The move from residency to attending is a major turning point. Many physicians want more than clinical work alone. They look for leadership roles, academic appointments, and a chance to influence how care is delivered. For those physicians, the career pathway matters as much as the first job.
The Los Angeles County Department of Health Services (LADHS) offers a structured path from entry-level physician to system leadership, backed by nationally recognized training programs and dual academic affiliations with the David Geffen School of Medicine at UCLA and USC Keck School of Medicine. LADHS operates four teaching hospitals that together serve more than 700,000 residents across Los Angeles County, with over 1,000 residents and fellows training in the system each year.
Why Career Pathways Matter for Graduating Residents
The 2026 match season pushes many residents to think beyond their first contract toward long-term growth. National data show that many academic promotions come after changing employers, which makes it harder to build continuity in a single community. Clear internal pathways allow physicians to grow without leaving their patients, teams, or research programs behind.
LADHS provides defined routes from Physician Specialist to Senior Physician, then to Medical Director and Chief roles, all within the same public health system. Physicians can build careers that combine clinical practice, teaching, research, and leadership while staying rooted in Los Angeles County.
Academic Advantage: UCLA and USC Partnerships
LADHS physicians work in a system linked to both UCLA and USC. That means access to two major academic networks, frequent teaching opportunities, and strong support for scholarship.
Harbor-UCLA Medical Center
- 570-bed public teaching hospital; physicians serve as UCLA faculty.
- One of two adult Level 1 trauma centers for LA County, serving a catchment area of more than 700,000 residents.
- Fellows in emergency medicine supervise residents and students, building real leadership skills at the bedside.
Olive View-UCLA Medical Center
- 377-bed hospital in Sylmar with 78 internal medicine residents.
- Trains more UCLA medical students than any other affiliated site and works with 27 specialties.
- Known for strong teaching, work on social determinants of health, and anti-racism curricula.
Los Angeles General Medical Center
- Formerly LAC+USC, now the primary teaching hospital for USC Keck School of Medicine.
- One of the largest public hospitals in the country and the nation’s busiest Level 1 trauma center.
- Hosts more than 950 residents and fellows, across 60+ residency and fellowship programs.
- Offers a Health System Leader Fellowship focused on quality improvement and leadership skills.
Rancho Los Amigos National Rehabilitation Center
- Nationally recognized rehabilitation center with education ties to USC, UCLA, and multiple universities.
- Offers Physical Medicine & Rehabilitation training, along with clinical psychology residency programs that follow Baltimore Guidelines.
- Interdisciplinary teams give physicians daily experience with complex, team-based care.
The Career Ladder: From Physician Specialist to Chief
One of the biggest advantages at LADHS is a clear, documented career ladder with salary ranges, bonus structures, and defined promotion tiers.
Entry Stage: Physician Specialist
Most physicians join LADHS as Physician Specialists (board-eligible or board-certified). In 2026, the salary range is $212,942 to $285,502 per year, with step increases over time. Multiple bonuses reward added value:
- Board certification bonus: 5.5% monthly.
- High Desert bonus: 10% of base salary for High Desert Regional Health Center.
- Bilingual bonus: $100 per month.
- Specialty premiums for OB/GYN, neurosurgery, thoracic surgery, psychiatry, and certain corrections or mental health roles.
Stacking bonuses can bring a board-certified family physician at High Desert to about $314,052 per year at the top of the range.
Development Tracks
LADHS supports three overlapping growth paths:
- Clinical track: Focus on direct care and bedside teaching across the four teaching hospitals, including supervision of residents and students and participation in quality and safety work.
- Academic track: Faculty appointments through UCLA or USC, access to research infrastructure, and protected time for scholarship.
- Leadership track: Participation in leadership programs such as the Transforming Our Organization through People (TOP) Program, Leadership Excellence Advancement Program (LEAP), TeamSTEPPS training, and the Health System Leader Fellowship.
The TOP Program alone has trained more than 1,200 managers and received a 2023 NACo Achievement Award. LEAP and other programs give physicians practical tools for leading teams and managing change.
Senior Physician and Beyond
Physicians who show strong performance in clinical care, teaching, and leadership move into Senior Physician roles, with a salary range of $234,252 to $728,220, depending on specialty and responsibility. Senior Physicians shift into the MegaFlex benefits plan, which offers more flexible and higher-tier benefits for leaders.
From there, experienced physicians may take on Medical Director roles overseeing programs, departments, or facilities. These positions combine direct care with responsibilities such as:
- Program design and policy work.
- Quality improvement and data review.
- Staff mentorship and training.
- Cross-department coordination and system planning.
At the top of the ladder, Chief Physician roles (Chief I, II, III) guide clinical strategy across service lines or facilities and participate directly in system-level decision-making.
