Which careers pay the most in the US, and what does it take to get there?
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If you’re aiming for top earnings, the US labor market offers several clear paths—from physician specialties to airline pilots and senior tech managers. But the right choice blends pay, time to qualify, day‑to‑day work, and long‑term demand. Below you’ll find current, sourced pay figures and what it takes to get into each path, plus a simple way to compare options and act on your choice.
BLS lists the top 20 occupations by 2025 median pay. Highlights:
| Occupation | 2025 median pay (national) | Typical entry education/training signal |
|---|---|---|
| Pediatric surgeon | $559,030 | MD/DO + 5–7 years residency/fellowship (varies by specialty); see OOH list for pay by specialty |
| Cardiologist | $496,010 | MD/DO + internal medicine residency + cardiology fellowship |
| Oral and maxillofacial surgeon | $352,220 | Dental degree (DDS/DMD) + surgical residency |
| Nurse anesthetist (CRNA) | $236,590 | RN + 1+ year critical‑care experience + graduate anesthesia program |
| Airline pilot (airline pilots, copilots, flight engineers) | $232,140 | FAA licenses up to ATP; generally 1,500 flight hours (with limited reductions) |
| IT manager | Around mid‑$170Ks | Bachelor’s in IT/computing + years of technical experience |
Sources: pay from the BLS highest‑paying list and the BLS pilots profile; training timelines from the AAMC, AANA and FAA; IT manager entry expectations from the BLS IT managers profile.
According to the Occupational Outlook Handbook, the highest 2025 median pay figures include pediatric surgeons ($559,030), cardiologists ($496,010), radiologists ($420,860), oral and maxillofacial surgeons ($352,220) and nurse anesthetists ($236,590). Airline pilots (airline pilots, copilots, and flight engineers) show a $232,140 median. Figures are national medians before bonuses or overtime. Sources: BLS highest‑paying occupations and the BLS pilots profile.
Physicians typically require 11–16 years including college, medical school and residency, depending on specialty, per AAMC guidance. Nurse anesthetists usually invest about 7–8.5 years including RN experience and graduate training, notes the AANA. Airline pilots need FAA licenses up to the Airline Transport Pilot certificate, which generally requires 1,500 flight hours (with limited reductions under specific programs).
BLS projects robust growth across healthcare roles through 2024–34 and fast growth in computer and mathematical occupations overall (+10.1%). Specific examples: nurse practitioners rank among the fastest‑growing healthcare roles; information security analysts and data scientists are among the fastest‑growing in tech. See BLS Monthly Labor Review 2026 overview of 2024–34 projections.
BLS medians are wages from employer-reported data—cash pay before overtime, bonuses, equity or benefits. Real offers can exceed medians (especially with bonuses, call pay or equity), but medians are useful for comparing occupations on an apples‑to‑apples basis.
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