By Kate Madden Yee, AuntMinnie.com staff writer

September 21, 2017 -- Female academic radiologists in the U.S. make as much money as their male colleagues -- a situation that's unusual among many medical specialties, according to a new study to be published in the November issue of the American Journal of Roentgenology.

Dr. Daniel Blumenthal
Dr. Daniel Blumenthal from Harvard Medical School.
Sex disparities do still exist in radiology: Only 24% of radiology residents are women, and women remain underrepresented in journal and departmental leadership positions. But despite these ongoing issues, a team led by Dr. Neena Kapoor of Harvard Medical School found that male and female radiologists at public medical schools in the U.S. had similar annual salaries both before and after adjusting for variables known to influence salary among academic physicians.

"Our findings reinforce that radiology has achieved a degree of sex equality that is uncommon in medicine," the researchers wrote.

Why? One reason could be proactive efforts by professional organizations such as the American College of Radiology (ACR), according to corresponding author Dr. Daniel Blumenthal, a cardiologist from Harvard.

"Salary and promotion are critical determinants of a person's professional satisfaction, and it's possible that the ACR began systematic efforts to improve parity between male and female radiologists at an earlier point than did other specialties' professional organizations," he told AuntMinnie.com.

On par?

Studies conducted on male and female physician salary parity outside of radiology have found that female academic physicians earn less than their male peers, even after adjusting for clinical and research productivity measures, Kapoor and colleagues wrote. In fact, a 2016 analysis of academic faculty published in JAMA Internal Medicine showed that female physicians earned an average of $20,000 less than their male colleagues. But the study also found that radiology was the only medical specialty in which men and women enjoyed salary parity.

Kapoor's team decided to conduct a study that focused specifically on salary issues in radiology. The group used online salary data published by 12 states to retrieve the salaries of all 573 academic radiologists at 24 public medical schools between 2011 and 2013. The researchers linked the data to physician characteristics such as sex, age, faculty rank, years since residency, clinical trial involvement, U.S. National Institutes of Health (NIH) funding, scientific publications, and clinical volume (measured by 2013 Medicare payments).

Among the 573 academic radiologists, 171 (29.8%) were women. Female radiologists were slightly younger than their male peers (48 versus 51 years, p = 0.001) and more likely to be assistant professors (50.9% versus 40.8%, p = 0.026).

The researchers found that salaries between male and female radiologists were similar in unadjusted analyses, with an absolute difference of only $863: Men earned on average $290,660 and women earned on average $289,797. This parity remained even after adjusting for age, faculty rank, years since residency, clinical trial involvement, publications, total Medicare payments, NIH funding, and graduation from a highly ranked medical school. (Not all comparisons were statistically significant.)

On the other hand, Kapoor and colleagues found that all academic radiologists making more than $500,000 annually were men.

Comparison of male and female radiologists along various parity metrics
  Male radiologists Female radiologists p-value
Mean salary $290,660 $289,797 0.930
Faculty rank
Assistant 40.8% 50.9% 0.026
Associate 22.9% 20.5% 0.525
Full 36.3% 28.7% 0.077
Mean time since residency (years) 20.7 16.6 0.001
Clinical trial involvement 3.7% 4.1% 0.897
Mean No. of publications 22 18 0.158
Radiologists receiving Medicare payments 91.8% 94.2% 0.327
NIH grants 3.7% 3.5% 0.897

"In contrast to our results, previous work has consistently found significant sex differences in physician compensation outside of radiology," the group wrote. "Our analysis adds ... [to a] growing body of evidence that radiology is one of the few medical specialties that has made important advances in sex equality as it relates to promotion and payment."

Why radiology?

The reasons for salary parity between male and female radiologists aren't clear and merit more research, according to the researchers. But radiology's strengths in payment and promotional parity could be a powerful recruitment tool to draw more women into the specialty. Studies have cited concerns over competitiveness, comfort with physics, and lack of patient contact as reasons why women don't pursue radiology, but other research has found that women's interest in the specialty is associated with having role models in the field.

"If young women learn directly from mentors that radiology as a field seems to do a better job than most other specialties in terms of compensating and promoting physicians in a sex-blind fashion, they may well become more interested in becoming radiologists," Kapoor and colleagues wrote.

In any case, understanding radiology's success in salary parity among men and women is a compelling topic for future study, Blumenthal said.

"What is it about radiology that has allowed it to achieve parity in salary and academic rank?" he said. "It's a good question for future work. It behooves us to figure out what radiology has done to make such inroads, and then try to apply its tactics to other specialties."


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