Promoting the advancement of minority women faculty in academic medicine: the National Centers of Excellence in Women's Health

Women of Color in the Health Professions: A Scoping Review of the Literature

Women of color (WoC) in the health professions encounter challenges in advancement to higher positions, disparities in wages, discrimination, lack of expectation to achieve leadership positions, and absence of extensive support networks. Articles in the literature have addressed race and/or gender in the context of professional development. However, applying an intersectional lens or framework to better understand the contextual issues of professional development for WoC remains to be addressed. Thus, this scoping review aimed to (i) identify health professions literature that addresses disparities affecting WoC, and (ii) describe strategies and approaches to support WoC in the health professions. Methods: The literature searches were conducted in multiple databases, including PubMed and MEDLINE (Ovid); and Google and Google Scholar were used to "hand search" further articles including gray literature. Three independent reviewers reviewed and screened articles for inclusion in accordance with a guide. Search included articles on pharmacy or healthcare professions, published in English, and which met three content criteria: racial disparities/inequities, professional development/career advancement, and women or gender disparities Results: A total of 31 articles were included-medicine (17), nursing (1), pharmacy (7), other (4), and multiple health professions (2). Key findings included underrepresentation of women and minority groups, inequities in professional advancement and leadership positions for WoC, and greater dissatisfaction and attrition among minority and women professionals. Conclusion: WoC face unique and distinct challenges and barriers in their professional careers resulting from the intersectionality of not only race and gender, but also lived experiences and opportunities. Strategies to improve diversity and representation should include an intersectional framework or lens and be critically evaluated.

A Closer Look at Women's Health Centers: Historical Lessons and Future Aims

Women's Health Centers (WHC) have evolved over the last few decades as comprehensive centers for women's health care. This article reviews the history and evaluation of WHC, as well as opportunities for women's health training. Prior studies comparing WHC with traditional primary care and obstetrics/gynecology clinics have found that WHC offer at least similar levels of preventative care, may increase access to care for a more diverse patient population, and improve patient/provider relationship satisfaction. WHC also increase women's health providers' education and research opportunities. There is still a gap in women's health education and training, although residency and fellowship programs have aimed to address this through women's health tracks and fellowships. The coronavirus disease 2019 (COVID-19) pandemic and its negative impact on women's access to care have further highlighted the potential of WHC to meet women's health care demands. WHC can provide comprehensive, convenient, and single-site care for women. The increased opportunities for women's health training through WHC give rise to more representation in leadership and investment in women's health. New research is needed to reassess and further evaluate health outcomes of WHC compared with traditional care models.

Increasing Diversity in Radiology and Molecular Imaging: Current Challenges

This paper summarizes the 2020 Diversity in Radiology and Molecular Imaging: What We Need to Know Conference, a three-day virtual conference held September 9–11, 2020. The World Molecular Imaging Society (WMIS) and Stanford University jointly organized this event to provide a forum for WMIS members and affiliates worldwide to openly discuss issues pertaining to diversity in science, technology, engineering, and mathematics (STEM). The participants discussed three main conference themes, “racial diversity in STEM,” “women in STEM,” and “global health,” which were discussed through seven plenary lectures, twelve scientific presentations, and nine roundtable discussions, respectively. Breakout sessions were designed to flip the classroom and seek input from attendees on important topics such as increasing the representation of underrepresented minority (URM) members and women in STEM, generating pipeline programs in the fields of molecular imaging, supporting existing URM and women members in their career pursuits, developing mechanisms to effectively address microaggressions, providing leadership opportunities for URM and women STEM members, improving global health research, and developing strategies to advance culturally competent healthcare.

Women in immunology: 2020 and beyond

Women have been at the forefront of tremendous achievements in immunology in the past decade. However, disparities still exist, limiting upward potential and further advancements. As four NIH intramural women scientists who care deeply about scientific progress and the progress of women in our field, we review ongoing challenges and discuss potential approaches to help advance the promotion of women in the sciences.

Supporting underrepresented minority women in academic dermatology. Int J Womens Dermatol 2019;6:57-60. [PMID: 32025561 PMCID: PMC6997820 DOI: 10.1016/j.ijwd.2019.09.009]

The lack of underrepresented minorities in medicine (UIM) in dermatology has been well established, but the challenges faced by UIM women in dermatology have not yet been explored. UIM women belong simultaneously to more than one underrepresented group and therefore face complex challenges that are common to women and underrepresented minorities. Yet, the literature that focuses explicitly on UIM women as a group is scarce. This commentary provides insight into some of the challenges faced by UIM women in academic dermatology and provides specific recommendations to support these women through mentorship, professional development, and legitimization of their contributions to institutional diversity and service efforts.

