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Gender Inequity in the House of Medicine

Updated: Feb 25, 2021

Today, Dr. Ken Milne joins us to discuss the gender inequity that persists in medicine. he discusses how to be a #HeforShe in medicine and shares FACTS about gender inequality as well as link to gender equity research.

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There is a long history of gender inequity in our society. It was 100 years ago that the 19th Amendment to the US Constitution was ratified protecting citizens right to vote that could not be abridged on the account of sex (Nineteenth Amendment to the U.S. Constitution). The Women’s suffrage movement is documented in many other countries.

There is also a long history of gender inequity in the house of medicine. Dr. Elizabeth Blackwell was the first woman physician to graduate in America from New York's Geneva Medical College in 1849. She experienced difficulty getting a job and practicing medicine. Challenges continue to face women physicians.

There are many examples of gender inequity in research and academic positions:

  • Men are more likely to rise to the top academic positions in medicine and emergency medicine

  • Men are more likely to be the first author on a medical publication and an emergency medicine publication

  • Pediatric emergency medicine (PEM) is 62% female but are the lead author of only 42% of PEM papers

  • Women physicians in academia are less likely than men to be promoted to the rank of associate or full professor or to be appointed to department chair

  • Women are also often excluded from being participants in medical research

We need to ensure that women are getting equal access to grant money, so they can ask the questions important to women and create the medical literature that informs our care of women. This will also lead to more women being first author on a medical publication. We need to include rather than exclude women as participants in medical research and not just extrapolate from male subjects.

There are many examples of gender inequity in the administrative side of medicine with 80% of the healthcare work force being female:

  • Men are more likely to rise to the top leadership positions within the hospital.

    • Only 3% of healthcare CEOs are women

    • 6% are Department Chairs

    • 9% are Division Chiefs

    • 3% are serving as Chief Medical Officers

    • Yet 80% of the healthcare workforce is female

There is a well-recognized gender pay gap in the house of medicine:

  • Men get paid more than women in medicine

    • ~$20,000 more per year more in medicine

    • ~$17,000 more per year in academic medicine

    • ~$12,000 more per year in academic emergency medicine

    • Female surgeons make 24% per hour than male surgeons on Ontario

    • Female physicians bill average of 15.6% less than male physicians in Ontario

    • Female physicians make 17% less than male physicians in the UK

Women made up more than 50% of medical school enrollment in 2017. A system must be in place to support those women who want leadership roles in healthcare. Pay inequity must also end.

Dr. Michelle Cohen and Dr. Tara Kiran wrote an article called Closing the gender pay gap in Canadian medicine (CMAJ 2020). It defines the problem of gender pay gap and dispels some of the myths. They describe some of the root causes of the gender pay gap and what can be done to close the gap.

Male colleagues can be allies for their female colleagues and support them in changing the system. They can also advocate for the elimination of the persistent gender inequities in the house of medicine.

Dr. Ken Milne

EM Physician in Canada

Creator of the Skeptics’ Guide to EM.

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