Mind the Gap: Career and Financial Success for Women in Medicine

  • Kristine D. OlsonEmail author
  • Jamie R. Litvack


Career advancement and financial success for female physicians entail navigating gender norms (real and perceived) in a still male-dominated profession. The evidence demonstrates that female physicians are able to perform at the level of their male counterparts and that gender diversity increases the value and performance of organizations, yet women have not yet achieved the same level of opportunity and reward. In this chapter we will explore the success gaps, that which contributes to the gaps, and what men and women can do to close the gaps to ensure the freedom and opportunity to pursue personal and professional success.


Leadership Academic advancement Finances Debt Pay Gap Promotion Negotiation Confidence Communication Tokenism 


  1. 1.
    Bulluck P. N.I.H. head calls for end to all-male panels of scientists. New York Times. 12 June 2019.Google Scholar
  2. 2.
    Manzoor M, Thompson K. Delivered by women, led by men: a gender and equity analysis of the Global Health and Social Workforce: World Health Organization; 3 Mar 2019. 60 p.Google Scholar
  3. 3.
    Heiser S. More women than men enrolled in U.S. medical schools in 2017: Association of American Medical Colleges; 2018 [updated December 18, 2017]. Available from:
  4. 4.
    Overberg P, Adamy J, Thuy L, Ma J. What’s your pay gap? Wall Street Journal; 2016 [cited 2016 May 17]. Available from:
  5. 5.
    Miller C. Pay gap is because of gender, not jobs. New York Times. 23 Apr 2014.Google Scholar
  6. 6.
    Doximity 2019 physician compensation report: doximity. 2019. Available from:
  7. 7.
    Freund KM, Raj A, Kaplan SE, Terrin N, Breeze JL, Urech TH, et al. Inequities in academic compensation by gender: a follow-up to the National Faculty Survey Cohort Study. Acad Med. 2016;91(8):1068–73.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Warner AS, Lehmann LS. Gender wage disparities in medicine: time to close the gap. J Gen Intern Med. 2019;34(7):1334–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Newcomb A. Women’s earnings lower in most occupations 2018 [May 22]. Available from:
  10. 10.
    Lo Sasso AT, Richards MR, Chou CF, Gerber SE. The $16,819 pay gap for newly trained physicians: the unexplained trend of men earning more than women. Health Aff. 2011;30(2):193–201.CrossRefGoogle Scholar
  11. 11.
    Carr PL, Raj A, Kaplan SE, Terrin N, Breeze JL, Freund KM. Gender differences in academic medicine: retention, rank, and leadership comparisons from the National Faculty Survey. Acad Med. 2018;93(11):1694–9.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Desai T, Ali S, Fang X, Thompson W, Jawa P, Vachharajani T. Equal work for unequal pay: the gender reimbursement gap for healthcare providers in the United States. Postgrad Med J. 2016;92(1092):571–5.PubMedCrossRefGoogle Scholar
  13. 13.
    Baker LC. Differences in earnings between male and female physicians. N Engl J Med. 1996;334(15):960–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Pollart SM, Dandar V, Brubaker L, Chaudron L, Morrison LA, Fox S, et al. Characteristics, satisfaction, and engagement of part-time faculty at U.S. medical schools. Acad Med. 2015;90(3):355–64.PubMedCrossRefGoogle Scholar
  15. 15.
    Foundation TP. Health Reform and the Decline of Physician Private Practice. A White Pater Examining the Effects of the Patient Protection and Affordable Care Act on Physicians Practices in the United States: Merrit Hawkins; 2010. p. pp 116.Google Scholar
  16. 16.
    Arnett DK. Plugging the leaking pipeline: why men have a stake in the recruitment and retention of women in cardiovascular medicine and research. Circ Cardiovasc Qual Outcomes. 2015;8(2 Suppl 1):S63–4.PubMedCrossRefGoogle Scholar
  17. 17.
    Zenger J, Folkman J. Research: women score higher than men in most leadership skills. Harvard Business Review. 2019.Google Scholar
  18. 18.
    Murphy H. Picture a leader. Is she a woman? New York Times. 16 Mar 2018.Google Scholar
  19. 19.
    Rosenstein AH. Strategies to enhance physician engagement. J Med Pract Manage. 2015;31(2):113–6.PubMedGoogle Scholar
  20. 20.
