The resident gender pay gap?

When people talk about the very real gender pay gap, they’re talking about women and men being paid different amounts for doing the same work. There is a pay gap in medicine, and that’s a problem.

What’s so odd then is this discussion of the gender pay gap in the most recent Medscape Resident Salary and Debt Report:

Salaries for women in residency are lower than those for men ($54,000 and $56,000, respectively). The gender disparity in residents, however, is only 4% compared with a disparity of 24% among all physicians, according to the latest Medscape Physician Compensation report. The much smaller difference among residents is most likely due to their work in the hospital setting, where salaries are consistent. But disparity seems to be a continuing problem.

And later:

Over three quarters (76%) of male residents work at least 51 hours per week in the hospital compared with 68% of women. Such a discrepancy might be one reason for the slight income disparity between male and female residents.

But:

• Resident salaries do not actually vary by gender.
• Residents cannot bargain for salary increases on an individual basis.
• Residents are salaried (stipended) workers who do not get paid by the hour as residents (moonlighting aside).

I can think of a few more plausible explanations for the small resident gender pay gap in this totally nonrandom sample of 1279 residents from different fields not accounting for seniority:

1. Out of survey respondents, men were more likely than women to choose specialties with long residencies. This is a general trend which has been demonstrated previously. Resident pay is graded by PGY level. If you are a resident longer, you will eventually get paid more. So a male PGY6 neurosurgery resident gets paid more than a female PGY3 pediatrics resident.
2. Out of survey respondents, the men who answered had a slightly higher PGY level on average than the female respondents, and this wasn’t controlled for. Same logic as above.
3. Out of survey respondents, slightly more men lived in geographically expensive areas with consequent larger salaries thanks to CMS.

I would argue that given the classically terrible methodology of Medscape surveys, that the above explanations or more likely than a nefarious but hitherto unknown hidden systematic gender pay gap among resident physicians. The real problem lies in landing that first job after residency and continues from there.

I’ll leave John Oliver to weigh in more eloquently: