Women physicians and the gender pay gap: why a majority pipeline still produces unequal pay

She finished her third night of call, signed out, and opened the email from human resources. A male classmate from residency (same board scores, same fellowship, same years on faculty) had been hired as an associate professor at a salary $38,000 higher than hers. She had negotiated. The chair said the market was tight for his procedure mix. Her panel was full. Her patient scores were higher. The numbers did not add up.

I hear versions of that story every year. It is rarely one catastrophic insult. It is a series of smaller ones: a starting offer that never quite matches, a promotion that arrives a year later, a full-time schedule that quietly becomes impossible after a second child, a chair search that produces another shortlist of men.

The national data put hard numbers next to those hallway conversations. Women are a clear majority of U.S. medical students. They remain a minority of practicing physicians, a thinner share of full professors, and a still thinner share of department chairs. After adjusting for specialty, location, and years of experience, women physicians still earned 26% less than men in 2024, according to Doximity's compensation survey. This page gathers the pipeline, specialty map, pay gaps, academic rank, leadership, attrition, and burnout figures a reporter can lift with the primary source named beside each one.

Year	Pay gap
2021	28%
2022	26%
2023	23%
2024	26%

Source: Doximity Physician Compensation Reports 2024 and 2025. Gap is adjusted for specialty, location, and years of experience.

Specialty	Percent female
Pediatrics	66.7%
Obstetrics and gynecology	64.1%
Hospice and palliative medicine	63.1%
Sports medicine (orthopedic surgery)	7.8%
Orthopedic surgery	6.8%

Source: AAMC 2025 Key Findings, U.S. Physician Workforce Data Dashboard (2024 active-physician data).

Career stage	Share who are women
Medical school enrollment (2024-25)	54.9%
Residents and fellows (2023)	49.1%
Full-time faculty (2023)	45%
Full professors (2023)	29%
Department chairs (2023)	25%
Medical school deans (2023)	27%

Sources: AAMC FACTS 2024-25 enrollment press release; AAMC Report on Residents 2024; AAMC State of Women in Academic Medicine 2023-2024 (as summarized by AAMC news coverage, July 2024).

Majority in training, minority in practice

The student pipeline flipped years ago. According to AAMC FACTS data, women made up 56.8% of applicants, 55.1% of matriculants, and 54.9% of total enrollment in U.S. MD-granting medical schools in 2024-25, the sixth consecutive year of majority status across all three. Women first crossed the majority threshold for total enrollment in 2019 at 50.5%. In 2023-24 they were 54.6% of medical school students. Graduates in 2022-23 were 52% women, up from 43% in 2000-01, per AAMC's State of Women in Academic Medicine 2023-2024.

Residency is closer to parity. The AAMC 2024 Report on Residents found that women accounted for 49.1% of residents and fellows in 2023, up from 48.3% in 2022, 47.3% in 2021, and 46.4% in 2020. Psychiatry was one specialty where women already outnumbered men among residents (52.5% in 2023).

The practicing workforce has not caught up. In 2024 the United States had 1,032,365 active physicians, of whom 38.7% were female, according to the AAMC's 2025 Key Findings. That is a gain from 26% in 2004 and from 38% (371,851 women) in 2022. From 2004 to 2022 the number of women in the active physician workforce rose 97%, while the number of men rose 13%. HRSA's State of the U.S. Health Care Workforce, 2025 frames the same picture as about 38% of active physicians female. A majority of students cannot rebalance a million-person workforce overnight when 23.9% of active physicians were already 65 or older in 2024, per AAMC. If women leave full-time clinical work earlier than men, the lag lengthens further.

Where women practice

According to the AAMC's 2025 Key Findings for 2024 active physicians, the specialties with the highest shares of women were pediatrics (66.7%), obstetrics and gynecology (64.1%), and hospice and palliative medicine (63.1%). The lowest were sports medicine within orthopedic surgery (7.8%) and orthopedic surgery itself (6.8%). Women remain a minority in most large specialties even after two decades of growth.

The AAMC's 2004-to-2022 specialty comparison fills in the trend. Pediatrics went from 52% women to 66%. Obstetrics and gynecology rose from 38% to 62%. Dermatology crossed majority status, from 35% to 53%. Family medicine/general practice reached 43%, up from 28%. Orthopedic surgery moved only from 3% to 6%. Among the 20 largest specialties in 2022, women increased their presence in 17; the fastest percentage growth rates for women included critical care, gastroenterology, urology, nephrology, and emergency medicine.

