Physician Salary in Tennessee (2026)
The average Physician in Tennessee earns around $250,000/year. After taxes, your estimated take-home is $183,182/year ($15,265/month).
Take-Home Pay Breakdown
| Category | Amount |
|---|---|
Annual Take-Home Pay | $183,182 |
Monthly Take-Home Pay | $15,265 |
Biweekly Take-Home Pay | $7,045 |
Hourly Take-Home Pay based on 2,080 hrs/year | $88/hr |
Federal Tax | $51,304 |
State Tax | $0 |
FICA Taxes | $15,514 |
Effective Tax Rate total taxes ÷ gross salary | 26.73% |
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Physician Salary Ranges in Tennessee
Not all Physicians earn the same — not even close
TN physician practice splits across four coherent tracks. Hospital-employed (HCA + Vanderbilt UMC + Methodist + Ardent + Lifepoint + Erlanger) carries volume bench. Academic (Vanderbilt UMC + UTHSC + ETSU Quillen + UT Knoxville + Meharry) is the senior teaching + research tier. Private practice + specialty group practice across Nashville + Memphis + Knoxville is the entrepreneurial path. Federal-clinical (VA TN Valley + VA Memphis + VA Mountain Home + military at Fort Campbell KY border) rounds out senior tracks. St. Jude pediatric specialty is globally distinctive.
Specialty Surgeon (CT / Neurosurgery / Spine)
$685,000–$1,800,000+
Vanderbilt UMC · HCA TriStar · Methodist · Erlanger · 7-8 yr residency + fellowship · highest TN comp
Hospital-Employed Senior Attending (Specialty)
$485,000–$985,000
HCA · Vanderbilt UMC · Methodist · oncology · GI · cardiology · IR · 10+ yrs · partner-track
Vanderbilt UMC Academic Faculty (Senior)
$385,000–$885,000
Vanderbilt UMC top-25 AMC · clinical professor · DRS pension + 403(b) + research grant access
St. Jude Children's Senior Physician
$385,000–$785,000+
St. Jude Children's pediatric oncology · globally-distinctive specialty bench · research grant access
Hospital-Employed Mid-Career Attending
$315,000–$485,000
5-10 yrs · HCA / Vanderbilt UMC / Methodist / Ardent / Lifepoint employed
Private Practice Partner / Group Practice Owner
$385,000–$885,000+
Multi-physician practice ownership · S-corp distribution + practice equity · Nashville urban + suburban
New Attending (Year 1-3)
$245,000–$345,000
Post-residency · primary care + general surgery + non-procedural specialty · signing bonus $50-200K typical
Federal Clinical Physician (VA Tennessee Valley)
$215,000–$385,000
VA Nashville + Memphis + Mountain Home · GS-14/15 + locality + FERS + PSLF
Resident (PGY-1 through PGY-3)
$58,000–$78,000
Vanderbilt UMC + UTHSC + ETSU Quillen + UT Knoxville + Meharry · graduated salary increase
Fellow (Subspecialty)
$72,000–$95,000
Vanderbilt + UTHSC + Methodist · ACGME-accredited fellowship · 1-3 yrs post-residency
Worth knowing: St. Jude Children's Research Hospital + Vanderbilt UMC + the HCA Healthcare cluster are TN-distinctive specialty depth no other US market matches. St. Jude (~5K employees, $1.1B+ annual budget) is the world's leading pediatric cancer treatment + research facility — ~250+ attending physicians + residents + fellows. Senior St. Jude attendings clear $485-885K cash + grant-funded research access. Vanderbilt UMC (top-25 US academic medical center, ~3K affiliated physicians) anchors the academic tier with Vanderbilt-Ingram Cancer Center NCI-designated comprehensive cancer center + Vanderbilt Heart and Vascular Institute. HCA Healthcare (~50K+ employed physicians across ~190 hospitals + ~50 surgery centers) is the largest US physician employer outside Kaiser. TN joined IMLC in 2018 — licensure mobility across 41 member states.
The TN physician market — HCA + Vanderbilt UMC + St. Jude + VA, IMLC compact mobility, opioid crisis specialty depth
0%
TN state income tax — clinical income + practice distributions tax-free at state
41
IMLC member states accessible from TN license (TN joined Interstate Medical Licensure Compact 2018)
~50K+
HCA Healthcare TN-employed physicians + APPs — largest single US physician employer outside Kaiser
~250+
St. Jude Children's attending physicians — globally-distinctive pediatric specialty bench
Licensed physicians are exempt under the Learned Professional exemption. TN license requires MD or DO from LCME / COCA school + ACGME residency + USMLE / COMLEX + TN jurisprudence exam + TN Board of Medical Examiners review. Salaried at hospital-employed plus production-bonus structures. Private practice partners receive distributions + practice equity.
