Persistent gender pay gaps among Canadian allergists: a population based longitudinal study

Abstract Background Despite growing representation of women in medicine, a persistent gender pay gap remains. In Ontario, women make up over half of Clinical Immunology and Allergy (CIA) physicians, making the field well-suited for examining income disparities. This study uses Ministry of Health data obtained by the Ontario Medical Association to quantify the gender pay gap in CIA and identify contributing factors. Methods We conducted a longitudinal analysis to investigate the gender pay gap among CIA physicians in Ontario, Canada from 2018 to 2023. Administrative health data, from the Ontario Health Insurance Plan, were analyzed to determine differences in clinical payments by gender. We used multivariable linear mixed-effects models (physician random intercepts) with log-transformed, inflation-adjusted annual clinical income as the outcome and adjusted for physician demographics, practice characteristics, and work patterns. Results Among 211 CIA physicians in Ontario (2018–2023), mean annual gross clinical payments were higher for male than female physicians ($443,969 vs $279,835; p < 0.001). In adjusted linear mixed-effects models, female physicians earned significantly less than male physicians (β = − 0.25; 95% CI − 0.37 to − 0.13; p < 0.001), corresponding to approximately 22% lower annual clinical income after adjustment for demographic factors, practice characteristics, and work patterns. Interpretation Our analysis reveals that women physicians earned significantly less than their male counterparts, and the gap persisted even after adjusting for demographic variables, practice characteristics, and work patterns. These findings point to systemic inequities and emphasize the need to address gender-based disparities to support physician retention, satisfaction, and quality of care.