Factors Influencing Compensation of Early Career Neonatologists

Background: Employment characteristics and compensation for early career neonatologists (ECN) remain poorly defined. Previous studies have explored similar factors in neonatologists at various career stages. This is the first study reviewing job characteristics and compensation data for graduating trainees and ECNs within five years of fellowship completion.

Methods: An anonymous 61-question survey was distributed to eligible members of American Academy of Pediatrics Trainees and Early Career Neonatologists (TECaN), a focus group within the Section on Neonatal-Perinatal Medicine. Survey questions assessed clinician characteristics, work environment, and compensation of ECNs graduating between 2015-2020. Data were analyzed using univariate and multivariate regressions. Models were refined for best fit using independent predictors of statistical significance from bivariate analyses and previously published literature. Statistical analysis was performed using SAS Software version 9.4.

Results: Of 548 eligible individuals contacted, 348 responded (64% response rate). The majority of respondents self-identified as female (78%) US medical graduates (74%) currently practicing in a non-academic (54%), large group setting consisting of 14 or more neonatologists (38%). Overall median salary was $220,000 (Interquartile Range [IQR]: $200,000-$250,000). Factors associated with ECN compensation are shown in Table 1. Graduation year, practice region, group type, and academic affiliation significantly influenced compensation. Graduation year and non-academic affiliation was predictive of $10,000 annual salary increase based on number of years worked (p < 0.001). Multivariate analysis estimating dollar impact of factors associated with ECN compensation is shown in Table 2. Female gender identity was most significantly associated with decreased compensation in this subgroup analysis (-$27,578.46 ± $10,694.36; p=0.011).

Conclusion: Salary is commensurate with years of experience for non-academically affiliated positions but did not significantly increase in academic positions. Discordant earnings based on gender persist despite adjusting for factors significantly associated with increased compensation in prior investigations.