A gender gap in both pay and negotiation success has lifetime effects

Survey data reveal a gender compensation gap for the first year of practice for ophthalmologists and a gender difference in the success of compensation negotiations.

Study design

This prospective study involved the collection of data from an anonymous and voluntary survey sent to all US residency program directors and practicing ophthalmologists. The survey queried respondents regarding demographics including residency and fellowship training, practice type and location, number of workdays per week, salary in the first year of practice, negotiations, and bonus.

Outcomes

In this 2020 survey, female ophthalmologists earned an initial base salary that was 10.6% less than their male colleagues. When choosing fellowships, 15.8% of female respondents chose the highest-paid subspecialty, vitreoretinal surgery, as compared to 40.2% of male respondents. When controlling for fellowship choice, female ophthalmologists earned nearly $31,000 less than their male counterparts. Analysis of practice type showed 42.8% of women and 30.2% of men were employed in academic institutions, where salary is lower than private practice. The study also demonstrated that there was no relationship between gender and the decision to negotiate, but gender and successful negotiations were significantly associated, with men having more success.

Limitations

Limitations of this study include voluntary participation and self-selection of participating sites, as well as lack of information on those who declined to participate. Bonus calculations were also somewhat arbitrary.

Clinical significance

In 2019, for the first time in US history, women accounted for the majority (51%) of medical school matriculants. This study demonstrates that despite these changes in matriculation rates over time,  a gender compensation gap remains for ophthalmologists in the first year of clinical practice. These starting salary inequalities have compounding effects that lead to significant discrepancies in lifetime earning potential. Due to this initial pay gap, an annual percentage pay increase over a 40-year career leads to a significant accrued difference in lifetime pay. This study underlines the importance of remedying the disparity in the gender pay gap and teaching our young ophthalmologists about the importance of negotiation.