Sometimes I think I grew up in a “post gender” world. Having never felt like I was handicapped for being a woman, I saw the struggles of feminism as an historical lesson. Growing up in the 80s and 90s, the generations who came before had already blazed the trails that I would easily follow. My mother, for instance, was told by her father that she should aspire to a career as a secretary. She bucked these expectations and studied accounting, eventually becoming an executive. I, on the other hand, was encouraged to choose any profession, the sky was the limit.

Intellectually I always knew that my experience wasn’t universal. I knew women both actively and subtly battled sexism and inequality on a daily basis. But I felt hopeful that my life showed that real progress had been made. I had never thought once while applying for jobs or schools or anything about how my gender would affect me. That is, until now. Now that I am on the doorstep of joining the adult workforce, I can’t stop thinking about it and specifically the gender wage gap.

I am currently in my final year of residency and as I go out on the interview trail I can’t help but dwell on how much I’m going to get paid. I did not go into medicine for the money. But the idea that I might sign a contract and do the same job that a guy is getting paid 20% more for makes me angry and scared.

Pay inequality has been in the news for months, years. It is not a revelation. But it particularly struck me the other day when I was reading an article written by actress Jennifer Lawrence on this topic in Lenny (a self-described feminist e-newsletter that is entirely worth the space it takes up in your inbox). It had come out several months ago that even this superstar was getting paid a fraction of what her male costars were making. In her short piece, she touched on three important points from her experience. I think generalizing attributes to women as a whole is obnoxious and condescending so I will just be speaking for myself here. I personally related to the lessons she shared.

First, she acknowledged that she didn’t negotiate initially because it seemed unimportant to her to fight for more money when she was already getting paid millions. Similarly, I find it difficult to imagine quibbling over $250k versus $260k when my current paycheck is well shy of 50 grand. It also seems petty when I will be in the top 5% of earners in the country regardless. This is definitely a barrier to advocating for higher pay.

This is a common problem that persists and is actually accentuated as women advance in careers. According to an article in the Harvard Business Review, “women tend to initiate negotiations four times less often than men and ask for about 30% less when they do negotiate.” The result of this is that the controlled pay gap triples as women move up the ladder to executive. I think women need to be aware of this trend and actively pursue wage equity.

Next she talks about the negotiation itself. She says, “I would be lying if I didn’t say there was an element of wanting to be liked that influenced my decision to close the deal without a real fight.” I think this is key not only for women but also for the medical profession. We have spent years just being grateful for the opportunity. I was thrilled to get into medical school. I was relieved that I matched into residency. I would have gone anywhere and taken anything. Now that I am going out into the workforce, I can’t just feel thankful for being hired.

I need to remember that I have a marketable and valuable skill and I deserve appropriate compensation. I also need to remember that negotiation is not conflict. Likability is important and an asset in the emergency department, but it should not come at the expense of advocating for yourself when it comes to contract and salary negotiations.

Finally, she talks about the wage discrepancy as a symptom of a more general problem. Women are expected to be compromisers and team players. We are discouraged from being assertive. And this is limiting. Only 38% of medical school faculty, 16% of medical school deans, and 10% of emergency department chairs are women. These numbers have increased over the past decade – on average 5-10% – but until women occupy a more representative number of leadership positions, income inequality will persist.

In the end, I think it comes down to every individual advocating for themselves. The wage gap is one of those institutional insults that persists. Maybe it won’t even be a problem for me. But I know for certain that I am going to ask what my peers get paid during my interviews and hopefully I’ll have the guts to negotiate if I don’t like the answer I hear.


Lawrence, Jennifer, “Hollywood’s Gender Wage Gap,” Lenny, October 13, 2015, Letter No. 3.

Frank, Lydia, “How the Gender Pay Gap Widens as Women Get Promoted,” Harvard Business Review, November 5, 2015.

This piece will also be published in the AWAEM Awareness newsletter.