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. Author manuscript; available in PMC: 2020 May 1.
Published in final edited form as: Acad Med. 2019 May;94(5):612. doi: 10.1097/ACM.0000000000002656

In Reply to Carvajal et al:

Andrea N Garcia 1, Tony Kuo 2, Eliseo J Pérez-Stable 3
PMCID: PMC6590907  NIHMSID: NIHMS1520952  PMID: 31021864

We thank Dr. Carvajal and her colleagues for their letter regarding pay parity for women1 and those underrepresented in medicine2 (URM). We wholeheartedly agree that pay parity is requisite for properly supporting physicians who work with underserved populations. URM faculty have been shown to pay a higher proportion of their earnings to student debt3, and our findings showed that URM students shoulder disproportionate educational and consumer debt, underscoring the need to eliminate structural and institutional barriers that impede access to quality care.

We posit that women and URM physicians in academic medicine not only accrue more financial debt, but they are disproportionately taxed in other ways. In their studies, Rodriguez and colleagues eloquently described the extra burdens of the minority tax4, and Carapinha and colleagues described the effects of discrimination and work-family conflict on the workplace climate for women-faculty.5 While the financial and psychosocial costs on women and URM faculty are high, we highlight the dividends that women and URM faculty also pay. Citing positive factors such as the opportunity to influence the institution, serving as a role model6, and maintaining cultural values such as belonging, connectedness, and giving back7, are just a few ways that URM and women faculty are resilient, can positively influence institutional culture, and are still more likely to work in underserved areas. It’s time these values receive the equitable compensation they deserve.

Footnotes

Disclosures: None reported.

Contributor Information

Andrea N. Garcia, Center for Health Services and Society, Department of Psychiatry, UCLA David Geffen School of Medicine; physician specialist, Los Angeles County Department of Mental Health, Los Angeles, California; andreagarcia@mednet.ucla.edu..

Tony Kuo, UCLA Fielding School of Public Health, and Health Sciences Associate Professor of Family Medicine, UCLA David Geffen School of Medicine; director, Division of Chronic Disease and Injury Prevention and the Office of Senior Health, Los Angeles County Department of Public Health, Los Angeles, California..

Eliseo J. Pérez-Stable, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland..

References

  • 1.Jena AB, Olenski AR, Blumenthal DM. Sex Differences in Physician Salary in US Public Medical Schools. JAMA Intern Med 2016;176(9):1294–1304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Ly Dan P, Seabury Seth A, Jena Anupam B. Differences in incomes of physicians in the United States by race and sex: observational study BMJ 2016; 353:i2923. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Rodríguez JE, Campbell KM. Minority faculty pay a higher proportion of their earnings to student debt. Acad Med 2014. March;89(3):371–2. [DOI] [PubMed] [Google Scholar]
  • 4.Rodríguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: what of the minority tax? BMC Med Educ 2015; 15: 6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Carapinha R, McCracken CM, Warner ET, Hill EV, Reede JY. Organizational Context and Female Faculty’s Perception of the Climate for Women in Academic Medicine. J Womens Health (Larchmt) 2017. May;26(5):549–559. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Sánchez JP, Poll-Hunter N, Stern N, Garcia AN, Brewster C. Balancing Two Cultures: American Indian/Alaska Native Medical Students’ Perceptions of Academic Medicine Careers. J Community Health 2016. August;41(4):871–80. [DOI] [PubMed] [Google Scholar]
  • 7.Elliott BA, Dorscher J, Wirta A, Hill DL. Staying connected: Native American women faculty members on experiencing success. Acad Med 2010. April;85(4):675–9. [DOI] [PubMed] [Google Scholar]

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