    Valantine H, Sandborg CI. Changing the culture of academic medicine to eliminate the gender leadership gap: 50/50 by 2020. Acad Med. 2013;88(10):1411–3.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Rotenstein L. Fixing the gender imbalance in healthcare leadership. Harvard Business Review. 2018.Google Scholar
  22. 22.
    Mangurian C, Linos E, Urminala S, Rodrigez C, Jagsi R. What is holding women in medicine back from leadership. Harvard Business Review. 2018.Google Scholar
  23. 23.
    Valantine HA, Grewal D, Ku MC, Moseley J, Shih MC, Stevenson D, et al. The gender gap in academic medicine: comparing results from a multifaceted intervention for Stanford faculty to peer and national cohorts. Acad Med. 2014;89(6):904–11.PubMedCrossRefGoogle Scholar
  24. 24.
    Program on Neotiation HLS. Harvard University; 2013.Google Scholar
  25. 25.
    Valerio A, Sawyer K. The men who mentor women. Harvard Business Review. 2016.Google Scholar
  26. 26.
    Turban S, Wu D, Letian LT. Research: When gender diversity makes firms more productive. Harvard Business Review. 2019.Google Scholar
  27. 27.
    Prince LA, Pipas L, Brown LH. Patient perceptions of emergency physicians: the gender gap still exists. J Emerg Med. 2006;31(4):361–4.PubMedCrossRefGoogle Scholar
  28. 28.
    Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. Comparison of hospital mortality and readmission rates for medicare patients treated by male vs female physicians. JAMA Intern Med. 2017;177(2):206–13.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Delgado A, Lopez-Fernandez LA, Luna JD. Influence of the doctor’s gender in the satisfaction of the users. Med Care. 1993;31(9):795–800.PubMedCrossRefGoogle Scholar
  30. 30.
    McMurray JE, Linzer M, Konrad TR, Douglas J, Shugerman R, Nelson K. The work lives of women physicians results from the physician work life study. The SGIM Career Satisfaction Study Group. J Gen Intern Med. 2000;15(6):372–80.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Files JA, Mayer AP, Ko MG, Friedrich P, Jenkins M, Bryan MJ, et al. Speaker introductions at internal medicine grand rounds: forms of address reveal gender bias. J Womens Health (Larchmt). 2017;26(5):413–9.CrossRefGoogle Scholar
  32. 32.
    Ruzycki SM, Fletcher S, Earp M, Bharwani A, Lithgow KC. Trends in the proportion of female speakers at medical conferences in the United States and in Canada, 2007 to 2017. JAMA Netw Open. 2019;2(4):e192103.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Kuhlmann E, Ovseiko PV, Kurmeyer C, Gutierrez-Lobos K, Steinbock S, von Knorring M, et al. Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union. Hum Resour Health. 2017;15(1):2.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Jagsi R, Guancial EA, Worobey CC, Henault LE, Chang Y, Starr R, et al. The “gender gap” in authorship of academic medical literature – a 35-year perspective. N Engl J Med. 2006;355(3):281–7.PubMedCrossRefGoogle Scholar
  35. 35.
    Jena AB, Olenski AR, Blumenthal DM. Sex differences in physician salary in US public medical schools. JAMA Intern Med. 2016;176(9):1294–304.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Bates C, Gordon L, Travis E, Chatterjee A, Chaudron L, Fivush B, et al. Striving for gender equity in academic medicine careers: a call to action. Acad Med. 2016;91(8):1050–2.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Dyrbye LN, Shanafelt TD, Balch CM, Satele D, Freischlag J. Physicians married or partnered to physicians: a comparative study in the American College of Surgeons. J Am Coll Surg. 2010;211(5):663–71.PubMedCrossRefGoogle Scholar
  38. 38.
    Jolly S, Griffith KA, DeCastro R, Stewart A, Ubel P, Jagsi R. Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers. Ann Intern Med. 2014;160(5):344–53.PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Ly DP, Jena AB. Sex differences in time spent on household activities and care of children among US physicians, 2003-2016. Mayo Clin Proc. 2018;93(10):1484–7.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Adesoye T, Mangurian C, Choo EK, Girgis C, Sabry-Elnaggar H, Linos E. Perceived discrimination experienced by physician mothers and desired workplace changes: a cross-sectional survey. JAMA Intern Med. 2017;177(7):1033–6.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Riska E. Towards gender balance: but will women physicians have an impact on medicine? Soc Sci Med. 2001;52(2):179–87.PubMedCrossRefGoogle Scholar
  42. 42.
