Issue 2 / 27 January 2015

THE gender pay gap was highlighted in the media late last year and Australian economists have highlighted the disparity in average wealth between single men and single women.

Using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey, the economists found that in 2010, single men’s wealth was on average 23% higher than single women’s wealth holdings — a doubling of the gender wealth gap since 2002, when it was 10%.

The numbers are no different in medicine. A 2010 Australian study found female GPs earned, on average, 25% less than male GPs, and female specialists earned 16.6% less than their male colleagues.

In the US, female doctors earn just 71% as much as male doctors.

Workforce participation is one reason for the wealth gap, with women more likely to work fewer hours compared with males. Other factors that contribute include women working in positions that attract lower pay; a lack of women in senior positions; a lack of part-time or flexible senior roles; and discrimination, both indirect and direct.

Only 34% of specialists in Australia are women. While this is frequently attributed to lifestyle choices, there is evidence from the US that gender discrimination and sexual harassment during medical school has some impact on specialty choice.

The US study showed that women pursuing a career in general surgery were most likely to experience discrimination and harassment. In Australia surgeons are the highest earners in the medical profession, and it is a specialty dominated by males.

Discrimination against women in the Australian workforce appears to start early. After university graduation, women will have a starting salary 4.4% lower than men, even after taking into account the field of education, personal and occupational characteristics. The discrimination continues into the upper echelons of business, with only one in five board members of Australia’s top 200 companies being women.

There are opportunities in medicine to reduce the male–female divide. Greater availability of part-time training in clinical and non-clinical work is one important step in promoting greater gender uniformity across medical specialties. However, this requires effort and ongoing reform on behalf of medical colleges, as well as health and hospital systems.

There are positive steps being taken with part-time training already established by a number of colleges and others offering in-principle support for implementing part-time training models. Further empirical work is required to understand the optimal curricula and processes needed to implement and encourage part-time training.

We should be striving for greater equality in Australia — on pay, on leadership and in workforce participation.

Such equality may be accomplished through increased transparency on pay and conditions in individual contracts; deep reflection on our own gender biases and advocacy to change; greater employer flexibility for female doctors who decide to have children; destigmatisation of paternity leave in medicine; and greater representation of women in medical leadership positions.

These goals are achievable and should be made a priority by the medical profession in 2015.

 

Dr Malcolm Forbes is a medical registrar, NHMRC postgraduate scholar, and adjunct lecturer in the College of Medicine and Dentistry, James Cook University.

Dr Harris Eyre is studying as a Fulbright Scholar at the University of California, Los Angles. He is a psychiatry registrar and undertaking a PhD through the University of Adelaide.


Poll

Should doctors more actively campaign to end gender pay inequality in the medical profession?
  • Yes – concerted campaign needed (65%, 51 Votes)
  • No – it’s up to individuals (22%, 17 Votes)
  • Maybe – depends on circumstances (13%, 10 Votes)

Total Voters: 78

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5 thoughts on “Malcolm Forbes

  1. daman langguth says:

    The authors have confused their arguments. There is no evidence that like for like in medicine women are paid different to me. Just look at hospital awards.

    What perhaps is important is what jobs people choose to do after graduation and the many reasons different paths are chosen.

    It is true in the past certain jobs were the preserve of male graduates (and may still be so), though certain other jobs may more picked by women. The fact that money is used as an arbiter of successI think is false. Time and time again in many jobs analysis of pay shows hours worked is the biggest factor in total pay. Maternity leave may well be a big factor in path chosen and pay, though without decent data this speculative article doesnt contribute much.

    Surely career satifaction is more important than income?

    Whilst its clear that women are under represented in busniess, the factors are complex, though few would argue a significant element of bias might not be in play. Knee jerk unthought out arguments wont help though.

    I think what can be done is to maximise the chance that here is equity of access, which doesnt mean equality of outcome.

    If one looks at life expectancy, alcoholism, drug dependence, incarceration women are miles ahead.

     

  2. Abeyna Jones says:

    I think that the first comment by Saul Geffen is simply patronising, deliberately insulting and illustrates the ignorance many have in the medical profession about gender disparity in all walks of life despite contributing just as much, if not more, to global labour. He also sounds incredibly embittered for some reason..?

    Even taking into account hours worked, women are still undercut in salaries.

    Why do women choose to work part time? Is this because women would rather be housewives/mothers moreso than a career they worked damn hard to get, or is it because society does not support equal opportunities for both men and women in the work place or even when it comes to parental leave, forcing women to make the sacrifice. Whatever happened to having the right to choose?

    And the relevance of female representation at board level? With some basic thought, one may realise that the best decisions are made by diverse boards because of the diversity of thought needed to serve the diverse population. Evidence shows that profitability improves with gender diverse boards and moreso with ethnically diverse boards. The only reason that marginalised groups are being excluded from these boards is because of elitism and discrimination.. Those organisations that illustrate this lose out competitively. I strongly advise you read “Women Matter” followed by reading “Diversity Matters” by McKinsey and co.. They looked at 360 public companies globally.

    And maybe one should campaign for Jews in rugby or left handed amputees in the opera. But we are talking about healthcare, and for some reason I believe it’s more of a priority.

  3. Dr Georgina Taylor says:

    Many gender-based assumptions are made about us from medical school onwards. Unlike male colleagues, women are warned away from non-family friendly specialties. If I want a family, then a partner (whether male or female) taking leave may determine my work hours. Paternity leave, which does not deserve “quotation marks”, is important for both men’s and women’s job satisfaction. Breasts or no breasts.

    ‘Equal pay per hour worked for equivalent degree of specialisation’ is only relevant if women can enter all specialties without discrimination. My own experience is that this is not the case. To cite an example from the article: “women pursuing a career in general surgery were most likely to experience discrimination and harassment.” Not pusuing these high-earning specialties clearly limits pay.

    We now include patients in decisions that affect them. The authors suggest ways to improve medicine’s gender gap, but don’t forget to include women in proposing the solutions. Promoting a feminist culture in medicine with no tolerance for discrimination should be a priority from medical school onwards.

  4. Dr Steve Trebble says:

    I find % pay difference less than a completely useless statistic, and moreoever, often used to be plainly misleading.

    The only question that matters is whether females receive equal pay per hour worked for equivalent degree of specialization.

    If there is no difference in pay per hour and our female co-workers simply choose to work less hours in a week, I do not see any inequality whatsoever.

    Painting descrepancies without any mention of work hours or specialization is just more pander you might expect from A Current Affair, not from medical professionals.

  5. Sau Geffen says:

    Oh dear. More social engineering from the MJA.

    Could the authors actually address the issue. What evidence is there that new female graduates of Medicine in Australia working fulltime are paid less than their male equivalents? None I suggest.

    What percentage of income gap remains if the current difference is adjusted for hours worked?

    What cost to society would be borne if multiple attempts and adjustments were made to increase the number of women training for specialities and they still chose to work part time after graduation? (My Colledge has done just that)

    What evidence is there that women with medical degrees want to work longer hours?

    Since Breast Feeding is clearly the best for babies for 6 months just how will I breast feed my child if I take “paternitey leave”? (Try as a might my hairy chest does not produce milk)

    Why are irrelevant gender issues about female representation at company board level even in this article? Perhaps the authors could also comment on the relative unfairness of low Jewish participation in professional Rugby League or left handed amputees in the Australian Opera.

    Did anyone proof read this?

     

    Saul Geffen FRACGP FAFRM RACP

     

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