Exploring salary negotiation and disparities in thoracic surgery

Compensation disparities persist in thoracic surgery, yet the dynamics of salary negotiation remain poorly understood. Exploring surgeon experience with negotiation may identify areas for targeted interventions.

An anonymous survey was distributed via the General Thoracic Surgical Club listserv to assess cardiothoracic surgeons' experiences with salary negotiation. Data gathered were used to assess demographics, experiences with initial salary negotiation and renegotiation, and access to negotiation training and resources.

Forty-six (20.9%) cardiothoracic surgeons completed the survey. Most respondents were men (65%), White (72%), and practiced in academic medical centers (70%). More than one half (53.5%) expected a fair salary without negotiation, although women more commonly disagreed with this statement (50% vs 10%, P = .07). The most common reason for not negotiating was the belief that the initial offer was fair (84.8%). Women more frequently cited cultural upbringing and mentor guidance as motivators for negotiation and prioritized work-life balance and career goals, whereas men emphasized schedule flexibility. During their first negotiation, women more often felt unprepared, whereas men reported feeling intimidated. Nearly all women (90.9%) reported renegotiating their salary compared with 23.3% of men, typically within the first 3 to 5 years of practice. Formal negotiation training was rare (7%), with nearly all respondents relying on mentor guidance.

There is considerable variation in salary negotiation experiences among thoracic surgeons, with many reporting inadequate preparation. Formal training was uncommon, but mentor guidance was influential. Structured support is needed, and opportunities exist for negotiation training and mentorship.