E. Pelley is associate professor, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
M. Carnes is professor, Departments of Medicine, Psychiatry, and Industrial & Systems Engineering and director, Center for Women's Health Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
Acad Med. 2020 Oct;95(10):1499-1506. doi: 10.1097/ACM.0000000000003555.
The gender composition of physician specialties varies dramatically with some becoming increasingly female predominant while others remain overwhelmingly male. In their analysis of physician workforce data, the authors demonstrate that despite large increases in the number of female physicians over 4 decades, the degree of gender segregation between specialties has not declined. The authors describe lessons from the highly gender-segregated U.S. workforce as a whole to understand these demographic patterns in the physician workforce. Echoing U.S. workforce findings, women physicians are becoming overrepresented in certain specialties, and this appears to be associated with a relative decline in earnings for physicians in these specialties over time. The authors found a strong negative relationship between the proportion of female physicians in a specialty and its mean salary, with gender composition explaining 64% of the variation in salaries among the medical specialties.Female physicians face biases in the workplace and fall behind male peers in leadership attainment, academic advancement, and earnings. Tenacious gender stereotypes and the conflation of gender and status contribute to these biases and reinforce occupational gender segregation. The clustering of women in certain specialties means these specialties will be disproportionately affected by gender bias. Recognizing the consequences of gender demographics within physician specialties is important to maintain the strong and diverse physician workforce needed to support the health care needs of the populations who depend on these specialties for care.
医师专业的性别构成差异很大，有些专业女性从业者越来越多，而有些专业则仍然以男性为主。作者在分析医师劳动力数据时表明，尽管女性医师的数量在过去 40 年中大幅增加，但专业之间的性别隔离程度并未降低。作者从整个高度性别隔离的美国劳动力中吸取教训，以了解医师劳动力中的这些人口统计模式。与美国劳动力的发现相呼应的是，女性医师在某些专业中的比例越来越高，而且随着时间的推移，这些专业的医师收入相对下降。作者发现，一个专业中女性医师的比例与该专业的平均薪酬之间存在很强的负相关关系，性别构成解释了医学专业之间薪酬差异的 64%。女性医师在工作场所面临偏见，在领导能力、学术进步和收入方面落后于男性同行。顽固的性别刻板印象和性别与地位的混淆导致了这些偏见，并加剧了职业性别隔离。女性在某些专业中的集中意味着这些专业将受到性别偏见的不成比例的影响。认识到医师专业中的性别人口统计学的后果对于维持支持依赖这些专业的人群的医疗保健需求所需的强大而多样化的医师劳动力非常重要。
