Doctor (ishi, 医師) take-home pay in Japan after tax, 2026
A kinmui, or hospital doctor, is a salaried employee inside shakai hoken exactly like any other company worker, which is nothing like the independent practice model common elsewhere. The monthly figure also conceals the largest single component of Japanese physician pay, the twice-yearly shoyo bonus. What each grade keeps, monthly and across the year, follows.
What each grade nets in 2026
Every figure is total annual gross, the nenpo, with typical summer and winter shoyo included. Coming off are shotokuzei plus the 2.1% reconstruction surtax, juminzei at 10% of taxable income, and shakai hoken covering health insurance, the kosei nenkin pension and employment insurance at a combined 15.22% of gross.
| Grade | Gross Salary | Monthly Net | Effective Rate |
|---|---|---|---|
| Kenshui (resident, yr 1-2) | ¥4,200,000 | ¥273,230/mo | 31.8% |
| Newly-qualified kinmui hospital doctor | ¥6,500,000 | ¥411,266/mo | 36.7% |
| Mid-career hospital specialist | ¥10,000,000 | ¥588,723/mo | 41.1% |
| Senior physician / department head | ¥15,500,000 | ¥834,937/mo | 47.4% |
| Independent clinic owner (kaigyoi, example) | ¥25,000,000 | ¥1,208,299/mo | 53.7% |
The monthly net simply divides annual net, bonus included, by twelve so it can be compared with other countries, and the section below explains why an actual payslip looks smaller. Clinic owner figures are illustrative only, since real kaigyoi income turns on patient volume, specialty and whether the building is owned or rented. Source: Japan Medical Association and MHLW physician salary survey, 2026.
Shoyo, and why the monthly salary understates everything
The kihonkyu base monthly salary looks unremarkable against Western comparisons, often ¥350,000 to ¥450,000 a month for a mid-career specialist. What closes the gap is shoyo, the twice-yearly bonus arriving around June or July and again in December, on top of the twelve ordinary 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 is why setting Japanese physician pay beside countries where bonuses are rare or discretionary misleads so easily, given that real annual income usually runs 20% to 40% above twelve times base salary. It also makes cash flow planning matter, and plenty of younger doctors budget around the base-only months while treating the bonuses as separate savings rather than smoothing spending across the year.
Employed doctor or clinic owner: the widest gap in Japanese medicine
Neither specialty nor hours decides a Japanese doctor's income as much as employment status does. A kinmui is salaried staff under shakai hoken, bound to the hospital's pay scale however many patients pass through. A kaigyoi running their own jiin keeps whatever the practice earns after costs, and MHLW economic surveys consistently put kaigyoi income well above kinmui at equivalent seniority.
Behind all of that lies a well-documented history of hours. Hospital medicine here was notorious for extreme overtime until the hatarakikata kaikaku work-style reforms, phased in for doctors from 2024, capped resident and hospital doctor overtime at statutory limits for the first time. Clinic owners largely set their own hours, and combined with the income gap that makes opening a clinic later in a career, usually after fifteen to twenty years of hospital training and specialty certification, an increasingly common and entirely rational move for doctors who want both more money and more control.
Where Japanese hospital doctors fall on the pay range
| Percentile | Gross Annual | Monthly Net |
|---|---|---|
| P25 (newly-qualified kinmui) | ~¥6,500,000 | ~¥411,266/mo |
| P50 Median (mid-career specialist) | ~¥10,000,000 | ~¥588,723/mo |
| P75 (senior physician / department head) | ~¥15,500,000 | ~¥834,937/mo |
| P90 (clinic owners / top hospital consultants) | ~¥25,000,000+ | ~¥965,312+/mo |
The distribution mixes salaried hospital doctors with independent clinic owners, and the P90 band belongs largely to kaigyoi and to senior university hospital consultants carrying private-patient or research income above their salary. Source: Japan Medical Association and MHLW physician salary survey, 2026.
Frequently asked questions
A kenshui resident on ¥4,200,000 for the year, any resident bonus included, keeps around ¥273,230 a month on average. A newly qualified kinmui hospital doctor on ¥6,500,000 keeps about ¥411,266, and a mid-career hospital specialist on ¥10,000,000 roughly ¥588,723. Independent clinic owners pass ¥25,000,000 and keep around ¥1,208,299 a month on average.
Paid in summer and winter on top of twelve months of base salary, shoyo is Japan's twice-yearly bonus. For hospital doctors the two together are frequently worth three to six months of base pay, and both are taxed exactly as salary is. Base monthly pay therefore understates real income by a wide margin, which is why the figures on this page spread base plus both bonuses across twelve months to show a realistic monthly take-home.
MHLW physician economic surveys consistently show independent clinic owners earning substantially more than hospital-employed doctors at equivalent seniority, since they keep clinic profit instead of drawing a fixed salary. What comes with it is business risk, setup costs paid upfront and no guaranteed income, which is why most doctors open a clinic only after fifteen to twenty years spent building a specialty and a referral network inside hospital practice.
An employed doctor pays shakai hoken, covering health insurance, the kosei nenkin pension and employment insurance, which comes to 15.22% of gross salary. On top sit national income tax, progressive from 5% to 45% with a 2.1% reconstruction surtax, and residence tax at a flat 10% of taxable income billed a year in arrears. Together these take roughly 32% to 48% of gross across the grades in the table above, and more again for high-earning clinic owners and senior consultants.