HCA Healthcare is the largest TN physician employer — ~50K+ employed physicians + APPs across ~190 hospitals + ~50 surgery centers. HCA TriStar Nashville employs ~3K Nashville-area physicians. HCA TN cluster spans rural + suburban + urban referral. Senior HCA-employed specialty surgical roles clear $585-985K cash + production. HCA partner-track adds equity.
Vanderbilt UMC is TN's top-25 US academic medical center. ~3K affiliated physicians across Medicine + Surgery + Pediatrics + OB-GYN + Anesthesia + Radiology. Vanderbilt-Ingram NCI-designated + Vanderbilt Heart and Vascular + Vanderbilt Eye Institute. Clinical professor $385-885K + DRS pension + + research grant access. Research in cardiovascular, autism, ADHD, oncology + Vanderbilt Kennedy Center.
St. Jude Children's Memphis is the globally-distinctive TN pediatric specialty bench. ~250+ attending physicians across pediatric oncology, hematology, infectious disease, surgery, neurology, plus survivorship clinic. Senior St. Jude attendings clear $485-885K cash + research grant access + globally-recruited mobility. Recent hires from CHOP + Boston Children's + Sloan Kettering Pediatrics + Princess Margaret Toronto.
VA TN Valley + VA Memphis + VA Mountain Home employ ~450+ attending physicians. Military / veteran specialty (PTSD, TBI, deployment trauma, polytrauma) drives sustained federal-clinical hiring. GS-13/14 / GS-15 + locality + FERS pension + eligibility makes VA federal-clinical the mid-career-stability path.
TN joined IMLC (Interstate Medical Licensure Compact) in 2018. TN physicians with IMLC standing can practice across 41 member states via expedited licensure (30-60 day turnaround vs 3-6 month traditional). For telemedicine + multi-state group practices + locum tenens, IMLC + TN 0% income tax create an attractive base. Senior multi-state physicians can serve CA / NY / IL / TX / FL with TN-based fee schedules + 0% state tax retention.
Opioid crisis depth drives addiction medicine + SUD specialty hiring across TN. TN has been among the most affected US states — overdose deaths peaked at ~3,800 in 2021 with sustained rates through 2024. Addiction-medicine boarded physicians (ABPM Addiction Medicine + ABAM) + buprenorphine-prescribing primary care + pain medicine + Vanderbilt Addiction Center + community mental health drive sustained hiring. X-waiver elimination post-2024 expanded the practitioner base.
Tennessee as a physician — HCA + Vanderbilt UMC + St. Jude + VA, IMLC compact mobility, opioid + addiction specialty
Nashville clinical + academic medicine centers on Vanderbilt UMC + HCA TriStar + ambulatory specialty. Vanderbilt UMC top-25 AMC + Vanderbilt-Ingram NCI-designated + Vanderbilt Heart and Vascular + Monroe Carell Jr. Children's + Vanderbilt Eye Institute. HCA TriStar Centennial + Skyline + Southern Hills. Methodist + Ardent + Lifepoint regional. Senior Vanderbilt clinical professors clear $385-885K + DRS pension.
St. Jude Children's Memphis is the globally-distinctive TN specialty bench. ~250+ attending physicians across pediatric oncology, hematology, infectious disease, surgery, neurology. 75-bed inpatient + outpatient + survivorship clinics. Recruits globally — CHOP + Boston Children's + Sloan Kettering + Princess Margaret Toronto. Senior attendings clear $485-885K cash + research grant access.
VA Tennessee Valley (Nashville + Murfreesboro) + VA Memphis + VA Mountain Home Johnson City together employ ~450+ attending physicians. Military / veteran specialty (PTSD, TBI, deployment trauma, polytrauma, SUD) drives sustained federal-clinical hiring. GS-13/14 / GS-15 + locality + FERS pension + eligibility makes VA federal-clinical the mid-career-stability path. VA Mountain Home serves East TN + Western NC + Southwest VA.
