Years ago, when hospital medicine emerged as a subspecialty, it seemed to offer several attractive qualities for women, including scheduling flexibility and a competitive salary. Moreover, it offered diversity, for those with interests in medical education, quality improvement, and patient safety. As a brand-new specialty, it held the promise of moving away from gender norms already firmly ensconced in existing subspecialties. But, has this young field fulfilled its promise of equal opportunity and advancement for women?

Despite rising salaries in hospital medicine, women receive a lower mean annual compensation than men in similar positions (1). Female hospitalists work more night shifts, are more likely to work in an academic setting, and earn nearly $15 000 per year less than their male peers (1). Even after such factors as hours worked are controlled for, these discrepancies persist. A recent article (which considered age, experience, rank, and productivity) found that female physicians at 24 public U.S. medical schools, across specialties, received significantly lower salaries than their male counterparts (2). Salary equity clearly has not been achieved in the medical field; however, drivers of this disparity are not fully understood. There are a host of hypothetical explanations, including implicit and explicit bias, poor negotiation skills (disproportionately affecting women), lack of transparency around compensation, and unawareness that the disparity exists. However, none adequately justify or explicate the difference, even though one remains (2).

几年前，当医院医学成为子专业时，它似乎为女性提供了多种吸引人的特质，包括灵活的安排时间和有竞争力的薪水。此外，它为那些对医学教育，质量改善和患者安全感兴趣的人提供了多样性。作为一个崭新的专业，它有望摆脱已经扎根于现有子专业中的性别规范。但是，这个年轻领域是否履行了妇女平等机会和地位提高的承诺？

尽管医院医学的薪水有所提高，但与处于类似职位的男性相比，女性的平均年薪要低（1）。女住院医生工作的夜班较多，更有可能在学术环境中工作，并且每年收入比男性同龄人少近1.5万美元（1）。即使在控制了工作时间等因素之后，这些差异仍然存在。最近的一篇文章（考虑了年龄，经验，职级和工作效率）发现，美国24个公立医学院不同专业的女医生的薪水明显低于男医生（2）。显然，在医疗领域还没有实现工资平等；但是，这种差异的驱动因素尚未得到充分理解。有许多假设的解释，包括内隐和外在偏见，谈判技巧差（对妇女的影响不成比例），薪酬缺乏透明度以及不知道存在这种差距。但是，即使有一个仍然存在，也没有一个能够充分证明或说明这种差异（2）。