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Devi J, Butt AS, Rai L, Kumar J, Memon S. Gender disparities in gastroenterology and hepatology conferences: The journey towards equality. Indian J Gastroenterol 2024:10.1007/s12664-024-01591-5. [PMID: 38935228 DOI: 10.1007/s12664-024-01591-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/11/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND This study scrutinizes gender representation in invited faculty and conference committee leadership at key gastroenterology and hepatology conferences in Pakistan over five years, exploring the impact of the "glass ceiling" and "sticky floor" phenomena on gender diversity within academic medicine. METHODS This cross-sectional study was conducted between January and March of 2023. The three major national societies of gastroenterology and hepatology in Pakistan that had been established for more than 10 years and the scientific programs of their annual conferences, which were publicly accessible, were included and coded as Society 1, Society 2 and Society 3 to maintain anonymity. The scientific programs for the last five years (2018-2022) were retrieved. The roles of invited faculties were identified as invited speakers, moderators, chairs/panelists, presidents and chairs of organizing or scientific committees and the gender makeup of the faculty was compared. Regression analysis was used to evaluate the trends for female representation over time for each role. RESULTS Significant gender disparity was evident by an extremely lower cumulative proportion of female invited faculty compared to males (211 [11.9%] vs. 1567 [88.1%], p 0.001). The predominance of invited male faculty was observed across all societies as well as in various roles of invited faculty (p 0.01). A significant disparity has also been observed in leadership positions of all three societies (43 [95.5%] males vs. 2 [4.5%] females, p 0.001), while the trend of women's underrepresentation across all societies remained almost unchanged over time (slope = 0.08, R2 = - 0.078, p-value = 0.875). CONCLUSION Our study unveils striking gender disparities in women's representation as invited speakers and other roles at the annual scientific conferences of major gastroenterology and hepatology. Additionally, male dominance remains entrenched, notably in leadership positions, necessitating a proactive, multifaceted approach to rectify gender inequities.
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Affiliation(s)
- Jalpa Devi
- Division of Gastroenterology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Amna Subhan Butt
- Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
| | - Lajpat Rai
- Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, Sindh, Pakistan
| | - Jatin Kumar
- Liaquat University of Medical and Health Sciences, Hyderabad, Sindh, Pakistan
| | - Sadik Memon
- Gastroenterology, Asian Institute of Medical & Health Sciences, Hyderabad, Sindh, Pakistan
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Ali Farhan S, Hasnain N, Moorpani M, Sajid EUD, Shahid I, Anand T, Khosa F. Gender Disparity in Academic Trauma Surgery: The Current State of Affairs. Am Surg 2024:31348241256080. [PMID: 38822562 DOI: 10.1177/00031348241256080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
INTRODUCTION Despite the increasing number of female surgeons in general surgery programs, women are still inadequately represented in leadership positions. This study aims to investigate the magnitude of gender bias in university-based trauma surgery fellowship programs and leadership positions in the United States of America. MATERIAL AND METHODS FRIEDA was used to identify trauma surgery programs. A thorough website review of each program obtained further information on faculty members, including their name, age, gender, and faculty rank. Trauma surgeons with an MD or DO qualification and a faculty rank of Professor, Associate Professor, or Assistant Professor were selected for inclusion in this study. SCOPUS was used to assess the H-index and the number of publications and citations of surgeons. RESULTS The total number of programs included was 136, consisting of 715 faculty members. Less than a quarter (n = 166; 23.2%) comprised females and less than one-fifth (n = 30; 19%) of female surgeons were Professors. The difference in the research productivity of male and female trauma surgeons was statistically significant (P < .05), with the average H-index being 10 vs 7.5, respectively, amongst the top 50 surgeons of both genders. Based on a multiple regression analysis, academic rank was significantly associated (P < .05), and gender was not significantly associated (P > .05) with H-index. CONCLUSION Gender disparity exists in the field of trauma surgery, as noted in senior faculty ranks and leadership positions. Female-inclusive state policies, appropriate mentorship, and supportive institutions can help to bridge this gap.
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Affiliation(s)
- Syed Ali Farhan
- Department of General Surgery, Harlem Hospital Center, New York, NY, USA
| | - Nimra Hasnain
- Department of Surgery, Dow University of Health Sciences, Karachi, Pakistan
| | - Manpreet Moorpani
- Department of Surgery, Dow University of Health Sciences, Karachi, Pakistan
| | - Emad-Ud-Din Sajid
- Department of Surgery, Dow University of Health Sciences, Karachi, Pakistan
| | - Izza Shahid
- Department of Cardiology, Houston Methodist Research Institute, Houston, TX, USA
| | - Tanya Anand
- Department of Trauma Surgery, University of Arizona, Tucson, AZ, USA
| | - Faisal Khosa
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
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Schaechter JD, Jacobs JW, Booth GS, Dupont WD, Silver JK. Gender Representation on Editorial Boards of JAMA Network Journals. J Womens Health (Larchmt) 2024; 33:446-452. [PMID: 38330429 DOI: 10.1089/jwh.2023.0685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Objective: Underrepresentation of women on editorial boards of biomedical journals has occurred for decades. The JAMA Network Journals have substantial and broad impact on advances in the biomedical sciences. We sought to determine the current status of gender representation on editorial boards of the 12 JAMA Network Journals. Methods: The gender of each editorial board member of the 12 JAMA Network Journals was classified based on review of online sources. The percentage of women on each board (i.e., number of women relative to total members) was calculated and compared to gender equity and parity benchmarks. The gender equity benchmark for each journal was defined as the percentage of women physicians in the medical specialty reflecting the journal's content based on Association of American Medical Colleges data. The gender parity benchmark for all journals was defined as 50% women. Results: There was considerable variation in the representation of women on the editorial boards of the JAMA Network Journals relative to gender equity and parity benchmarks. Women were underrepresented on 50% (6 of 12) of boards relative to gender equity and 67% (8 of 12) of boards relative to gender parity. Conclusions: Women were found to be underrepresented on 50% or more of the editorial boards of the JAMA Network Journals. This finding reflects gender inequities in academic publishing and the broader biomedical enterprise, which limits advances in the biomedical sciences and health care. Those JAMA Network Journals that continue to underrepresent women on their editorial boards are urged to remediate this longstanding issue.
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Affiliation(s)
- Judith D Schaechter
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Jeremy W Jacobs
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology and Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - William D Dupont
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Julie K Silver
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
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Vyas R, Morahan PS, Yuan S, Amaral E, Burch V, Campos HH, Mukherjee S, Salt J, Supe A, van Zanten M, Mladenovic J. FAIMER Global Faculty Development: A Sustainable Partnership Model to Advance Health Professions Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:1131-1138. [PMID: 37146238 PMCID: PMC10516165 DOI: 10.1097/acm.0000000000005264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The Foundation for Advancement of International Medical Education and Research (FAIMER), a member of Intealth, offers longitudinal faculty development programs (LFDPs) in health professions education (HPE) and leadership through its International FAIMER Institute (IFI) in the United States and FAIMER Regional Institutes (FRIs) globally. FAIMER fosters mutual collaboration and delineates shared responsibilities for FRI development in partnership with local institutions, using an adapted hub-and-spoke organizational design. This paper describes FAIMER's model, its sustainability, and its impacts at individual, institutional, and national levels. IFI was launched in 2001 in Philadelphia, Pennsylvania, as a 2-year part-time hybrid LFDP; with the COVID-19 pandemic onset, IFI transitioned to a fully online program. Since FAIMER's launch, 11 FRIs developed in Brazil, Chile, China, Egypt, India, Indonesia, and South Africa, each modeled on the IFI curriculum and adapted to local context. The more than 1,600 IFI and FRI graduates (fellows) from over 55 countries now form a global community of health professions educators who have shared exposure to HPE methods and assessment, leadership and management, educational scholarship and research, and project management and evaluation. Across all global locations and program formats, fellows self-reported a similar increase in knowledge and skills in HPE. All programs center on the fellows' institutional projects as experiential learning; these projects have focused primarily on educational methods and curriculum revisions. An increased quality of education was reported as the top impact resulting from fellows' projects. As a result of these programs, fellows have influenced education policy in their countries and established academic societies for HPE, thus contributing to recognition of the HPE academic specialty. FAIMER has successfully developed a sustainable model for advancing HPE globally, creating a vibrant network of health professions educators who have influenced country-specific educational policy and practice. FAIMER's model offers one approach to building global capacity in HPE.
