Women academic ophthalmologists earned 85 to 91 cents for every dollar earned by men in 2024, with projected compensation parity achievable only at the two lowest ranks and not expected at the professor or department chair level, according to a retrospective economic evaluation published in JAMA Ophthalmology.

 

The study analyzed full-time academic ophthalmology faculty compensation reported annually by US medical schools to the Association of American Medical Colleges (AAMC) Faculty Salary Survey from 2016 to 2024. An average of 1,470 ophthalmologists per year were included, approximately 59% of whom were men. The dataset captures a substantial proportion of US academic faculty across participating institutions.

 

 

Overall, median total compensation—comprising fixed salary, medical practice supplement, and bonus or incentive pay, but excluding benefits—increased across all academic ranks from 2016 to 2024. Growth generally tracked closely with inflation, with only assistant professor salaries modestly exceeding inflation while other ranks showed slight shortfalls.

 

 

Growth generally tracked closely with inflation, with only assistant professor salaries modestly exceeding inflation while other ranks showed slight shortfalls. In 2024, women comprised 52% of assistant professors, 42% of associate professors, 30% of professors, and 19% of department chairs. Women's representation increased at an average of 0.82% per year at the assistant professor rank, 0.12% per year at the associate professor rank, 1.88% per year at the professor rank, and 0.98% per year at the chair rank.

 

Despite this, women were compensated less than men at every rank in every year of the study. In 2024, median total compensation for male vs female assistant professors was $324,000 vs $296,000; for associate professors, $411,000 vs $350,000; for professors, $445,000 vs $377,000; and for chairs, $761,000 vs $696,000. Women earned $0.91 per male dollar at assistant professor and chair levels, while women associate professors and professors each earned $0.85 per male dollar.

 

Over a modeled 30-year academic career, men were projected to earn $7.91 million vs $6.87 million for women—a difference of $1.04 million, corresponding to women earning 87 cents per male dollar cumulatively. Sensitivity analyses varied career length (20, 25, or 35 years) and time to promotion (4, 6, 8, 10, or 12 years).

 

 

Compensation for women has been increasing faster than men’s at the assistant and associate professor ranks, suggesting parity could be reached within approximately 7.5 and 14.6 years, respectively. However, compensation growth remains slower for women at the professor and chair levels, and parity at these ranks is not expected under current trends.

 

 

The authors noted a prior 2-year AAMC-based study (2019–2020) found women academic ophthalmologists earned a mean of $50,300 less annually than men, with differences ranging from $6,000 at the instructor level to $112,000 at the chief level. The current study extends these findings with longer-term trend analysis and career earnings modeling.

 

 

The AAMC survey does not provide data on clinical or surgical volume, hours worked, years in practice, supplemental income sources, academic-protected time, or subspecialty. Data are reported by institution rather than by individual faculty, which may generalize results. Financial models used simplified assumptions, holding 2024 compensation levels constant and not adjusting for taxes, loans, or insurance. The study was also limited to full-time academic ophthalmologists, who represent approximately 25% of all ophthalmologists. Race and ethnicity data were not available.

 

 

In an invited commentary published alongside the study, Kathryn Colby, MD, PhD, and Dimitra Skondra, MD, PhD, of NYU Grossman School of Medicine/NYU Langone Health, argued that the $1.04 million career earnings gap materially underestimates the true magnitude of inequity. They noted that a $33,000 annual pay gap sustained over 30 years, if invested at a 6% to 8% annual return, compounds to an estimated $2.5 to $3.8 million difference by retirement—transforming a career earnings gap into a generational wealth deficit.

 

They described a self-reinforcing cycle in which lower compensation constrains women's ability to delegate nonacademic responsibilities, reducing academic productivity, slowing promotion, and perpetuating lower pay—particularly given documented evidence that women physicians spend more time on household activities and childcare than their male counterparts even after accounting for professional hours. They called for structured and transparent institutional compensation systems, periodic department-wide salary reviews, equalization of starting salaries, and incorporation of financial literacy and negotiation training into mandatory medical education curricula beginning in medical school.

 

"Gender-based salary inequity in academic ophthalmology is, therefore, not a peripheral fairness issue," the commentators wrote. "It is an institutional failure that drains financial capital, suppresses intellectual potential, and limits generational opportunity."

 

Disclosures are available in the published investigation and accompanying invited commentary.

 

Source: JAMA Ophthalmology, Invited Commentary