“That’s your answer”, my husband stated very matter-of-factly. “People give more respect to those who are paid more. This is a corporate world”, he went on to say, as we were looking at the publicly available salary information online. Just that afternoon, the fellow on my infectious diseases consult team was upset over being treated badly by a physician practicing in a higher paid specialty. We spent a portion of our rounding time that afternoon helping her feel better about her choice to train for a couple additional years beyond internal medicine residency. The dynamics of career choices, salary and respect in the workplace may be too complicated, but the recent article in JAMA Internal Medicine highlighting sex differences in physician salary in US public medical schools brings numbers to the discussion on gender parity or as Julie Gerberding, the former director of the Centers for Disease Control and Prevention, puts it, gender dividend. (Anupam B. Jena, MD, PhD; Andrew R. Olenski, BS; Daniel M. Blumenthal, MD, MBA. JAMA Intern Med. doi:10.1001/jamainternmed.2016.3284 Published online July 11, 2016.)

In general, there’s less pay in academic medicine. Physicians start their real jobs in academia after completing 7-15 years of training beyond college and work through the initial years paying off college loans, raising a family, and establishing themselves in the field of their choice. I don’t have hard data, but most physicians in academic medicine work well over 55-60 hours a week.

This study found that female physicians are paid on average $19,878 (95% confidence interval $15,261 – $24,495) less than their male counterparts. The authors studied salaries of over ten thousand physicians in 24 public medical schools in 12 states. The salaries were adjusted for faculty rank, age, years since residency, specialty, NIH funding, clinical trial participation, publication count, total Medicare payments and graduation from a top twenty medical school. In addition to highlighting the gender gap in salaries, the paper makes some sobering points. Women make up only 35% of the faculty. The proportion becomes increasingly smaller with advancing academic ranks. Neurology, infectious diseases, and family medicine are the lowest paid specialties; they train for four, five and three years respectively, beyond medical school. The gender gap in salaries is wider in surgical specialties. Medical schools in the West have the largest gap, while those in the Midwest had the smallest gender gap. On the bright side, radiology seems to have the narrowest gender gap of all specialties.

The gender pay gap is expected to close in 2058 and many working women today will probably not live to see that. I hope you will agree with me that it’s time for the medical schools and organizations that oversee them to ‘Lean In’.

Suggested Reading:

  1. http://archinte.jamanetwork.com/article.aspx?articleid=2532788
  2. http://archinte.jamanetwork.com/article.aspx?articleid=2532784
  3. http://www.nytimes.com/2016/07/12/health/women-doctors-salaries-pay-gap.html?_r=0 (Reference for the picture in this blogpost)
  4. http://www.pewresearch.org/fact-tank/2015/04/14/on-equal-pay-day-everything-you-need-to-know-about-the-gender-pay-gap/
  5. http://www.iwpr.org/publications/pubs/gender-wage-gap-projected-to-close-in-year-2058-most-women-working-today-will-not-see-equal-pay-during-their-working-lives