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Affiliation(s)
- Rashmi Vyas
- R. Vyas is senior associate, FAIMER global lead, Foundation for Advancement of International Medical Education and Research (FAIMER), a member of Intealth, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0003-2770-8124
| | - Page S. Morahan
- P.S. Morahan is founding codirector, FAIMER Institute, and professor emerita, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Shiyao Yuan
- S. Yuan is senior technical associate and research and data scientist, FAIMER, a member of Intealth, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0003-3951-2137
| | - Eliana Amaral
- E. Amaral is founding codirector, Brazil FAIMER Regional Institute, coordinator, Nucleous on Assessment and Evaluation of Education for Health Professions, and professor, Obstetrics and Gynecology Department, School of Medical Sciences, University of Campinas, São Paulo, Brazil; ORCID: https://orcid.org/0000-0001-9151-3108
| | - Vanessa Burch
- V. Burch is founding codirector, sub-Saharan Africa FAIMER Regional Institute (SAFRI), executive director, Education and Assessment, Colleges of Medicine of South Africa, and honorary professor, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Henry H. Campos
- H.H. Campos is founding codirector, FAIMER Brazil Regional Institute, and professor of internal medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil; ORCID: https://orcid.org/0000-0001-8882-364X
| | - Snigdha Mukherjee
- S. Mukherjee is senior associate and researcher, FAIMER, a member of Intealth, Philadelphia, Pennsylvania
| | - Jessica Salt
- J. Salt is senior associate and international graduate support lead, FAIMER, a member of Intealth, Philadelphia, Pennsylvania
| | - Avinash Supe
- A. Supe is founding director, GSMC FAIMER Regional Institute, and professor emeritus, Seth Gordhandas Sunderdas Medical College, Mumbai, India
| | - Marta van Zanten
- M. van Zanten is senior associate and researcher, FAIMER, a member of Intealth, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0002-7433-6418
| | - Jeanette Mladenovic
- J. Mladenovic is past-president, FAIMER, a member of Intealth, and president and CEO, Centre for Women in Academic Medicine and Science, Seattle, Washington; ORCID: https://orcid.org/0000-0003-3369-5155
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Jacobs JW, Fleming TK, Jagsi R, Stanford FC, Spector ND, Booth GS, Silver JK. Analysis of Race and Ethnicity Among United States Medical Board Leadership. J Womens Health (Larchmt) 2023; 32:921-926. [PMID: 37498526 PMCID: PMC10510691 DOI: 10.1089/jwh.2023.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Background: The inequitable representation of women and members of racial and ethnic minority groups in leadership positions within academic medicine is an ongoing challenge with practical and realistic solutions. The purpose of this study was to assess the race and ethnicity of individuals in leadership positions among the 24 Member Boards of Directors (Boards) of the American Board of Medical Specialties (ABMS). Methods: We performed a cross-sectional analysis of the race and ethnicity patterns for individuals holding leadership positions among the 24 Boards of the ABMS as of March 1, 2022. Two independent coders with 100% concordance recorded race and ethnicity using online biographies and photographs. Percentages were compared to the Association of American Medical Colleges (AAMC) 2018 data reports. Results: Among 449 director positions, 415 (92.4%) were physicians. Within the physician subset, 12.3% (51/415) Asian, 8.2% (34/415) Black, and 3.4% (14/415) Hispanic individuals were identified. Women who are members of racial and ethnic minority groups have less representation than men of the same race. Of 24 Boards, 37.5% (9/24) had no Asian women, 50.0% (12/24) had no Black women, and 75.0% (18/24) had no Hispanic women. White physicians were overrepresented on 14 of 21 (66.7%) Boards compared to the proportion of active White physicians or White individuals in the United States general population. Conclusion: Disparities exist for members of racial and ethnic minority groups, particularly women from these groups. As a leader in academic medicine, the ABMS should ensure its Boards are diverse with respect to gender, race, and ethnicity. Diverse groups often contribute unique insights that support medical education, advance science, and improve clinical care.
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Affiliation(s)
- Jeremy W. Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Talya K. Fleming
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute at Hackensack Meridian Health, Rutgers Robert Wood Johnson Medical School, Edison, New Jersey, USA
| | - Reshma Jagsi
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Fatima Cody Stanford
- Department of Medicine-Neuroendocrine Unit, Department of Pediatrics-Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy D. Spector
- Executive Director, Executive Leadership in Academic MedicineDrexel University College of Medicine, Philadelphia, Pennsylvania, USA. (ELAM) and Executive Leadership in Health Care, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Garrett S. Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Julie K. Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
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Weiss M, Dogan R, Jeltema HR, Hatipoglu Majernik G, Venturini S, Ryang YM, Darie L, Engel D, Ferreira A, Ilic T, Lawson McLean AC, Malli A, Mielke D, Vanchaze K, Hernández-Durán S. Women in leadership positions in European neurosurgery - Have we broken the glass ceiling? BRAIN & SPINE 2023; 3:101777. [PMID: 37701290 PMCID: PMC10493481 DOI: 10.1016/j.bas.2023.101777] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 09/14/2023]
Abstract
Introduction The proportion of male neurosurgeons has historically been higher than of women, although at least equal numbers of women have been entering European medical schools. The Diversity Committee (DC) of the European Association of Neurosurgical Societies (EANS) was founded recently to address this phenomenon. Research question In this cross-sectional study, we aimed to characterize the status quo of female leadership by assessing the proportion of women heading European neurosurgical departments. Material and methods European neurosurgical departments were retrieved from the EANS repository. The gender of all department chairs was determined via departmental websites or by personal contact. The proportion of females was stratified by region and by type of hospital (university versus non-university). Results A total of 41 (4.3%) female department chairs were identified in 961 neurosurgery departments in 41 European countries. Two thirds (68.3%) of European countries do not have a female neurosurgery chair. The highest proportion of female chairs was found in Northern Europe (11.1%), owing to four female chairs in a relatively small number of departments (n = 36). The proportions were considerably smaller in Western Europe (n = 17/312 (5.5%)), Southern Europe (n = 14/353 (4.0%)) and Central and Eastern Europe (n = 6/260 (2.3%)) (p = 0.06). The distribution of female chairs in university (n = 19 (46.3%)) versus non-university departments (n = 22 (53.7%)) was even. Discussion and Conclusion There is a significant gender imbalance with 4% of all European neurosurgery departments headed by women. The DC intends to develop strategies to support equal chances and normalize the presence of female leaders in European neurosurgery.
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Affiliation(s)
- Miriam Weiss
- Department of Neurosurgery, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Rabia Dogan
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Gökce Hatipoglu Majernik
- Department of Neurosurgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sara Venturini
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Yu-Mi Ryang
- Department of Neurosurgery & Center for Spine Therapy, HELIOS Hospital Berlin Buch, Berlin, Germany
- Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Lucia Darie
- Department of Neurosurgery, University College London Hospitals, London, United Kingdom
| | - Doortje Engel
- Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen, Germany
| | - Anna Ferreira
- Department of Clinical Neuroscience and Mental Health, Faculdade de Medicina da Universidade Do Porto, Portugal
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Tijana Ilic
- Department of Neurosurgery, Centre Hospitalier Du Luxembourg, Luxembourg
| | | | - Antonia Malli
- Department of Neurosurgery, The National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Dorothee Mielke
- Department of Neurosurgery, University Medical Center Göttingen, Germany
| | | | | | - for the European Association of Neurosurgical Societies' Diversity Committee
- Department of Neurosurgery, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
- Department of Neurosurgery, University Medical Center Groningen, Groningen, the Netherlands
- Department of Neurosurgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Department of Neurosurgery & Center for Spine Therapy, HELIOS Hospital Berlin Buch, Berlin, Germany
- Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- Department of Neurosurgery, University College London Hospitals, London, United Kingdom
- Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen, Germany
- Department of Clinical Neuroscience and Mental Health, Faculdade de Medicina da Universidade Do Porto, Portugal
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Neurosurgery, Centre Hospitalier Du Luxembourg, Luxembourg
- Department of Neurosurgery, Jena University Hospital, Jena, Germany
- Department of Neurosurgery, The National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
- Department of Neurosurgery, University Medical Center Göttingen, Germany
- Department of Neurosurgery, St Lucas Hospital, Ghent, Belgium
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Representation of Female Speakers at the American Academy of Orthopaedic Surgeons Annual Meetings Over Time. J Am Acad Orthop Surg 2023; 31:283-291. [PMID: 36727899 DOI: 10.5435/jaaos-d-22-00615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/30/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In the United States, women comprise 16% of orthopaedic surgery residents, 4% of fellows, and 6% of practicing orthopaedic surgeons. The underrepresentation of women in surgical subspecialties may be because of lack of early exposure to female mentors. Conference speaker roles are important for visibility. This study aims to evaluate the representation of women in speaker roles and responsibilities at the American Academy of Orthopaedic Surgeons (AAOS) meetings over time. METHODS The names of speakers and session titles at the annual AAOS meetings were obtained from conference programs for the years 2009, 2014, and 2019. Each speaker was classified based on sex and role. Sessions discussing scientific or surgical topics were classified as technical and those that did not were classified as nontechnical. Descriptive statistics are provided, as well as individual-year odds ratios (ORs) and confidence intervals (CIs) examining sex versus technical session status and sex versus speaker role; combined results controlling for year are calculated using the Cochran-Mantel-Haenszel method. RESULTS Overall, 3,980 speaking sessions were analyzed; 6.8% of speaking sessions were assigned to women. Women were more likely than men to participate in nontechnical speaking roles (OR 3.85; 95% CI, 2.79 to 4.78). Among talks given by women, the percentage that were nontechnical increased (25.5% in 2009, 24.3% in 2014, and 44.1% in 2019). Among moderator roles, the percentage assigned to women increased (4.5% in 2009, 6.0% in 2014, 14.5% in 2019). DISCUSSION Our findings demonstrate an increase in female speakers at AAOS meetings from 2009 to 2019. The percentage of female moderators and nontechnical sessions given by women increased since 2009. A need for a shift in the distribution of speaker role exists, which promotes inclusivity and prevents professional marginalization. Representation of women as role models increases visibility and may address the leaky pipeline phenomenon and paucity of women in orthopaedics.
