Compensation and advancement of women in academic medicine: Is there equity?

Background: women have been entering academic medicine in numbers at least equal to their male colleagues for several decades. Most studies have found that women do not advance in academic rank as fast as men and that their salaries are not as great. These studies, however, have typically not had the data to examine equity, that is, do women receive similar rewards for similar achievement? Objective: To examine equity in promotion and salary for female versus male medical school faculty nationally. Design: Mailed survey questionnaire. Setting: 24 randomly selected medical schools in the contiguous United States. Participants: 1814 full-time U.S. medical school faculty in 1995-1996, stratified by sex, specialty, and graduation cohort. Measurements: Promotion and compensation of academic medical faculty. Results: Among the 1814 faculty respondents (response rate, 60%), female faculty were less likely to be full professors than were men with similar professional roles and achievement. For example, 66% of men but only 47% of women (P < 0.01) with 15 to 19 years of seniority were full professors. Large deficits in rank for senior faculty women were confirmed in logistic models that accounted for a wide range of other professional characteristics and achievements, including total career publications, years of seniority, hours worked per week, department type, minority status, medical versus nonmedical final degree, and school. Similar multivariable modeling also confirmed gender inequity in compensation. Although base salaries of nonphysician faculty are gender comparable, female physician faculty have a noticeable deficit (-$11691; P = 0.01). Furthermore, both physician and nonphysician women with greater seniority have larger salary deficits (-$485 per year of seniority; P = 0.01). Limitations: This is a cross-sectional study of a longitudinal phenomenon. No data are available for faculty who are no longer working full-time in academic medicine, and all data are self-reported. Conclusions: Female medical school faculty neither advance as rapidly nor are compensated as well as professionally similar male colleagues. Deficits for female physicians are greater than those for nonphysician female faculty, and for both physicians and nonphysicians, women's deficits are greater for faculty with more seniority.