Doctors still earn high wages, but there are distinct gaps based on speciality—and, unfortunately, gender.

A survey released by Medscape of 19,200 doctors in about 26 medical specialties reveals that orthopedists are the top earners in the medical field, at an average annual salary of $443,000. That group is followed by cardiologists at $410,000 and dermatologists at $381,000. The lowest earners were pediatricians with an annual salary of $204,000, followed by endocrinologists at $206,000 and family physicians at $207,000.

A few medical specialties saw hikes in their pay, including significant increases for rheumatologists and internists. “Over 10,000 baby boomers turn 65 every day, driving demand for internists, and their compensation, higher,” said Travis Singleton, senior vice president of national physician search firm Merritt Hawkins, in the Medscape report.

Doctors in the allergy and pulmonology specialties had signifiant drops in income, for reasons that are unclear.

Get our Health Newsletter. Sign up to receive the latest health and science news, plus answers to wellness questions and expert tips. Please enter a valid email address. Sign Up Now Check the box if you do not wish to receive promotional offers via email from TIME. You can unsubscribe at any time. By signing up you are agreeing to our Terms of Use and Privacy Policy . This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Thank you! For your security, we've sent a confirmation email to the address you entered. Click the link to confirm your subscription and begin receiving our newsletters. If you don't get the confirmation within 10 minutes, please check your spam folder.

Medical providers in the north central United States and in the Southeast had the highest salaries, regionally speaking, and physicians in the Northeast and Mid-Atlantic had the lowest. One of the reasons for this could be that government policies have recently focused on getting more doctors into rural and low-income communities, which could result in higher wages for doctors in these areas. The three top earning states in the report were North Dakota, New Hampshire and Nebraska.

Unfortunately, as in many professional fields, male physicians earn more than female doctors. Male primary care doctors earned $225,000 a year compared to female primary care doctors, who earned $192,000. Female specialists also earned about $100,000 less than male doctors in the same speciality.

The report authors note that women’s salaries did increase more between the years 2012 to 2016 compared to men’s. Still, female doctors make 24% less overall than male docs. Other recent studies have found that white male doctors earn more than black doctors and women.

Contact us at letters@time.com.