The highest-paying jobs in the U.S. tend to be among the most stressful. For our Workplace Stress Premium Report, we analyzed the day-to-day working conditions (like time pressure, conflict, difficult people, and long hours) of 754 U.S. occupations. More than half of six-figure jobs (54 of 93) scored as high-stress, and all 14 six-figure jobs with a median wage of $200,000 or more were high-stress.
| Job | Stress Index (0–100) | Median Annual Salary | Estimated Job Growth (2025–2035) |
|---|---|---|---|
| Anesthesiologist | 100 | $391,490 | 4% |
| Emergency medicine physician | 99 | $335,550 | 3% |
| Psychiatrist | 98 | $281,870 | 7% |
| Neurologist | 98 | $248,560 | 6% |
| Nurse anesthetist | 100 | $236,590 | 10% |
| Airline pilot | 98 | $232,140 | 8% |
| Chief executive | 98 | $213,990 | 3% |
| Physician assistant | 99 | $135,880 | 21% |
| Nurse practitioner | 96 | $132,300 | 41% |
| Veterinarian | 97 | $130,100 | 9% |
Stress Index: 0 = least stressful, 100 = most stressful (of the 754 occupations we analyzed). Scores work like percentiles: a job scoring 98 is more stressful than 97% of the jobs we analyzed. Median pay: BLS, May 2025.
The 10 most stressful six-figure jobs, ranked by pay
1. Anesthesiologist
- Stress Index: 100/100 (more stressful than 99% of jobs)
- Median annual salary: $391,490
- Median hourly wage: $188.22
- Top 10% of earners: $557,130
- Number of jobs: 38,800
- Estimated job growth (2025–2035): 4%
- Typical education: Doctoral or professional degree
What does an anesthesiologist do?
Anesthesiologists administer anesthesia to patients undergoing surgery and other procedures, monitor their vital signs throughout, and manage their pain relief.
Why is anesthesiology a high-stress job?
Almost all anesthesiologists (99%) regularly work more than 40 hours a week, compared with 42% across all jobs. Most (83%) say a mistake would be very or extremely serious, and 81% face time pressure every day.
How to become an anesthesiologist
Anesthesiologists earn a bachelor’s degree, complete four years of medical school, and then train in an anesthesiology residency. All states require physicians to pass national licensing exams.
2. Emergency medicine physician
- Stress Index: 99/100 (more stressful than 98% of jobs)
- Median annual salary: $335,550
- Median hourly wage: $161.32
- Top 10% of earners: $495,910
- Number of jobs: 32,900
- Estimated job growth (2025–2035): 3%
- Typical education: Doctoral or professional degree
What does an emergency medicine physician do?
Emergency medicine physicians evaluate and stabilize patients whose illnesses or injuries need immediate care.
Why is emergency medicine a high-stress job?
Almost all emergency physicians (97%) deal with angry or unpleasant people every week, compared with 32% across all jobs, and 97% say a mistake would be very or extremely serious. Their hours are more contained than in other specialties, with only 27% regularly working more than 40 hours a week.
How to become an emergency medicine physician
Like other physicians, emergency medicine physicians complete medical school after a bachelor’s degree. They then train in an emergency medicine residency and pass national licensing exams before obtaining a state medical license.
3. Psychiatrist
- Stress Index: 98/100 (more stressful than 97% of jobs)
- Median annual salary: $281,870
- Median hourly wage: $135.51
- Top 10% of earners: $446,520
- Number of jobs: 28,000
- Estimated job growth (2025–2035): 7%
- Typical education: Doctoral or professional degree
What does a psychiatrist do?
Psychiatrists diagnose and treat mental illness through counseling, medication, and, when needed, hospitalization.
Why is psychiatry a high-stress job?
Most psychiatrists (78%) have to deal with angry or unpleasant people every week, and 81% handle conflict weekly (both more than double the average). Long weeks are common too, with 77% regularly working more than 40 hours.
How to become a psychiatrist
Psychiatrists are medical doctors. After medical school, they complete a psychiatry residency and pass national licensing exams.
4. Neurologist
- Stress Index: 98/100 (more stressful than 97% of jobs)
- Median annual salary: $248,560
- Median hourly wage: $119.50
- Top 10% of earners: $450,780
- Number of jobs: 10,600
- Estimated job growth (2025–2035): 6%
- Typical education: Doctoral or professional degree
What does a neurologist do?
Neurologists diagnose and treat disorders of the brain and nervous system, such as strokes, epilepsy, Parkinson’s disease, and nerve damage that causes numbness, tingling, and pain elsewhere in the body.
Why is neurology a high-stress job?
