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How Far Women Have Come in Otolaryngology Compensation Parity and What Needs to Happen Next

by Erin K. O’Brien, MD •

On these pages in 2010, Linda Brodsky, MD, discussed the gender gap in compensation and leadership positions in otolaryngology (ENTtoday. February 1, 2010. Available here). How far have we come since she highlighted issues of gender inequity nearly a decade ago?

In the two decades since I was a medical student rotating in otolaryngology, women have made progress in leadership roles in our academic societies and training programs. However, progress toward equity in our specialty has not come quickly enough.

A pay gap still exists in salaries for women in otolaryngology. In 2004, Jennifer Grandis, MD, a professor of otolaryngology–head and neck surgery at the University of California San Francisco, reported a 15% to 20% gender pay gap even after controlling for confounding variables (Arch Otolaryngol Head Neck Surg. 2004;130:695–702). More recent data suggests this pay disparity persists. The 2018 Medscape survey of full-time otolaryngologists found that women were paid $75,000 (19%) less than men. A 2016 study of 10,000 university physicians also found a pay gap for female physicians despite controlling for experience, faculty rank, specialty, research productivity, and clinical volume, with surgical specialties demonstrating the largest absolute adjusted sex differences in salary (JAMA Intern Med. 2016;176:1294–1304) (See “Sex Differences in Physician Salary and Rank in U.S. Public Medical Schools,” below).

Table 1. Sex Differences in Physician Salary and Rank in U.S. Public Medical Schools

(click for larger image) Table 1. Sex Differences in Physician Salary and Rank in U.S. Public Medical Schools
Source: JAMA Intern Med. 2016;176:1294–1304

Female otolaryngologists are paid less than male colleagues right out of residency (Health Aff (Millwood). 2011;30:193–201). Some skeptics may still not believe a pay gap exists, while others may attribute a gap to women’s career choices. However, we have no recent data to determine whether women see fewer patients or perform fewer procedures or decline leadership opportunities, as some may assume, to explain lower salaries for women in our specialty. The other possibility is that women are not being paid equally for equal work and are not provided the same opportunities to earn a salary comparable to their male colleagues.

Research funding in otolaryngology also has a gender gap, with women awarded less money per NIH-funded grant than men at both the assistant professor level and at 10 to 20 years of experience. Women are also awarded fewer R-series grants, with less money awarded per grant (Otolaryngol Head Neck Surg. 2013;149:77–83). Women were 31% of recipients of NIH otolaryngology funding from 2005 through 2014. However, 78% of female recipients had a PhD versus 55% of male recipients; only 21 of the 331 recipients were female physicians. (Otolaryngol Head Neck Surg. 2017;157:774–780). A study in Lancet found the gender gap in research funding could be attributed entirely to the score of the scientist, not the science itself, with lower scores for female applicants (Lancet. 2019;393:531–540).

I left my position as a physician–scientist after my research repeatedly was not funded; this may have been entirely due to my own failings and nothing to do with gender, but I wonder how many women in otolaryngology have left research due to inequities in funding and support.