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Jumreornvong O, Henson P, Haque A, Sanchez AN, Samaan A, Nehrbass E, Silver JK, Escalon MX. Analysis of physician recipients of recognition awards from the American Academy of Physical Medicine and Rehabilitation by Race and Ethnicity. PM R 2023; 15:352-362. [PMID: 35187846 DOI: 10.1002/pmrj.12792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Medical society recognition awards are important resources for physicians in advancing their careers. There is a need to better understand the representation of physician recipients by race and ethnicity, especially in women with intersectional identities. OBJECTIVE To assess the proportions of American Academy of Physical Medicine and Rehabilitation (AAPM&R) award recipients by race and ethnicity and the intersection of gender. DESIGN Cross-sectional and retrospective study. SETTING AND METHODS One hundred seven (n = 107) published online physician award recipients from 2011 to 2020 were categorized by race, ethnicity, and gender by two independent researchers. There was 100% interrater agreement on race and gender and 95% on ethnicity. Data were analyzed with descriptive analysis and multilinear regression. MAIN OUTCOME MEASUREMENTS Awards given to physicians coded by race (White/Caucasian, Asian, and Black/African American), ethnicity (Hispanic/Latino), and the intersection of gender with race and ethnicity were analyzed. The primary comparator was proportions by race, ethnicity, and gender of academic physicians in physical medicine and rehabilitation (PM&R) using Association of American Medical Colleges (AAMC) data. A secondary aim was recipients' proportions compared to AAMC benchmarks for all practicing physiatrists. RESULTS There were no significant differences in representation of award recipients by race or ethnicity compared to the primary comparator of their percentages in academic PM&R. Notably, 96.3% of awards were given to physicians identified as being in or having been in academic medicine. Secondary analysis of award recipients to all practicing physiatrists revealed significant underrepresentation of recipients who were coded as (1) White/Caucasian women, Asian men and women, Black/African American men and women (p = .016), and (2) Hispanic/Latino men and women (p = .028). CONCLUSIONS This is a novel study assessing race and ethnicity in physician recognition awards presented by a medical society. No significant disparities were found among recipients as compared to representation in academic PM&R. However, there were significant disparities when compared to all practicing physiatrists. These findings deserve further investigation and consideration as medical societies strive to equitably support all members.
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Affiliation(s)
| | - Philip Henson
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Abid Haque
- Department of Rehabilitation and Human Performance, New York, New York, USA
| | - Ashley N Sanchez
- Department of Internal Medicine, McGovern Medical School, UT Health Science Center at Houston, Houston, Texas, USA
| | - Angela Samaan
- Department of Rehabilitation and Human Performance, New York, New York, USA
| | - Elena Nehrbass
- Department of Rehabilitation and Human Performance, New York, New York, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
- Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Charlestown, Massachusetts, USA
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Miguel X Escalon
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Rehabilitation and Human Performance, New York, New York, USA
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Iyer MS, Wilson K, Draucker C, Hobgood C. Physician Men Leaders in Emergency Medicine Bearing Witness to Gender-Based Discrimination. JAMA Netw Open 2023; 6:e2249555. [PMID: 36602802 PMCID: PMC9857061 DOI: 10.1001/jamanetworkopen.2022.49555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IMPORTANCE Approximately 60% of women physicians in emergency medicine (EM) experience gender-based discrimination (GBD). Women physicians are also more likely to experience GBD than men physicians, particularly from patients, other physicians, or nursing staff. OBJECTIVE To describe the responses of men who are academic department chairs in EM to GBD directed toward a woman colleague. DESIGN, SETTING, AND PARTICIPANTS This qualitative study was a secondary data analysis drawn from interviews of men EM academic department chairs at 18 sites who participated in a qualitative descriptive study between April 2020 and February 2021 on their perceptions of the influence of gender and leadership in academic medicine. Narrative data related to GBD were extracted and coded using conventional content analysis. Codes were clustered into themes and subthemes and summarized. Data were analyzed from November to December 2021. EXPOSURE Semistructured interviews conducted via teleconferencing. MAIN OUTCOMES AND MEASURES Qualitative findings identifying experiences witnessing or learning about incidents of GBD against women colleagues, the impact of these observations, and personal or leadership actions taken in response to their observations. RESULTS All 18 men participants (mean [SD] age, 52.2 [7.5] years; mean [SD] time as a department chair, 7.2 [5.1] years) discussed witnessing or learning about incidents of GBD against women colleagues. The participant narratives revealed 3 themes: emotional responses to GBD, actions they took to address GBD, and reasons for not taking action to address GBD. When witnessing GBD, participants felt anger, disbelief, guilt, and shame. To take action, they served as upstanders, confronted and reported discrimination, provided faculty development on GBD, or enforced "zero-tolerance" policies. At times they did not take action because they did not believe the GBD warranted a response, perceived a power differential or an unsupportive institutional culture, or sought self-preservation. CONCLUSIONS AND RELEVANCE In this qualitative study of men physician leaders, we found all participants reported feeling troubled by GBD against women colleagues and, if possible, took action to address the discrimination. At times they did not take action because of unsupportive workplace cultures. These findings suggest that institutional culture change that supports the interventions of upstanders and does not tolerate GBD is needed.
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Affiliation(s)
- Maya S. Iyer
- Division of Emergency Medicine, Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Kalah Wilson
- Department of Sociology North Carolina State University, Raleigh, North Carolina
| | - Claire Draucker
- Division of Community and Health Systems Indiana University School of Nursing, Indianapolis
| | - Cherri Hobgood
- Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill
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Baldwin CD, Lewis V, Thorndyke LE, Morahan PS, Gusic ME. Becoming by doing: How women in academic health sciences build a leadership identity through project experiences. MEDICAL TEACHER 2023; 45:73-79. [PMID: 35914521 DOI: 10.1080/0142159x.2022.2102469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Leadership development programs often use institutional projects to activate learning. We explored how project work shaped leadership identity formation in senior women leaders from one academic health science center who enrolled in The Hedwig von Ameringen Executive Leadership in Academic Medicine (ELAM®) program. MATERIALS AND METHODS We interviewed ELAM Fellows and conducted a qualitative analysis of transcripts. Our primary analysis focused on the influences of projects on Fellows and institutions. Leadership identity formation emerged as a distinct pattern, so this narrative content was separated for secondary analysis. All authors approved the final assignment of themes and codes. RESULTS Participants described a multi-dimensional process for developing a leadership identity. Themes encompassed participants' View of Self and One's Image as a Leader, Interpersonal Relationships, and Commitment to a Value-based Goal. These internal factors grounded external influences, such as interactions with colleagues and institutional leaders, and the world beyond the institution. CONCLUSIONS We examined the process of leadership identity formation from the perspective of women leaders in academic health sciences who completed an institutional project during a leadership development program. Findings illustrate how internal and external forces, experienced in the context of project work, combine to influence leadership identity formation in women.
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Affiliation(s)
- Constance D Baldwin
- Division of General Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Vivian Lewis
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Page S Morahan
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Maryellen E Gusic
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
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Jacobs JW, Jagsi R, Stanford FC, Sarno D, Spector ND, Silver JK, Booth GS. Gender Representation Among United States Medical Board Leadership. J Womens Health (Larchmt) 2022; 31:1710-1718. [PMID: 36318764 PMCID: PMC9805854 DOI: 10.1089/jwh.2022.0271] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To assess the gender composition of the American Board of Medical Specialties' (ABMS) member boards and evaluate the equitable inclusion of women and a subset of women physicians. Methods: The gender of individuals on 24 boards as of March 1, 2022, was assessed. Two benchmarks-parity (50:50 representation) and equity (compared to the proportion of practicing physicians in each medical specialty)-were utilized to determine if women are equitably represented on medical boards. Results: Four hundred forty individuals hold 449 total positions on the boards examined. Of board the members, 60.7% (267/440) are men, and 92.3% (406/440) are physicians. Physician board members comprised more men (64.0%, 260/406; p < 0.001), whereas more women comprise the 34 nonphysician board members (79.4%, 27/34; p < 0.001). Using specialty representation (equity) as the benchmark, of 22 specialties for which physician gender/sex data are available, women physicians are underrepresented on 36.4% (8/22) of boards. When parity (50%) is the comparator, 72.0% (18/25) of boards comprised less than 50% women. Compared to a 2016 analysis, the proportion of women overall (including non-physicians) increased on 68.0% (17/25), decreased on 24.0% (6/25), and remained unchanged on 8.0% (2/25) of boards in 2022. Conclusions: This study reveals mixed results in the equitable inclusion of women on ABMS boards. Our findings suggest that progress should not be assumed and that it may be subject to setbacks when it occurs. There is a need to continue to monitor the equitable inclusion of women on ABMS boards.
