• Kelsey Gray, Angela Neville, Amy H Kaji, Mary Wolfe, Kristine Calhoun, Farin Amersi, Timothy Donahue, Tracy Arnell, Benjamin Jarman, Kenji Inaba, Marc Melcher, Jon B Morris, Brian Smith, Mark Reeves, Jeffrey Gauvin, Edgardo S Salcedo, Richard Sidwell, Kenric Murayama, Richard Damewood, V Prasad Poola, Daniel Dent, and Christian de Virgilio.
• Department of Surgery, Harbor-UCLA (University of California, Los Angeles) Medical Center, Torrance.
• JAMA Surg. 2019 Nov 1; 154 (11): 1023-1029.

ImportanceIn general surgery, women earn less money and hold fewer leadership positions compared with their male counterparts.ObjectiveTo assess whether differences exist between the perspectives of male and female general surgery residents on future career goals, salary expectations, and salary negotiation that may contribute to disparity later in their careers.Design, Setting, And ParticipantsThis study was based on an anonymous and voluntary survey sent to 19 US general surgery programs. A total of 606 categorical residents at general surgery programs across the United States received the survey. Data were collected from August through September 2017 and analyzed from September through December 2017.Main Outcomes And MeasuresComparison of responses between men and women to detect any differences in career goals, salary expectation, and perspectives toward salary negotiation at a resident level.ResultsA total of 427 residents (70.3%) responded, and 407 responses (230 male [58.5%]; mean age, 30.0 years [95% CI, 29.8-30.4 years]) were complete. When asked about salary expectation, female residents had lower expectations compared with men in minimum starting salary ($249 502 [95% CI, $236 815-$262 190] vs $267 700 [95% CI, $258 964-$276 437]; P = .003) and in ideal starting salary ($334 709 [95% CI, $318 431-$350 987] vs $364 663 [95% CI, $351 612-$377 715]; P < .001). Women also had less favorable opinions about salary negotiation. They were less likely to believe they had the tools to negotiate (33 of 177 [18.6%] vs 73 of 230 [31.7%]; P = .03) and were less likely to pursue other job offers as an aid in negotiating a higher salary (124 of 177 [70.1%] vs 190 of 230 [82.6%]; P = .01). Female residents were also less likely to be married (61 of 177 [34.5%] vs 116 of 230 [50.4%]; P = .001), were less likely to have children (25 of 177 [14.1%] vs 57 of 230 [24.8%]; P = .008), and believed they would have more responsibility at home than their significant other (77 of 177 [43.5%] vs 35 of 230 [15.2%]; P < .001). Men and women anticipated working the same number of hours, expected to retire at the same age, and had similar interest in holding leadership positions, having academic careers, and pursuing research.Conclusions And RelevanceThis study found no difference in overall career goals between male and female residents; however, female residents' salary expectations were lower, and they viewed salary negotiation less favorably. Given the current gender disparities in salary and leadership within surgery, strategies are needed to help remedy this inequity.

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