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The Effect of Sex on Orthopaedic Surgeon Income

Beebe, Kathleen S. MD1; Krell, Ethan S. MBS1; Rynecki, Nicole D. BA1; Ippolito, Joseph A. MD1

doi: 10.2106/JBJS.18.01247
The Orthopaedic Forum

Background: Several studies have identified discrepancies in salary between male and female surgeons. Our aim was to investigate the impact of sex on an orthopaedic surgeon’s yearly earnings by evaluating stratified income and specialty data from a large sample survey of orthopaedic surgeons.

Methods: Self-reported data were obtained from the 2014 and 2008 American Academy of Orthopaedic Surgeons (AAOS) biennial censuses. Responses were received from 6,805 (24.26%) of those who were surveyed. The census form is a 19-question survey that includes information regarding work status (full time versus part time), sex, years in practice, practice type (private versus academic), specialty, hours worked, case volume, and income. The main outcome evaluated was self-reported income, and a multivariate regression model was used to control for confounding variables.

Results: Male surgeons reported higher incomes than female colleagues working equivalent hours ($802,474 versus $560,618; p = 0.016); however, male surgeons reported a greater case volume for the same number of hours. Among surgeons who performed ≥26 procedures per month, male and female surgeons reported comparable incomes ($949,508 versus $872,903; p = 0.649). Incomes of those in practice for >20 years also were comparable. Regression analysis controlling for subspecialty choice, hours worked, work status, case volume, years in practice, and practice setting revealed that income was $62,032.51 less for women than men (p < 0.001).

Conclusions: Income disparity between male and female orthopaedic surgeons remains significant, and the gap increased from 2008 to 2014. Although subspecialty choice, practice setting, years in practice, and amount and distribution of procedures performed can partially explain salary differences, our regression analysis suggests persistence of an income gap based on sex in orthopaedic surgery.

1Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, New Jersey

E-mail address for E.S. Krell:

Investigation performed at the Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, New Jersey

Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Disclaimer: The data utilized in this manuscript were obtained through the American Academy of Orthopaedic Surgeons (AAOS) 2008 and 2014 census reports. The views and conclusions expressed in this manuscript are those of the authors and do not represent the views or official stance of the AAOS.

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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