With rare exceptions, White male physicians and scientists are paid significantly more than women of all races and men of color, even after accounting for rank, specialty, and degree, according to the first-ever, national-level analysis of full-time faculty salaries in academic medicine by gender, race, and ethnicity.
The analysis, based on the AAMC’s annual Faculty Salary Survey, also found that while gender was the primary factor driving pay inequities, Black, Indigenous, and people of color (BIPOC) faculty also experienced compensation inequities — even in departments and specialties with the most diverse faculty.
Exploring Faculty Salary Equity at U.S. Medical Schools by Gender and Race/Ethnicity was released on Oct. 7. The 2021 Faculty Salary Report (on which this analysis is based) will be available to individual faculty and academic medical institutions in December.
“For 40 years, women have represented a significant proportion of medical school graduates, but they continue to experience well-documented disparities in opportunity and compensation within medicine,” says Amy Gottlieb, MD, chief faculty development officer at Baystate Health and associate dean for faculty affairs at UMass Chan Medical School-Baystate and a contributor to the report. “This report provides us with the first opportunity to explore salary disparities in our profession through a robust intersectional lens.”
Adds AAMC Chief Diversity Officer David A. Acosta, MD: “White women and BIPOC women and men have demonstrated repeatedly that they are critical contributors to medicine and science. As such, they should be compensated on par with their other colleagues. I hope that the leaders of medical schools and teaching hospitals will collectively use this report to intentionally explore and address ways to close the salary gaps that have existed in academic medicine for far too long.”
The new report builds on the AAMC’s 2019 report, Promising Practices for Understanding and Addressing Faculty Salary Equity at U.S. Medical Schools, which found that women were paid between $0.72 and $0.96 per $1 paid to men across different departments and specialties.
That report was unable to disaggregate the data across race and ethnicity, however, because that information was not collected in the Faculty Salary Survey until 2020. This new analysis is the first that includes data on race and ethnicity by gender for multiple specialties and departments.
The key findings of the report include:
- In most cases, White men received a higher median compensation than men of other races and women of all races and ethnicities.
- Gender was the primary factor driving compensation inequities; men consistently made more than women of the same race and ethnicity.
- No particular BIPOC faculty group experienced consistent pay inequities over others. In some cases, however, the sample size of BIPOC faculty was small. The report includes the number of faculty represented in each category in its appendix.
“The implications of these findings are very clear: We need to amplify our hiring practices and accelerate our efforts to retain diverse faculty across all specialties,” says Valerie Dandar, director of medical school operations for the AAMC and a co-author of the report.
The way forward
While the report did not delve into the reasons behind the pay disparities, Gottlieb says they stem from long-standing gender biases that are baked into compensation models for individuals in medicine and science. “Our traditional way of compensating physicians and faculty inadvertently devalues women’s contributions and monetizes men’s,” she says.
For instance, women — and particularly BIPOC women — spend disproportionately more time in organizational service, such as serving on committees and workgroups. While this work is critical for institutions, it may take time away from activities that are more heavily weighted in compensation models, such as clinical work, grant awards, or publication of research.
Gottlieb — whose 2021 book, Closing the Gender Pay Gap in Medicine: A Roadmap for Healthcare Organizations and the Women Physicians Who Work for Them, delves into the complexities of compensation inequity — says the new AAMC report will give leaders in academic medicine an opportunity to reflect on and examine their own compensation outcomes using these national data as a guide.
“We continue to encourage institutions to do their own salary audits as part of their larger equity studies,” says Diana Lautenberger, director of faculty and staff research for the AAMC and a co-author of the report. And while those audits can be time-consuming, “the return on investment is significant,” particularly since faculty who believe their institution’s policies are equitable are less likely to leave an institution or academic medicine. “Salary equity is really part of the overall approach to institutional equity,” she says, “and it has cultural and institutional benefits.”
Adds Gottlieb: “The consequences of continuing to undervalue women’s efforts could be considerable for their continued engagement and the future of our profession.”