Work as a neurologist combines high stakes with long hours. Most (90%) say a mistake would be very or extremely serious, and 92% regularly work more than 40 hours a week.
How to become a neurologist
Neurologists complete medical school, followed by an internship and neurology residency. They then obtain a state medical license and may pursue board certification. Some go on to complete a fellowship, typically lasting one to two years, to specialize in areas such as epilepsy, stroke, or neuromuscular medicine.
5. Nurse anesthetist
- Stress Index: 100/100 (more stressful than 99% of jobs)
- Median annual salary: $236,590
- Median hourly wage: $113.75
- Top 10% of earners: $339,500
- Number of jobs: 51,800
- Estimated job growth (2025–2035): 10%
- Typical education: Master’s degree
What does a nurse anesthetist do?
Nurse anesthetists give anesthesia and care for patients before, during, and after surgery and other procedures.
Why is nurse anesthesia a high-stress job?
Nearly all nurse anesthetists (96%) say a mistake would be very or extremely serious, and 89% say they have high responsibility for the health and safety of others. Most (65%) also have to deal with angry or unpleasant people every week, about double the average.
How to become a nurse anesthetist
Nurse anesthetists are registered nurses who need at least a year of critical care experience before starting an accredited nurse anesthetist program. After the program, they pass a national certification exam and get a state license.
6. Airline pilot
- Stress Index: 98/100 (more stressful than 97% of jobs)
- Median annual salary: $232,140
- Median hourly wage: Not published by BLS
- Top 10% of earners: $463,830
- Number of jobs: 103,600
- Estimated job growth (2025–2035): 8%
- Typical education: Bachelor’s degree
What does an airline pilot do?
Airline pilots fly passengers and cargo on scheduled routes. The captain is in charge of the crew and the flight, and the first officer shares flying duties.
Why is flying for an airline a high-stress job?
Most airline pilots (83%) say they have high responsibility for the health and safety of others, and 77% say a mistake would be very or extremely serious. Long weeks are less common, with 20% regularly working more than 40 hours, but overnight layovers often keep pilots away from home.
How to become an airline pilot
Airline pilots usually have a bachelor’s degree and build flight hours through flight school, commercial flying, or the military. Every pilot on a scheduled airliner needs an FAA airline transport pilot certificate, and pilots must pass regular medical exams.
7. Chief executive
- Stress Index: 98/100 (more stressful than 97% of jobs)
- Median annual salary: $213,990
- Median hourly wage: $102.88
- Top 10% of earners: $507,730
- Number of jobs: 204,400
- Estimated job growth (2025–2035): 3%
- Typical education: Bachelor’s degree
What does a chief executive do?
Chief executives set the overall direction of a company or organization, oversee its operations, and usually report to a board of directors.
Why is being a chief executive a high-stress job?
Nearly all chief executives (95%) have a lot of freedom to make decisions, and they’re held responsible for their organization’s results. Most (86%) regularly work more than 40 hours a week, and 71% handle conflict weekly.
How to become a chief executive
Chief executives usually have a bachelor’s or master’s degree in business, engineering, or a related field, and large corporations often prefer an MBA. Most work their way up through management roles, often within the same organization.
8. Physician assistant
- Stress Index: 99/100 (more stressful than 98% of jobs)
- Median annual salary: $135,880
- Median hourly wage: $65.33
- Top 10% of earners: $190,280
- Number of jobs: 162,200
- Estimated job growth (2025–2035): 21%
- Typical education: Master’s degree
What does a physician assistant do?
Physician assistants work with physicians to examine, diagnose, and treat patients. They order tests, prescribe medication, and treat injuries.
Why is being a physician assistant a high-stress job?
Most physician assistants (89%) say a mistake would be very or extremely serious, and 69% have to deal with angry or unpleasant people every week, more than double the average. Competition is high too, with 84% describing their work environment as highly or extremely competitive.
How to become a physician assistant
Physician assistants complete a master’s program of at least two years, usually after gaining hands-on patient care experience in roles like emergency medical technician or medical assistant. They then pass a certification exam and get a state license.
9. Nurse practitioner
- Stress Index: 96/100 (more stressful than 95% of jobs)
- Median annual salary: $132,300
- Median hourly wage: $63.61
- Top 10% of earners: $174,420
- Number of jobs: 323,000
- Estimated job growth (2025–2035): 41%
- Typical education: Master’s degree
What does a nurse practitioner do?
Nurse practitioners provide primary and specialty care. They assess patients, order tests, and prescribe medication, often focusing on a group such as children or mental health patients.
Why is being a nurse practitioner a high-stress job?
Most nurse practitioners (83%) say a mistake would be very or extremely serious, and 57% have to deal with angry or unpleasant people every week. Nearly half (48%) face time pressure every day.
