Gender Pay Gap Widens Among Doctors at Belgian University Hospitals

Female doctors in Belgium earn significantly less than their male counterparts, and the disparity is actually growing at university hospitals (UZ), according to a new investigation by Belgian newspaper De Morgen. The findings, published on June 11, 2026, shed light on persistent gender-based salary inequalities within one of the country’s most prestigious professions.

Context & Background

The gender pay gap in Belgium has long been a subject of debate, with two competing statistical measures often cited. According to Statbel, Belgium’s official statistical office, the harmonized gender pay gap stood at just 0.7% in 2023 when measured on an hourly wage basis in companies with at least 10 employees. However, the Institute for the Equality of Women and Men calculates a significantly larger gap of 7% based on annual gross salaries corrected for working hours, rising to 19.5% without correction for part-time work.

In the broader healthcare sector, the gap is even more pronounced. Data indicates that the gender pay gap in Belgian healthcare stands at approximately 18.3%, making it one of the sectors with the widest disparities.

Belgian doctors are among the highest-paid professionals in the country. According to analyses of salary structures, top specialists such as neurosurgeons can earn upwards of €50,000 per month, while mid-tier specialists earn between €20,000 and €35,000. However, these figures are complicated by hospital deductions that can absorb up to 70% of billing, and by the fact that female doctors are disproportionately concentrated in lower-paying specialties.

Key Developments

The De Morgen investigation, authored by Cathy Galle, Dieter De Cleene, Dimitri Thijskens, and Sara Vandekerckhove, reveals that while doctor salaries in Belgium have increased substantially in recent years, the gains have not been distributed equally between men and women. The report finds that inequality is actually increasing at university hospitals, a trend that experts describe as particularly concerning given the highly regulated wage-setting environment.

Several structural factors contribute to the persistent gap. Female doctors are overrepresented in lower-paying specialties such as pediatrics, psychiatry, and geriatrics, while remaining underrepresented in higher-paying surgical and technical specialties. Career interruptions for family responsibilities, a higher likelihood of part-time work, and potential unconscious bias in discretionary compensation elements all play a role.

Belgium has seven university hospitals — including UZ Leuven, UZ Gent, UZ Antwerpen, and UZ Brussel — which combine patient care with medical research and education. Unlike self-employed specialists who operate on a fee-for-service basis, doctors at UZ hospitals are salaried employees, making the wage-setting process more transparent in theory. Yet the De Morgen investigation reveals that even within this structured environment, gender-based disparities are not only persisting but widening.

Analysis & Implications

The timing of the investigation is significant. Belgium faced a June 7, 2026 deadline to transpose the EU Pay Transparency Directive (2023/970) into national law. The directive requires salary ranges in job postings, bans on salary history questions, and mandatory gender pay gap reporting for companies. Flemish Minister of Equal Opportunities Caroline Gennez (Vooruit) announced stricter measures against wage discrimination in March 2026, including fines for employers who deliberately discriminate.

“The intention is that employers adjust their behavior and guarantee equal pay for equal work,” Gennez said at the time.

Experts warn that the pay gap has long-term consequences that extend beyond active working years. Prof. Petra Foubert (UHasselt) noted: “If you look at it over a lifetime, you notice that the pay gap turns into a pension gap.” This means that the disparities seen today will compound into retirement income inequality for female doctors.

Prof. Ive Marx (UAntwerpen) pointed to Belgium’s institutionalized wage-setting system as both a strength and a potential weakness: “The most important reason is that we have a very institutionalized wage-setting system… No distinction may be made.” Yet despite these formal protections, the data shows that disparities persist and even grow.

What’s Next

The De Morgen findings could strengthen the case for more aggressive enforcement of equal pay laws in Belgium’s healthcare sector. With the EU Pay Transparency Directive now due for implementation, policymakers have a fresh set of tools to address the gap, including mandatory reporting requirements that will make salary disparities more visible.

For the university hospitals themselves, the findings raise uncomfortable questions about internal compensation practices and whether performance-based pay systems may be disproportionately benefiting male-dominated specialties. As Belgium works to implement the EU directive, all eyes will be on how UZ hospitals respond to these revelations and what concrete measures they take to close the widening gap.

The investigation also adds urgency to broader debates about healthcare compensation and resource allocation in Belgium. With the country’s gender pay gap figures — ranging from 0.7% to 19.5% depending on the methodology — already a subject of political contention, the specific evidence of worsening inequality in the medical profession provides a concrete case study for policymakers. The coming months will reveal whether the combination of EU transparency requirements and domestic political pressure can reverse a trend that, as the De Morgen investigation shows, is moving in the wrong direction.