Industry Pays Far Less in Royalties, Consulting Fees to Female vs Male Surgeons

NEW ORLEANS, LA—Female cardiothoracic surgeons received substantially less money from industry in 2023 than did their male counterparts, according to new data.

The findings are in line with prior studies, both in the specialty and more broadly, as well as with discrepancies in pay identified by the Society of Thoracic Surgeons (STS) annual compensation survey.

“We were in shock when we saw the data,” Sofia Viana, MD (University of Cincinnati College of Medicine, OH), who presented the results at the recent 2026 STS Annual Meeting, told TCTMD. They expected to find differences in what male and female surgeons took home, but not to this extent, she said.

In their analysis of OpenPayments data from all cardiothoracic surgeons who received consulting fees and royalties from medical device and pharmaceutical companies in 2023, Viana and colleagues found that men (n = 427) took home $8,618,735 overall while women (n = 41) totaled $766,238.

Median payment was higher in men than women across specialties and clinical titles. When looking at career length, there was no difference among those with fewer than 5 years in practice, while the amount was higher among female versus male surgeons with 5-10 years of practice and lower among those with more than 10 years of practice.

Median Individual Payments in 2023 for Cardiothoracic Surgeons

The results were maintained when only consulting fees were included (median $6,000 vs $6,536; P = 0.0043)—no female surgeons reported receiving royalties so that comparison couldn’t be made. When surgeons were stratified by their h-index, female surgeons who have published more than 100 papers still brought in less money from industry compared with males in the same category (median $8,057 vs $8,650; P < 0.001).

On multivariate analysis, gender alone did not contribute to the payment disparities, but clinical position did. “We can say that gender itself doesn’t have [a direct] influence on the industry payment,” Viana said, but it does influence an individual’s clinical status and research opportunities, which can in turn affect these payments.

Notably, when researchers looked at the five highest consulting fee payments from pharmaceutical and device companies, they found large gender gaps favoring men versus women:

• AstraZeneca: $84,767.25 vs $60,706.50
• CSL Plasma: $113,441.50 vs $0
• AstraZeneca UK: $50,484.75 vs $38,813.40
• Regeneron Pharmaceuticals: $63,519.35 vs $0
• E.R. Squibb & Sons: $17,602.50 vs $11,519.50
• Atricure: $1,336,648.46 vs $255,056.00
• Edwards Lifesciences: $1,224,428.07 vs $27,937.50
• Paragonix Technologies: $976,650.00 vs $8,000
• Abbott Laboratories: $511,768.97 vs $7,012.50
• Anthrex: $399,927.20 vs $0

The discrepancy was even clearer when they looked at the five highest royalty payments made to men, with women receiving nothing in this category from any of these medical device companies:

• Medtronic: $788,715.12
• Zimmer Biomed Holdings: $189,566.07
• KLS-Martin: $52,123.07
• Becton, Dickinson and Company: $11,305.36
• Veran Medical Technologies: $1,930.00

While Viana has not yet approached any of the companies named in her study, she said she’d like to see them respond proactively by looking at their own rosters of consultants, for instance, and trying to include more women.

Commenting on the study for TCTMD, Shubham Gulati (Icahn School of Medicine at Mount Sinai, New York, NY), a medical student who published a similar study in 2025, said much of the onus to close these gaps should fall to pharmaceutical and device companies.

“Where industry can step in and be useful in the sense of changing this narrative is by tackling implicit bias through counter-stereotypic exposure—basically placing more female CT surgeons in places of power as advocates [and] as subject matter experts,” he said. “Industry’s going to be very intentional about who they choose, so [gender] should be a factor that should be part of the intentionality if they want to contribute to this idea that female CT surgeons are just as much experts as men.”

One open question is whether female surgeons could possibly be less likely to want to seek out industry relationships compared with men, Viana acknowledged. She’d like to see future survey work examining this further.

When speaking with female cardiothoracic surgeons in the past, Gulati said, many mentioned not feeling “seen as subject matter experts to the same extent that male CT surgeons are,” he said. “Sometimes this is because they’re not as senior. But a lot of that’s changed. In 2 years, the president of the STS will be a female CT surgeon, and the STS president was a female CT surgeon a year back. Things have drastically shifted from 20 years ago.”

Additionally, Gulati would like to see more work done looking at industry perspectives for how companies choose their consultants. “People from academia can keep publishing these numbers on OpenPayments and whatnot, . . . but that can only go so far,” he said. “Maybe there’s a clear reason for why, or maybe there’s a reason that wasn’t part of the thought process and hasn’t come up.”