My opinion on the gender pay gap

Studies tell us that women make less than men, in part because they go into lower paying professions. I get this. When most people hear housekeeper or secretary they think female. Stereotypes are typically true, which is why they’re stereotypes. Surely there isn’t gender pay inequality in medicine, I told myself. After all, specialized doctors have the same training for their specialty and the annual salary for doctors who work for the state (often university affiliated) have their incomes listed online.

Then a friend from medical school told me about her specialty. Not surgery, which is typically a male-dominated specialty (more on that in a bit), but an internal medicine specialty. She is on the path to partnership. Partnership generally means more time commitment, and possibly more risk, but often means higher earnings. Yet, she’s the only female, in a group of 13 docs (five females), who is on the path to being a partner. She’s single and doesn’t have kids, but still isn’t sure she wants this commitment. Since none of the other females are partners, nor are they interested, the men in the practice are working more and therefore making more. It could be argued that the women in this group opted out of the opportunity to make more, so there isn’t a gender pay inequality. But I haven’t convinced myself of that. Rather, I see it as gender pay discrepancy in disguise.

Now let’s look at surgery. Few women go into the specialty every year, and 25% leave surgery during residency. It’s hard to make it in a male-dominated profession without strong female role models. This is seen across professions that require a graduate school degree. In part, it’s difficult to attract females into a field when there is a dearth of strong female role models. Looking beyond our mentor, it comes down to “culture,” i.e. stereotypes. Part of this culture is relationships fail when the woman is the breadwinner. But is the culture that women leave work for family one that we want to defy? Do we feel the need to fulfill the stereotype that we should be the ones to take sick days for family? Or is it something we want to do?

Do men want to be the ones at home when disaster strikes (sometimes a sick kid feels like a disaster) but men are expected to focus on their career? It shouldn’t have been media-worthy when Doyin Richards did his daughter’s hair in the morning just because he’s a dad.

The culture that women are the first to support family is such a part of our culture that it has a name, “the motherhood penalty.” I’ve seen and experience the pressure for women to report to work override their desire, or the culture, to emotionally support their families, so babysitters or extended family are called in. I certainly called on our babysitter several times when I felt pressured to work when we had a sick kid at home. The expense to pay our sitter for my 10-hour workday wasn’t negligible, especially when we felt she deserved more than average since she was a registered nurse at a prestigious hospital and had to spend her day off nursing a febrile infant.

If the pressure to maintain a powerful appearance at work was removed from women and men alike, would more men choose family over professional prestige? It’s discussion worthy when a company offers paternity leave. Shoot, it’s almost remarkable when a women is offered paid maternity leave, especially when she is supported in her decision. And I’ve heard of plenty of women in medicine, especially the male-dominated fields, who only take a few days off after birthing an eight pound human. Then there’s the decreased incidence of breast feeding in high earning women despite abundance evidence of the benefits that educated women understand.

But I digress. Gender pay inequality is real, even in medicine. When I graduated from residency I asked advisors what is a fair starting salary in family medicine. They didn’t know how to answer. So I reached out to friends, most hired by the same healthcare system that trained us, to see what their starting salary was. I got the same blank faces. As I expressed my frustration to a colleague I was informed that no one could give me a straight answer because everyone had signed a non-disclosure agreement to not discuss their salary! They couldn’t even give me a ballpark or direct me to an online resource that could help me out. Again, I see this as a way to mask unequal pay between men and women in medicine.

So women are punished for doing what our bodies are meant to do! Punished from career advancement. Punished from opportunity to earn the same as men. Women earn less after the birth of their first child. What if men want to stay home with kids? Is the stereotype that men work and women stay home so ingrained in us that men are hesitant to speak up? Why doesn’t a father’s salary drop after having a child? Women in medicine report to work part-time because of children, men report they work part-time because they are committed to other high level positions. Women are also more likely to report depressive symptoms than their male counterparts, in part because of work-family disequilibrium.


What do you think, is it gender pay inequality when women are opting out of grueling hours and labor to have a life, with or without kids? Or is it only when executives make the salaries, and don’t offer equal pay to men and women in high income earning professions? Please share your thoughts and experiences below.


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