Social media in the mentorship and networking of physicians: Important role for women in surgical specialties

BACKGROUND

Social media may be a useful supplement to physician and trainee interactions; however, its role in enhancing mentorship has not been described.

METHODS

A 35-item survey investigating trainee and physician social media use was distributed. Responses were analyzed using descriptive statistics.

RESULTS

282 respondents completed the survey, among whom 136 (48.2%) reported careers in surgical specialties. Women in surgical specialties were more likely to describe the specialty as being dominated by the opposite sex (p < 0.001) and to be mentored by the opposite sex though wish to be mentored by individuals of the same sex (p < 0.001). Respondents in surgical specialties were also more likely to report using social media to build a network of same-sex mentorship (p = 0.031).

CONCLUSIONS

Social media serves as a valuable tool to enhance the networking and mentorship of surgeons, particularly for women in surgical specialties who may lack exposure to same-sex mentors at their own institution.

The Native Investigator Development Program: Increasing the Presence of American Indian and Alaska Native Scientists in Aging-Related Research

The 2005 National Academy of Sciences’ report, Assessment of NIH Minority Research Training Programs: Phase 3, underscored the importance of minority representation in the scientific workforce for acquiring the knowledge required to address our nation’s racial and ethnic health disparities. This conclusion stands in sharp contrast to the finding that, in 1999, the National Institutes of Health supported35,000grants; among the principal investigators, only 9 were designated American Indian or Alaska Native (AI/AN). How can we increase the presence of AI/ANs in leadership roles? The authors describe a highly successful postdoctoral training program that prepares young AI/AN investigators for careers as independent, externally funded scientists who work at the nexus of research on culture, aging, and health. The program employs a structured, skill-driven approach that intensively mentors Native trainees without requiring relocation from their home institutions. This model holds promise for training similar populations in this and other fields.

The Nonwhite Woman Surgeon: A Rare Species

BACKGROUND

As of 2012, 39% of medical student graduates were nonwhite, yet very few nonwhite women graduates chose to become surgeons.

METHODS

To better understand issues regarding nonwhite women in surgery, an online survey was sent to surgeons across the United States. Results are based on self-reported data. Mean data are reported.

RESULTS

A total of 194 surgeons (42% women) completed the survey; only 12% of responders were nonwhite. Overall, 56% of nonwhite women felt they earned less than what men surgeons earn for equal work. Nonwhite women surgeons earned less than what men surgeons ($224,000 vs. 351,000, p < 0.00002) and white women surgeons ($285,000, p = 0.02) earned. Overall, 96% of nonwhite surgeons believed that racial discrimination currently exists among surgeons.

CONCLUSIONS

The few nonwhite women surgeons in the United States recognize that they are paid significantly less than what other surgeons are paid. Inequitable remuneration and a discriminatory work environment encountered by nonwhite women surgeons must be addressed.

Anticipatory guidance as a principle of faculty development: managing transition and change

Although one cannot anticipate every individual's unique responses to the transitions and changes that regularly occur in academic medicine, a department-wide faculty development program, based on predictable transition points and supporting faculty at all levels, can minimize such negative responses to change as stress and burnout. In 2007, the authors implemented a new, formal faculty development program in the pediatrics department built on the principle of anticipatory guidance, defined as providing guidance in anticipation of future academic events. The primary components of the program are mentoring committees for individual junior faculty, group leadership development and teaching forums for midlevel faculty, and events that focus on life and career changes for senior faculty. Other department-wide activities augment the program, including review of grant submissions, annual review by a senior faculty committee of the progress of National Institutes of Health mentored research (K-) awardees, women faculty luncheons, and discussions about faculty development at regular faculty meetings. The department's faculty also participate in the University of Rochester Medical Center's active faculty development program. Feedback on the faculty development program has been constructive and mainly positive and will serve to guide the continuing evolution of the program.

Effects of an educational intervention on female biomedical scientists' research self-efficacy

Women and people of color continue to be underrepresented among biomedical researchers to an alarming degree. Research interest and subsequent productivity have been shown to be affected by the research training environment through the mediating effects of research self-efficacy. This article presents the findings of a study to determine whether a short-term research training program coupled with an efficacy enhancing intervention for novice female biomedical scientists of diverse racial backgrounds would increase their research self-efficacy beliefs. Forty-three female biomedical scientists were randomized into a control or intervention group and 15 men participated as a control group. Research self-efficacy significantly increased for women who participated in the self-efficacy intervention workshop. Research self-efficacy within each group also significantly increased following the short-term research training program, but cross-group comparisons were not significant. These findings suggest that educational interventions that target sources of self-efficacy and provide domain-specific learning experiences are effective at increasing research self-efficacy for women and men. Further studies are needed to determine the longitudinal outcomes of this effort.

