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Original Investigation
August 28, 2019

Career Goals, Salary Expectations, and Salary Negotiation Among Male and Female General Surgery Residents

Author Affiliations
  • 1Department of Surgery, Harbor-UCLA (University of California, Los Angeles) Medical Center, Torrance
  • 2Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance
  • 3Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance
  • 4Department of Surgery, University of California, San Francisco, Fresno
  • 5Department of Surgery, University of Washington Medical Center, Seattle
  • 6Department of Surgery, Cedars Sinai Medical Center, Los Angeles, California
  • 7Department of Surgery, UCLA Health, Los Angeles
  • 8Department of Surgery, New York Presbyterian/Columbia University Medical Center, New York
  • 9Gunderson Medical Foundation, Gundersen Health System, La Crosse, Wisconsin
  • 10Department of Surgery, University of Southern California, Los Angeles
  • 11Department of Surgery, Stanford University Medical Center, Palo Alto, California
  • 12Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia
  • 13Department of Surgery, University of California, Irvine, Medical Center, Orange
  • 14Department of Surgery, Loma Linda University Health, Loma Linda, California
  • 15Department of Surgery, Santa Barbara Cottage Hospital, Santa Barbara, California
  • 16Department of Surgery, University of California, Davis, School of Medicine, Sacramento
  • 17Department of Surgery, Iowa Methodist Medical Center, Des Moines
  • 18Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
  • 19Department of Surgery, WellSpan York Hospital, York, Pennsylvania
  • 20Department of Surgery, Southern Illinois School of Medicine, Springfield
  • 21Department of Surgery, University of Texas at San Antonio Health Center, San Antonio
JAMA Surg. Published online August 28, 2019. doi:10.1001/jamasurg.2019.2879
Key Points

Question  What are the similarities and differences between male and female general surgery residents in terms of future salary expectations, career goals, and views on salary negotiation?

Findings  In this survey-based study of 606 male and female surgery residents, overall career goals were similar for men and women; however, women had lower future salary expectations and a significantly more negative view of salary negotiation.

Meaning  These findings may aid in identifying strategies to help narrow the gender gap in general surgery.

Abstract

Importance  In general surgery, women earn less money and hold fewer leadership positions compared with their male counterparts.

Objective  To assess whether differences exist between the perspectives of male and female general surgery residents on future career goals, salary expectations, and salary negotiation that may contribute to disparity later in their careers.

Design, Setting, and Participants  This study was based on an anonymous and voluntary survey sent to 19 US general surgery programs. A total of 606 categorical residents at general surgery programs across the United States received the survey. Data were collected from August through September 2017 and analyzed from September through December 2017.

Main Outcomes and Measures  Comparison of responses between men and women to detect any differences in career goals, salary expectation, and perspectives toward salary negotiation at a resident level.

Results  A total of 427 residents (70.3%) responded, and 407 responses (230 male [58.5%]; mean age, 30.0 years [95% CI, 29.8-30.4 years]) were complete. When asked about salary expectation, female residents had lower expectations compared with men in minimum starting salary ($249 502 [95% CI, $236 815-$262 190] vs $267 700 [95% CI, $258 964-$276 437]; P = .003) and in ideal starting salary ($334 709 [95% CI, $318 431-$350 987] vs $364 663 [95% CI, $351 612-$377 715]; P < .001). Women also had less favorable opinions about salary negotiation. They were less likely to believe they had the tools to negotiate (33 of 177 [18.6%] vs 73 of 230 [31.7%]; P = .03) and were less likely to pursue other job offers as an aid in negotiating a higher salary (124 of 177 [70.1%] vs 190 of 230 [82.6%]; P = .01). Female residents were also less likely to be married (61 of 177 [34.5%] vs 116 of 230 [50.4%]; P = .001), were less likely to have children (25 of 177 [14.1%] vs 57 of 230 [24.8%]; P = .008), and believed they would have more responsibility at home than their significant other (77 of 177 [43.5%] vs 35 of 230 [15.2%]; P < .001). Men and women anticipated working the same number of hours, expected to retire at the same age, and had similar interest in holding leadership positions, having academic careers, and pursuing research.

Conclusions and Relevance  This study found no difference in overall career goals between male and female residents; however, female residents’ salary expectations were lower, and they viewed salary negotiation less favorably. Given the current gender disparities in salary and leadership within surgery, strategies are needed to help remedy this inequity.

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