Base Salaries for Ophthalmologists Significantly Lower for Women

A survey-based study found that, after factoring in bonuses with salary, the difference is more than $30,000 per year.

Women in ophthalmology earn significantly less than men in the first year of clinical practice, according to findings published in Ophthalmology.

Researchers conducted a cross-sectional study to identify the role of gender and other factors in influencing compensation among ophthalmologists. The study consisted of the completion of an anonymous survey sent to US residency program directors and practicing ophthalmologists who recently completed residency training, and included data from those who completed residency <10 years ago and responded to questions regarding gender, fellowship training, state of practice, and salary.

The main outcome measure was base starting salary with bonus (SWB) received in the first year of clinical position. The researchers performed a propensity score match (PSM) analysis with age, academic residency, top residency, fellowship, state median wage, practice type, ethnicity, and number of workdays. Multivariate linear regression (MLR) analysis was also used to control for additional factors.

Of 684 included participants from 68 programs, 56% (n=384) were women. The study found that the mean SWB earned by women ophthalmologists was $33,139.80 less than their male counterparts (12.5% gap, P =.00), with a difference of $27,273.89 identified in the PSM analysis (10.3% gap, P =.0015). In separate PSM analyses, SWB differences were also calculated with the number of workdays substituted by operating room (OR) days (P =.0013) and clinic days (P =.0064). Additionally, there were significant differences in the MLR analyses, which controlled for work (-$22,261.49, P =.017), clinic (-$18,604.65, P =.015), and OR (-$16,191.26, P =.002) days separately. In all 3 analyses, gender independently predicted income (P <.05), and a greater portion of men reported success in negotiation (P =.03). 

The researchers point out another finding regarding fellowship training between the genders.

“Although similar proportions of female and male ophthalmologists completed at least 1 fellowship training after residency (83.7% vs. 87.0%, respectively), type of fellowship differed significantly between genders, with men more likely to pursue the highest paid subspecialty, vitreoretinal surgery (average $247,029.1+$61,701.12).”

Despite the salary differences inherent to fellowship type, the researchers note that women ophthalmologists still earned $30,726.51 less than men (P =.0003, 11.6% gap) when the study controlled for fellowship subspecialty as an independent variable. 

Study limitations include sample size as well as self-reporting, anonymity, inability to verify extreme outliers, and other factors inherent to a survey-based study.


Jia J, Lazzaro A, Lidder A, et al. Gender compensation gap for ophthalmologists in the first year of clinical practice. Ophthalmol. 2021;128(7):971-980. doi:10.1016/j.ophtha.2020.11.022.