Staying connected: Native American women faculty members on experiencing success

PURPOSE

To document how medical school faculty who are Native American women describe their sense of personal and professional success, so that mentoring can be better informed and diversity increased.

METHOD

This qualitative study was designed using snowball sampling methodology. Open-ended questions were developed with the authors' expertise and asked of five Native American women physician faculty participants until saturation was achieved. Transcripts were coded, organized, and interpreted to generate tentative themes and working hypotheses. The study was completed in 2006 and 2007.

RESULTS

Native American women defined their place in the world through their primary culture. From analysis of the transcripts, three themes emerged as important in participants' sense of professional success: (1) Maintaining Native American values of belonging, connectedness, and giving back was essential, (2) success was perceived and experienced to have changed over time, and (3) mentoring relationships made success possible.

CONCLUSIONS

Native American women faculty based their identity and definition of success in their primary culture's values, relationships, and expectations. Academic success can be accomplished with mentorship that honors the Native American woman's responsibility to her culture over time (with clinical and academic opportunities) while also assisting with development of appropriate academic skills and opportunities.

Building infrastructure for HIV/AIDS and mental health research at institutions serving minorities

The National Institutes of Health and other funding agencies have initiated various programs aimed at enhancing diversity in the workforces for health care delivery and biomedical research. These programs have resulted in improvements in research infrastructure and moderate successes in increasing, retaining, and strengthening the pool of underrepresented minority students and junior faculty at resource-poor institutions serving minorities. We discuss some of the barriers and obstacles confronting such institutions, and the enablers and facilitators that may ameliorate or overcome such barriers. Although our analysis is drawn from lessons learned at an institution serving a largely Asian and Pacific Islander population, analogous situations may be found for other institutions serving minorities.

Enhancing American Indian and Alaska Native health research: a multi-faceted challenge

The quality, relevance, timeliness, and impact of public health research among American Indians and Alaska Natives (AIAN) has improved markedly over the last several decades. These advances are attributable to the more careful fit between investigative methods and field exigencies, to the increased presence of Native scientists among research teams, to greater emphasis on meaningful collaboration between researchers and participating communities, and to new Federal investments in the infrastructure that supports health research within this special population. This paper describes the lessons learned from this recent progress, and highlights opportunities to promote further gains as well as continuing needs in developing our capacity to conduct policy relevant AIAN health research.

Development of a Comprehensive Women's Health Program in an Academic Medical Center: Experiences of the Indiana University National Center of Excellence in Women's Health

BACKGROUND

The IU National Cancer of Excellence (CoE) in Women's Health was funded by the Office on Women's Health, Department of Health and Human Services, in 1997 as part of the "second generation" of CoEs. The purpose of this paper is to describe the changes that the existence of this Center have wrought within the IU School of Medicine.

METHODS

This paper describes the creation, mission, and function of the IU CoE, as well as some of its accomplishments to date.

RESULTS

Through its missions targeting clinical care, research, education, community outreach, and leadership development, the IU CoE has significantly changed the delivery of care to and by women at this institution.

CONCLUSIONS

The IU CoE has been responsible for major changes in the concepts of women's health from a clinical, research, education, and leadership perspective at the IU School of Medicine. Similar cases can be made for most of the other CoEs around the country. The challenges being faced continue to be sustained and sufficient funding for these valuable Centers.

Increasing women's leadership in academic medicine: report of the AAMC Project Implementation Committee

The AAMC's Increasing Women's Leadership Project Implementation Committee examined four years of data on the advancement of women in academic medicine. With women comprising only 14% of tenured faculty and 12% of full professors, the committee concludes that the progress achieved is inadequate. Because academic medicine needs all the leaders it can develop to address accelerating institutional and societal needs, the waste of most women's potential is of growing importance. Only institutions able to recruit and retain women will be likely to maintain the best housestaff and faculty. The long-term success of academic health centers is thus inextricably linked to the development of women leaders. The committee therefore recommends that medical schools, teaching hospitals, and academic societies (1) emphasize faculty diversity in departmental reviews, evaluating department chairs on their development of women faculty; (2) target women's professional development needs within the context of helping all faculty maximize their faculty appointments, including helping men become more effective mentors of women; (3) assess which institutional practices tend to favor men's over women's professional development, such as defining "academic success" as largely an independent act and rewarding unrestricted availability to work (i.e., neglect of personal life); (4) enhance the effectiveness of search committees to attract women candidates, including assessment of group process and of how candidates' qualifications are defined and evaluated; and (5) financially support institutional Women in Medicine programs and the AAMC Women Liaison Officer and regularly monitor the representation of women at senior ranks.