    Coe IR, Wiley R, Bekker LG. Organisational best practices towards gender equality in science and medicine. Lancet. 2019;393(10171):587–93.PubMedCrossRefGoogle Scholar
  43. 43.
    McNamee S, MIller R. The meritocracy myth. 2nd ed. Landham: Rowman & Littlefield; 2009.Google Scholar
  44. 44.
    Thomas K, Mack D, Mantagliani A. The arguments against diveristy: are they valid? In: Stockdale MS, Crosby FJ, editors. The psychology and management of workplace diversity. Malden: Blackwell Publishing; 2004.Google Scholar
  45. 45.
    Harris C. Whiteness as property. Harv Law Rev. 1993;106(8):1707–91.CrossRefGoogle Scholar
  46. 46.
    Markovitz D. How life became an endless, terrible competition. The Atlantic. Sept 2019.Google Scholar
  47. 47.
    Kang SK, Kaplan S. Working toward gender diversity and inclusion in medicine: myths and solutions. Lancet. 2019;393(10171):579–86.PubMedCrossRefGoogle Scholar
  48. 48.
    Delgado A, Saletti-Cuesta L, Lopez-Fernandez LA, Toro-Cardenas S, Luna del Castillo J d D. Professional success and gender in family medicine: design of scales and examination of gender differences in subjective and objective success among family physicians. Eval Health Prof. 2016;39(1):87–99.PubMedCrossRefGoogle Scholar
  49. 49.
    Maji S, Dixit S. Self-silencing and women’s health: a review. Int J Soc Psychiatry. 2019;65(1):3–13.PubMedCrossRefGoogle Scholar
  50. 50.
    Kay K, Shipman C. The confidence gap. The Atlantic. 2014. pp. 56–66.Google Scholar
  51. 51.
    Menendez A. The likeability trap. Harper Business: New York; 2019. 256 p.Google Scholar
  52. 52.
    Rodriguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: what of the minority tax? BMC Med Educ. 2015;15:6.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Fallin-Bennett K. Implicit bias against sexual minorities in medicine: cycles of professional influence and the role of the hidden curriculum. Acad Med. 2015;90(5):549–52.PubMedCrossRefGoogle Scholar
  54. 54.
    Frankel LP. Nice girls still don’t get the corner office. New York: Business Plus Books; 2014.Google Scholar
  55. 55.
    Zimmer L. Tokenism and women in the workplace: the limits of gender-neutral theory. Soc Probl. 1988;35(1):64.CrossRefGoogle Scholar
  56. 56.
    Hu YY, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381(18):1741–52.PubMedCrossRefGoogle Scholar
  57. 57.
    Dampier C, Lieff S, LeBeau P, Rhee S, McMurray M, Rogers Z, et al. Health-related quality of life in children with sickle cell disease: a report from the Comprehensive Sickle Cell Centers Clinical Trial Consortium. Pediatr Blood Cancer. 2010;55(3):485–94.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Tarbox K. Is #MeToo backlash hurting women’s opportunities in finance? Harvard Business Review. 2018.Google Scholar
  59. 59.
    Brody DS, Miller SM, Lerman CE, Smith DG, Lazaro CG, Blum MJ. The relationship between patients’ satisfaction with their physicians and perceptions about interventions they desired and received. Med Care. 1989;27(11):1027–35.PubMedCrossRefGoogle Scholar
  60. 60.
    Martin A. Women benefit when they down play gender. In: Torres N, editor. Defend your research. Harvard Business Review; 2018.Google Scholar
  61. 61.
    Kanter R. Men and women of the corporation. New York: Basic Books; 1977.Google Scholar
  62. 62.
    Kanter R. A tale of “O” - on being different in an organization. New York: Harper Row; 1980.Google Scholar
  63. 63.
    Ibarra H, Carter N, Silva C. Why men still get more promotions than women. Harvard Business Review. 2010.Google Scholar
  64. 64.
    Johnson WB, Smith DG. How men can become better allies to women. Harvard Business Review. 2018.Google Scholar
  65. 65.
