What Maryland Physicians Earn and Why the Gender Pay Gap Persists

September is Women in Medicine Month, and it is a good time to look at a number that has not moved much. The physician gender pay gap is not a theoretical problem. In Maryland, it has been measured, published, and largely unchanged for years. Female physicians in this state earn more than 30% less than their male colleagues, even after controlling for specialty, hours worked, practice setting, and age. Nationally, the Doximity 2026 Physician Compensation Report puts the gap at 26%, with men earning an average of $122,276 more per year on a model-adjusted basis. At that pace, the difference compounds to roughly $2 million over a 40-year career. Here is where things stand and what physicians can do about it.

What the Numbers Show in Maryland

A peer-reviewed study published in 2023 analyzed four years of Maryland physician income data, including through the COVID-19 pandemic. The findings were consistent throughout: male physicians averaged $320,000 in annual pretax income compared to $213,000 for female physicians. The gap held across practice types and was not explained by specialty selection.

Breaking it down by specialty category: male primary care physicians averaged $262,542 compared to $172,542 for women, a 41% difference. For surgeons and diagnostic specialists, the gap was 33.5%. The study found the gap present and stable across all four years examined, including during the pandemic period when practice patterns shifted substantially.

What makes these numbers notable is that they persist after adjustment. Female physicians in Maryland earn less than male physicians even when the analysis accounts for specialty, hours, practice status, and career stage. The difference is not a byproduct of different choices. It is a pay disparity.

If you have not benchmarked your compensation against current data for your specialty and region, the Doximity Physician Compensation Report and the Maryland Academy of Family Physicians Pay Equity Toolkit are both practical starting points. Knowing where you stand relative to peers is the first step.

The Gap Is Widening, Not Closing

The national trend is moving in the wrong direction. According to Doximity, male physician compensation rose 5.7% in 2024 compared to 1.7% for women, accelerating the divergence. The 2026 gap of 26% is up from 23% in 2023. It is not narrowing on its own.

One structural driver: surgical specialties have seen the largest compensation growth, and those specialties remain male-dominated. That dynamic pulls aggregate numbers for men upward faster. But the gap exists within every specialty Doximity measured, with the sole exception of pediatric cardiology.

Research published in the New England Journal of Medicine found that differences in work hours explain only a portion of the gap in primary care, and that even when hours are equalized, a significant disparity remains. Hours and specialty choice together do not account for what is being measured.

If you are in a leadership or hiring role, salary transparency and standardized compensation frameworks are among the most effective structural interventions the evidence supports. The Maryland Academy of Family Physicians Pay Equity Toolkit includes practical guidance for practice administrators and physician leaders, not just individual physicians.

Why It Persists: What the Research Says

The Maryland study identified unconscious employer discrimination as the primary contributing factor, followed by differences in negotiation. Both are worth taking seriously.

On negotiation: research consistently shows that female physicians negotiate less frequently and accept initial offers at higher rates than male colleagues. That is not a character flaw; it reflects documented patterns in how negotiations play out differently by gender, including how assertiveness is perceived. But the practical result is that the gap often begins with the initial offer and compounds from there.

On institutional factors: studies find that women are less likely to receive performance bonuses, less likely to hold equity positions in group practices, and more likely to be in employment models with lower compensation ceilings. These are structural, not individual, problems.

For physicians negotiating a new contract or renegotiating an existing one: request salary ranges before disclosing your current compensation, ask explicitly about bonus structures and equity pathways, and use published benchmarks as anchors. The MDAFP Pay Equity Toolkit includes negotiation guidance developed specifically for Maryland physicians.

MCMS Is Watching This

MCMS is tracking pay equity as a physician workforce issue in Montgomery County and will continue to share data and resources as they become available. If you have experienced or observed pay disparities in your practice, we want to hear from you. Reach us at info@montgomerymedicine.org