Otolaryngology’s Gender Wage Gap

According to Doximity’s 2020 Physician Compensation Report, the largest gap between men’s and women’s salaries in different medical specialties occurs in otolaryngology. Women made 77.9% of what men earned, a difference of 22.1%.

In addition to the difference in pay, wage gaps can result in other negative outcomes. “When someone is paid less for the same work, they feel personally devalued,” said Sujana S. Chandrasekhar, MD, a partner at ENT and Allergy Associates, LLP, in New York, N.Y. “Consequently, they aren’t likely to push themselves in terms of research projects, mentoring, sponsoring, or leadership opportunities.”

When asked what contributes to the large gap, Dana L. Crosby, MD, MPH, department chair, residency program director, and associate professor in the department of otolaryngology– head and neck surgery at Southern Illinois University School of Medicine in Springfield, said that one component of the pay gap is often attributed to gender lag, given that higher proportions of women are now in training and in the earlier stages of their careers. In 2017, women comprised 36% of active otolaryngology residents. In 2019, the Association of American Medical Colleges Physician Specialty Data Report showed that just 18% of practicing otolaryngologists were women.

Along these lines, Erin O’Brien, MD, associate professor and chair of the division of rhinology in the department of otolaryngology–head and neck surgery at Mayo Clinic in Rochester, Minn., pointed out that Medicare billing data have shown higher billings by older otolaryngologists. “Women in otolaryngology are younger on average, so the average age may be responsible for part of the gap,” she said. Secondly, female otolaryngologists are more likely to practice in urban areas than rural areas. Rural otolaryngologists bill for more services than urban otolaryngologists, so geographic differences may also play a role in the gender gap (Ann Otol Rhinol Laryngol. 2022;131:749–759).

Dr. Crosby said that gender lag alone cannot account for this significant disparity, however. A 2021 study showed that there was a significant salary gap at every career stage in academic positions, from instructor through full professor, when comparing men to women (Laryngoscope. 2021;131:989–995). “The study estimated that over the course of a 30-year career, the difference in salary by gender would amount to $3,365,000,” she said.

The study estimated that over the course of a 30-year career, the difference in salary by gender would amount to $3,365,000. —Dana L. Crosby, MD, MPH

Regarding career advancement, accelerators in pay such as promotions and leadership opportunities are often offered to those with the closest relationships to those already in leadership positions or to individuals in whom current leadership can see characteristics of themselves, Dr. Crosby continued. Because White men have historically served in those roles, persistent homogeneity in leadership roles has occurred. “Changing this culture will take time, but more importantly, intentionality is required to begin to close this gap,” she said.