    Smith DG, Johnson B. Lots of men are gender-equality allies in private. Why not in public? Harvard Business Review. 2017.Google Scholar
  66. 66.
    Physicians Mom’s Group (PMG) [Available from:
  67. 67.
    Bellock S. Research-based advise for women working in male-dominated fields. Harvard Business Review. 2019.Google Scholar
  68. 68.
    Zheng W, Kark R, Meister A. How women manage the gender norms of leadership. Harvard Business Review. 2018.Google Scholar
  69. 69.
    Ibarra H, Ely R, Kolb D. Educate everyone about second-generation gender bias. Harvard Business Review. 2013.Google Scholar
  70. 70.
    Wikipedia. Second-generation gender bias: Wikipedia; 2019. Available from:
  71. 71.
    Johnson SK, Hekman DR, Chan ET. If there’s only ONe woman in your candidate pool, there’s statistically no chance she’ll be hired. Harvard Business Review. 2016.Google Scholar
  72. 72.
    Hall WJ, Chapman MV, Lee KM, Merino YM, Thomas TW, Payne BK, et al. Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. Am J Public Health. 2015;105(12):e60–76.PubMedPubMedCentralCrossRefGoogle Scholar
  73. 73.
    Gonzalez CM, Garba RJ, Liguori A, Marantz PR, McKee MD, Lypson ML. How to make or break implicit bias instruction: implications for curriculum development. Acad Med. 2018;93(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 57th Annual Research in Medical Education Sessions):S74–81.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Johnson SK, Davis K. CEO’s explain how they gender-balanced their boards. Harvard Business Review. 2017.Google Scholar
  75. 75.
    Bohnet I. How to take the bias out of interviews. Harvard Business Review. 2016.Google Scholar
  76. 76.
    Rivera L, Tilcsik A. One way to reduce gender bias in performance review. 2019.Google Scholar
  77. 77.
    Rotenstein L, Dudley JC. How to close the gender pay gap in U.S. medicine. Harvard Business Review. 2019.Google Scholar
  78. 78.
    Dermody SM, Litvack JR, Randall JA, Malekzadeh S, Maxwell JH. Compensation of otolaryngologists in the veterans health administration: is there a gender gap? Laryngoscope. 2019;129(1):113–8.PubMedCrossRefGoogle Scholar
  79. 79.
    Maxwell JH, Randall JA, Dermody SM, Hussaini A, Rao H, Nathan AS, et al., editors. Pay transparency among surgeons in the veterans health administration: closing the gender gap. American College of Surgeons Clinical Congress. 25 Oct 2019. San Francisco.Google Scholar
  80. 80.
    Villablanca AC, Beckett L, Nettiksimmons J, Howell LP. Career flexibility and family-friendly policies: an NIH-funded study to enhance women’s careers in biomedical sciences. J Womens Health (Larchmt). 2011;20(10):1485–96.CrossRefGoogle Scholar
  81. 81.
    Shanafelt T, Goh J, Sinsky C. The business case for investing in physician well-being. JAMA Intern Med. 2017;177(12):1826–32.PubMedCrossRefGoogle Scholar
  82. 82.
    Royce TJ, Davenport KT, Dahle JM. A burnout reduction and wellness strategy: personal financial health for the medical trainee and early career radiation oncologist. Pract Radiat Oncol. 2019;9(4):231–8.PubMedCrossRefGoogle Scholar
  83. 83.
    J D. The White Coat Investor 2020. Available from:
  84. 84.
    Physician on FIRE (Financial Independence and Retire Early), 2020. Available from:
  85. 85.
    Koo B. Wealthy Mom MD. 2020.Google Scholar
  86. 86.
    Rohlfing J, Navarro R, Maniya OZ, Hughes BD, Rogalsky DK. Medical student debt and major life choices other than specialty. Med Educ Online. 2014;19:25603.PubMedCrossRefGoogle Scholar
  87. 87.
    Pisaniello MS, Asahina AT, Bacchi S, Wagner M, Perry SW, Wong ML, et al. Effect of medical student debt on mental health, academic performance and specialty choice: a systematic review. BMJ Open. 2019;9(7):e029980.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Internal MedicineYale School of Medicine, Yale New Haven HospitalNew HavenUSA
  2. 2.Surgery, Washington State UniversityPullmanUSA

Personalised recommendations