That map matters for pay. Procedure-heavy fields sit at the top of compensation tables; primary care and many pediatric fields sit near the bottom. When women concentrate in lower-paying specialties, the unadjusted pay gap widens even before any within-specialty disparity is measured. The adjusted gap, the one that holds specialty constant, is the cleaner test of unequal pay for similar work, and it has not gone away. Geography is real but smaller: in 2024 the highest shares of female physicians were in the District of Columbia (50.6%), the U.S. Virgin Islands (47.2%), and Massachusetts (45.5%); Utah sat at 27.4%, per AAMC Key Findings.

For patients, specialty mix is not an abstract diversity metric. Counties already short on obstetricians and pediatricians (a pattern we mapped in our review of maternity care deserts and provider shortages) draw from the same workforce that still has deep gender skews in surgical and procedural fields. Representation in training does not automatically become access on the ground.

The pay gap that survives adjustment

Start with the number most newsrooms will quote. In 2024 the gender pay gap for U.S. physicians returned to 26%, according to Doximity's 2025 Physician Compensation Report. That is up from 23% in 2023, matching 26% in 2022, and below the 28% reported for 2021. Men's average compensation rose 5.7% in 2024; women's rose 1.7%. After Doximity adjusted for specialty, location, and years of experience, women physicians earned $120,917 less than men. The prior year, with the gap at 23%, the adjusted dollar difference was nearly $102,000.

Those figures already hold specialty constant. They do not erase the larger unadjusted gap that appears when you compare average pay for all men and all women physicians, which is inflated by specialty mix. Both numbers matter. The unadjusted gap describes the economic reality of women's careers as currently structured. The adjusted gap is the one that survives the usual explanations: "she chose pediatrics," "he has more years," "rural markets pay more."

Career math makes the annual gap harder to dismiss. Using Doximity survey data from 80,342 full-time U.S. physicians and a simulated forty-year career, Whaley, Jena, and colleagues estimated in Health Affairs (2021) that male physicians earned an average adjusted gross income of $8,307,327 compared with $6,263,446 for female physicians. The absolute adjusted difference was $2,043,881, or 24.6%. The model adjusted for hours worked, clinical revenue, practice type, and specialty. Differences were largest for surgical specialists ($2.5 million), then nonsurgical specialists ($1.6 million), then primary care ($0.9 million).

Academic pay shows the same pattern with different units. AAMC's 2023-2024 report, as summarized in AAMC news coverage, put 2022 median compensation for women clinical MD associate professors at 78 cents on the dollar relative to men, and clinical MD full professors at 83 cents. Basic science PhD full professors were near parity at 98 cents. The gap is smaller where pay is more formulaic and larger where clinical revenue and negotiation dominate. Some of the remaining gap reflects choices made under constraints that are not free: childcare architecture, part-time tracks that never rejoin the promotion ladder, referral patterns that send high-RVU cases to men. The data are stronger on the size of the gap than on the exact share attributable to discrimination versus constrained choice. That uncertainty does not make a 26% adjusted gap acceptable.

Academic rank and leadership

If medical school is majority women and the faculty pipeline were frictionless, leadership would already look different. It does not. According to AAMC's State of Women in Academic Medicine 2023-2024, women were 45% of full-time faculty in 2023, up from 38% in 2013. Full professors tell a different story: women held 29% of those positions. The rank gap is the first place the pipeline visibly thins.

Leadership roles improved from a low base and still trail student and faculty shares. In 2023, women were 34% of division and section chiefs (up from 24% in 2013), 32% of center and institute directors, 25% of department chairs (up from 15%), 27% of deans (up from 16%), and 25% of health system CEOs in the first year AAMC collected that figure. Even in obstetrics and gynecology, where 69% of full-time faculty were women, only 38% of department chairs were women.

In the 1990s about 40% of medical students were women, AAMC gender equity director Diana Lautenberger noted when the report was released; similar proportions in top leadership should be visible by now if promotion were proportional. They are not. Climate is part of the mechanism: 31% of women reported gender harassment by colleagues in the medical school workplace, compared with 12% of men; among LGB-plus women the figure rose to 44%. Who leads departments also shapes what gets studied and who gets mentored. That pattern connects to the research gaps in our review of women in clinical trials and research funding statistics.

Attrition, part-time work, and burnout

Representation is not only about who enters. It is about who stays full-time long enough to become a senior partner, a full professor, or a chief.

Frank, Zhao, Sen, and Guille followed early-career physicians from the Intern Health Study and published the results in JAMA Network Open in 2019. Within roughly six years of completing training, 22.6% of women physicians were not working full-time, compared with 3.6% of men (odds ratio 7.83). Among physicians with children, 30.6% of women versus 4.6% of men were not full-time. A 9.6-point gender gap in full-time work was already present in the first year after training and grew to 38.7 points by six years. Of women currently part-time or not working, 77.5% cited family as the factor that shaped that decision. Among full-time physicians, 64.4% of women had considered part-time work, versus 21.2% of men. The study is several years old and remains one of the cleanest early-career attrition estimates; newer national longitudinal series with the same design are thinner than I would like.