TN IMLC membership since 2018 + addiction medicine post-opioid crisis are TN-distinctive practice tracks. IMLC across 41 member states enables multi-state telemedicine + locum tenens with expedited licensure. Addiction medicine boarded physicians + buprenorphine-prescribing PCP + pain medicine + Vanderbilt Addiction Center + community mental health drive sustained SUD specialty hiring. Music industry medicine niche (Porter's Call adjacent + Country Music Mental Health Coalition addiction) is a parallel Nashville-distinctive specialty.
How TN taxes work for physicians — 0% income tax, practice-distribution efficiency, federal-AGI conformity, regressive sales-tax offset
TN charges 0% state income tax — substantial advantage at every physician comp tier. At new-attending $285K, TN saves ~$22,800 vs CA's 8.0% blended or NY's 7.5%. At senior specialty surgeon $785K, TN saves $62,800+ vs CA. Over 25-30 years, TN-vs-CA compounds to $1.5-2.5M+. Senior practice owners at specialty group practices see larger compounding effects.
TN federal- conformity is clean. No add-back of federal pre-tax , , FSA, or IRA contributions. Mega Backdoor Roth at HCA, Vanderbilt UMC, Methodist, St. Jude flows through at federal-only level. Senior physician practice-sale events (group practice equity exits + ASC sales) face only federal LTCG (15-20%) plus NIIT (3.8%) — no state CGT pickup like WA's 7% above $270K.
TN property tax ~0.71% effective — well below TX 1.6-2.5% peers. A senior specialty surgeon at $885K cash owning a $2.5M Belle Meade home pays ~$17,750/yr property tax vs $40,000-62,500 on Austin equivalent. The 'no state income tax' framing is genuinely favorable in TN versus TX — property tax doesn't offset the savings.
TN combined sales tax averages 9.55% (highest alongside LA) — regressive offset at resident + fellow + new-attending tiers. At senior + specialty surgeon levels small relative to comp. TN doesn't exempt groceries (one of 13 states fully taxing food).
- →Capture employer / match. HCA (50% up to 9% = 4.5% effective — most generous), Vanderbilt UMC (Retirement Plan + optional 403(b) + triple-defer), VA / federal (FERS + TSP up to 5%), Methodist (50% on first 6%), St. Jude (403(b) up to 6%). Triple-defer at Vanderbilt UMC is the most generous physician retirement structure in TN.
- →Max your / ($24,500 in 2026). At TN 0% plus federal 32-37%, every $1,000 deferred saves $320-$370. Vanderbilt UMC academic faculty multi-defer eligibility (Vanderbilt Retirement + optional + 403(b)) supports ~$70K+ annual pre-tax contributions.
- → at HCA, Vanderbilt UMC, Methodist Le Bonheur, St. Jude. §415(c) cap $72,000 (2026). After $24,500 employee + match, $25-35K room. At TN 0% plus federal 32-37%, MBR converts $30K into perpetual Roth tax-free growth — highest-ROI move at senior-attending + specialty surgeon levels.
- →Federal student loan strategy is critical given typical medical school debt loads $200-400K. via Vanderbilt UMC academic positions, VA Tennessee Valley + VA Memphis + VA Mountain Home, TN Dept of Mental Health, or community health centers (PSLF-eligible nonprofits) plus IDR makes 10-year forgiveness viable for ~20-30% of TN physicians. VA federal positions combine PSLF + FERS + competitive comp + 4-day workweek option.
- →Practice-ownership + group practice equity events. Multi-physician group practice ownership in Nashville + Memphis + Knoxville. Group practice sales to private equity (post-2018 wave) at 8-12x EBITDA peak settled to 6-9x in 2024-25. ASC (ambulatory surgery center) co-ownership typical for specialty surgeons. Equity events face federal only — TN 0% state tax keeps the math favorable.
- →Section 199A applies to private-practice physician income as a Specified Service Trade or Business () — phases out at federal $201,775 single / $403,550 . Most senior physicians exceed thresholds and lose QBI entirely. Mid-career physicians below the threshold can claim QBI deduction.
Three TN metros for physicians — Nashville Vanderbilt UMC + HCA TriStar, Memphis St. Jude + Methodist + VA, Knoxville UT Medical + VA Mountain Home + ETSU
TN physician practice splits by region + setting. Nashville is Vanderbilt UMC + HCA TriStar + VA Tennessee Valley + ambulatory + specialty. Memphis is St. Jude Children's + Methodist Le Bonheur + UTHSC + VA Memphis + Regional One. Knoxville + East TN is UT Medical Center + ETSU Quillen + VA Mountain Home (Johnson City).
