Delivers babies and treats everything from fertility to cancer of the reproductive organs. Twelve years of training, surgery, clinic, and births at 3am.
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What you earn and what it costs to get there.
Typical
$292,910
Academic or part-time
$94,680
Busy surgical practice
$437,300
The national median is $292,910 a year, and the bottom tenth sit near $94,680. This federal survey counts physicians who are paid as employees. Those in private partnerships are not counted at all, and many of them earn more.
About $65,000 to $80,000
Salary across four years of residency
Four years of paid hospital work, frequently at 70 or 80 hours a week, while the interest on your medical school loans keeps building.
Malpractice insurance
Among the highest premiums of any specialty
Obstetrics carries unusually high insurance costs because a claim about a birth can be brought many years later, while the child is still a minor. Employed physicians have it paid for them. If you own a practice, you pay it yourself and it is a large number.
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a community college start, a bachelor's degree finished at a public university in your own state, and a state medical school at about 40,000 dollars a year. The high end is four full years of undergraduate study plus a private medical school closer to 65,000 dollars a year. Both include the medical school admission test at around 345 dollars, 3,000 dollars or more in applications and interview travel, the three steps of the national licensing examination, and the written and oral board exams after residency. Residency is paid, but most graduates who borrow leave school around 200,000 dollars in debt, and nonprofit hospital work can cancel the balance after ten years of payments.
Medical graduates who borrow typically finish around $200,000 in debt. Working for a nonprofit hospital or a university makes you eligible for the Public Service Loan Forgiveness program, which clears the balance after ten years of payments.
Malpractice insurance paid
Standard in employed jobs, and in this specialty that is worth a great deal of money.
Signing bonuses and loan repayment
Common outside big cities, because many rural hospitals have closed their maternity units for lack of staff.
Two careers in one
You operate and you run a clinic. If you get tired of one side, you can shift the balance.
Long patient relationships
You look after people for decades, and often deliver the babies of women you first met as teenagers.
The exact path from high school to qualified.
Twelve years after high school before you practice on your own.
High school
Grades 11 and 12
Biology, chemistry, physics and math, with the grades for a competitive college.
Bachelor's degree
4 years
Any major, as long as you finish the pre-medical science courses and sit the MCAT (Medical College Admission Test).
Medical school
4 years
Two years of science, two years of hospital rotations. You graduate a Doctor of Medicine or a Doctor of Osteopathic Medicine.
Residency
4 years
Four years of obstetrics and gynecology: deliveries, operating room, clinic, emergencies. Paid and supervised throughout.
Board certification
After residency
The American Board of Obstetrics and Gynecology requires written and oral examinations, and the oral one comes after you have been in practice.
Fellowship, if you want one
3 years
Maternal-fetal medicine, fertility, gynecologic oncology or urogynecology. Optional, and each adds three years.
Biology
Reproduction, hormones and development. The whole specialty is built on it.
Chemistry
Required for every pre-medical program, and hormone medicine is chemistry.
Physics
Ultrasound is physics, and you will use it in almost every appointment.
Anything that trains your hands
This is a surgical specialty. Fine motor skill matters and it can be practiced.
Residency in this specialty is moderately competitive to match into, well short of dermatology or neurosurgery. Getting into medical school at all is the harder step.
Every state licenses physicians through its own medical board, and you hold a separate license in each state where you practice. The exams are national: the three steps of the United States Medical Licensing Examination during medical school and residency, then certification by the American Board of Obstetrics and Gynecology, a nonprofit that has been certifying physicians for over 99 years and lists more than 38,000 current holders. Certification is technically voluntary. In practice no hospital grants delivery privileges without it. Be aware too that state law around reproductive care now varies enormously, and it shapes what this job looks like where you live.
Public medical schools
Much cheaper for in-state residents, and many favor in-state applicants heavily.
Private medical schools
No state preference, considerably higher tuition.
Osteopathic schools
Award a Doctor of Osteopathic Medicine degree and train in the same residency programs.
Residency matching
Positions are assigned by a national computer match. You rank programs, they rank you, and an algorithm decides.
Things you don't need, but that help.
Maternal-fetal medicine
High risk pregnancy. Three more years, and the person everyone calls when something is wrong.
Gynecologic oncology
Cancer surgery and chemotherapy. The most surgical route out of this specialty.
Reproductive endocrinology and infertility
Fertility treatment. Clinic based, predictable hours, and often the best paid.
Urogynecology
Pelvic floor surgery, mostly in older patients. Steady work with no overnight deliveries.
Ability to function without sleep
Babies arrive at 3am and there is no version of this job where that is not true.
Calm in an emergency
Obstetrics goes from routine to life threatening in under a minute, more than almost any other field.
Comfort with hard conversations
Miscarriage, infertility and cancer are all part of an ordinary week.
Research during medical school
Helps for competitive fellowships and for academic jobs later.
A lot of obstetrician-gynecologists eventually drop the obstetrics half and practice gynecology only. The hours become predictable, the malpractice premium falls, and the work becomes clinic and scheduled surgery. It is a normal mid-career move rather than a retreat, and it is worth knowing early that the specialty has that exit built into it. The opposite also exists: some doctors do almost nothing but deliveries, working shifts on a labor ward the way an emergency physician works an emergency department.
Day to day, pros and cons, where you'd work.
Rounds at 6:30am on the women who delivered overnight. Then the operating room for a scheduled hysterectomy, gown on by 7:45. Clinic from noon: a first pregnancy scan, a contraception visit, a woman with bleeding who is frightened about what it means. At 4pm someone on the labor ward goes from normal to an emergency cesarean and you are in theatre in eight minutes. You finish notes at 7pm, and if you are on call you go back in at 2am for a delivery that will not wait.
The good
The hard parts
Things people don't tell you.
The American Board of Obstetrics and Gynecology has been certifying physicians for over 99 years and lists more than 38,000 current holders of its certificate.
Very few doctors both operate regularly and see routine patients for checkups year after year. This is one of the only fields where the same person does both all week.
Employment in this occupation is projected to grow slowly. That sits oddly beside the fact that rural maternity units keep closing for lack of staff: the shortage is about where doctors are, not how many exist.
Certification is not finished when residency ends. The board requires an oral examination taken once you have been in practice, based partly on a log of the cases you actually handled.
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.