Otolaryngology’s Gender Wage Gap

Only after she left academic practice to open her private practice was she paid equitably, she said.

Historically, women tend to negotiate less than their male counterparts, which undoubtedly contributes to the gender wage gap. “Many women in medicine, especially competitive surgical specialties, continue to suffer at higher rates from impostor syndrome,” Dr. Crosby said. “I have personally entered into negotiating situations feeling lucky to have an opportunity rather than considering all of the work that I’ve done to get there. I think, ‘I’m happy to even be considered. I certainly wouldn’t want to push too hard, or they might offer the position to somebody else.’

“Simply stating that women need to be better negotiators, though, is nothing more than victim blaming,” Dr. Crosby continued. “Individuals with the power to determine salaries and incentives must hold themselves accountable for offering equal pay for equal effort.”

The Importance of Leadership Roles

Academic promotion often requires national leadership roles, so having more women in leadership may help more women achieve higher academic ranks and salary increases. “The gender salary gap starts early, including lower starting salaries for female physicians,” Dr. O’Brien said. “Waiting for women to achieve leadership roles in academic societies won’t close the gap in accumulated wealth over a career.”

A 2020 study showed that only 15.3% of leadership roles, including department chairs, residency program directors, or fellowship program directors, were held by women (Laryngoscope. 2020;130:1664–1669). When the study was published, only five of 99 otolaryngology departments nationwide had female chairs, Dr. Crosby said. The number of female chairs has grown only slightly since then.

Women who held these leadership roles tended to have fewer years in practice and were at lower ranks. “While my hope is that this is because talented young women are being identified and elevated early in their careers, I’m concerned that some of these leadership positions are being offered to women because they come with less pay and more work,” Dr. Crosby said.

Dr. Crosby currently holds the titles of both department chair and residency program director. “The latter position continues to grow in paperwork and bureaucratic requirements, but the pay is often not commensurate with the level of work required to do the job effectively,” she said. “Based on my own experiences, I worry that when offered these opportunities women are less likely to negotiate for pay that is appropriate for the level of work required, and instead simply remain thankful for the opportunity.”