Dive Brief:
- A compensation analysis of nearly 800,000 postgraduate trainees published in JAMA last week found racial and ethnic minorities and women were less likely to be represented in top-paying specialties.
- White males were more likely to work in higher-paying specialties, including neuroscience. Surgical specialties also tended to have less diverse representation and were higher compensated than nonsurgical specialties, according to the study.
- The results suggest that lucrative specialties were less successful at recruiting underrepresented groups in medicine, though the study emphasized the reason behind the gap needs further research.
Dive Insight:
The gender and racial pay gap in medicine has flummoxed the healthcare industry for years. Overall, physician salaries have risen year over year, but the gender pay gap has also grown in turn.
As of 2018, a Medscape report found male primary care physicians earned an average of $239,000 annually, while women earned $203,000 — a 2% increase in the compensation gap compared to 2017. Black physicians earned an average of $50,000 less than white physicians, and Black female physicians made nearly $100,000 less than Black male physicians.
Despite ongoing conversations about the pay gap and plans from organizations like the AMA to address systemic gaps in compensation, the problem has remained entrenched. Women and minorities consistently earn less than their white male counterparts, even as women begin to make up a larger share of the medical profession.
The JAMA study, which analyzed trainee compensation for 21 clinical specialties between 2015 and 2022, suggests one source of the compensation gap may be that top-paying specialties are less successful at recruiting women and underrepresented groups.
The report found that neurosurgery and orthopedic surgery programs, the two top-paying specialties, had a median of 81% and 83% men, respectively. In contrast, the two lowest paid specialties, pediatrics and preventive medicine, consisted of 66.7% and 45.6% women.
The report cautions that more research is needed to explain this pattern, noting it could be due to a number of factors including discrimination, attrition or specialty culture.
The compensation gap exists even in specialties more heavily dominated by women. One 2021 study conducted by RAND found that female primary care physicians can expect to earn $900,000 less over the course of their career than men. Gaps can be even deeper for women who are also mothers.
There’s been some progress toward closing the gender pay gap. The gap narrowed in 2022 for the first time in five years, according to a Medscape report. However, women still made about 19% less than men and the racial pay gap hadn’t budged.
Last year, multiple states and localities, including California, New York City and Washington State, introduced salary transparency laws in an effort to force employers broadly to address the wage gap, though research is mixed on whether such approaches are effective.
