Doctor (ishi, 医師) salary in Japan after tax — 2026

Take-home pay by grade — 2026

Figures are total annual gross (nenpo) including typical shoyo (summer and winter bonus). Deductions are national income tax (shotokuzei) plus the 2.1% reconstruction surtax, residence tax (juminzei, 10% of taxable income), and shakai hoken — health insurance, kosei nenkin pension, and employment insurance (15.22% combined on gross).

Monthly net is the annual net figure (including bonus) divided by 12 for comparability — see below for why the actual monthly payslip looks smaller than this. Clinic owner (kaigyoi) income is illustrative only; real income depends heavily on patient volume, specialty, and whether the clinic building is owned or leased. Source: Japan Medical Association (JMA) / MHLW physician salary survey 2026.

Shoyo — why a doctor's "monthly salary" understates real pay

Japanese hospital doctors are paid on a base monthly salary (kihonkyu) that, taken alone, looks modest by Western standards — often ¥350,000–450,000/month for a mid-career specialist. What closes the gap is shoyo: a biannual bonus paid in summer (around June/July) and winter (around December), on top of the 12 monthly payments.

• Typical hospital doctor bonus: often equivalent to 3–6 months of base salary combined across both payments, though public and university hospitals vary the exact multiple by year and department budget
• Take-home impact: the tables on this page use total annual gross (base + both bonuses) divided by 12 to give a realistic average monthly net — the actual payslip in a non-bonus month will show noticeably less, and the June/July and December payslips noticeably more
• Tax treatment: shoyo is fully taxable income, subject to the same shotokuzei, juminzei, and shakai hoken structure as regular salary — there is no separate lower bonus tax rate in Japan

This also explains why comparing Japanese physician pay to countries where bonuses are rare or discretionary can be misleading — a Japanese doctor's real annual income is usually 20–40% higher than "base salary × 12" would suggest. It also means cash-flow planning matters: many younger doctors budget around the base-only months and treat the bonus payments as separate savings, rather than smoothing spending across the year.

Employed doctor vs clinic owner — the widest gap in Japanese medicine

The single biggest determinant of a Japanese doctor's income isn't specialty or hours — it's employment status. Hospital-employed doctors (kinmui) are salaried staff under shakai hoken, subject to the hospital's pay scale regardless of how many patients they see. Independent clinic owners (kaigyoi) who run their own clinic (jiin) keep the practice's profit after costs, and MHLW physician economic surveys consistently show kaigyoi income running well above kinmui income at equivalent seniority.

There's also a well-documented working-hours backstory: Japanese hospital medicine was long known for extreme overtime, and it took the "hatarakikata kaikaku" (work-style reform) legislation, phased in for doctors from 2024, to cap resident and hospital-doctor overtime at statutory limits for the first time. Clinic owners largely set their own hours, which — combined with the income gap — makes opening a clinic later in a career (typically after 15–20 years of hospital training and specialty certification) an increasingly common and financially rational path for Japanese physicians who want both higher pay and more control over their schedule.

Salary distribution — where Japanese hospital doctors sit

Distribution blends employed hospital doctors and independent clinic owners — the P90 band is dominated by kaigyoi and senior university-hospital consultants with private-patient or research income on top of salary. Source: Japan Medical Association (JMA) / MHLW physician salary survey 2026.