How to become a nurse practitioner
Nurse practitioners are registered nurses who complete at least a master’s degree in advanced practice nursing. They then pass a national certification exam and get a state license.
10. Veterinarian
- Stress Index: 97/100 (more stressful than 96% of jobs)
- Median annual salary: $130,100
- Median hourly wage: $62.55
- Top 10% of earners: $215,700
- Number of jobs: 83,900
- Estimated job growth (2025–2035): 9%
- Typical education: Doctoral or professional degree
What does a veterinarian do?
Veterinarians diagnose and treat illness and injury in pets, livestock, and other animals, including performing surgery and giving vaccinations.
Why is veterinary medicine a high-stress job?
Most veterinarians (79%) say a mistake would be very or extremely serious, and 61% face time pressure every day. The work can also be emotionally difficult, including caring for abused animals, euthanizing sick animals, and supporting anxious owners.
How to become a veterinarian
Veterinarians earn a Doctor of Veterinary Medicine degree, a four-year program with competitive admission that usually follows a bachelor’s degree in science. They then pass a national licensing exam and, in most states, a state exam.
How to thrive in a high-pressure work environment
Thriving in a high-pressure role takes more than technical expertise: it requires smart habits that help you perform at your best.
These strategies will keep you sharp, balanced, and effective even when the stakes are high.
1. Take intentional breaks
High-pressure roles often involve life-or-death stakes or multimillion-dollar decisions, which can cloud your judgment if you never step away. Employers value candidates who can maintain clarity under stress. Even a short walk or coffee break can reset your focus so you can return to work with a clearer mind.
2. Prioritize your sleep
Caring for yourself outside of work is just as important as managing tasks during the day. Employers recognize that performance drops when employees run on little rest. Getting sufficient sleep helps you sustain high performance over the long term.
3. Organize and delegate effectively
When deadlines pile up, strong professionals show they can manage multiple tasks rather than freeze. Organize your tasks, focus on the most urgent priorities, and delegate when possible to keep projects moving and reduce stress.
Methodology
These jobs come from our Workplace Stress Premium Report, which analyzed 754 U.S. occupations using the O*NET 31.0 database (August 2026) and pay and outlook data from the U.S. Bureau of Labor Statistics.
The Stress Index (0–100) combines eight O*NET measures. O*NET’s Stress Tolerance rating, which shows how much coping with stress matters for doing a job well, makes up one-third of the score. The other two-thirds are split equally across seven work conditions: time pressure; conflict situations; dealing with unpleasant or angry people; consequences of errors; responsibility for the health and safety of others; level of competition; and the share of workers on weeks longer than 40 hours. Each measure was converted to a percentile rank across all 754 occupations, combined, and ranked again to give a 0–100 score. Because the final score is a rank, it works like a percentile: a job scoring 98 is more stressful than 97% of the jobs we analyzed. A score of 67 or above counts as high-stress.
Main list: The 10 six-figure jobs with the highest Stress Index scores in the Workplace Stress Premium Report. Six-figure jobs have a median annual wage of $100,000 or more, at least 10,000 workers nationwide, and positive projected growth through 2035. Catch-all “All Other” occupations are excluded. Where scores tie at the cutoff, the higher-paying job is included. The list is ordered here by median annual wage.
Pay and growth: Median annual pay, median hourly pay, 90th percentile pay, and number of jobs come from the BLS Occupational Employment and Wage Statistics (May 2025). Projected growth and typical entry-level education come from BLS Employment Projections 2025–35. Worker percentages come from O*NET survey data.
Limitations: The Stress Index is a relative measure of day-to-day working conditions for the typical job in each occupation. It isn’t a clinical measure, and it doesn’t cover any particular employer. Some high-paying occupations, including cardiologists and orthopedic surgeons, couldn’t be scored because O*NET hasn’t published work-condition survey data for them. Wages are national medians and vary by location, experience, and employer.
This page includes information from the O*NET 31.0 Database by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA). Used under the CC BY 4.0 license. O*NET® is a trademark of USDOL/ETA. Resume Genius has modified all or some of this information. USDOL/ETA has not approved, endorsed, or tested these modifications.
Sources
- O*NET Resource Center, O*NET 31.0 Database
- U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics
- U.S. Bureau of Labor Statistics, Employment Projections
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook
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About the Author
Jack Hulatt graduated from the University of Greenwich with a bachelor’s degree in Politics and International Relations before pursuing certifications in computer science and data analytics. In his short career, he has already worked on multiple entrepreneurial projects and as part of a larger team, giving him direct insight into the needs and wants of young job seekers today.
