Unequal Pay for Equal Work: The Gender Gap in Academic Medicine

Arbitrators recently awarded $2.2 million to a woman whose employer, a large brokerage firm, systematically paid women less than men for similar work (1). Such discrimination is not unique to the world of high finance. Things seem to be much worse in medicine. In June 2004, the U.S. Census Bureau released an analysis of the earnings of full-time workers that reported that female physicians' wages averaged 63 cents for every dollar earned by their male colleagues (2). The Census Bureau report was limited in that it did not examine factors, such as specialty, practice setting, seniority, and performance, that are likely to contribute to salary differentials. In 1996, a Committee of the Association of Academic University Professors concluded that the gender gap in academic medicine was the result of women practicing in lower-paying specialties (3). If women in medicine decide to forgo increased earning power because of their choice of specialty or the desire to have more flexible working hours, then the salary gap would be expected and would be more acceptable. However, evidence from academic medicine suggests that these factors do not fully explain why women in academic medicine earn less than their male colleagues.

In this issue, Ash, Carr, and colleagues analyzed data from a national survey of academic physicians and reported that women earned less than their male colleagues, even after accounting for specialty, hours worked, and many other measures of productivity and achievement (4). In addition, they found that women were less likely than men to reach the highest academic ranks. However, differences in rank did not fully account for the salary gap. Women still had significantly lower compensation than men at the same academic rank, even after adjustment for confounders, such as specialty, job characteristics, and productivity. More disturbing, women started …