BACKGROUND: Women are becoming doctors in greater numbers. Despite this, there is evidence of female doctors' continued differential treatment compared to their male counterparts. PURPOSE: The aim of this study was to review systematically the extant literature on the gender-based pay gap in medicine across time, different medical specialties, and different countries of clinical practice. METHODS: Systematic search of three databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies needed to be empirical and contain either an unadjusted or adjusted gender-based finding related to pay. RESULTS: A total of 46 articles published since 2000 contained a gender-based finding related to physician pay. Thirty-two of these 46 articles presented either adjusted or unadjusted means comparisons (or both) comparing pay between male and female physicians. Eighteen of the 46 articles controlled for one or more variables in examining pay between the two groups. Across almost all studies, female doctors earn significantly less than men, often tens of thousands of dollars less annually, despite similar demographic and work-related profiles. This earnings gap is persistent across time, medical specialty, and country of practice. PRACTICE IMPLICATIONS: The gender-based pay gap is an ongoing crisis within medicine that must be addressed. From a practice perspective, women physicians may benefit from greater organizational awareness of potential workplace bias and the implementation of more supportive policies aimed at better equalizing compensation through greater support and transparency related to salary negotiations, promotional opportunities, and pay scales across various job titles.
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