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Affiliation(s)
- Jeremy W. Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Reshma Jagsi
- Department of Radiation Oncology, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Fatima Cody Stanford
- Neuroendocrine Unit, Department of Medicine, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Endocrinology, Department of Pediatrics, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Danielle Sarno
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy D. Spector
- Executive Leadership in Academic Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Julie K. Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Garrett S. Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Keating JA, Jasper A, Musuuza J, Templeton K, Safdar N. Supporting Midcareer Women Faculty in Academic Medicine Through Mentorship and Sponsorship. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 42:197-203. [PMID: 35180741 PMCID: PMC10351961 DOI: 10.1097/ceh.0000000000000419] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Midcareer women faculty face unique career challenges that may benefit from mentorship and sponsorship, yet such programs focused on the needs of this career phase are scarce in academic medicine. Many midcareer faculty require intentional and individual career planning to choose a path from the broad array of options in academic medicine. Ambiguous promotion criteria, increased workloads because of service or citizenship tasks, and a lack of sponsorship are among the barriers that inhibit midcareer faculty's growth into the high-visibility roles needed for career advancement. In addition, issues faced by women midcareer faculty members may be further exacerbated by barriers such as biases, a disproportionate share of family responsibilities, and inequities in recognition and sponsorship. These barriers contribute to slower career growth and higher attrition among women midcareer faculty and ultimately an underrepresentation of women among senior leadership in academic medicine. Here, we describe how a mentoring program involving individuals (eg, mentors, mentees, and sponsors) and departments/institutions (eg, deans and career development offices) can be used to support midcareer faculty. We also provide recommendations for building a mentoring program with complementary support from sponsors targeted toward the specific needs of women midcareer faculty. A robust midcareer mentoring program can support the career growth and engagement of individual faculty members and as a result improve the diversity of academic medicine's highest ranks.
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Affiliation(s)
- Julie A Keating
- Dr. Keating: Research Health Scientist, the William S. Middleton Memorial Veterans Hospital, Madison, WI. Dr. Jasper: Research Intern, the Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI. Dr. Musuuza: Research Health Scientist, the William S. Middleton Memorial Veterans Hospital, and Associate Research Specialist, the Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI. Dr. Templeton: Professor and Vice-Chair for Diversity, Equity, and Inclusion in the Orthopedic Surgery, the Department of Orthopedic Surgery, the University of Kansas School of Medicine, Kansas City, KS. Dr. Safdar: Professor of Medicine and Vice Chair of Research, the Department of Medicine, the University of Wisconsin-Madison School of Medicine and Public Health, and the Associate Chief of Staff-Research, the William S. Middleton Memorial Veterans Hospital, Madison, WI
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Hong LJ, Rubinsak L, Benoit MF, Teoh D, Chandavarkar U, Brockmeyer A, Stevens E, Ioffe Y, Temkin SM. Gynecologic Oncology and Inclusion of Women Into the Surgical Workforce: The Canary in This Coal Mine. Front Oncol 2022; 12:789910. [PMID: 35463315 PMCID: PMC9020218 DOI: 10.3389/fonc.2022.789910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Women make up a majority of the gynecologic oncology workforce. Increasing the numbers of women in leadership has been proposed as a path towards professional gender equity. This study examined whether leadership gender and departmental infrastructure impact the work environment for women gynecologic oncologists. Methods Members of a 472-member private Facebook group “Women of Gynecologic Oncology” (WGO) who self-identified as women gynecologic oncologists provided demographics, practice infrastructure, personal experience with workplace bullying, gender discrimination, microaggressions using a REDcap survey platform. Results Of 250 (53%) respondents to this survey, most were younger than age 50 years (93.6%); White (82.2%) and non-Hispanic (94.3%); married (84.7%); and parenting (75.2%). Practice environments included academic (n=152, 61.0%), hospital employed (n=57, 22.9%), and private practice (n=31, 12.4%), and 89.9% supervised trainees. A significant percent of respondents had experienced bullying (52.8%), gender discrimination (57%) and microaggressions (83%). Age, race, ethnicity, practice setting, or mentorship were not statistically significantly associated with these experiences. Reported perpetrators were varied and included colleagues (84%), patients (44%), staff (41%), administrators (18%), and trainees (16%). Prevalence of bullying (55.0 vs 47.7%, p=0.33), gender discrimination (59.1 vs 52.3%, p=0.33) and microaggressions (83.3 vs 83.0%, p=1.00) were similar irrespective of departmental leadership gender. Conclusions Women gynecologic oncologists report a high prevalence of workplace bullying, gender discrimination and microaggressions regardless of the gender of their immediate leadership. Proactive and deliberate structural interventions to improve the work environment for surgeons who are women are urgently needed.
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Affiliation(s)
- Linda J Hong
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Loma Linda University School of Medicine, Loma Linda, CA, United States
| | - Lisa Rubinsak
- Division of Gynecologic Oncology, Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Michelle F Benoit
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kaiser Permanente Washington, Seattle, WA, United States
| | - Deanna Teoh
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, United States
| | - Uma Chandavarkar
- Department of Oncology, Sutter Medical Group, Sacramento, CA, United States
| | - Amy Brockmeyer
- Division of Gynecologic Oncology and Gynecology, Department of Surgery, Virginia Mason Medical Center, Seattle, WA, United States
| | - Erin Stevens
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prevea Health, Green Bay, WI, United States
| | - Yevgeniya Ioffe
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Loma Linda University School of Medicine, Loma Linda, CA, United States
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Creating work environments where people of all genders in gynecologic oncology can thrive: An SGO evidence-based review. Gynecol Oncol 2022; 164:473-480. [PMID: 35000796 PMCID: PMC9465952 DOI: 10.1016/j.ygyno.2021.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/14/2021] [Accepted: 12/27/2021] [Indexed: 01/10/2023]
Abstract
Equality, equity, and parity in the workplace are necessary to optimize patient care across all aspects of medicine. Gender-based inequities remain an obstacle to quality of care, including within the now majority women subspecialty of gynecologic oncology. The results of the 2020 SGO State of the Society Survey prompted this evidence-based review. Evidence related to relevant aspects of the clinical care model by which women with malignancies are cared for is summarized. Recommendations are made that include ways to create work environments where all members of a gynecologic oncology clinical care team, regardless of gender, can thrive. These recommendations aim to improve equality and equity within the specialty and, in doing so, elevate the care that our patients receive.
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Hunter J, Crofts H, Keehn A, Schlagintweit S, Luc JGY, Lefaivre KA. Gender imbalance amongst promotion and leadership in academic surgical programs in Canada: A cross-sectional Investigation. PLoS One 2021; 16:e0256742. [PMID: 34437636 PMCID: PMC8389450 DOI: 10.1371/journal.pone.0256742] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/13/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Women are underrepresented at higher levels of promotion or leadership despite the increasing number of women physicians. In surgery, this has been compounded by historical underrepresentation. With a nation-wide focus on the importance of diversity, our aim was to provide a current snapshot of gender representation in Canadian universities. METHODS This cross-sectional online website review assessed the current faculty listings for 17 university-affiliated academic surgical training departments across Canada in the 2019/2020 academic year. Gender diversity of academic surgical faculty was assessed across surgical disciplines. Additionally, gender diversity in career advancement, as described by published leadership roles, promotion and faculty appointment, was analyzed. RESULTS Women surgeons are underrepresented across Canadian surgical specialties (totals: 2,689 men versus 531 women). There are significant differences in the gender representation of surgeons between specialties and between universities, regardless of specialty. Women surgeons had a much lower likelihood of being at the highest levels of promotion (OR: 0.269, 95% CI: 0.179-0.405). Men surgeons were statistically more likely to hold academic leadership positions than women (p = 0.0002). Women surgeons had a much lower likelihood of being at the highest levels of leadership (OR: 0.372, 95% CI: 0.216-0.641). DISCUSSION This study demonstrates that women surgeons are significantly underrepresented at the highest levels of academic promotion and leadership in Canada. Our findings allow for a direct comparison between Canadian surgical subspecialties and universities. Individual institutions can use these data to critically appraise diversity policies already in place, assess their workforce and apply a metric from which change can be measured.
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Affiliation(s)
- Jennifer Hunter
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Helen Crofts
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alysha Keehn
- Division of General Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Sofie Schlagintweit
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jessica G. Y. Luc
- Division of Cardiovascular Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly A. Lefaivre
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
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16
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The Role of Gender in Careers in Medicine: a Systematic Review and Thematic Synthesis of Qualitative Literature. J Gen Intern Med 2021; 36:2392-2399. [PMID: 33948802 PMCID: PMC8342686 DOI: 10.1007/s11606-021-06836-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Gender disparities exist in the careers of women in medicine. This review explores the qualitative literature to understand how gender influences professional trajectories, and identify opportunities for intervention. METHODS A systematic review and thematic synthesis included articles obtained from PubMed, Cochrane Central Register of Controlled Trials (Ovid), EMBASE (Ovid), APA PsycInfo (Ovid), and GenderWatch (ProQuest) on June 26 2020, updated on September 10, 2020. Included studies explored specialty choice, leadership roles, practice setting, burnout, promotion, stigma, mentoring, and organizational culture. Studies taking place outside of the USA, using only quantitative data, conducted prior to 2000, or focused on other health professions were excluded. Data were extracted using a standardized extraction tool and assessed for rigor and quality using a 9-item appraisal tool. A three-step process for thematic synthesis was used to generate analytic themes and construct a conceptual model. The study is registered with PROSPERO (CRD42020199999). FINDINGS Among 1524 studies identified, 64 were eligible for analysis. Five themes contributed to a conceptual model for the influence of gender on women's careers in medicine that resembles a developmental socio-ecological model. Gender influences career development externally through culture which valorizes masculine stereotypes and internally shapes women's integration of personal and professional values. CONCLUSION Medical culture and structures are implicitly biased against women. Equitable environments in education, mentoring, hiring, promotion, compensation, and support for work-life integration are needed to address gender disparities in medicine. Explicit efforts to create inclusive institutional cultures and policies are essential to support a diverse workforce.