Nashville (Vanderbilt UMC + HCA TriStar + Music Row Addiction)
Resident $58-78K · Fellow $72-95K · New attending $245-345K · Mid-career $315-485K · Senior $485-985K · Specialty surgeon $685K-$1.8M+TN's physician core. Vanderbilt UMC top-25 US academic medical center (~3K affiliated physicians, Vanderbilt-Ingram Cancer Center NCI-designated, Vanderbilt Heart + Vascular + Monroe Carell Jr Children's). HCA TriStar Centennial + Skyline + Southern Hills + ~50 HCA TN hospitals (~50K+ employed physicians + APPs). VA Tennessee Valley (Nashville + Murfreesboro). Methodist + Ardent + Lifepoint regional. Vanderbilt Addiction Center + music industry medicine niche (Porter's Call adjacent).
Belle Meade / Forest Hills ($1.4-3.5M+ specialty surgeon / senior), Green Hills / Oak Hill ($875K-$2.4M mid-career + senior), Brentwood / Franklin ($750K-$2.5M family-stage academic + private practice), Hillsboro Village ($550K-$1.2M residents + fellows). Davidson County 0.71% property tax effective.
Memphis (St. Jude Children's + Methodist Le Bonheur + UTHSC + VA Memphis)
Resident $58-78K · Fellow $72-95K · New attending $235-325K · Mid-career $305-465K · Senior $465-885K · Specialty surgeon $585K-$1.5M+TN's pediatric specialty + Mid-South corridor. St. Jude Children's Research Hospital (~250+ attending physicians, globally-distinctive pediatric specialty). Methodist Le Bonheur (~8K employees including ~400 attendings). UTHSC Memphis academic + research. Regional One Health (Mid-South Level I trauma). VA Memphis (~80 attendings). Memphis MSA serves Mid-South + North Mississippi + East Arkansas referral catchment.
East Memphis ($425-825K SF mid-career), Germantown / Collierville ($550-1,150K family senior + specialty surgeon), Midtown ($325-625K residents + fellows + new attending), Bartlett ($350-650K family). Shelby County 1.31% property tax effective — higher than Davidson.
Knoxville / East TN (UT Medical + ETSU Quillen + VA Mountain Home)
Resident $58-78K · Fellow $72-95K · New attending $225-315K · Mid-career $285-445K · Senior $445-785KEast TN's physician corridor. UT Medical Center Knoxville (~700-bed academic + Level I trauma). ETSU James H. Quillen College of Medicine (Johnson City). VA Mountain Home (Johnson City) serves East TN + Western NC + Southwest VA. Erlanger Health Chattanooga + UT Health Chattanooga (~1K affiliated physicians). Tennova Healthcare regional. Smaller bench than Nashville / Memphis but distinct East TN + Appalachian corridor depth.
Sequoyah Hills / Westmoreland ($550-950K SF senior + specialty), West Knoxville ($385-725K family + mid-career), Farragut ($425-725K family). Knox County 0.85% + Carter County 0.65% property tax effective.
The TN physician career arc — resident through senior attending / specialty surgeon / academic chair
TN physician careers typically start with MD or DO from Vanderbilt SOM, UTHSC Memphis, ETSU Quillen, UT Knoxville, Meharry Medical College (HBCU), LMU-DCOM, or out-of-state programs. Residency at Vanderbilt UMC + UTHSC + Methodist + Erlanger Chattanooga + Regional One Memphis + ETSU Quillen + UT Knoxville pays $58-78K (PGY-1 through PGY-7+ by specialty). USMLE / COMLEX pass rates ~90% first-time.
Fellow + new attending (years 5-10 post-med-school): Fellow $72-95K during subspecialty training. New attending $245-345K post-residency at HCA / Vanderbilt UMC / Methodist Le Bonheur / Erlanger / Ardent / Lifepoint. Signing bonus $50-200K typical. Specialty fork at this stage between hospital-employed + private practice + academic + federal (VA) tracks. IMLC opens multi-state telemedicine + locum tenens.
Mid-career attending (years 10-15): comp $315-485K cash + production. Specialty boarded surgeons + interventional specialists + GI / cardiology / oncology earn 30-50% premium over generalist primary care. Vanderbilt UMC academic-track candidates pursue clinical-faculty via competitive promotion. Partner-track at multi-physician group practices typically year 10-12.
