The Gender Gap Persists but There Is Reason for Optimism
As a group, female physicians consistently make less money than their male counterparts in Medscape reports, and 2017's report is no exception.
The good news is that the gender gap for PCPs has been narrowing somewhat. It was 18.9% in 2012 and is 16% this year, with male doctors earning $229,000 and females $197,000.
But there are signs that the gender pay gap could abate in the future. For older groups, the gender pay gap ranges from 35% to 37%. Medscape's breakdown of the gap by age groups shows that it has narrowed to 18% for physicians 34 years of age or younger.
For specialists, the gender gap is considerably wider. Male specialists make $345,000 and female specialists make $251,000—a gap of 37%. Last year the gap was 33%—$324,000 for men and $242,000 for women. These results are likely influenced by the relative scarcity of women in some of the higher-paying specialties.
The Medscape report shows that female physicians are twice as likely as males to work part-time (less than 40 hours per week). While 11% of men work part-time, 22% of women do so. (Lower part-time incomes are not a factor in the pay gap; we compared incomes only for full-time workers.)
However, one possible factor in the pay gap is that women physicians are more likely to be employed, and employed physicians earn less than their self-employed colleagues. The Medscape Employed Doctors Report, released in June 2016, showed that female doctors have a slight edge over male doctors in employment: 82% versus 78%.
Several lower-paying specialties have a higher concentration of women than all of medicine: pediatrics (53%), psychiatry (38%), and family medicine (36%), according to Medscape 2016 compensation report. Meanwhile, several high-paying specialties have very low concentrations of women: urology (7%), orthopedics (9%), and cardiology (12%).
None of these factors, however, fully explain the gender gap in physician income, and Singleton finds the gap "puzzling," because it isn't apparent in employment contracts.
A 2015 Medscape articlesuggested that women are less assertive about getting the best benefits when they negotiate their contracts, but Singleton does not feel that that's a factor. "Female candidates are just as assertive, just as astute as men," he says.
Foreign Graduates Trail US Grads in Income
The Medscape survey shows that international medical graduates (IMGs)—graduates of foreign medical schools, who make up almost 25% of all US doctors—generally earn less than US medical graduates (USMGs).
USMGs earn an average of $301,000 a year, and almost all national groups of IMGs earn less than that. The one exception is Canadian medical school graduates, who make up almost 9% of IMGs and earn $328,000, according to the new survey.
Canadian graduates can enter US medicine more easily than any other IMG group. In fact, many US medical educators don't even consider Canadians to be IMGs because their medical schools are accredited by the same group that accredits US schools.
Moreover, to practice in most states, Canadians don't even have to take a US residency, which all other IMGs have to do. Forty state licensing boards consider Canadian residency training as equivalent to US training, according to an article by Carl Shusterman, an immigration attorney for IMGs.
However, Canadian doctors do face one significant barrier, he wrote. To get a temporary visa for a US job, they must pass the US Medical Licensing Exam, which they didn't take in Canada. According to Shusterman, Canadian graduates can avoid this hurdle by immediately applying for permanent residency in the United States, but that's not an easy route to take.
Canadian graduates have a financial incentive to work here. In Canada, PCPs make two thirds and orthopedic surgeons make less than half of what their US counterparts make, according to a 2011 studyin Health Affairs.
The flow of Canadian doctors to the United States crested in the 1970s, and by 2011, more USMGs were migrating to Canada than the other way around, according to a reportin the Canadian newspaper the National Post.
Other IMG nationality groups earn less than US graduates, and one key reason is that IMGs have a very small presence in some of the highest-paying specialties. High-earning specialties with low percentages of IMGs include dermatology (4.9%), orthopedic surgery (5.5%), urology (11.7%), and plastic surgery (10.2%), according to a 2015 reportby the Association of American Medical Colleges (AAMC).
The report also shows high concentrations of IMGs in a few higher-earning specialties, such as interventional cardiology (43.6%) and gastroenterology (28.2%). Except for internal medicine (38.6%), IMGs are not concentrated in lower-paying primary care specialties, such as pediatrics (25.4%) and family medicine (22.0%).
In the Medscape report, incomes of IMGs from China fall just a little below those of US graduates. This relatively small but growing group makes $290,000, according to the Medscape survey. Next come physicians from India, who make up 15%-20% of IMGs and earn $277,000; and physicians from Pakistan, who account for more than 5% of IMGs and make $273,000.
Then come physicians trained in Mexico, almost 6% of IMGs, who earn $263,000; and physicians trained in the Philippines, almost 9% of IMGs, earning $243,000.
US-born IMGs (USIMGs) are estimated to make up about 20%-30% of all IMGs, and many of them graduated from medical schools in the Caribbean. According to the Medscape report, graduates of Caribbean schools make an average of $256,000.
USIMGs who enter internal medicine are less likely than USMGs to enter subspecialty fellowships, where they could earn more money, according to a report in Health Affairs.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Leigh Page. Doctors' Incomes Are on the Rise -- Is Yours? Medscape Physician Compensation Report 2017 - Medscape - Apr 04, 2017.