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Silver JK, Cuccurullo S, Weiss L, Visco C, Sowa G, Oh-Park M, Karimi DP, Frontera WR, Fleming TK, Bosques G, Ambrose AF, Knowlton T. Association of Academic Physiatrists Women's Task Force Follow-up Report. Am J Phys Med Rehabil 2021; 100:610-619. [PMID: 33350644 DOI: 10.1097/phm.0000000000001670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The Association of Academic Physiatrists convened a Women's Task Force in 2016, under the leadership of then Association of Academic Physiatrists President Gerard Francisco, MD, to evaluate data and metrics pertaining to the representation and inclusion of female physiatrists in the society. An initial published report focused on a retrospective analysis of data in categories such as leadership, conference presentations, and recognition awards. The findings, which highlighted areas in which the Association of Academic Physiatrists had been successful in supporting gender equity as well as areas in which female physiatrists were underrepresented, provided a base from which to strategically focus on closing gaps in representation. The task force developed an action plan that was approved by the Board of Trustees and included strategies aimed at closing gaps and collecting data to determine corresponding effectiveness. Because most of the categories fell under the supervision of various Association of Academic Physiatrists committees, an appointee from each committee ("diversity steward") liaised with the Women's Task Force. The diversity stewards reviewed the plan with their respective committees and collected data within their committee's purview. This task force follow-up report documents recent progress, consistent with the Association of Academic Physiatrists Board of Trustees commitment to transparency and gender equity.
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Affiliation(s)
- Julie K Silver
- From the Harvard Medical School and Spaulding Rehabilitation Network, Boston, Massachusetts (JKS); Association of Academic Physiatrists Women's Task Force, Owing Mills, Maryland (JKS, SC); JFK Johnson Rehabilitation Institute and Rutgers Robert Wood Johnson Medical School/Hackensack Meridian School of Medicine, Edison, New Jersey (SC, TKF); New York University, Long Island School of Medicine, Mineola, New York (LW); Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York (CV); NewYork-Presbyterian Hospital-Columbia and Cornell, New York, New York (CV); University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (GS); Burke Rehabilitation Hospital, Albert Einstein College of Medicine, Montefiore Health System, New York City, New York (MO-P); University of California Irvine School of Medicine, Irvine, California (DPK); University of Puerto Rico School of Medicine, San Juan, Puerto Rico (WRF); McGovern Medical School at University of Texas Health Science Center, Shriners Hospital for Children in Houston, TIRR Memorial Hermann Hospital, Houston, Texas (GB); Montefiore Medical Center, Albert Einstein College of Medicine, New York City, New York (AFA); and Association of Academic Physiatrists, Owing Mills, Maryland (TK)
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Kramer M, Heyligers IC, Könings KD. Implicit gender-career bias in postgraduate medical training still exists, mainly in residents and in females. BMC MEDICAL EDUCATION 2021; 21:253. [PMID: 33933035 PMCID: PMC8088689 DOI: 10.1186/s12909-021-02694-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 04/19/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND More and more female residents enter postgraduate medical training (PGMT). Meanwhile, women are still underrepresented in academic medicine, in leadership positions and in most surgical specialties. This suggests that female residents' career development may still be negatively impacted by subtle, often unconscious stereotype associations regarding gender and career-ambition, called implicit gender-career bias. This study explored the existence and strength of implicit gender-career bias in doctors who currently work in PGMT, i.e. in attending physicians who act as clinical trainers and in their residents. METHODS We tested implicit gender-career bias in doctors working in PGMT by means of an online questionnaire and an online Implicit Association Test (IAT). We used standard IAT analysis to calculate participants' IAT D scores, which indicate the direction and strength of bias. Linear regression analyses were used to test whether the strength of bias was related to gender, position (resident or clinical trainer) or specialty (non-surgical or surgical specialty). RESULTS The mean IAT D score among 403 participants significantly differed from zero (D-score = 0.36 (SD = 0.39), indicating bias associating male with career and female with family. Stronger gender-career bias was found in women (βfemale =0 .11; CI 0.02; 0.19; p = 0.01) and in residents (βresident 0.12; CI 0.01; 0.23; p = 0.03). CONCLUSIONS This study may provide a solid basis for explicitly addressing implicit gender-career bias in PGMT. The general understanding in the medical field is that gender bias is strongest among male doctors' in male-dominated surgical specialties. Contrary to this view, this study demonstrated that the strongest bias is held by females themselves and by residents, independently of their specialty. Apparently, the influx of female doctors in the medical field has not yet reduced implicit gender-career bias in the next generation of doctors, i.e. in today's residents, and in females.
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Affiliation(s)
- Maud Kramer
- School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
- Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Centre, Heerlen, The Netherlands.
| | - Ide C Heyligers
- School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - Karen D Könings
- School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Harris CE, Clark SD, Chesak SS, Khalsa TK, Salinas M, Pearson AC, Williams AW, Moeschler SM, Bhagra A. GRIT: Women in Medicine Leadership Conference Participants' Perceptions of Gender Discrimination, Disparity, and Mitigation. Mayo Clin Proc Innov Qual Outcomes 2021; 5:548-559. [PMID: 34195547 PMCID: PMC8240154 DOI: 10.1016/j.mayocpiqo.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To assess demographic characteristics and perceptions of female physicians in attendance at a medical conference for women with content focused on growth, resilience, inspiration, and tenacity to better understand major barriers women in medicine face and to find solutions to these barriers. Patients and Methods A Likert survey was administered to female physicians attending the conference (September 20 to 22, 2018). The survey consisted of demographic data and 4 dimensions that are conducive to women's success in academic medicine: equal access, work-life balance, freedom from gender biases, and supportive leadership. Results All of the 228 female physicians surveyed during the conference completed the surveys. There were 70 participants (31.5%) who were in practice for less than 10 years (early career), 111 (50%) who were in practice for 11 to 20 years (midcareer), and 41 (18.5%) who had more than 20 years of practice (late career). Whereas participants reported positive support from their supervisors (mean, 0.4 [SD 0.9]; P<.001), they did not report support in the dimensions of work-life balance (mean, -0.2 [SD 0.8]; P<.001) and freedom from gender bias (mean, -0.3 [SD 0.9]; P<.001). Conclusion Female physicians were less likely to feel support for work-life balance and did not report freedom from gender bias in comparison to other dimensions of support. Whereas there was no statistically significant difference between career stage, trends noting that late-career physicians felt less support in all dimensions were observed. Future research should explore a more diverse sample population of women physicians.
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Affiliation(s)
| | | | | | | | - Manisha Salinas
- Department of General Internal Medicine, Mayo Clinic, Jacksonville, FL
| | - Amy C.S. Pearson
- Department of Anesthesiology, University of Iowa, Iowa City, Iowa
| | - Amy W. Williams
- Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | | | - Anjali Bhagra
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN
- Correspondence: Address to Anjali Bhagra, MD, Department of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
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Affiliation(s)
- Shannon M Ruzycki
- Division of General Internal Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Susan Franceschet
- Department of Political Science, University of Calgary, Calgary, Canada
| | - Allison Brown
- Division of General Internal Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Has a critical mass of women resulted in gender equity in gynecologic surgery? Am J Obstet Gynecol 2020; 223:665-673. [PMID: 32585225 DOI: 10.1016/j.ajog.2020.06.038] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/29/2020] [Accepted: 06/18/2020] [Indexed: 11/23/2022]
Abstract
Gender equity in medicine and surgery has recently received widespread attention. Unlike surgical specialties that remain predominantly male, the majority of obstetrician-gynecologists have been women for nearly a decade, and women have composed the majority of trainees since the 1990s. Despite a critical mass of women, biases related to gender persist in the field. Professional and behavioral expectations of men and women gynecologists remain different for patients and workplace colleagues. Gender discrimination and sexual harassment are still experienced at high rates by both trainees and obstetrician-gynecologists in practice. In addition, in other surgical fields, women gynecologic surgeons face a gender wage gap that is unexplained by differences in experience, hours worked, or subspecialty training. Academic advancement and the attainment of leadership positions remain a challenge for many women. Policies related to pregnancy and parenting may disproportionately affect the careers of women gynecologists. This article presents peer-reviewed evidence relevant to gender equity in the workplace and suggests proactive interventions to ensure diversity and inclusion for gynecologic surgeons.
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Ovseiko PV, Taylor M, Gilligan RE, Birks J, Elhussein L, Rogers M, Tesanovic S, Hernandez J, Wells G, Greenhalgh T, Buchan AM. Effect of Athena SWAN funding incentives on women's research leadership. BMJ 2020; 371:m3975. [PMID: 33106283 DOI: 10.1136/bmj.m3975] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Pavel V Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Mark Taylor
- NIHR Central Commissioning Facility, Twickenham, UK
| | | | - Jacqueline Birks
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Leena Elhussein
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Mike Rogers
- NIHR Central Commissioning Facility, Twickenham, UK
| | | | | | - Glenn Wells
- Oxford Academic Health Science Centre, Oxford, UK
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Abstract
Europe represents true diversity, with cultural, linguistic and geopolitical variation spanning a large geographical area. Politics for many of its 750 million inhabitants revolves around the European Union (EU) and its 27 member states. The overarching goal of the EU is to promote peace and the values of the union (inclusion, tolerance, justice, solidarity and non-discrimination).1,2EFORT was created to connect orthopaedic associations across Europe, fostering relationships between member countries that celebrated diversity and facilitated the exchange of knowledge. Whilst the global landscape changes and politics attempts to interfere in how we live our lives, it is important to remember that a strong organization is a diverse one that evolves over time.Various initiatives exist across the global landscape to support diversity in terms of culture; gender; black, Asian and minority ethnic (BAME) groups; disability groups; lesbian, gay, bisexual, transgender and queer (or questioning) and others (LGBTQ+); and the 'ageing' surgeon. This article explores the creation of some of these initiatives and how they have been supported by different orthopaedic organizations. Cite this article: EFORT Open Rev 2020;5:743-752. DOI: 10.1302/2058-5241.5.200022.
