer other things to attract them.
Tuition, fees, exams and kit. Not rent, food or travel
The low end is an in state public university for the bachelor's degree, then a public medical school in your own state, plus the MCAT (Medical College Admission Test), applications and the three licensing exam steps. The high end is a private medical school with no in state rate anywhere along the way. Residency and the geriatrics fellowship are paid jobs, so those years add no tuition. This is a field where Public Service Loan Forgiveness genuinely applies, because so many geriatricians work for nonprofit health systems, academic medical centers or the Department of Veterans Affairs.
File the FAFSA (Free Application for Federal Student Aid) every year. Most graduates owe well over $150,000. This is a field where Public Service Loan Forgiveness genuinely applies, because so many geriatricians work for nonprofit health systems, academic medical centers or the Department of Veterans Affairs.
Public Service Loan Forgiveness
Nonprofit hospitals, universities and veterans hospitals all qualify. Residency and fellowship years count toward the 10 years of payments.
Federal jobs with a pension
The Department of Veterans Affairs is one of the largest employers of geriatricians in the country.
Malpractice insurance paid
Employers cover it, and premiums in this field are lower than in surgical specialties.
Predictable hours
Clinic-based geriatrics has far less night and weekend work than most doctor jobs.
The exact path from high school to qualified.
Eleven or twelve years after high school. The last year is the one that makes you a geriatrician.
High school
Grades 11 and 12
Biology, chemistry, physics and math, plus any time you can spend around older people. Volunteering in a care home is genuinely useful here.
Bachelor's degree
4 years
Any major, as long as you finish the pre-medical science courses and hold a high GPA. Sit the MCAT (Medical College Admission Test).
Medical school
4 years
Two years of science, then two years of hospital rotations. You graduate as an MD (Doctor of Medicine) or a DO (Doctor of Osteopathic Medicine).
Residency
3 years
Family medicine or internal medicine, three years, matched through the national residency match.
Geriatric medicine fellowship
1 to 2 years
One year in an accredited program, with a second year available for research or academic work. Then sit the added qualification exam.
Biology and chemistry
Required for nearly every pre-medical program.
Physics
Tested on the MCAT (Medical College Admission Test).
Psychology
Dementia, depression and decision-making capacity are daily work.
English
You spend hours explaining things to patients and to their adult children.
To practice you need a license from the medical board of your own state, earned by passing the USMLE (United States Medical Licensing Examination) in three steps, or the osteopathic equivalent. Geriatrics itself is not a separate license. It is an added qualification granted jointly by the American Board of Family Medicine and the American Board of Internal Medicine after an accredited fellowship and an exam. In plain terms: you are already a family doctor or an internist, and this certifies the extra year.
Most competitive fellowships turn people away. Geriatric medicine has the opposite problem: accredited programs across the country regularly finish the year with unfilled positions. If you want this training and you have completed a family medicine or internal medicine residency, you will almost certainly get a place. That is good news for you and bad news for the country.
Things you don't need, but that help.
Outpatient clinic
Long appointments, complicated medication lists, families in the room.
Nursing home and post-acute care
Medical director roles pay a stipend on top of clinical work.
Hospital consult service
Called in when an older patient is confused, falling or failing after surgery.
Home-based primary care
House calls for people too frail to reach a clinic. Medicare pays for it.
Palliative care
A separate additional fellowship that many geriatricians also complete.
Real time with older people
Care home volunteering, or looking after your own grandparents. Programs notice.
Patience with families
Often you are managing three worried adult children as much as one patient.
An interest in medication
Knowing what to stop is the core skill of the specialty.
A second language
Older patients are the least likely to be comfortable in a second language themselves.
Most doctors add treatments. Geriatricians take them away. An 85-year-old on fourteen prescriptions is often sicker because of the pills than despite them, and working out which ones to stop, in what order, without causing harm is genuinely difficult. The specialty has a word for it, deprescribing, and it is one of the few areas of medicine where doing less is the expert move.
Day to day, pros and cons, where you'd work.
Eight to twelve clinic visits, each 30 to 40 minutes rather than the 15 a family doctor gets. Each one covers memory, mood, balance, medication, hearing, continence and whether the person can still manage at home. A daughter is often in the room. Between visits: calls to nursing homes and home care agencies, forms, and conversations about what someone actually wants from the years they have left.
The good
The hard parts
Things people don't tell you.
The number of doctors training in geriatric medicine has stayed roughly flat for years while the population over 65 keeps growing. Accredited fellowship positions go unfilled every single year, which is why hospitals recruit so hard for the ones who do finish.
Nearly every patient a geriatrician sees is covered by Medicare, the federal health program for people 65 and over. That single payer sets what the visits are worth, which is the main reason the specialty earns less than procedure-heavy fields.
The doctor visiting your home looked like a thing of the past, then Medicare started paying for home-based primary care. Geriatrics is the specialty that revived it, because the frailest patients are exactly the ones who cannot get to a clinic.
You do not become a geriatrician instead of a family doctor or an internist. You become one on top of it. The certificate is issued jointly by the family medicine and internal medicine boards, which is unusual in American medicine.
Last checked September 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise.