Infectious disease remains among the lowest-paid specialties in medicine, according to Doximity’s Physician Compensation Report 2025.
With an average annual compensation of $320,730, ID ranked among the 20 specialties with the lowest pay, many of which were pediatric and primary care specialties such as internal medicine, preventive medicine, and pediatrics. Pediatric infectious disease fared even worse, as the third least compensated specialty, with an average annual salary of $248,322.
The report, issued July 31, 2025, is based on data collected from more than 37,000 full-time physicians in 2024.
“This is not a surprise, but it is definitely indicative of a serious problem that I know IDSA [Infectious Diseases Society of America] has prioritized and is working hard to correct,” said Amanda Jezek, the senior vice president for public policy and government relations at IDSA. “When we think about compensation, it’s not in a vacuum. We have to consider it in terms of the workforce and in terms of what hospitals, health systems, and the American public really need. As medical care grows increasingly complex, as we have an aging population, a population that is taking more biologics and other medications that can weaken the immune system, we have an increasing need for infectious diseases specialists. That’s not even taking into account the increasing rates of outbreaks that are associated with climate change and the fact that we may very well see another pandemic in our lifetimes.”
Unfortunately, the ever-increasing need for ID physicians and their expertise is not reflected in the healthcare payment system. “How do we look at this in a way that compensation can be appropriate to ensuring that we have enough infectious disease specialists to meet the American public’s needs?” Ms. Jezek asked.
She noted that IDSA has launched an initiative to provide members with resources and training to help them better negotiate for improved compensation. The ID Physician Compensation Initiative includes tools like a “Compensation Negotiation Playbook,” a guide to value-based arrangements that helps ID physicians negotiate compensation aligned with quality, outcomes, and cost-saving performance, as well as the “ID Compensation Conversation” series, live webinar sessions led by experts that cover compensation models, value-based contracting, and negotiation techniques.
Related Content
Growing Compensation
The increased resources appear to be paying off—although the Doximity survey still showed ID in the bottom 20 of the compensation ladder, the Medscape Physician Compensation Report 2025, issued in July, found that the specialty experienced a 6% overall increase in pay over the past year, outpaced only by diabetes/endocrinology at 7%.
“We have also been working at a federal policy level to improve compensation overall,” Ms. Jezek said. “Last year, working with the Centers for Medicare & Medicaid Services, we were able to get a new add-on code created for complex infectious disease care. When our physicians are providing services that are so complex that they go far above and beyond what typical evaluation and management codes will cover, they’re able to use this code. It just went into effect at the beginning of 2025, so we are still gathering data to assess its impact, but we are excited to at least have this tool to make sure compensation more accurately reflects the complexity of the work being done.”
IDSA is also exploring strategies to better position ID physicians to participate in value-based arrangements. “We know that infectious disease care and services like antimicrobial stewardship provide tremendous value and save money, but our physicians aren’t really able to share in the savings that their work generates,” Ms. Jezek explained.
The growing burden of medical school debt is one of the reasons more physicians are drawn to the more lucrative, higher-paying specialties, she noted. “Every year we hear a lot of medical students and residents say, ‘Oh, I love ID, it’s such a fascinating specialty, but I have to pay back these student loans.’ So we’re also working on legislation that would help address the student loan issue and provide student loan repayment for infectious diseases physicians that work in underserved areas.”
Pressure on the Specialty
Given the adversarial stance that the current leadership of the Department of Health and Human Services has taken toward ID prevention, including dismantling vaccine programs, Ms. Jezek expressed concern that the specialty’s pipeline could be affected. “I think it will be very interesting to see what the next fellowship match looks like, to see if there is any change upward or downward,” she said. “Over the past two years, we had about 50% of programs filling, which is already far below where most other specialties are. And when we hear about proposed funding cuts at the NIH [National Institutes of Health], that is a huge concern because we know that funding from the National Institute for Allergy and Infectious Disease is an important resource for training new ID positions and sustaining careers for those who want to go the physician-scientist route.”
How Does ID Compare?
Infectious disease boasts one of the smallest gender pay gaps of any medical specialty. According to the Doximity report, male ID physicians reported an average salary of $333,055, compared with $294,649 for their female counterparts. That’s a difference of 11.5%, compared with disparities of 15.5% to 16.5% for the specialties with the greatest pay gaps, which included pediatric nephrology, allergy and immunology, ophthalmology, plastic surgery, and gastroenterology.
Overall, the Doximity report found that average physician compensation in the United States increased 3.7% from 2023 to 2024, a slightly lower increase than the 5.9% reported in the prior year. “This modest growth comes amid several consecutive years of reimbursement cuts—a trend that many physicians worry could impact their ability to care for Medicare and Medicaid patients in the near future,” the report noted. “Many physicians also believe that current reimbursement policy has contributed to the steady decline of independent practices in their fields. According to the American Medical Association, the share of physicians working in private practices dropped by 18 percentage points—from 60.1% to 42.2%—between 2012 and 2024.”
Ms. Jezek reported no relevant financial disclosures.