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Kraus MB, Gali B, Cunningham GW, Moeschler SM, Schulte PJ, Johnson MQ, Sharpe EE. Speaker Gender Representation for Anesthesiology Grand Rounds at a Large Academic Medical Center. THE JOURNAL OF EDUCATION IN PERIOPERATIVE MEDICINE : JEPM 2020; 22:E654. [PMID: 33447653 PMCID: PMC7792565 DOI: 10.46374/volxxii-issue4-sharpe] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Invited speakerships, such as speaking at grand rounds, are part of the pathway to promotion in academic medicine. This project sought to evaluate if the gender of invited grand rounds speakers at a major academic institution were distributed as expected based on the specialty workforce. MATERIALS AND METHODS Archived lists of speakers for grand rounds for the Mayo Clinic Department of Anesthesiology were obtained from 2007 through 2018. The Cochran-Armitage test and logistic regression models were used to analyze the change in proportion of invited women speakers over time. One-sample proportion tests were conducted to compare the proportion of women speakers to the expected percentage of available women speakers based on gender data from national organizations. RESULTS Of the 122 invited external speakers, 28 (23%) were women. Men invited 104/122 (85.2%) of all the speakers, of which 21 (20.2%) were women speakers. There was not significant evidence the proportion of women speakers increased over time (P = .29). Women speakers comprised a lower proportion of external invited speakers compared to the proportion of women in the academic anesthesia workforce; however, this association was not statistically significant (P = .07). The percentage of new residents that were female increased over this time period (P = .001). DISCUSSION The percentage of women invited to be grand rounds speakers did not increase over the study period. Intentional measures should be instituted to increase the proportion of women grand rounds speakers.
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Balmer DF, Courts KA, Dougherty B, Tuton LW, Abbuhl S, Hirshfield LE. Applying the Theory of Gendered Organizations to the Lived Experience of Women with Established Careers in Academic Medicine. TEACHING AND LEARNING IN MEDICINE 2020; 32:466-475. [PMID: 32458706 DOI: 10.1080/10401334.2020.1767106] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Phenomenon: The number of women who enter medical school has been on par with the number of men for almost 20 years, but parity in training has not translated to equity in professional life. To capitalize on the perspective of women faculty with established careers in academic medicine and to bring theory to the largely descriptive research on gender inequity in academic medicine, the authors used the Theory of Gendered Organizations to demonstrate how academic medical centers function as inherently gendered organizations. Approach: The authors recruited women faculty with established careers at one academic medical center based on purposeful and snowball sampling and interviewed 30 participants in Summer/Fall 2018. They coded and analyzed data inductively. In later stages of analysis they used sensitizing concepts from the Theory of Gendered Organizations to guide our focus on formal expectations of, and informal interactions in, the academic medical center. Findings: The disjuncture, i.e., "lip service", between formal expectations intended to be gender-neutral and informal interactions that advantaged men demonstrated how the academic medical center functioned as a gendered organization. Participants experienced these interactions as being treated differently than men and/or being stereotyped. As their careers progressed, participants recognized gender inequity as embedded in the organization, or as they said, "the way things were stacked". Subsequent to this recognition, they navigated this gendered organization by advocating for themselves and younger women faculty. Insights: Women with established careers in academic medicine experienced gender inequity as embedded in the organization but navigate gendered interactions by advocating for themselves and for younger women. Using the Theory of Gendered Organizations as an analytic lens demonstrates how academic medical centers function as gendered organizations; these findings can inform both theory-based research and pragmatic change strategies.
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Affiliation(s)
- Dorene F Balmer
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kelly A Courts
- St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA
| | - Bridget Dougherty
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lucy Wolf Tuton
- Departments of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stephanie Abbuhl
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura E Hirshfield
- Departments of Medical Education and Sociology, University of Illinois-Chicago, Chicago, USA
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Chang S, Guindani M, Morahan P, Magrane D, Newbill S, Helitzer D. Increasing Promotion of Women Faculty in Academic Medicine: Impact of National Career Development Programs. J Womens Health (Larchmt) 2020; 29:837-846. [PMID: 32466701 PMCID: PMC7307676 DOI: 10.1089/jwh.2019.8044] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Three national career development programs (CDPs)-Early and Mid-Career Programs sponsored by the Association of American Medical Colleges and the Hedwig van Ameringen Executive Leadership in Academic Medicine sponsored by Drexel University-seek to expand gender diversity in faculty and institutional leadership of academic medical centers. Over 20 years of success and continued need are evident in the sustained interest and investment of individuals and institutions. However, their impact on promotion in academic rank remains unknown. The purpose of the study is to compare promotion rates of women CDP participants and other faculty of similar institutional environment and initial career stage. Methods: The study examined retrospective cohorts of 2,719 CDP participants, 12,865 nonparticipant women, and 26,810 men, from the same institutions, with the same degrees, and first years of appointment in rank. Rates of promotion to Associate and Full Professor ranks in respective cohorts of Assistant and of Associate Professors were compared using Kaplan-Meier survival curves and log-rank tests, and logistic regression adjusting for other predictors of academic success. Results: In adjusted analyses, participants were more likely than men and non-participant women to be promoted to Associate Professor and as likely as men and more likely than non-participant women to be promoted to Full Professor within 10 years. Within 5 years, CDP participants were more likely than nonparticipant women to be promoted to Associate Professor and as likely as to be promoted to Full Professor; in the same interval, participants were promoted to both higher ranks at the same rates as men. For both intervals, nonparticipant women were significantly less likely than men to be promoted to either rank. Conclusions: The higher rates of promotion for women participating in national CDPs support the effectiveness of these programs in building capacity for academic medicine.
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Affiliation(s)
- Shine Chang
- Division of Cancer Prevention and Population Sciences, Department of Epidemiology, Cancer Prevention Research Training Program, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michele Guindani
- Department of Statistics, University of California, Irvine, Irvine, California, USA
| | - Page Morahan
- Academic Medicine (ELAM) Program for Women, Philadelphia, Pennsylvania, USA
- Foundation for Advancement of International Medical Education and Research (FAIMER) Institutes, Philadelphia, Pennsylvania, USA
- Microbiology and immunology at Drexel, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Diane Magrane
- Academic Medicine Program, Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Sharon Newbill
- Folkstone: Evaluation Anthropology, Pensacola, Florida, USA
| | - Deborah Helitzer
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
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Marcelin JR, Manne-Goehler J, Silver JK. Supporting Inclusion, Diversity, Access, and Equity in the Infectious Disease Workforce. J Infect Dis 2020; 220:S50-S61. [PMID: 31430384 DOI: 10.1093/infdis/jiz213] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
In medicine, a wide array of evidence demonstrates the presence of gender, racial, ethnic, and other disparities in representation, compensation, and career development. These disparities also exist in the field of infectious diseases, providing important opportunities for the Infectious Diseases Society of America to identify and report its successes in and challenges to achieving equity. In this article, we review the literature documenting challenges with equity broadly in medicine and specifically in infectious diseases. We then introduce the Be Ethical Campaign, an initiative that encourages healthcare leaders to use metrics and data analysis to identify workforce equity gaps and pursue opportunities to close them.
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Affiliation(s)
| | - Jennifer Manne-Goehler
- Massachusetts General Hospital, Boston, Massachusetts.,Brigham and Women's Hospital, Boston, Massachusetts
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Rouse LP, Nagy-Agren S, Gebhard RE, Bernstein WK. Women Physicians: Gender and the Medical Workplace. J Womens Health (Larchmt) 2020; 29:297-309. [PMID: 31967945 DOI: 10.1089/jwh.2018.7290] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Understanding the work habits, attitudes, and experiences of women physicians is critical for optimal patient care. In a gendered work environment, obstacles faced hinder women physicians from contributing to their full ability. This study investigated how women physicians' work habits are viewed, in the context of women's attitudes and experiences. Methods: An analysis of the medical literature (1990-2017) was undertaken. Published studies were located using search engines, article references, consultation with experts, and relevant Mesh terms. Of 1185 listings, 354 studies were evaluated and 44 articles, selected by three reviewers, were analyzed in detail. Results: Four themes emerged-practice styles, productivity, prevailing attitudes, and the workplace environment. Comparing women physicians to male colleagues as a standard for evaluating performance, for example, undervalues distinctive characteristics women bring to medical practice. Productivity models that focus on work hours, procedures, and publications do not encompass the full scope of patient care. Conclusions: Solutions offered mainly have been designed to help women physicians fit into existing workplace environments, but traditionally available "adapt or exit" options in response to challenges faced appear insufficient. A gender equity perspective helps to explain findings and suggests ways to reshape the health care workplace to better understand, utilize, and retain women physicians.
