Letters to the Editor
To the Editor:
In the January 2018 issue, Garcia and colleagues1 shared that women and underrepresented-in-medicine (URM) medical school graduates planning to provide specialty care are more likely to report intention to work with underserved populations compared with their white male counterparts. This is congruent with past research reporting that URMs in primary care more frequently practice in underserved areas.2 These authors suggest improving incentive programs and pipeline diversification as important steps to retain such physicians in underserved areas. While we support these valuable steps, we wish to expand on the authors’ suggestions by asserting that pay parity for women and URMs in academia is also critical for retention and, moreover, for the provision of quality care for underserved populations.3
Pay disparity between genders and among URM faculty persists in academic medicine.4,5 For women physicians, salaries are only 70% of what men make, which means the gap has actually been widening compared with previous years.5 URM faculty are mostly women,6 giving them two factors outside their control that affect their salary. As we strive to reduce health inequities, we must consider the disparities among physicians who care for our most vulnerable and are the most dedicated to addressing issues of health disparity and social injustice.7 Paying women and URM physicians less than white male physicians is unjust and immoral. Leaders must ensure equitable compensation because when disparity is eliminated, the true winners are our patients.
Diana Nicole Carvajal, MD, MPH
Assistant professor and director, Reproductive Health Education, Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland; email@example.com.
Kristin Powell Reavis, MD, MBS
Assistant professor, associate residency program director, and director of maternal child health, Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
José E. Rodriguez, MD
Interim associate vice president of health equity and inclusion and professor of family and preventive medicine, University of Utah School of Medicine, Salt Lake City, Utah.
1. Garcia AN, Kuo T, Arangua L, Pérez-Stable EJ. Factors associated with medical school graduates’ intention to work with under served populations: Policy implications for advancing workforce diversity. Acad Med. 2018;93:82–89.
2. Marrast LM, Zallman L, Woolhandler S, Bor DH, McCormick D. Minority physicians’ role in the care of underserved patients: Diversifying the physician workforce may be key in addressing health disparities. JAMA Intern Med. 2014;174:289–291.
3. Bates C, Gordon L, Travis E, et al. Striving for gender equity in academic medicine careers: A call to action. Acad Med. 2016;91:1050–1052.
4. Zambrana RE. Income and wealth gaps, inequitable public policies, and the tentacles of racism. Am J Public Health. 2017;107:1531–1532.
6. Guevara JP, Adanga E, Avakame E, Carthon MB. Minority faculty development programs and underrepresented minority faculty representation at US medical schools. JAMA. 2013;310:2297–2304.
7. Vela MB, Chin MH, Press VG. Advocacy training as a complement to instruction about health disparities. Acad Med. 2016;91:449.