Women earn less than men in more than 90% of academic medical specialties, both when starting their careers and 10 years later, according to a study published in JAMA Network Open.

The data suggest that the average starting salary for women in academic medicine is 10% lower than the average starting salary for men. After a decade on the job, the average salary for women is 9% lower. 

“What’s new with this paper is the 10-year data, which was not available before and is sobering,” said Narjust Duma, MD, of the Dana-Farber Cancer Institute and Harvard Medical School in Boston, who was not involved in the study. 

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“We already know there are discrepancies at the moment of hiring, but women then tend to work twice as hard to get recognition, so my hope was that it was no longer there after 10 years. But the data shows that, in many cases, after 10 years, the pay discrepancies are even worse.”

Disparities in Starting Salary and Over Time 

The study included compensation data from 24,593 female and 29,886 male academic physicians across pediatric and adult subspecialties, both medical and surgical.

Overall, the starting salary for women was a median of $26,800 lower than the starting salary for men. Women had a lower starting salary across 42 of the 45 subspecialties evaluated (93%). The average starting salary was $34,036 lower for women in adult hematology/oncology and $14,270 lower for women in pediatric hematology/oncology. 

The 3 subspecialties for which women earned more than men were all in pediatrics — gastroenterology, nephrology, and rheumatology. The study authors noted that pediatric specialties are a traditionally lower-paying area of medicine.

After a decade of working, women still tended to earn less than men. Overall, the year-10 salary was a median of $22,890 lower for women.

Year-10 salaries were lower for women in 43 of the 45 subspecialties (96%). The subspecialties in which women did not earn less than men were pediatric neurology and pediatric rheumatology. The average year-10 salary was $6,683 lower for women in pediatric hematology/oncology and $26,363 lower for women in adult hematology/oncology. 

The subspecialty with the largest pay disparity after 10 years was adult neurosurgery, with men earning about $333,000 more annually than women. The gap favoring men exceeded $100,000 annually, on average, in adult cardiology and adult dermatology at 10 years. 

“Over the last few years, we’ve increasingly seen more objective data around all types of gender disparities in medicine, and this new paper contributes to that,” said Pamela Kunz, MD, of Smilow Cancer Hospital and Yale Cancer Center in New Haven, Connecticut. 

“Objective data is helpful, but I think that many of us in this space are starting to ask, how much more data do we need? There’s clearly a problem, and I think we need to really pivot towards focusing on the solutions,” said Dr Kunz, who was not involved in the study.

Closing the Gap: Potential Solutions

Two interventions that could help close the gender pay gap are equalizing starting salaries and equalizing annual salary growth rates, according to the study authors. 

They found that equalizing starting salaries for the subspecialties in which women earned less could increase women’s earning potential by a median of $250,075. Equalizing annual salary growth rates could increase a women’s earning potential by a median of $53,661.

Dr Duma noted that some institutions already equalize starting salaries. “Even when starting salaries are equal, there are many ways in which these rules can be broken,” she said. “For example, an institution may provide a signing bonus for a man and not for a woman, or more funding for research for men than women.”