背景:越来越多的证据表明医学中存在性别工资差距,这是家庭医学最近发现的更令人担忧的发现:在非常早期的职业阶段就可以发现16%的性别工资差距。本文探讨了妇女在居留权之外为第一份工作进行谈判的经验的定性证据,以确定妇女对谈判过程的参与和态度。
方法:我们招募了2019年毕业于住院医师的家庭医生,并回应了美国家庭医学委员会2022研究生调查。我们开发了一个半结构化的采访指南,遵循一种改进的生活史方法,通过从居住到劳动力的过渡阶段来揭示女性的经历。一位定性研究人员使用Zoom采访了19位在地理和种族上多样化的早期职业女性医生。访谈被逐字转录并使用NVivo软件按照归纳内容分析方法进行分析。
结果:数据中出现了三个主要主题。首先,工资被发现是不可谈判的,以参与者无法更改初始工资报价为例。第二,在整个居住和早期职业生涯中,同伴支持的作用对于发现和纠正工资不平等至关重要。第三,在少数族裔和低收入家庭的妇女中发现了薪酬期望差距。
结论:为了纠正医药领域的性别薪酬差距,需要一种系统级的方法。这可以通过各种水平的干预措施来实现:在社会上扩大使用和消除围绕育儿假的污名,认识到目前未由基于生产力的支付模式评估的捐款的重要性,检查关于领导力的假设;在制度上远离收费服务系统,鼓励灵活的时间表,提高工资透明度,提高推进透明度。
BACKGROUND: Nested within a growing body of evidence of a gender pay gap in medicine are more alarming recent findings from family medicine: a gender pay gap of 16% can be detected at a very early career stage. This article explores qualitative evidence of women\'s experiences negotiating for their first job out of residency to ascertain women\'s engagement with and approach to the negotiation process.
METHODS: We recruited family physicians who graduated residency in 2019 and responded to the American Board of Family Medicine 2022 graduate survey. We developed a semistructured interview guide following a modified life history approach to uncover women\'s experiences through the transitory stages from residency to workforce. A qualitative researcher used Zoom to interview 19 geographically and racially diverse early career women physicians. Interviews were transcribed verbatim and analyzed using NVivo software following an Inductive Content Analysis approach.
RESULTS: Three main themes emerged from the data. First, salary was found to be nonnegotiable, exemplified by participants\' inability to change initial salary offers. Second, the role of peer support throughout residency and early career was crucial to uncovering and rectifying salary inequity. Third, a pay expectation gap was identified among women from minority and low-income households.
CONCLUSIONS: To rectify the gender pay gap in medicine, a systems-level approach is required. This can be achieved through various levels of interventions: societally expanding the use of and removing the stigma around parental leave, recognizing the importance of contributions not currently valued by productivity-based payment models, examining assumptions about leadership; and institutionally moving away from fee-for-service systems, encouraging flexible schedules, increasing salary transparency, and improving advancement transparency.