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Affiliation(s)
- Linda P Rouse
- Department of Sociology and Anthropology, The University of Texas at Arlington, Arlington, Texas
| | | | - Roberta E Gebhard
- Gender Equity Task Force, The American Medical Women's Association, Reston, Virginia
| | - Wendy K Bernstein
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, New York
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Alwazzan L, Al-Angari SS. Women's leadership in academic medicine: a systematic review of extent, condition and interventions. BMJ Open 2020; 10:e032232. [PMID: 31948988 PMCID: PMC7044906 DOI: 10.1136/bmjopen-2019-032232] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/24/2019] [Accepted: 11/26/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Because culture reflects leadership, the making of diverse and inclusive medical schools begins with diversity among leaders. The inclusion of women leaders remains elusive, warranting a systematic exploration of scholarship in this area. We ask: (1) What is the extent of women's leadership in academic medicine? (2) What factors influence women's leadership? (3) What is the impact of leadership development programmes? DESIGN Systematic review. DATA SOURCES A systematic search of six online databases (OvidMEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library and ERIC) from the earliest date available to April 2018 was conducted. Bridging searches were conducted from April 2018 until October 2019. ELIGIBILITY CRITERIA: (1) Peer-reviewed; (2) English; (3) Quantitative studies (prospective and retrospective cohort, cross-sectional and preintervention/postintervention); evaluating (4) The extent of women's leadership at departmental, college and graduate programme levels; (5) Factors influencing women's leadership; (6) Leadership development programmes. Quantitative studies that explored women's leadership in journal editorial boards and professional societies and qualitative study designs were excluded. DATA EXTRACTION AND SYNTHESIS Two reviewers screened retrieved data of abstracts and full-texts for eligibility, assessment and extracted study-level data independently. The included studies were objectively appraised using the Medical Education Research Quality Study Instrument with an inter-rater reliability of (κ=0.93). RESULTS Of 4024 records retrieved, 40 studies met the inclusion criteria. The extent of women's leadership was determined through gender distribution of leadership positions. Women's leadership emergence was hindered by institutional requirements such as research productivity and educational credentials, while women's enactment of leadership was hindered by lack of policy implementation. Leadership development programmes had a positive influence on women's individual enactment of leadership and on medical schools' cultures. CONCLUSIONS Scholarship on women's leadership inadvertently produced institute-centric rather than women-centric research. More robust contextualised scholarship is needed to provide practical-recommendations; drawing on existing conceptual frameworks and using more rigorous research methods.
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Affiliation(s)
- Lulu Alwazzan
- Medical Education, Al Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Samiah S Al-Angari
- Otolaryngology, Head & Neck surgery, King Saud University, Riyadh, Saudi Arabia
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Van Heest A. Gender Diversity in Orthopedic Surgery: We All Know It's Lacking, but Why? THE IOWA ORTHOPAEDIC JOURNAL 2020; 40:1-4. [PMID: 32742201 PMCID: PMC7368510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND 15% of orthopedic surgery trainees in 2018-2019 in ACGME accredited programs are female, which lags behind all other specialties. METHODS The bottleneck for achieving gender diversity in orthopedic surgery is that female medical students do not choose orthopedic surgery as a career. In 2018-2019, twelve ACGME accredited programs had no women trainees, highlighting the uneven distribution of female trainees across residency programs. Social science has outlined that 30% representation within a population is the diversity goal. CONCLUSION A goal of having females comprise 30% of orthopedic surgeons trainees can be achieved with: pipeline programs such as the Perry Initiative and Nth Dimensions; increased orthopedic surgery rotation clinical experience during medical school; and mentorship that promotes and encourages gender diversity. Additionally, recognizing implicit bias as well as explicit discrimination, harassment, and bullying, creates a workplace environment that is inclusive and safe for employees, trainees and physicians, as well as the patients that we serve.Level of Evidence: V.
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Affiliation(s)
- Ann Van Heest
- University of Minnesota, Department of Orthopedic Surgery, Vice Chair of Education, Residency Program Director, Minneapolis, MN
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32
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Larson AR, Sharkey KM, Poorman JA, Kan CK, Moeschler SM, Chandrabose R, Marquez CM, Dodge DG, Silver JK, Nazarian RM. Representation of Women Among Invited Speakers at Medical Specialty Conferences. J Womens Health (Larchmt) 2019; 29:550-560. [PMID: 31687866 DOI: 10.1089/jwh.2019.7723] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Gender-related differences have been found among invited speakers in select professional and medical societies. We examined whether similar disparities existed among keynote speakers, plenary speakers, and invited lecturers in a broad range of medical specialty conferences from 2013 to 2017. Materials and Methods: A cross-sectional study was performed on 27 U.S. medical specialty conferences for which data were available on plenary speakers, keynote speakers, and/or invited lecturers. For each speaker, gender and degree(s) were determined. Fisher's exact test was performed to compare proportions of women among speakers to Association of American Medical Colleges' (AAMC) physician workforce data on gender distribution. Results: In aggregate, we identified 246 women among 984 speakers, significantly lower than expected when compared with 2015 AAMC data (25.0% vs. 34.0%; p < 0.00001). Compared with AAMC data reported in 2013, 2015, and 2017, women were significantly underrepresented in 2013 (p = 0.0064) and 2015 (p = 0.00004). In 2017, the proportion of women among invited speakers trended lower than AAMC active women physicians but did not reach significance (p = 0.309). Analysis of individual conference data stratified by year indicated that, while the representation of women among all speakers improved between 2015 and 2017, the representation of women among keynote speakers, plenary speakers, and invited lectureships was variable (including zero levels some years during the study period) and remained lower than expected as compared with workforce data for specific medical specialties. Conclusions: Evaluating for and improving disparities is recommended to ensure gender equity among invited speakers across all medical specialty conferences.
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Affiliation(s)
- Allison R Larson
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Katherine M Sharkey
- Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Julie A Poorman
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Carolyn K Kan
- Boston University School of Medicine, Boston, Massachusetts
| | - Susan M Moeschler
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota
| | - Rekha Chandrabose
- Department of Anesthesiology, University of California San Diego School of Medicine, San Diego, California
| | - Carol M Marquez
- Department of Radiation Oncology, Stanford University, San Jose, California
| | - Daleela G Dodge
- Department of Surgery, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Rosalynn M Nazarian
- Dermatopathology Unit, Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
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33
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McKinley SK, Wang LJ, Gartland RM, Westfal ML, Costantino CL, Schwartz D, Merrill AL, Petrusa E, Lillemoe K, Phitayakorn R. "Yes, I'm the Doctor": One Department's Approach to Assessing and Addressing Gender-Based Discrimination in the Modern Medical Training Era. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1691-1698. [PMID: 31274522 DOI: 10.1097/acm.0000000000002845] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
While gender-based bias and discrimination (GBD) is known to exist in medical training, there is limited guidance for training programs on how to understand and combat this issue locally. The Massachusetts General Hospital Department of Surgery established the Gender Equity Task Force (GETF) to address GBD in the local training environment. In 2017, members of the GETF surveyed residents in surgery, anesthesia, and internal medicine at 2 academic hospitals to better understand perceived sources, frequency, forms, and effects of GBD. Overall, 371 residents completed the survey (60% response rate, 197 women). Women trainees were more likely to endorse personal experience of GBD and sexual harassment than men (P < .0001), with no effect of specialty on rates of GBD or sexual harassment. Patients and nursing staff were the most frequently identified groups as sources of GBD. While an overwhelming majority of both men (86%) and women (96%) respondents either experienced or observed GBD in the training environment, less than 5% of respondents formally reported such experiences, most frequently citing a belief that nothing would happen. Survey results served as the basis for a variety of interventions addressing nursing staff and patients as sources of GBD, low confidence in formal reporting mechanisms, and the pervasiveness of GBD, including sexual harassment, across specialties. These results reproduce other studies' findings that GBD and sexual harassment disproportionately affect women trainees while demonstrating how individual training programs can incorporate local GBD data when planning interventions to address GBD.
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Affiliation(s)
- Sophia K McKinley
- S.K. McKinley is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. L.J. Wang is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. R.M. Gartland is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. M.L. Westfal is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. C.L. Costantino is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. D. Schwartz is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. A.L. Merrill is a fellow, Department of Surgery, Ohio State University, Columbus, Ohio. E. Petrusa is associate professor, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. K. Lillemoe is professor and chair, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. R. Phitayakorn is associate professor, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
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Spector ND, Asante PA, Marcelin JR, Poorman JA, Larson AR, Salles A, Oxentenko AS, Silver JK. Women in Pediatrics: Progress, Barriers, and Opportunities for Equity, Diversity, and Inclusion. Pediatrics 2019; 144:peds.2019-2149. [PMID: 31548337 DOI: 10.1542/peds.2019-2149] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2019] [Indexed: 11/24/2022] Open
Abstract
Gender bias and discrimination have profound and far-reaching effects on the health care workforce, delivery of patient care, and advancement of science and are antithetical to the principles of professionalism. In the quest for gender equity, medicine, with its abundance of highly educated and qualified women, should be leading the way. The sheer number of women who comprise the majority of pediatricians in the United States suggests this specialty has a unique opportunity to stand out as progressively equitable. Indeed, there has been much progress to celebrate for women in medicine and pediatrics. However, many challenges remain, and there are areas in which progress is too slow, stalled, or even regressing. The fair treatment of women pediatricians will require enhanced and simultaneous commitment from leaders in 4 key gatekeeper groups: academic medical centers, hospitals, health care organizations, and practices; medical societies; journals; and funding agencies. In this report, we describe the 6-step equity, diversity, and inclusion cycle, which provides a strategic methodology to (1) examine equity, diversity, and inclusion data; (2) share results with stakeholders; (3) investigate causality; (4) implement strategic interventions; (5) track outcomes and adjust strategies; and (6) disseminate results. Next steps include the enforcement of a climate of transparency and accountability, with leaders prioritizing and financially supporting workforce gender equity. This scientific and data-driven approach will accelerate progress and help pave a pathway to better health care and science.