Burnout is the other attrition channel. HRSA's 2025 workforce report, citing Medscape's 2024 survey, put physician burnout at 49% and depression at 20%, down from 53% and 23% in 2023. Those are overall rates, not gender-stratified. Gender-stratified samples consistently show higher burnout among women physicians, though exact national percentages vary by instrument and year. Workplace strain for women physicians is not only about hours. It is the second shift after clinic, parental leave that never quite restarts the research clock, and the midlife hormonal transition that hits during peak leadership years. We examined that pattern in the broader labor force in our piece on menopause workplace and economic cost statistics. For women physicians navigating fertility timing while training, the clinical clocks are the same ones their patients face; tools such as our IVF date calculator and ovulation calculator do not fix leave policy, but they are the practical instruments many of us end up using when training leaves no margin for delay.

What the gap means for patients

Pay and promotion gaps are not only labor-market stories. They shape who is available to see patients, in which specialties, and for how many years of a career. When women reduce hours or leave clinical practice at higher rates in the first six years after training, the effective full-time equivalent of the majority medical school class shrinks before it replaces the retiring cohort. HRSA projects a shortfall of 141,160 full-time-equivalent physicians by 2038, with nonmetro areas hit harder. You cannot solve a shortage while leaking early-career women from full-time work at sevenfold the rate of men.

Specialty segregation also shapes access. Fields that are majority women (pediatrics, obstetrics and gynecology, palliative care) often face lower relative pay and high emotional load. Fields that remain overwhelmingly male include several high-volume procedural specialties. Patients do not experience "the physician workforce." They experience whether there is an obstetrician in their county and whether the orthopedic surgeon has a three-month wait. A system that underpays and under-promotes half its workforce is choosing inefficiency, and it already fails women as patients in measurable ways; our overview of women's healthcare access disparities documents the access side of that failure.

Policy handles exist: transparent starting salary bands, equity audits that publish adjusted gaps by department, parental leave that does not reset the promotion clock, childcare that matches hospital schedules, and real consequences for gender harassment. The AAMC data make the case that culture and compensation, not a shortage of qualified women, are the binding constraints at the top of the ladder. The colleague who opened that HR email did not need a national dashboard to know she was underpaid. She needed a system that stopped treating unequal offers as market noise. The numbers on this page exist so the next report or board meeting can quote a figure with a source, a year, and no room to wave it away as anecdote.

Frequently asked questions about women physicians and the pay gap

What percentage of U.S. physicians are women?

In 2024, 38.7% of active U.S. physicians were female, according to the AAMC U.S. Physician Workforce Data Dashboard (2025 Key Findings). That is up from 38% in 2022 and 26% in 2004. The United States had 1,032,365 active physicians in 2024. HRSA's 2025 workforce brief similarly reports about 38% of active physicians as female.

Are most medical students women?

Yes. Women accounted for 54.9% of total enrollment and 55.1% of matriculants at U.S. MD-granting medical schools in 2024-25, per AAMC FACTS data. They first became a majority of enrolled medical students in 2019 (50.5%). Applicants in 2024-25 were 56.8% women, the sixth straight year of majority status across applicants, matriculants, and enrollment.

How large is the physician gender pay gap?

Doximity's 2025 Physician Compensation Report put the adjusted gender pay gap at 26% in 2024, with women earning $120,917 less than men after specialty, location, and years of experience. The gap was 23% in 2023 and 26% in 2022. Men's pay rose 5.7% in 2024 versus 1.7% for women. A 2021 Health Affairs analysis estimated a $2.04 million adjusted career earnings gap over 40 years.

Which specialties have the most and fewest women physicians?

Per AAMC 2024 data, pediatrics (66.7%), obstetrics and gynecology (64.1%), and hospice and palliative medicine (63.1%) had the highest shares of women among active physicians. Sports medicine (orthopedic surgery) at 7.8% and orthopedic surgery at 6.8% had the lowest. Women remain a minority in most large specialties despite growth since 2004.

What share of medical school leaders are women?

In 2023, women were 45% of full-time faculty, 29% of full professors, 25% of department chairs, 27% of deans, and 34% of division or section chiefs, according to AAMC's State of Women in Academic Medicine 2023-2024. Department chairs rose from 15% women in 2013; deans rose from 16%. Nearly 31% of women reported gender harassment in the medical school workplace, versus 12% of men.

Do women physicians leave full-time practice more often than men?

Yes, especially early in their careers. Frank and colleagues in JAMA Network Open (2019) found that within six years of completing training, 22.6% of women physicians were not working full-time, compared with 3.6% of men. Among those with children, the figures were 30.6% versus 4.6%. Family responsibilities were the dominant reason women cited for reduced hours.