Senior attending / specialty surgeon / academic chair (years 15+): senior specialty surgeon at Vanderbilt UMC / HCA TriStar / Methodist Le Bonheur $685K-$1.8M+. Vanderbilt UMC senior professor / dept head $485-885K + DRS pension. Senior St. Jude attending $485-885K cash + research grant access. VA TN senior / chief medical $285-485K + locality + FERS. Senior practice owners $585K-$1.4M+ cash + practice equity + ASC equity. TN's 0% income tax + 0.71% property tax + IMLC mobility + federal make senior TN careers financially better than CA / NY / OR peers.
Where TN physicians live — Belle Meade, Green Hills, Brentwood, East Memphis, Germantown, Sequoyah Hills
TN physicians cluster by setting + region. Nashville Vanderbilt UMC + HCA + private practice to Belle Meade / Forest Hills (specialty surgeon / senior), Green Hills (mid-career + senior), Hillsboro Village (residents + fellows + new attending), Brentwood / Franklin (family-stage). Memphis St. Jude + Methodist senior to East Memphis / Germantown. Knoxville + East TN UT Medical + VA Mountain Home to Sequoyah Hills + Johnson City.
Belle Meade / Forest Hills (Nashville specialty surgeon / senior)
5-15 min downtown · top-tier · $1.4-3.5M+ SF · specialty surgeon + senior physician primary neighborhood
Green Hills / Oak Hill (Nashville mid-career + senior)
10-20 min downtown · $875K-$2.4M SF · mid-career + senior attending residential
Hillsboro Village / Germantown (residents + fellows + new attending)
5-15 min Vanderbilt UMC · $550K-$1.2M SF · post-doc + new attending walkable urban
Brentwood / Franklin (Williamson Co family + academic)
20-30 min downtown · $750K-$2.5M family · top schools · in-house + senior academic + private practice
East Memphis (Memphis mid-career)
10-15 min downtown · $425-825K SF · Methodist + St. Jude mid-career + Sr Associate residential
Germantown / Collierville (Memphis family senior + St. Jude)
20-30 min downtown · $550-1,150K SF · top schools · St. Jude senior + Methodist specialty surgeon residential
Sequoyah Hills (Knoxville senior + UT Medical)
5-10 min downtown · $550-950K SF · UT Medical Center senior + specialty surgeon residential
Johnson City / Mountain Home (VA federal-clinical)
$325-585K SF · 5-10 min VA Mountain Home · federal-clinical physician + locality premium
TN physician residential geography reflects the dispersed nature of TN healthcare — Nashville concentration for academic + HCA + private practice plus material outposts in Memphis (St. Jude + Methodist), Knoxville + Johnson City. IMLC compact tele-medicine opens further geographic flexibility — TN-licensed physicians with IMLC standing practice across 41 member states from any TN residence.
Is this the right move?
TN for physicians — who it actually works for
Working in your favor
- +TN 0% state income tax saves $22,800-$80,000+/yr depending on tier — substantial advantage over CA, OR, and NY at every comp level
- +IMLC compact since 2018 (41 member states) + TN 0% income tax create attractive multi-state telemedicine + locum tenens base
- +HCA Healthcare (~190 hospitals + ~50K+ employed physicians) is the largest US physician employer outside Kaiser — career mobility unmatched
- +Vanderbilt UMC top-25 US academic medical center + Vanderbilt-Ingram NCI-designated + Vanderbilt Heart + Vascular is deep academic-clinical research bench
- +St. Jude Children's globally-distinctive pediatric specialty + VA Tennessee Valley + VA Memphis + VA Mountain Home (~450+ attendings) provide TN-distinctive career tracks
Worth knowing before you sign
- −TN combined sales tax averages 9.55% (highest alongside LA) — regressive offset at resident + fellow + new-attending tiers
- −TN medical school debt loads $200-400K pressure new-attending cash flow — PSLF via Vanderbilt UMC / VA / community health is essential
- −Section 199A QBI does not apply to senior practice income (SSTB + threshold) — most senior physicians lose this federal deduction at $200K+
- −TN does not exempt groceries from sales tax (one of 13 states fully taxing food) — meaningful tax burden at lower tiers
- −Memphis physician market trails Nashville in specialty depth (except St. Jude pediatric) — career-trajectory ceiling lower than Nashville peers
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