Skip to content

Women's Lower Expectations, Discomfort with Negotiation May Contribute to Income Gap Between Male and Female Urologists

Key findings

  • In this study, researchers analyzed data on 705 urology residents who responded to the American Urological Association census between 2016 and 2018; 196 respondents (28%) were women
  • Men and women were similar in educational debt load and the value they placed on future compensation
  • 73% of women reported they felt unprepared to handle the business aspects of medicine, including salary negotiation, versus 52% of men (P<0.001)
  • 53% of female respondents expected to earn less than $300,000 in their first year of practice versus 32% of male respondents (P<0.001)
  • Short-term solutions would be for employers to remove salary negotiation from compensation structures or make salary data more accessible; another important focus should be to train all urology residents in business practices and negotiation

Female surgeons in the U.S. earn $32,000 less per year than male surgeons, on average, even after accounting for experience, academic impact, hours worked and types of duties. More women enter the urological workforce every year, and this gender pay gap has significant implications for the future of the field.

In analyzing a nationally representative sample of U.S. urology residents, Eugene B. Cone, MD, clinical fellow with the Department of Urology at Massachusetts General Hospital, and colleagues found that women had significantly lower salary expectations than men did and felt significantly less prepared to handle business aspects of medicine. The researchers suggest short-term solutions in their report in Urology.

Study Methods

The researchers analyzed data collected from 2016 to 2018 as part of the American Urological Association census of urologists and trainees. By merging samples from each of those years, they created a U.S. resident–specific dataset (n=705). 196 of those respondents (28%) were women.

Similarities Between Genders

Men and women were similar in age, race, educational debt load and distribution by year of training.

"What is important to you as you consider practice opportunities?"

  • Family/lifestyle/call schedule—85% of women and 89% of men
  • Location—67% and 87%
  • Compensation—70% and 80% (P=0.05 for all comparisons)

The importance residents placed on business-related factors affecting their future practice (local urologist supply, contractual obligation, research climate and malpractice climate) was also similar between genders.

Differences Between Genders

 

Expected first-year salary

  • Less than $300,000—53% of women vs. 32% of men
  • More than $350,000—14% vs. 33% (P<0.001 for both comparisons)

Preparation for the business of medicine, including salary negotiation

  • Unprepared—73% of women vs. 52% of men
  • Somewhat prepared—24% vs. 44%
  • Very prepared—2% vs. 3% (P<0.001 for all comparisons)

The Way Forward

Women's lower expectations about salary and discomfort with negotiation—or unawareness that salary negotiation is typically possible—can lead to lower initial income that sets a career-defining pattern.

Some short-term solutions would be for employers to remove salary negotiation from compensation structures and make salary data more accessible. Another important focus should be to train all urology residents in business practices and contract negotiation.

54%
of female vs. 32% of male urology residents expect a first-year salary <$300,000

14%
of female vs. 33% of male urology residents expect a first-year salary >$350,000

73%
of female vs. 52% of male urology residents feel unprepared for the business of medicine, including salary negotiation

85%
of female and 89% of male urology residents say family/lifestyle/call schedule is important as they consider practice opportunities

Visit the Department of Urology

Refer a patient to the Department of Urology

Related

Massachusetts General Hospital urologists Ajay Singla, MD, and Elise J. B. De, MD, are among a limited number of providers offering non-mesh surgical alternatives only, including Burch colposuspension and fascial pubovaginal sling. Here's why.

Related

In the first randomized, controlled trial of its kind, Milena M. Weinstein, MD, of the Department of Obstetrics and Gynecology, and colleagues found that use of a motion-based digital device for pelvic floor muscle training (PFMT) provides benefits beyond those of unsupervised PFMT alone.