Reply to commentary to: Gender and rank salary trends among academic dermatologists

Dear Editors,

We thank Lipner et al. for their interest in our article and appreciate their effort in highlighting the contribution of gender in salary disparities among Veterans Affairs (VA) dermatologists. In their recently published article, Do and Lipner (2020) described the discrepancies in compensation for male and female VA dermatologists. Multivariate analysis showed that, overall, gender was not a significant contributor to VA dermatologists’ salaries, and instead h-index, academic rank, and years since graduation were significant contributors. Their study found that true gender-based salary disparity was only noted regionally, specifically in the Midwest.

We concur that female dermatologists are underrepresented in higher academic ranks, and a significant salary gap remains prevalent despite a narrowing of the gap between 2013 and 2018. These trends suggest a need for further studies over a longer time period that incorporate the previously mentioned factors affecting salary to identify the extent of gender-based salary gaps.

Our paper reports the results of a pilot study using the Faculty Salary Survey database. We discussed how the lack of consideration for faculty salary based on full-time equivalent, geographic influences, clinical versus nonclinical faculty, and academic tracks are limitations of this database. The challenge in performing the same analysis using the Association of American Medical Colleges faculty database is, unlike the VA data, the lack of access to complete individual demographic data. This precludes a comprehensive analysis of the confounding factors Lipner et al. mention, such as h-index and other academic merits.

We also agree that measures are likely being implemented to address gender salary gaps, as the commenters mention a higher median salary growth rate in women versus men in some ranks. However, despite the trend towards closing this gap observed in the 5-year period, there remains an unequal distribution of higher academic ranks between men and women.

Many academic faculty members have employment at multiple nearby institutions. For example, a faculty member can have appointments and salary sources at the university medical center, VA, or state children’s hospital. Various factors may contribute to the existence and size of gender discrepancies within different institutions. A larger-scale study than ours and the commenters’ that compares salary sources and additional confounding factors is needed. We also need increased transparency and more accuracy in reporting and accessing other incentives and outside sources of income to have a more complete picture of compensation discrepancies between male and female dermatologists.

The commenters suggested a re-analysis of the dataset by including additional confounders, such as h-index. However, adding h-index and publication merits still would not fully address all potential confounding factors, such as variable funding sources, protected paid academic/administrative times, sabbaticals, bonuses, and benefits.

In summary, we appreciate the stimulating discussion and wholeheartedly agree that analyzing various salary components between different academic ranks and geographic regions is needed to clarify gender-based disparities in compensation for dermatologists and allow for the implementation of targeted measures to narrow these gaps and promote gender equality.

Financial disclosures

This research did not receive any funding from public, commercial, or not-for-profit sectors.

Conflicts of interest

None.

Study approval

N/A.