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What explains wage differences between male and female Brazilian physicians? A cross-sectional nationwide study
  1. Giulia Marcelino Mainardi,
  2. Alex J Flores Cassenote,
  3. Aline G Alves Guilloux,
  4. Bruno A Miotto,
  5. Mario Cesar Scheffer
  1. Medicina Preventiva, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil
  1. Correspondence to Dr Giulia Marcelino Mainardi; gmmainardi{at}


Objective In many countries an increase in the number of women in medicine is accompanied by gender inequality in various aspects of professional practice. Women in medical workforce usually earn less than their male counterparts. The aim of this study was to describe the gender wage difference and analyse the associated factors in relation to Brazil’s physicians.

Participants 2400 physicians.

Setting Nationwide, cross-sectional study conducted in 2014.

Methods Data were collected via a telephone enquiry. Sociodemographic and work characteristics were considered factors, and monthly wages (only the monthly earnings based on a medical profession) were considered as the primary outcome. A hierarchical multiple regression model was used to study the factors related to wage differences between male and female physicians. The adjustment of different models was verified by indicators of residual deviance and the Akaike information criterion. Analysis of variance was used to verify the equality hypothesis subsequently among the different models.

Results The probability of men receiving the highest monthly wage range is higher than women for all factors. Almost 80% of women are concentrated in the three lowest wage categories, while 51% of men are in the three highest categories. Among physicians working between 20 and 40 hours a week, only 2.7% of women reported receiving >US$10 762 per month, compared with 13% of men. After adjustment for work characteristics in the hierarchical multiple regression model, the gender variable estimations (ß) remained, with no significant modifications. The final effect of this full model suggests that the probability of men receiving the highest salary level (≥US$10 762) is 17.1%, and for women it is 4.1%. Results indicate that a significant gender wage difference exists in Brazil.

Conclusion The inequality between sexes persisted even after adjusting for working factors such as weekly workload, number of weekly on-call shifts, physician office work, length of practice and specialisation.

  • gender disparity
  • earning gaps women physicians
  • health workforce
  • pay gap
  • gender inequality

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  • GMM and AJFC contributed equally.

  • Contributors All authors had full access to all the data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. GMM, AJFC, AGAG, BAM and MCS have made substantial contributions to the conception, design of the work, acquisition, analysis and interpretation of data, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. GMM, AJFC, BAM, AGAG and MCS planned, designed and contributed ideas to create this paper. GMM, AJFC and AGAG planned the data analysis. AJFC and AGAG undertook the data analysis. GMM and AJFC wrote the first draft of the paper, and all authors contributed to further drafts and approved the final version. GMM, AJFC, AGAG, BAM and MCS revised critically all the work for important intellectual content and approved the final and revised manuscript. GMM, AJFC, AGAG, BAM and MCS have read, and confirm that they meet, the ICMJE criteria for authorship.

  • Funding Team financial support by grant number 0075/2015, Fundação Faculdade de Medicina (FFM), Conselho Regional de Medicina do Estado de São Paulo (Cremesp) and Conselho Federal de Medicina (CFM). This study was also funded by the UK Medical Research Council, grant number (MRC / R022747 / 1) and the Foundation for Research Support of the State of São Paulo (FAPESP, grant number 17 / 50356-7). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests We have read and understood BMJ open policy on declaration of interests and declare no competing interests

  • Ethics approval The study was reviewed and approved by the Medical School Research Ethics Committee from São Paulo University (Protocol Number #79.424), in accordance with Brazilian and international regulations for research with human subjects.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Patient consent for publication Not required.

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