Compensation, Benefits, and Loan Support
Salary is only part of the value. LADHS offers strong benefits and several ways to reduce educational debt.
Loan Repayment
Physicians at LADHS can access multiple programs:
- National Health Service Corps (NHSC) Loan Repayment Program, up to $50,000 for a two-year commitment in qualifying locations.
- California State Loan Repayment Program (STAR LRP), up to $50,000 for work in underserved areas.
- Additional HCAI programs for specific specialties and settings.
Together, these programs can reach a total of up to $250,000 in loan repayment. For a physician earning $212,942 with $250,000 in loan support over five years, that adds the equivalent of $50,000 in value per year.
Retirement and Health Benefits
Los Angeles County offers:
- A 457(b) deferred compensation plan with County matching contributions.
- Pension benefits for long-tenured employees.
- Health benefits allowances in 2026 ranging from $1,241.15 per month (individual) to $2,675.05 (family).
- A $244 monthly allowance for physicians who waive County medical coverage.
Senior Physicians and Chiefs receive expanded options under the MegaFlex benefits plan.
Professional Development
LADHS supports ongoing learning through:
- Paid time toward continuing education requirements.
- CME funding for courses and conferences.
- System-wide training, webinars, and formal leadership programs at no cost to participants.
Teaching and Academic Growth
With more than 1,000 residents and fellows across the system, almost every LADHS attending participates in education.
- Olive View hosts 78 internal medicine residents and multiple other programs.
- LA General trains more than 950 residents and fellows in over 60 programs.
- Harbor-UCLA and Rancho Los Amigos contribute additional residency, fellowship, and student rotations.
Physicians supervise trainees on inpatient and outpatient services, lead case conferences, and help shape curricula. Many also design and publish education projects, which supports promotion on clinician-educator tracks.
Academic titles through UCLA or USC (Instructor, Assistant Professor, Associate Professor, Professor) give physicians access to university resources and create a path for academic promotion alongside the LADHS leadership ladder.
Research Opportunities
Physicians interested in research can work at several levels:
- Local quality improvement projects focused on outcomes, efficiency, or equity.
- Health services research at sites like Olive View, where teams study access, delivery, and outcomes in safety net populations.
- NIH-funded studies and physician-scientist training through programs such as UCLA STAR.
UCLA STAR Program data show that nearly half of graduates receive career development awards and 19% receive NIH grants, with many going on to hold major leadership roles in academic medicine.
Work-Life Balance and Practicing in LA County
LADHS offers full-time, part-time, and per diem options so physicians can adjust their schedules to fit personal and family needs. Content like “Thrive as a Physician in Los Angeles: Master Balance Between Career and Lifestyle” reflects the system’s focus on sustainable work patterns.
Burnout reduction efforts focus on system changes rather than only individual resilience. Examples include longer visit times in some settings, better support staff coverage, and leadership training that promotes psychological safety and effective communication. These efforts align with research showing that organization-led changes are more effective in reducing burnout than individual coping strategies alone.
Los Angeles County itself offers mild weather, diverse neighborhoods, cultural attractions, and strong schools and universities, with practice sites spread across the South Bay, San Fernando Valley, downtown, and southeast county areas.
Mission-Driven Practice with Safety Net Populations
Many physicians choose LADHS because they want their daily work to improve access and equity. LADHS functions as the safety net provider for the largest county in the United States, caring for patients regardless of ability to pay.
Harbor-UCLA and Olive View in particular serve communities with high proportions of immigrants, refugees, and patients with limited resources. Many clinicians describe this mission as a key source of meaning and long-term satisfaction, which aligns with research showing that purpose-driven work reduces burnout and improves retention.
Why LADHS Is a Strong Path from Residency to Leadership
For residents and fellows finishing training in 2026, LADHS offers:
- Clear internal promotion steps from Physician Specialist to Chief roles.
- Two premier academic partners (UCLA and USC) for teaching and research.
- Robust leadership development programs recognized at the national level.
- Competitive pay with stacked bonuses, strong retirement options, and meaningful loan support.
- Daily teaching and mentorship opportunities in a large training environment.
- A mission-centered practice caring for underserved communities across Los Angeles County.
Taking the Next Step
Residents finishing in June 2026, fellows exploring attending roles, and experienced physicians looking for a mission-driven system can all find pathways at LADHS. Current openings include roles in physical medicine and rehabilitation, orthopedics, primary care, pediatric hospital medicine, psychiatry, dermatology, and more across the four teaching hospitals.
To explore roles and discuss how your interests align with LADHS, visit ladhsphysicianjobs.com and connect with the physician recruitment team. The decision you make after residency can put you on a path not only to a strong first attending role, but to leadership in one of the nation’s largest public health systems.