GENDER INEQUALITIES IN MEDICAL CAREERS

Women have made a significant progress in the medical profession. In 2013, they accounted for 46.8% of total physicians in OECD countries, a 10% increase from 2003. In Italy, women account for almost 40% of the medical work-force in 2013 and their increase has been very strong in years, up to +34% in the decade 2001-2011 and up to +3% from 2012 to 2013. Notwithstanding the strong feminization of the medical workforce, gender inequalities still persist. Empirical research has shed light on gender inequalities in pay, leadership and specialty fields. It is widely acknowledged that women physicians earn less than men, cluster in less remunerative specialties and progress more slowly through ranks. Most of these studies have taken place in the United States, where cross-sectional and longitudinal dataset are available. This research is part of the wider European project S.T.A.G.E.S. (Structural Transformation to Achieve Gender Equality in Science) at the University of Milan and it aims to fill the gap in the literature – with respect to the European context – on gender inequalities in medical careers. Data on more than one thousand physicians working in five hospitals in the Lombardy Region have been collected through an online survey with a rate of response of 48.7%. Data have been analysed through descriptive statistics and through regression analysis. The results point out that women earn 15% less than men, controlling for human capital, work and family characteristics, while they are 44.4% less likely to be promoted to the intermediate levels of the career ladder. Female physicians tend to cluster in medical specialties, while surgery still remains a male-dominated specialty area. Moreover, they do less private practice than their male colleagues, which is highly remunerative. Compared to private institutions, public hospitals seem to guarantee a stronger equality in earnings. The division of paid and unpaid work appears strongly unbalanced, with women as the main responsible for the care of children and the elderly. As a consequence, they tend to solve their work-life conflict by outsourcing care activities while reducing the number of children or renouncing to motherhood (39% of women in the dataset are childless). Regression analysis show that mechanisms of gender discrimination take place both in pay and promotions. Moreover, the same attributes are differently “rewarded” whether they refer to women or men. Hence, being father significantly increase men’s income and their likelihood to promotion. The pay penalty for motherhood is significant at 90% level from the third child, while it negatively affects promotion from the second child. Overall, the fatherhood premium appears stronger than the motherhood penalty. Being married positively increases male’s income but it doesn’t have any effect on female colleagues. Educational credential “pays” more for men than for women in terms of pay, as well as being a surgeon and a head of a unit. Doing private practice is more rewarding, controlling for work hours, for men than for women. The amount of time spent at work and the years of work experience are also differently rewarded in terms of career outcomes, suggesting that gender inequalities are not only a matter of “being like men are”. Overall, these results fill a gap in knowledge and argue that structural constraints – preventing female physicians to earn as much as men do and to have the same chances of career than men have – are taking place.