The Ontario Medical Association (OMA) has recommended interventions to combat what it calls a “substantial” pay gap between male and female doctors in the Canadian province, including making improvements to fee schedules and payment models.

While the suggestions are a step towards equality, race and non-binary identities do not appear to be accounted for, suggesting the new approach may not address all the disparities some underrepresented doctors face.

OMA cites a 2020 paper published by the Canadian Medical Association Journal as a source in identifying the gap. The paper found female physicians bill less than 87 cents for each dollar billed by men on average.


A large-scale study published in 2019 based out of St. Michael’s Hospital echoed the findings, reporting female surgeons earned approximately 24 per cent less per hour than male surgeons between 2014 and 2016.

The conclusion is based on an analysis of 1.5 million surgical procedures conducted by 3,275 surgeons in the province of Ontario during that time.

Even after researchers adjusted for specialty, the pay gap remained The Canadian Press reports (CP). The largest mean difference appears to be in cardiothoracic surgery, which logged a discrepancy of $79.23 (CAD) per hour. The second-highest gap was in orthopedic surgery at $73.66 per hour.

“Our findings show the drivers of financial and remuneration differences for men and women in surgery and dispels the myth that women don’t earn as much because they don’t work as hard,” Dr. Nancy Baxter, author of the study and a scientist with the Li Ka Shing Knowledge Institute of St. Michael’s, said in a statement.

Male surgeons out-earned their female counterparts even in fields dominated by women, like gyaenocology. In that area, CP reports a mean difference of $22.90 per hour.

“Female surgeons are working in a system that wasn’t designed to support them. None of the disparities are due to choices — women are not choosing to make less — and we hope that the findings highlight the need for a solution,” said Dr. Fahima Dossa, co-lead author and general surgery resident at St. Michael’s.


“The pay gap issue among physicians is complex and there may be different causes for doctors in different practice settings,” OMA CEO Allan O’Dette said in a statement.

“If there is no single cause to explain the gender pay gap, then no single policy will fully address it. A series of interventions is needed to address this issue of basic fairness.”


Both papers referenced above separate physicians by gender and specialty, not accounting for racial disparities found in the Canadian healthcare system. A focus on gender also erases the experience of non-binary physicians, a group so marginalized it is often difficult to find relevant studies to cite.

Here’s another thing: Black and Indigenous physicians of all genders are underrepresented in Canada and documenting their experiences, and salaries, could add a greater understanding to what is creating pay disparities among Canadian physicians.

According to the University of Toronto, citing the 2016 census by Statistics Canada, Black Canadians make up about 4.7 per cent of Ontario’s population, but 2015 research suggests only 2.3 per cent of the province’s physician population is Black. 

Indigenous representation is even harder to find. According to 2016 Statistics Canada census data, only 760, or less than 1 per cent, of Canada’s 93,985 specialists and general practitioners identified as Indigenous, despite this demographic accounting for 4.5 per cent of the country’s total population.