Female physicians accumulated more than $2 million less in lifetime earnings compared to their male counterparts over a simulated 40-year career, according to a viewpoint published in JAMA. The analysis revealed women physicians typically started their careers earning 75% of their male colleagues' wages.

The paper, authored by researchers from Stanford University School of Medicine's Clinical Excellence Research Center, documented how parenthood affected physician compensation differently by gender. Women experienced decreased annual income with each additional child, while men saw increased earnings after becoming fathers.

The authors identified both between-specialty and within-specialty income differences. Women were more frequently represented in lower-paying specialties such as pediatrics and family medicine. Within specialties like surgery and internal medicine, female physicians earned less than male counterparts for similar work.

The COVID-19 pandemic may have intensified these disparities, though researchers noted limited data availability on its specific impact on clinical and academic productivity among female physicians with children.

The University of California, San Francisco School of Medicine implemented an annual faculty salary audit program that identified and addressed approximately $2 million in gender-based pay discrepancies between 2015 and 2022.

The researchers recommended several approaches for health systems:

• Providing on-site or subsidized childcare
• Conducting regular salary audits
• Implementing collective pay agreements
• Creating transparent salary structures
• Offering focused coaching programs
• Developing equitable promotion opportunities

The authors noted that lower income, parenting status, and female sex correlated with increased burnout and work-life integration challenges among physicians.

Conflict of interest disclosures can be found in the letter.