Healthcare Recruiting
OB/GYN Compensation 2026: Generalist, Laborist, MFM, Urogyn, Gyn-Onc — National Pay Tables, Call Math
OB/GYN in 2026 has fragmented into multiple distinct career paths with different lifestyle and compensation profiles. The generalist OB/GYN doing a full scope (obstetrics + gynecology + surgery + call) is increasingly rare — most OB/GYNs are now choosing one of the specialized tracks early in their career.
This guide covers what OB/GYNs are actually earning across all major paths in 2026, including the laborist model that has changed obstetric staffing nationally.
National compensation by track — 2026
| Track | Median (W-2) | 25th | 75th |
|---|---|---|---|
| Generalist OB/GYN (full scope) | $385,000 | $335,000 | $455,000 |
| OB-only (laborist / OB hospitalist) | $345,000 | $295,000 | $405,000 |
| GYN-only (no obstetrics) | $365,000 | $315,000 | $425,000 |
| Maternal-Fetal Medicine (MFM) | $445,000 | $385,000 | $525,000 |
| Urogynecology | $425,000 | $375,000 | $505,000 |
| Gynecologic oncology | $485,000 | $425,000 | $575,000 |
| Reproductive endocrinology / fertility | $465,000 | $405,000 | $565,000 |
Laborist model — what it means for OB comp
The laborist (OB hospitalist) model has rapidly grown since 2018. Laborists work shift-based hospital coverage doing obstetric care without continuity-of-care patient panel:
- Schedule: 24-hour shifts, typically 7–10 shifts/month (180–240 hours/month)
- Comp structure: Hourly $145–$225 or shift-rate $2,400–$3,800 per 24-hour shift
- Total annual: $295K–$405K depending on shift count
- No clinic, no continuity, no late-night call from home
The laborist trade-off: lower total comp than generalist OB/GYN but no clinic, no continuity, and predictable schedule. Particularly popular with mid-career OB/GYNs experiencing burnout from generalist call.
Generalist call math
The generalist OB/GYN call schedule is the make-or-break lifestyle variable:
| Call structure | Frequency | Stipend |
|---|---|---|
| Solo call (small practice) | 1:1 (every other weekend) | Built into base |
| Small group (2–4 OBs) | 1:2 to 1:4 | Often unpaid |
| Large group (6–10 OBs) | 1:6 to 1:10 | $1,500–$2,500/24-hour shift |
| Group with laborist coverage | 1:8 to 1:12 | $2,000–$3,000/shift |
RVU targets
- Generalist OB/GYN: 7,500–9,500 wRVU target, $52–$68/wRVU
- OB-only / laborist: Hourly model, no RVU bonus typical
- GYN-only: 6,500–8,500 wRVU target, $58–$72/wRVU
- MFM: 6,000–7,500 wRVU target, $65–$82/wRVU
- Gyn-onc: 8,500–10,500 wRVU target, $68–$85/wRVU (long surgical cases)
Malpractice — the OB tax
OB malpractice premiums are the highest in medicine outside of neurosurgery. Annual premium ranges:
- OB-only / laborist: $35K–$95K (lower because no clinic continuity)
- Generalist OB/GYN: $65K–$185K depending on state
- GYN-only: $18K–$45K (no obstetric exposure)
- MFM: $85K–$245K (high-risk patient population)
State variation is enormous. Florida, New York, and Illinois have the highest OB premiums; California has high baseline malpractice but moderate for OB given MICRA caps. Texas tort reform has reduced OB premiums significantly since 2003.
Hospital-employed OB/GYNs typically have malpractice covered by the hospital. Private group OB/GYNs pay premiums out of practice gross — so net income is base minus malpractice. A $400K base in a private group with $145K malpractice produces $255K net malpractice cost.
Top-paying states — 2026
- South Dakota: Generalist $475K — rural premium
- Iowa: $445K generalist
- Mississippi: $435K generalist, $545K MFM
- Wisconsin: $425K generalist (Mayo / Aurora ecosystems)
- Oklahoma: $415K generalist
For laborists, geography matters less — most laborist programs pay similar shift rates nationwide.
Locum tenens rates
- Generalist OB/GYN: $2,200–$3,000/day, $275–$375/hour
- Laborist (24-hour shift): $2,800–$4,200/shift
- GYN-only: $1,800–$2,400/day
- MFM: $2,800–$3,800/day
- Gyn-onc (case-by-case): $4,000–$6,500/case
What we see at Ava Health
The fastest-growing OB/GYN placement category in 2026 is laborist roles. We've placed 11 OB/GYNs into laborist programs in the last 12 months — most are mid-career generalists transitioning out of clinic continuity for lifestyle reasons. The shift comp ($2,800–$3,400/24-hour) at 8–10 shifts/month produces total annual comp of $290K–$345K with no clinic, no continuity, no malpractice premium, and predictable schedule.
For OB/GYNs considering specialty fellowships: MFM is the highest-pay-to-effort fellowship in OB. Three-year fellowship unlocks $80K+ comp delta over generalist with significantly lower malpractice. Gyn-oncology offers the highest absolute comp but requires intensive surgical training and high-acuity case load.
The hardest-to-fill OB positions: rural community generalist OB/GYN with solo call. We see 3+ open positions for every qualified candidate willing to take rural solo call. The compensation premium is meaningful ($475K vs $385K national median) but the lifestyle cost is severe.
Related: OB/GYN Salary by State 2026, Physician Burnout Crisis 2026, Physician Contract Negotiation Levers.
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