Women radiologists start with lower salaries, earn less over time

Women radiologists in academic practice start their post-training careers with lower salaries and continue to earn less than their male counterparts. The trend is also seen in other medical specialties, according to a study published February 18 in JAMA Network Open.

That being said, salary disparities for women in academic radiology practice are less than those in other subspecialties, ranging from 3% to 7% over three measures compared with a range of 9% to 10%, a team led by Dr. Eva Catenaccio of the Children's Hospital of Philadelphia found.

Still, the problem of gender inequality in salary must be solved, and the truth is that inequities in earning potential in academic medicine could have a relatively simple fix, Catenaccio's group explained.

"Equalizing starting salaries would address the majority of the differences in earning potential," the team noted.

It's not necessarily news that gender disparities in academic medicine exist, the study authors explained. But how these disparities impact the earning potential of early-career physicians and how they could be resolved has not been thoroughly studied.

"Subspecialties that have a higher proportion of women, such as pediatrics, tend to be less well-compensated than those that have a higher proportion of men, such as orthopedic surgery," the group wrote. "Moreover, as the proportion of women in a subspecialty increases over time, compensation in that subspecialty has often decreased relative to other subspecialties, helping to support the theory of the devaluation of work that is seen as women's work."

Catenaccio and colleagues used mean debt and compensation data for full-time academic physicians between 2019 and 2020, as well as starting salary, salary in the first decade of employment, annual salary growth, and overall earning potential in the first 10 years of employment and compared results by gender and across 45 subspecialties to compare earning potential between female (24,593) and male (29,886) academic physicians in the first decade of post-training employment. The group also assessed the potential impact of the timing of promotions, starting salary, and salary growth rate on this earning potential.

The investigators noted the following overall results:

• Women had lower starting salaries in 93% and lower year 10 salaries in 96% of subspecialties.
• Women had lower mean annual salary growth rates in 49% subspecialties, and lower earning potential in 96% of subspecialties.

Postponed promotions also impacted the earning potential of female academic physicians: A one-year delay from assistant to associate professor decreased their earning potential by a median of $26,042. And not being promoted at all had an even more dramatic effect on earning potential, reducing it by a median of $218,724.

Catenaccio and colleagues found that, even when annual salary growth rates were on par between female and male academic physicians, differences in starting salary translated to differences in earning potential in the first 10 years of practice. Making starting salaries equal could increase women's earning potential by a median of $250,075 in subspecialties in which women receive lower starting salaries than their male counterparts, and that aligning annual salary growth rates could increase women's earning potential by a median of $53,661.

"The findings of this study suggest that gender-based disparities in starting salary and early career earning potential are pervasive in academic medicine in the U.S." the investigators concluded. "Equalizing starting salaries would address the majority of the differences in earning potential."

How can starting salaries be brought to level? Open conversation is key, as is transparency of starting salaries, wrote a group led by Dr. Mariana Socal of Johns Hopkins Bloomberg School of Public Health in Baltimore, in an accompanying commentary. They also suggested prohibiting employers from seeing the salary history of prospective employees.