having a pay cut during the COVID-19 pandemic. The majority of the monetary loss was a result of low volume of patients and lack of elective surgeries. Compared to foreign countries The United States has the highest paid general practitioners in the world. The US has the second-highest paid specialists in the world behind the Netherlands. Public and private payers pay higher fees to US primary care physicians for office visits (overall 27 percent more for public and 70 percent more for private) than in Australia, Canada, France, Germany and the United Kingdom. US primary care physicians also earn more (overall earning $186,000 yearly) than the foreign counterparts, with even higher numbers for physician compensation for medical specialists. Higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, mainly drive higher US spending. Variations within the US A survey of 15,000 physicians practicing in the United States reported that, across all specialties, male physicians earn approximately 41% more than female physicians. Also, female physicians are more likely to report working fewer hours than their male counterparts. The same survey reported that, the highest-earning physicians were located in North Central region, comprising Kansas, Nebraska, North and South Dakota, Iowa, and Missouri, with a median salary of $225,000 per year, as per 2010. The next highest earning physicians were those in the South Central region, comprising Texas, Oklahoma, and Arkansas, at $216,000. Those physicians reporting the lowest compensation levels were located in the Northeast and Southwest, earning an across-specialty median annual income of $190,000. The survey concluded that physicians in small cities (50,000–100,000) earned slightly more than those living in community types of other sizes, ranging from metropolitan to rural, but the differences were only marginal (a few percent more or less). Other results from the survey were that those running a solo practice earned marginally less than private practice employees, who, in turn, earned marginally less than hospital employees. In contrast, the Bureau of Labor Statistics reports median annual income for physicians at $166,400. Medical education The US medical education for physicians includes participation in a US medical school that eventually grants a US form of Doctor of Medicine (M.D.) degree or a Doctor of Osteopathic Medicine degree. During the process of medical school, physicians who wish to practice in the U.S. must take standardized exams, such as the United States Medical Licensing Examination steps