In a famous demonstration that scientists are susceptible to subtle gender bias, Moss-Racusin and colleagues designed faux applications for a laboratory manager position.8 These were identical with the exception of the names of the application, some of which were male and some of which were female. When these were submitted to 127 male and female professors, male candidates were rated significantly better and were offered higher salaries than female applicants.

Successful strategies to increase fairness and diversity in hiring in medicine include more metric-based, conscious decision-making rather than following a “gut feeling” about a candidate. Establishing a job description and list of qualifications prior to launching a search, allowing time for review of CVs and publications, and use of structured questions can all allow fuller evaluation of women or candidates from underrepresented groups.

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The #MeToo movement has inspired many women to relate stories of harassment, and again medicine is no exception. The power differentials in hospitals, the scale of the investment of money and effort required of students to get into medical school or a competitive training program, and even the geography of the hospital and the call room may render women in medicine particularly vulnerable to harassment and particularly unwilling to complain when harassed. Harassment intimidates and marginalizes women, and can lead women to drop out of a program or leave a good position. The ways in which these effects contribute to unhappiness and burnout, and interfere with success, strong negotiating, and competitiveness for leadership positions are just starting to be explored.

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A large body of evidence now exists to demonstrate that the gender pay gap is pervasive in medicine, that it cannot be fully explained by the personal choices of individual women who are not fairly paid, and that a lower valuation continues to be placed on work when it comes from a woman. This is the case despite the fact that women now represent over half of new medical school enrollees, provide medical care that leads to superior outcomes, and that these attainments come in spite of a climate that is consistently less supportive to women than to men.

Yet each of our trainees, each young doctor who brings the gifts and the years of study and service that are the price of entering our field, deserves an equal chance to succeed and an equal chance to be valued for that success. It is past time for some models to narrow these pay gaps, rather than a further series of papers demonstrating that they exist.


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