A DESCRIPTION OF THE 2021 AFMRD SALARY SURVEY AND NEXT STEPS

The Association of Family Medicine Residency Directors (AFMRD) biannually conducts a Salary Survey of membership as a member benefit. The survey asks program directors (PDs) to report total taxable annual income for themselves, associate program directors, core faculty, program coordinators/administrators, and behavioral health faculty. Full survey reports are available to AFMRD members online in its PD Toolbox.

The most recent survey was conducted between September and October of 2021 and circulated to 587 PDs in the United States with 168 (28.6%) responding. Key demographics of PD participants and their programs are listed in Table 1. Additionally, the mean age of PDs was reported 49.9 years and mean total years of PD experience as 6.98 (minimum <1 year, maximum 36 years). Participants were also surveyed as to additional training or certifications, length of practice and scope of practice. The mean, standard deviation, and median annual taxable income per role are summarized in Table 2.

In reviewing results of the 2021 survey, the AFMRD Board of Directors noted a significant difference between male and female PDs with males reporting higher compensation on average (P = 0.009) (Table 3).

Increasing attention has been directed toward salary equity among physicians, including in academic medicine, in recent years. Gender appears to be the primary driving confounder in salary inequity at all levels. Among US medical school faculty, women earn $0.72 to $0.96 for every dollar earned by men peers of the same race/ethnicity.¹ Gender inequity also exists amongst internal medicine residency faculty and is most pronounced in subspecialties with procedural components.² Even after controlling for subspecialty, as well as academic rank and age, differences in salary by gender persist among internal medicine program directors.³ At the clinical department chair level in US medical schools, women earn $0.88 for every dollar received by men counterparts.⁴

Recently published data from the American Board of Family Medicine’s New Graduate Survey Data suggests that, within 3 years of graduation from residency, women family physicians report earning 16% less than men who graduated the same year.⁵ Little data has been published around compensation equity specific to family medicine graduate medical educators and leaders.

Initial analysis of the AFMRD Salary Survey showed a statistically significant difference in 2020 total taxable income with respondents identifying as male PDs earning more than identifying females. This is consistent with published literature showing gender disparities in salaries.^3,4,5 Compensation methods of family medicine PDs are admittedly complex and variable by program. The initial survey analysis did not allow for deeper study of potential confounders to salary, such as geographic region, program type, sponsor, or size, nor for a variety of program director identity factors, years of experience, or scope of practice.

Leaders in academic family medicine need to be aware that sex differences in salary exist in the specialty as a first step toward change. A next step may be to develop a formal hypothesis around gender equity in compensation of PDs and conduct a cross-sectional analysis that controls for potential confounding factors to determine if compensation inequity by gender exists. Cross-sectional analysis could also include past or future AFMRD Salary Surveys to evaluate historical trends or, where disparity exists, future progress toward equity.

• © 2022 Annals of Family Medicine, Inc.