Show Me the Money: A Movement Towards Transparency in Pediatric Emergency Medicine Compensation.

Abstract

Background: National studies report sustained gender-based differences in physician compensation, even after adjustment for workplace factors such as academic rank, specialty type, and work hours. This study examines differences in compensation among pediatric emergency medicine (PEM) fellows' first job after training.

Methods: Between May 2023 and June 2023, we distributed an electronic survey to all United States PEM fellowship program directors (FPDs), requesting they forward it to their graduating fellows. Survey completion was anonymous and voluntary, and included demographics, employment characteristics, and compensation package questions. We defined underrepresented in medicine (URiM) as individuals who self-identified as Black, Hispanic, Native American, Alaskan, or Pacific Islander.

Results: The survey was forwarded by 39 PEM FPDs to 107 eligible graduating PEM fellows, 80 (75%) of whom responded to the survey. Most respondents (71.3%) were women, 92.5% completed Pediatric residency, and 70.1% identified as White. The reported median base salary was $255,000 (IQR 222,000, 288,811). A high proportion of respondents were unaware of financial benefits beyond salary, such as employer retirement contributions. Compared to Pediatric hiring departments, Emergency Medicine (EM) departments had a significantly higher mean base salary (EM $277,079 vs. Pediatrics $239,540 p = 0.036) and annual clinical hours (EM 1393 vs. Pediatrics 1269, p = 0.035). While there were no statistical differences for base salary, annual clinical hours, sign-on bonus, or relocation stipend by gender or by underrepresented in medicine (URiM)-status, the mean difference in base salary for men was $25,628 higher than that of women (95% CI -$7903, $59,159). The mean difference in base salary for non-URiM versus URiM was $20,440 (95% CI -$22,000, $63,000).

Conclusion: While no statistically significant differences in salary by gender or race among PEM fellowship graduates were found, the difference in mean base salaries between genders is impactful over time. Transparency, financial education, and strategic action are important steps toward compensation equity.