Every Canadian weighing two residency systems eventually opens a spreadsheet and puts two salaries side by side. We understand the impulse, and we have done it.
The spreadsheet is the easy part. The hard part is that the two columns measure different things. This article gives the Canadian numbers from CaRMS, explains what we could and couldn’t confirm on the American side, and lists what changes the comparison.
What Canadian Residents Are Paid
CaRMS publishes first-year (PGY-1) salary by province. Here is what the pages said when we checked them on 14 October 2026, in Canadian dollars per year. [1]
Ontario is listed at $73,367.35, on a page dated 6 January 2025. British Columbia is $71,390.44, with a note that it takes effect after 1 April 2027. Alberta is $67,440. Quebec is $58,728. Nova Scotia, which CaRMS says is shared with New Brunswick and Prince Edward Island, is $78,578. [1]
The page doesn’t label these as annual; we are reading them as annual from their size. The Ontario figure is also more than a year old, so confirm the current collective agreement.
What We Could Not Confirm for the US
We tried to pull the current American figure from the AAMC’s survey of resident and fellow stipends, and the page wouldn’t load for us. Other sites publish averages, but they aren’t primary sources and some contradict each other, so we aren’t printing a US number.
US residency salaries are set by each hospital or program and published on program websites. Use that number rather than a national average.
Why Headline Numbers Mislead
The currency is the first problem. A US salary in US dollars and a Canadian salary in Canadian dollars can’t be compared until you convert, and the exchange rate moves. A comparison that looked good in January can look different by June.
Taxes are the second. US residents pay federal tax and, depending on where they train, state or local tax. Canadian residents pay federal and provincial tax. The effective rates differ, and for a Canadian in the US there are cross-border rules, which we cover in our guide to taxes for Canadians doing residency in the US.
Cost of living is the third. A salary in a large coastal American city and one in a mid-sized Canadian city buy very different lives. A raw number says nothing about what is left after rent.
Visa costs are the fourth. A J-1 or H-1B comes with fees, legal costs and, for the J-1, a two-year home-country requirement afterwards. We wrote about the trade-offs in our visa article.
Hours and benefits are the fifth. Health coverage, parental leave, call stipends, moving allowances and housing support differ, and they all have a dollar value.
Debt Changes the Calculation
For most Canadians trained abroad, the salary question is really about servicing borrowing. Interest-only payments on a professional line of credit continue during residency, and the balance usually doesn’t shrink. We explained that in our debt article.
So a higher salary matters less than it looks if the borrowing is the same and the extra income goes on tax, rent or exchange rates. A return-of-service commitment, which affects where you live, can also change what you take home after expenses. We discuss that in our article on Ontario return of service.
How We Would Compare Two Offers
We would take the specific program salary rather than the national average. We would convert to one currency at a conservative rate, subtract an estimate of tax for that jurisdiction (ideally from a cross-border accountant), and subtract rent for the actual city. Then we would add the one-off costs of moving, visas and licensing in each country.
It takes an afternoon, and the answer is far more realistic than two headline figures.
The Bottom Line
CaRMS lists first-year resident pay at $73,367.35 in Ontario, $71,390.44 in British Columbia (from April 2027), $67,440 in Alberta, $58,728 in Quebec and $78,578 in Nova Scotia, New Brunswick and PEI. We couldn’t confirm a current American figure from a primary source, so we aren’t printing one.
Compare the actual programs you might attend, in one currency, after tax and rent. Salaries change with agreements, so use the CaRMS pages and each program’s own site rather than this article. Our Resources page lists them.
References
- CaRMS. (2026). R-1 Main Residency Match: salary. https://www.carms.ca/match/r-1-main-residency-match/salary/