Author Insights: Gender-Based Pay Gap Persists Even for Top Medical Researchers

Reshma Jagsi, MD, DPhil, associate professor in the department of radiation oncology at the University of Michigan, and her colleagues found that sex-based pay disparities exist even among high-achieving physician researchers. (Image: University of Michigan Health System)

Among elite medical researchers in the prime of their careers, those who are female are paid about $12 000 less per year than their male counterparts, according to an analysis of survey results published in JAMA today. This disparity persisted even when the authors of the analysis adjusted for factors such as hours worked and the specialty of the researcher.

Previous studies have suggested that women physicians are paid less than men, but there has been a persistent debate about whether this disparity could be explained by different choices made by men and women physicians. Some have argued, for example, that the pay gap is the result of women choosing lower-paying specialties or working fewer hours than male physicians. To probe whether such choices explain this pay gap, a team of researchers surveyed a select group of US physicians who had received K08 or K23 grants from the National Institutes of Health between 2000 and 2003 and analyzed the responses of 800 actively practicing at US academic institutions.

Lead author Reshma Jagsi, MD, DPhil, associate professor in the department of radiation oncology at the University of Michigan, discussed the results with news@JAMA.

news@JAMA: How does your study advance our understanding of the pay gap between male and female physician researchers?

Dr Jagsi: We chose a cream-of-the-crop group of physician researchers, all at the same point in their career, and even after we controlled for differences in specialty, academic rank, leadership positions, publication, and work hours, women were still paid less than men. Male researchers in this cohort made on average $12 000 more per year, or a cumulative $350 000 more over the course of a career. In Michigan, that’s enough to buy a house or to fund your children’s college educations.

news@JAMA: What are the potential explanations for the pay gap?

Dr Jagsi: We tried to adjust for as many choices as we could think of and measure. Based on our analysis, the pay gap is not entirely explained by different choices between men and women. I don’t think the pay disparity is the result of a conscious bias against women. I think it’s much more likely to be the result of unconscious biases. Studies show men and women are both more likely to hire a man than a woman and to give credit to a man. Employers may be thinking about a family wage, that a man needs to support a household. But it’s hard to justify the difference. These are men and women doing similar work at the same place in their career.

news@JAMA: Is there anything that you didn’t adjust for that may have contributed to the gap?

Dr Jagsi: Women were less likely to have changed institution. That may mean women may be less willing to look at other institutions or use offers from other institutions to negotiate a higher salary. Maybe women were less likely to raise a credible threat of leaving than men. It could be some other unmeasured factor. Maybe women are choosing more attractive locations to work.

news@JAMA: Why do you think that fewer women in your sample were in leadership positions?

Dr Jagsi: In the past, some have argued that women may not want to be promoted. Maybe they go into academic medicine for a different reason than men, maybe they want to teach and don’t do as much research. But that’s why this is a particularly good sample. These are all adults, mostly in their mid 30s, who won very competitive and prestigious grants. These are go-getters. These are not people who are torn about whether to progress in their careers. It’s hard to argue that the women in our sample were not motivated to advance.

news@JAMA: Did parental status play a role in the gap?

Dr Jagsi: Women in our population were less likely to be parents than men; 84% of women had children and 89% of men did, a significant difference. Even women without children in our sample have lower pay. Other studies have suggested women with children are dissuaded from advancing, but women without children do as well as men. But that was not what we found.



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