• Trump’s new Department of Government Efficiency aims to reduce the number of federal workers.
• Business Insider looked at the highest average salaries of federal civilian employees by occupation.
• The top 20 had average salaries over $160,000, with medical officers ranking No. 1.

Federal workers who are employed as medical officers, ship pilots, and general attorneys earn lucrative pay on average — but their jobs might be at risk under President-elect Donald Trump‘s new government efficiency initiative.

Trump’s Department of Government Efficiency, or DOGE, is spearheaded by Tesla CEO Elon Musk and former GOP presidential candidate Vivek Ramaswamy. The two leaders of the commission wrote in a recent opinion piece in The Wall Street Journal that they will aim to slash government spending and reduce head count at federal agencies, meaning government workers are at risk of losing their jobs.

Using US Office of Personnel Management data as of March, Business Insider looked at the average salaries of federal civilian employees for all agencies to see who is earning the most on average among hundreds of occupations.

Three of the five jobs with the highest average salaries were health-related. Medical officers, who largely worked for the Department of Veterans Affairs, had the highest average salary. Financial analysis workers rounded out the top 20 highest-paying jobs on average; their largest employer, with about 300 analysts, was the Federal Deposit Insurance Corporation. Most of the top jobs were classified as white-collar by OPM.

Looking at the average salaries of workers within cabinet-level agencies regardless of occupation, the Department of Education and the Department of Energy had the highest, with averages over $140,000.

Musk and Ramaswamy floated in the op-ed requiring all federal employees to come into the office five days a week, which may lead to higher voluntary turnover. Office of Personnel Management data showed around 1.3 million federal civilian workers as of March were “eligible to participate in telework,” many of whom were professional and administrative workers.

“DOGE intends to work with embedded appointees in agencies to identify the minimum number of employees required at an agency for it to perform its constitutionally permissible and statutorily mandated functions,” Musk and Ramaswamy wrote.

Musk and Ramaswamy also suggested early retirement and severance packages to incentivize lower headcount but didn’t provide further detail on the benefits they would offer impacted employees.

“The American people re-elected President Trump by a resounding margin giving him a mandate to implement the promises he made on the campaign trail,” Karoline Leavitt, a spokesperson for the Trump-Vance transition, previously told BI when asked about DOGE’s plan for spending cuts. “He will deliver.”

Are you a federal worker worried about your employment or looking to move into the private sector? Reach out to these reporters at mhoff@businessinsider.com and asheffey@businessinsider.com to share.