How to become a pediatrician

1. 1Earn a bachelor's degree with premed courses

   Time: 4 yearsCost: Undergraduate tuitionSources 1

   Medical schools accept any major, but you need the standard premed sciences: biology, general and organic chemistry, physics and usually biochemistry, plus strong grades. For a future pediatrician, the most useful extras involve children: volunteering in a children's hospital, tutoring, coaching or working at a camp for kids with chronic illness. Shadowing a general pediatrician shows you how much of the day is prevention, parent education and routine illness rather than rare disease.

2. 2Take the MCAT and apply to medical school

   Time: About 1 yearCost: $360 MCAT; AMCAS $180 + $48 per added schoolSources 2, 3, 1

   The MCAT costs $360 for 2027 test dates, or $145 for students approved for AAMC Fee Assistance. MD applications go through AMCAS, which charges $180 for the first school and $48 for each additional school. Applicants to osteopathic (DO) schools use a separate service. After the primary application come secondary essays and interviews. Some students skip this step by entering a combined bachelor's-MD program straight from high school.

3. 3Complete medical school and the first licensing exams

   Time: 4 yearsCost: Median federal debt $208,644Sources 4, 5, 12

   Years one and two are mostly classroom and lab science; years three and four are clinical rotations, including a pediatrics clerkship. MD students take USMLE Step 1 and Step 2 CK ($695 each for 2026 and 2027), while DO students take COMLEX Level 1 and Level 2-CE ($745 each). In the final year you apply to pediatrics residencies through the national Match, choosing between categorical pediatrics or a combined program such as internal medicine-pediatrics.

4. 4Complete a 3-year pediatrics residency

   Time: 3 years (36 months)Cost: Paid as a residentSources 6, 4, 5

   ACGME requires pediatrics residencies to last 36 months. Training includes at least 24 weeks of inpatient medicine, 12 weeks of intensive care (including 4 weeks each in the PICU and NICU), 4 weeks of newborn nursery, 12 weeks of emergency and acute illness care, and 4 weeks each of adolescent medicine, mental health and developmental-behavioral pediatrics. Throughout, residents run their own continuity clinic, at least 36 half-day sessions a year, following the same panel of patients. Most take USMLE Step 3 ($955) or COMLEX Level 3 ($950) during residency.

5. 5Get a full state medical license

   Time: A few weeks to several monthsCost: State license fee (varies)Sources 13, 1, 7

   Every state requires physicians to be licensed by its medical board. Boards generally want proof of medical school graduation, passing scores on all three USMLE steps or COMLEX levels, and completed postgraduate training, plus a background check. The rules and fees differ by state, so check your board's requirements through the CareerOneStop License Finder early. A full, unrestricted license is also a condition for sitting the pediatrics board exam.

6. 6Pass the ABP certifying exam

   Time: Offered once a year in OctoberCost: $2,337 (2027 regular registration, new applicants)Sources 7, 8, 14

   The American Board of Pediatrics gives the General Pediatrics Initial Certifying Examination at computer testing centers once a year; in 2027 it runs October 12, 13 or 14. Applicants must have completed the full three-year ACGME residency and must send the ABP a valid, unrestricted US or Canadian medical license by October 1. Regular registration costs $2,337 for new applicants, and late registration costs $2,682. You must certify within seven years of finishing training or complete supervised practice to regain eligibility.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Communicating with parents

Most visits run through a parent or guardian, so pediatricians must explain diagnoses, vaccine questions and treatment plans in a way anxious families understand and accept.

Putting children at ease

A frightened toddler or a guarded teenager will not cooperate with an exam or share what is wrong unless the doctor adapts tone and approach to the child's age.

Knowledge of normal development

Spotting a speech delay, a growth problem or early signs of autism depends on knowing exactly what is typical at each age.

Clinical judgment under uncertainty

Young children cannot describe symptoms, so pediatricians must tell a routine fever from sepsis or meningitis using exam findings and a few tests.

Precise dosing and attention to detail

Children's drug doses are calculated by weight, and a decimal-point error can cause serious harm.

Patience

Days include many short visits, repeated questions and families who are skeptical of vaccines or treatment, and calm persistence keeps care on track.

O*NET 31.0 rates these skills as most important for the occupation: speaking, critical thinking, reading comprehension, active listening, writing.

Training cost

$215K–$215K

Before financial aid

Time

11 years

Typical path

Median pay

$210,040

All US jobs: $50,980

Payback once qualified

1.3–1.4 yrs

Pay above the all-jobs median vs. cost

Counts typical medical school borrowing plus the fixed test and certification fees, not the full price of training. Base: $208,644, the College Scorecard median federal loan debt for medicine first professional degree graduates. Low adds the MCAT ($360), AMCAS applications to 15 schools ($180 + 14 x $48 = $852), USMLE Step 1, Step 2 CK and Step 3 ($695 + $695 + $955) and the ABP General Pediatrics certifying exam for new applicants ($2,337, 2027 regular registration). High swaps in AMCAS for 30 schools ($1,572) and COMLEX Levels 1-3 ($745 + $745 + $950). Excludes college tuition, loan interest, residency application and travel costs, state license fees and living costs. Residents are paid during the 3-year residency.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Pediatric cardiologist$496,010 median

  Complete an ACGME pediatric cardiology fellowship after pediatrics residency and pass the ABP subspecialty exam; general pediatrics certification comes first.

• Child neurologist$248,560 median

  Train in an ACGME child neurology program, which combines pediatrics training with neurology; the ABP offers a combined pediatrics-neurology pathway.

• Neonatologist

  Complete a three-year neonatal-perinatal medicine fellowship and earn ABP subspecialty certification to run a NICU.

• Child and adolescent psychiatrist$281,870 median

  Requires psychiatry training: either a psychiatry residency followed by child and adolescent psychiatry fellowship, or a five-year combined pediatrics, psychiatry and child psychiatry program. A pediatrics background helps with the medical side of children's mental health.

• Practice partner or medical director

  With experience, pediatricians can buy into a group practice or lead a clinic, hospital department or residency program, which adds management and teaching duties.