Nisha Mehta, MD, applied for a job in an area of the US where her husband — a plastic surgeon — was committed for training. Her potential bosses knew this and offered her $30,000 less than others were being offered for the same position. Mehta learned about the lowball from physicians who were hired the same year.

“I actually had more training than anybody else did,” she said — two fellowships compared with the other applicants’ one. “I know that they tried to do it because they thought they could get away with it, because they knew I was stuck there.”

Mehta walked into the office of the physician who made her the offer and said, “You know what? I could get a telemedicine job somewhere else, but I can’t come to work every day knowing that you guys are paying me less just because you think you can get away with it and doing the same job that others are getting paid so much more for. Out of principle, I am not okay with knowing that that was used against me, so I’m going to decline the job offer.” 20 minutes later, they came back with a matching offer.

The gender pay gap in medicine, even after years of being brought to light and criticized, persists.

“Female colleagues in the same specialty, same years of experience, get paid meaningfully less. Probably seven figures over a career,” said Graham Walker, MD, an emergency physician in San Francisco, and co-founder of Offcall, an online physician salary transparency tool.

Behind every salary statistic are the women physicians whose careers and lives have been shaped by compensation inequities. For some, it’s meant being offered lower salaries than less-qualified colleagues of the opposite sex. Others have found themselves taking on significantly more work for the same pay or questioning whether they can afford to stay in a job they love.

No matter the specifics, the conclusion is still the same: This is what life is like if you’re a woman in medicine.

If Money Talks, What Does This Data Say?

“There’s roughly a 15% gender pay gap in medicine,” said Anupam B. Jena, MD, PhD, a Joseph P. Newhouse Professor of Health Care Policy with the Department of Health Care Policy at Harvard Medical School in Boston. Jena noted that this is consistent across most specialties. And over the past 15 years that he’s been studying the issue, he said the gap has remained relatively stable.

Medscape has been publishing its annual Physician Compensation Reports for years, and the 2026 data shows the situation is worse than what Jena saw. Across all specialties, doctors who are men averaged $429,000 a year, whereas women came in at $327,000, a 31% advantage for men. In 2023, the gap was 29%, so things have not improved.

Negotiation may be one pain point. Gender aside, the Medscape compensation report found roughly 3 out of 4 physicians engage in no meaningful negotiation on salary. Meanwhile, 61% of physicians surveyed said they were underpaid. While that’s not just a gender problem, according to the data, Walker said, “Women are often socialized not to push back.” 

More Qualifications = Less Pay

Mehta, a radiologist and founder of the Physician Side Gigs community, has had the gender pay gap show up persistently throughout her career. “I’m married to a plastic surgeon, and I think that there is always this assumption that I don’t need to make money because he is making money, and that he is the primary breadwinner,” she said.

On the Physician Side Gigs site, Mehta sees physicians post about seeking out additional income or more flexible work arrangements. While she’s heard many reasons doctors pursue side work, she believes the gender pay gap can be a factor that pushes women to question whether a demanding, full-time clinical role is worth it.

“I think that the gender pay gap is also a source of burnout,” she said. “It’s yet another reason why people are jaded with the system and feel as though their work isn’t respected.”

Same Pay = More Work

Gina Maccarone, MD, is a triple board-certified plastic surgeon and founder of The Surgeonista. She practiced general surgery and trauma surgery for 13 years before the inequities she faced early on inspired her to move into private-practice cosmetic surgery.

“I was employed by a large hospital system here in Cincinnati, and I was the only female surgeon in our group of four,” she said. She and her colleagues were paid based on relative value units (RVUs). While on paper she was paid the same as her colleagues, she found herself taking on significantly more administrative work than her male counterparts.

“I was doing probably twice as much administrative, noncompensated work than they were,” she said. “And so if you lined up the number of hours per week that we were each working, mine was always more.”

Maccarone was deemed the “organized person,” responsible for creating the call schedule. “I was the nice and congenial person, so if there was ever an issue, administration would always come to me first,” she said.

She cited a 2022 study from Harvard Medical School, which found that female physicians receive about 25% more patient messages than their male counterparts. This was her experience.

“I was answering a lot more messages. I was spending more time talking to patients…all those kinds of things,” she said. While she didn’t have official data that showed she was getting paid less, Maccarone felt the effects of doing more work and not getting compensated for it.

She raised the issue with her bosses. They offered to find “someone else” to take on the extra work. But she knew that person would not be a physician, which she worried would affect the quality of her care and her group’s coverage.

