Differences in Lifetime Earning Potential Between Pediatric and Adult Physicians

TLDR

The study compares lifetime earnings of academic pediatric versus adult medicine generalists and subspecialists. Using 2019‑2020 national physician survey data on compensation and debt, the authors modeled lifetime earnings for academic pediatric and adult physicians, including scenarios with shortened pediatric subspecialty training. Adult physicians earned about 25% more lifetime income—roughly $1.2 million—than pediatric counterparts, a gap largely driven by lower pediatric compensation rather than longer training, with inpatient, procedure‑oriented subspecialties consistently higher than outpatient ones.

Abstract

Compare lifetime earning potential between academic pediatric and adult medicine generalists and subspecialists. Evaluate the effect of decreasing the length of training for pediatric subspecialties whose length of training is longer than that for the adult medicine counterpart.Using compensation and debt data from national physician surveys for 2019-2020, we estimated and compared the lifetime earning potential for academic pediatric and adult physicians.Lifetime earning potential was higher for adult physicians than for pediatric physicians across all comparable areas of both general and subspecialty academic practice. The lifetime earning potentials for adult physicians averaged 25% more, or $1.2 million higher, than those of the corresponding pediatric physicians. These differences predominantly were not attributable to unequal training length: when we modeled a shortened length of training for pediatric subspecialists, lifetime earning potential for adult subspecialists still averaged 19% more than that for pediatric subspecialists. For both pediatric and adult medicine, the primarily inpatient, procedure-oriented subspecialties had higher lifetime earning potential than the outpatient, less procedure-oriented subspecialties.Wide differences in lifetime earning potential between pediatric and adult physicians reflected lower compensation in pediatrics, rather than any differences in training length. Inpatient-based, more procedure-oriented subspecialties had higher lifetime earning potential than outpatient-based, less procedure-oriented subspecialties. Interventions that improve the lifetime earning potential of general pediatrics and the pediatric subspecialties, as well as the less procedure-oriented subspecialties across both pediatric and adult medicine, have the potential to impact both clinical practice and access to care.