The Gender Pay Gap in Urology

Introduction:Female physicians earn less than males in every medical specialty. We sought to determine whether a pay gap existed in urology and explore potential associated factors.Methods:We used 2,323 responses to the 2017 American Urological Association census to represent all 12,517 U.S. urologists. We limited analysis to ages 34 to 65 and matched on years in practice. We explored the association between self-reported salary (more than $350,000 vs less than $350,000) and gender using multivariable logistic regression adjusted for age and practice.Results:On bivariate analysis males were more likely to make more than $350,000 (56.9% vs 39.7%, p=0.01). There were no gender differences in weekly clinical (43.1 female vs 46.9 male, p=0.13) or nonclinical hours (7.9 female vs 9.1 male, p=0.23). Men do more inpatient procedures per month (7.8 vs 5.6, p=0.02) and more patient visits per week (78.4 vs. 68.4, p=0.04). Women spent more time with each patient (17.6 vs 14.9 minutes, p <0.01). On unadjusted logistic regression men were more likely to earn more than $350,000 (OR 2.01, p=0.02). On multivariable regression, gender was no longer significant (OR 1.59, p=0.11). Factors associated with earning more than $350,000 include more clinical/fewer nonclinical hours, shorter/more office visits, more inpatient surgeries, private practice, subspecialty training, Northeast location and nonWhite race.Conclusions:This analysis suggests a gender pay gap. While men and women work equal hours, women urologists are more likely to work in less profitable settings, perform fewer inpatient procedures and see fewer patients. Future research needs to understand whether women choose these practices or whether external factors compel them to do so.