Eventually, the uneven workload began to burn Maccarone out. “When you’re the person who’s making the call schedule and three other men say, ‘Well, I can’t do that weekend,’ someone has to cover that.” She ended up taking more calls, which generated more RVUs, but pushed her further into exhaustion. “Not being able to make family plans, not being able to go out of town, and missing events because you’re on call… Because it was my responsibility, then I’m the one who’s picking up the slack,” she said.

Now in a private practice that offers cash-only cosmetic surgery, Maccarone said, “How much I work is how much I get paid.”

A Job You Love = Sacrifices

Ashley Huggett, DO, is an academic infectious disease physician nearly 5 years into a position she enjoys. But lately, she’s found herself increasingly questioning whether she can afford to stay.

One of the biggest turning points for Huggett was the hiring of a new male physician. “I am an assistant professor, an associate program director. I make $191,000, and we are hiring our only second-year fellow, and they’re starting him at $200,000,” she said, noting that she also has far more responsibilities and experience. She stresses that she doesn’t blame her direct supervisor, who she said has gone to bat for her, but rather hospital leadership, which claims this is the going rate to attract new hires.

With the exception of the new male hire, the rest of Huggett’s colleagues have been women. “One just left,” she said. And “two of the ones that are still here are actually making less than [I do],” adding that they are frustrated as well.

At the same time, Huggett’s hospital has continued to use RVUs, despite the fact that she has no opportunity to earn a bonus. Rather than ordering visits to generate billable work, Huggett chooses to focus on what is best for her patients. 

“Why should I bill a patient just to show up to say hi to them if nothing’s going to change?” she asked. “Why would I charge a bill to just generate RVUs so the hospital can basically make more money? Because I won’t see a bonus.”

This situation has been especially challenging, as she is the breadwinner for her family. “My husband is a stay-at-home dad because our 4-year-old has special needs, and then we have an almost 2-year-old.”

The family had to build a special, Americans with Disabilities Act-compliant home with widened hallways and doorways and reinforced ceiling beams and floor joists to hold the weight of wheelchairs. It would not be easy to move elsewhere, and there is little money left over for things such as vacations.

Despite those challenges, Huggett genuinely enjoys her job. “I absolutely love my colleagues and my boss. I like my hospital. I like the area,” she said. “But it frustrates me. It makes me sad that I have to potentially leave this job that I really do care about.”

How to Make Things Add Up

“Transparency, full stop,” said Walker, is what physicians must advocate for around compensation. “When salaries are secret, bias has room to run.” This has been the inspiration behind Offcall, Walker’s online database, which compiles salary information so doctors can compare their compensation across specialty, geography, and employer. He hopes institutions will begin to publish compensation bands by specialty and experience and that medical students and residents will receive negotiation training.

Meanwhile, the American Academy of Family Physicians (AAFP) created a family medicine career dashboard based on data from 8500 physicians on salary, benefits, and job satisfaction. When you go to the landing page, the first thing you see in big letters is “Know Your Worth.”

Jena agreed on transparency and hopes that healthcare organizations shift toward more clearly defining how salaries are determined, examining whether physicians in similar roles are being paid equitably, and holding leaders accountable for correcting disparities when they are identified.

The secretive atmosphere implies that gender differences in pay are being concealed, he said. A major first step, he suggested, is for healthcare systems first to actively measure where inequities exist so they can begin addressing them.

Diana Lautenberger, MA, director of gender equity initiatives at the Association of American Medical Colleges, said institutions also need to recognize work that often falls outside traditional compensation models, such as committee service, mentoring, teaching, and other administrative responsibilities. But she has been encouraged seeing more women advocating to be compensated for those efforts rather than accepting them as expected parts of the job.

“I think a lot of women are taking a look at that and saying, ‘Well, I need to actually start to get paid for some of this,’” said Lautenberger. They have realized their institution isn’t going to pay them to run a committee along with patient care, research, and everything else.

As Mehta watches doctors on her forum discuss their pay situations, she encourages women physicians to know their worth (like the AAFP says), negotiate confidently, and have honest conversations about compensation.

Huggett agrees, having only discovered her own pay disparity after learning what a newly hired male colleague would be making. While some leaders at her organization were unhappy that compensation details had become known, she believes those conversations are essential. “The only people who benefit from us not talking about our salaries,” she said, “are the people paying us.”

The experts cited in this article had no relevant disclosures.