Despite continuing overall inequities, the number of female residents matriculating to high-paying medical specialties has increased, with a notable rise in women entering high compensation surgical fields.

University of Michigan researchers have reported these findings in "Trends in female physicians entering high-compensation specialties, 2008 to 2022," published in JAMA.

While women constituted 55% of incoming United States medical students, there exists a significant pay gap between male and female doctors, driven in part by overrepresentation of men in high-paying specialties.

Lately, however, the proportion of female matriculants to high compensation residency specialties has increased, from 32.7% in 2008 to 40.8% in 2022.

Matriculation to high-compensation surgical specialties drove that increase, with women representing 28.8% of applicants in 2008 and 40.8% in 2022. Over the same 14-year period, the number of female applicants to non-surgical, high compensation specialties dropped from 36.8% to 34.3%.

"That programs have been successful in attracting more women to enter surgery despite low levels of intervention is surprising and great to see," said Amy S. B. Bohnert, Ph.D., M.H.S., professor in U-M's department of Anesthesiology and senior author on the paper. "I think it's encouraging that this trend could eventually lead to parity, since women make up more than half of people going into medicine now."

The research team was motivated to investigate these trends after noticing the proportion of women now entering the medical profession and continuing inequities in pay compared to men.

In addition to now constituting the majority of incoming medical students, women still make up a larger percentage of people entering non-high-compensation specialties (53.0% in 2008 and 53.3% in 2022).

"There's been a lot of research on disparities in physician salaries and the underrepresentation of women in high compensation specialities among practicing physicians. But with more women entering medicine, we wanted to see if that trend was also happening with those starting their training in these highly compensated specialities," said Karina Pereira-Lima, Ph.D., research fellow in the U-M Department of Neurology and lead author of the paper.

"There is also prior research showing that women tend to be underrepresented in surgical residencies, but it looks like this isn't just a surgical issue–it's something we're seeing across high-paying specialities in general."

One possible explanation for the relative increase in female surgical residents is the growing spotlight on the issue through both research and social media campaigns such as #ILookLikeASurgeon in 2015, which attempted to combat stereotypes of surgery as a male specialty by celebrating women in the field.

The researchers behind the paper highlight the need for future investigations to determine to what extent, if at all, these efforts explain current application trends.

"An important aspect of the trend that we identified is that it seems to be driven by more women applying to surgical specialties, rather than increased acceptance rates," said Srijan Sen, M.D., Ph.D., principal investigator of the Intern Health Study and director of the Eisenberg Family Depression Center.

"Going forward, it will be important to identify why the specialties and programs that drove the trend have been successful in increasing applications from women."

Another potential future area of study is the ability of high-compensation specialties to retain and support women as they progress through the career pathway. While the number of female residents entering high-compensation specialties has increased, the overall numbers remain far below parity, a reality showing that much work is still needed to achieve gender equality in physician representation and compensation across different specialties.