Salary Levels by Experience
| Experience Level | Salary Range | Est. Annual Net |
|---|---|---|
| EM Resident | $70,000–$95,000 | ~$62,483 |
| Junior Attending | $324,000–$421,000 | ~$228,757 |
| Senior Attending | $410,000–$508,000 | ~$273,565 |
| Medical Director | $486,000–$648,000 | ~$329,023 |
Tax Breakdown at $400,000 (Bi-Weekly)
| Component | Per Paycheck | Annual | % of Gross |
|---|---|---|---|
| Gross Pay | $15,384.62 | $400,000 | 100% |
| Federal Income Tax | −$4,011.42 | −$104,297 | 26.1% |
| CA State Income Tax | −$1,308.88 | −$34,031 | 8.5% |
| FICA (SS + Medicare) | −$712.23 | −$18,518 | 4.6% |
| Net Take-Home | $9,352 | ~$243,153 | 60.8% |
What Drives Emergency Medicine Physician Pay in San Francisco
Emergency medicine physicians in New York City staff the nation's most visited emergency departments, handling patient volumes that exceed most other U.S. markets. The combination of high acuity cases, a large uninsured and underinsured population, and 24/7 operational demands makes NYC EM one of the most demanding — and well-compensated — specialties in the city.
NYC emergency departments managed by large hospital systems like Northwell often employ physicians on productivity models that can boost earnings above base salary. The shift-based schedule of emergency medicine also makes moonlighting at urgent care centers or freestanding EDs feasible, adding $30,000–$60,000 in supplemental income for many attending physicians. NYC's Level I trauma centers command the highest pay due to case complexity.
- Trauma center level and patient volume
- Shift differential for nights and weekends
- Academic appointment and teaching responsibilities
- Medical directorship or administrative role
Top San Francisco Employers
Major employers hiring emergency medicine physicians in San Francisco include: UCSF, Kaiser SF, Sutter Health, California Pacific Medical Center.
Tax note: An emergency medicine physician earning $370,000 in NYC will owe approximately $160,000–$180,000 in combined federal, state, and city income taxes, making employer-sponsored deferred compensation plans highly valuable.
Frequently Asked Questions
An emergency medicine physician earning $400,000 in San Francisco takes home approximately $243,153 per year, or $9,352 per bi-weekly paycheck, after all taxes. The effective tax rate is 39.2%.
San Francisco emergency medicine physician salaries range from $70,000–$95,000 at entry level to $486,000–$648,000 for senior professionals. The median mid-career salary is approximately $400,000.
Most San Francisco EM attendings work 12–15 shifts per month (roughly 1,440–1,800 hours per year), with each shift typically 9–12 hours; this below-average hours structure relative to other specialties partially offsets the demanding pace and contributes to EM's strong lifestyle-adjusted compensation.
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