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Affiliation(s)
- Nancy D Spector
- Executive Leadership in Academic Medicine Program, Department of Pediatrics, College of Medicine, Drexel University, Philadelphia, Pennsylvania;
| | - Philomena A Asante
- University Health and Counseling Services, Northeastern University, Boston, Massachusetts
| | | | - Julie A Poorman
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.,Spaulding Rehabilitation Hospital Boston, Charlestown, Massachusetts
| | - Allison R Larson
- Department of Dermatology, School of Medicine, Boston University, Boston, Massachusetts
| | - Arghavan Salles
- Department of Surgery, Washington University in St Louis, St Louis, Missouri; and
| | | | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.,Spaulding Rehabilitation Hospital Boston, Charlestown, Massachusetts
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Bavan B, Chavez J, Saravanabavanandhan B, Li J, MacLaughlan David S. Leadership aspirations among residents in obstetrics and gynecology in the United States: a cross-sectional analysis. BMC MEDICAL EDUCATION 2019; 19:332. [PMID: 31484518 PMCID: PMC6727386 DOI: 10.1186/s12909-019-1757-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 08/19/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Most residents and faculty in obstetrics and gynecology (Ob/Gyn) are women. However, only a third of Ob/Gyn academic leadership positions are held by women in the United States. METHODS This is an IRB-approved cross-sectional study of leadership aspirations among Ob/Gyn residents in the U.S. as related to gender and mentorship using an electronic survey distributed nationwide in 2017. The primary outcome was resident interest in academic leadership. Mediator variables included demographics and training environment characteristics. Descriptive statistics and comparative analyses were performed using SPSS. RESULTS We received 202 completed surveys, for a representative cross-section of 4% of all Ob/Gyn residents in the U.S. The majority (86%) of respondents were women (n = 174), reflecting the same gender distribution of all Ob/Gyn residents in training. Sixty-seven percent of all respondents reported an interest in pursuing academic leadership (n = 133). Women reported leadership aspirations less often than men (64% vs 86%, p < 0.05) and reported lower mean Likert scores (3.73 vs 4.14, p < 0.05) regarding interest in leadership. A marginal difference between mean Likert scores was observed between women and men when controlled for other demographics (coefficient - 0.344, SE 0.186; p = 0.066). No difference in leadership aspirations was noted between women and men when controlled for mentorship, presence of female program director, and presence of three or more female leaders in a program. CONCLUSIONS Gender disparity in goal-setting toward leadership is identified as early as residency training in Ob/Gyn. This imbalance in leadership aspirations can be addressed with targeted mentorship.
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Affiliation(s)
- Brindha Bavan
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305-5317 USA
| | - Jordan Chavez
- Stanford Health Care, Department of Social Work, 300 Pasteur Drive, Stanford, CA 94305-5617 USA
| | - Briana Saravanabavanandhan
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305-5317 USA
| | - Jie Li
- Department of Graduate Medical Education, Stanford University School of Medicine, 300 Pasteur Drive - Room HC435, Stanford, CA 94305-5207 USA
| | - Shannon MacLaughlan David
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 1740 W Taylor St, Chicago, IL 60612 USA
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Marcelin JR, Siraj DS, Victor R, Kotadia S, Maldonado YA. The Impact of Unconscious Bias in Healthcare: How to Recognize and Mitigate It. J Infect Dis 2019; 220:S62-S73. [DOI: 10.1093/infdis/jiz214] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AbstractThe increasing diversity in the US population is reflected in the patients who healthcare professionals treat. Unfortunately, this diversity is not always represented by the demographic characteristics of healthcare professionals themselves. Patients from underrepresented groups in the United States can experience the effects of unintentional cognitive (unconscious) biases that derive from cultural stereotypes in ways that perpetuate health inequities. Unconscious bias can also affect healthcare professionals in many ways, including patient-clinician interactions, hiring and promotion, and their own interprofessional interactions. The strategies described in this article can help us recognize and mitigate unconscious bias and can help create an equitable environment in healthcare, including the field of infectious diseases.
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Danhauer SC, Tooze JA, Barrett NA, Blalock JS, Shively CA, Voytko ML, Crandall SJ. Development of an Innovative Career Development Program for Early-Career Women Faculty. Glob Adv Health Med 2019; 8:2164956119862986. [PMID: 31360616 PMCID: PMC6636414 DOI: 10.1177/2164956119862986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/01/2019] [Accepted: 05/21/2019] [Indexed: 11/16/2022] Open
Abstract
Objective Our institutional Women in Medicine & Science Program (formerly the Office of Women in Medicine and Science) developed the Early Career Development Program for Women to promote the careers of women faculty. At 6 monthly sessions, participants learn relevant content (imposter syndrome, strengths, change style, career management, assertive communication, feedback, personal influence, conflict management, negotiation, importance of mentors, resilience, and self-care); exchange ideas; and expand their professional networks. Here, we report changes in participants' career skills/knowledge, confidence, and perceptions of the current environment after attending the program. Method Between 2014 and 2017, participants (N = 65) completed pre- and post-program surveys that assessed career knowledge and skills, confidence, and perceptions of the current environment and provided program feedback. Results Most skills showed pre-post significant improvement. The greatest increases occurred in knowing paths to promotion, tailoring communication style, ability to manage conflict, and ability to handle personal-professional role balance. Women reported a significant increase for all items measuring confidence. Among these items, establishing networks, understanding institutional culture, providing feedback, motivating others, strategic planning, delegating, and conflict management had the largest increases. Overall, 89.3% of respondents rated the program impact as very strong/profound, 98.5% rated the concepts as essential, 95.2% rated the skills as essential, and 90.8% rated the sense of community with women in their class as very/extremely close. Conclusions Work-related skills/knowledge, confidence, and perceptions of the current environment increased significantly among program participants. These early-career women faculty indicated that the program augmented the skills needed to develop their careers in an academic medical center.
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Affiliation(s)
- Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Natalie Am Barrett
- Office of Faculty Affairs, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jamie S Blalock
- Department of Physician Assistant Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Carol A Shively
- Department of Pathology-Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mary Lou Voytko
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sonia J Crandall
- Department of Physician Assistant Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Silver JK. Understanding and addressing gender equity for women in neurology. Neurology 2019; 93:538-549. [DOI: 10.1212/wnl.0000000000008022] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/12/2019] [Indexed: 11/15/2022] Open
Abstract
Despite the fact that the percentages of women among physicians and neurologists have been rising, gender-related disparities in numerous metrics persist, notably in compensation, promotion, funding, recognition, leadership, publishing, and speaking. Simultaneously, women working in academia, including medicine, face high rates of sexual harassment. Leaders of all health care-related organizations must accept the moral and ethical imperative to expeditiously address both gender-related discrimination and harassment (inclusive of but not limited to sexual harassment) of women in medicine. At this unique time in history, there is an opportunity for leaders in neurology to strategically accelerate efforts to address workforce gender disparities and ensure harassment-free training and work environments. Leaders will have to plan an intentional path forward, using a systematic process, metrics, and strategies unique to their own organizations, to overcome barriers to an equitable and safe work environment for women. Moreover, leaders in 4 gatekeeper organizations—medical schools/academic medical centers, funding agencies, journals, and medical societies—must hold each other accountable for gender equity as their own success and financial return on investment is dependent on the efforts of those in the other categories. In short, the path forward is to focus on ethical principles and behavior when it comes to addressing workforce gender disparities for women in medicine.
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Molina RL, Ricciotti H, Chie L, Luckett R, Wylie BJ, Woolcock E, Scott J. Creating a Culture of Micro-Affirmations to Overcome Gender-Based Micro-Inequities in Academic Medicine. Am J Med 2019; 132:785-787. [PMID: 30716299 DOI: 10.1016/j.amjmed.2019.01.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Rose L Molina
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Mass; Harvard Medical School, Boston, Mass; Division of Women's Health, Brigham and Women's Hospital, Boston, Mass.
| | - Hope Ricciotti
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Lucy Chie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Rebecca Luckett
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Mass; Harvard Medical School, Boston, Mass; Botswana Harvard AIDS Initiative Partnership, Gabarone, Botswana
| | - Blair J Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Ebonie Woolcock
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Mass
| | - Jennifer Scott
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Mass; Harvard Medical School, Boston, Mass; Division of Women's Health, Brigham and Women's Hospital, Boston, Mass
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Shillcutt SK, Silver JK. Barriers to Achieving Gender Equity. J Cardiothorac Vasc Anesth 2019; 33:1811-1818. [DOI: 10.1053/j.jvca.2019.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 11/11/2022]
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Analysis of H-index in Assessing Gender Differences in Academic Rank and Leadership in Physical Medicine and Rehabilitation in the United States and Canada. Am J Phys Med Rehabil 2019; 98:479-483. [DOI: 10.1097/phm.0000000000001129] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Shillcutt SK, Parangi S, Diekman S, Ghalib R, Schoenthaler R, Girgis LM, Parekh R, Bhargava H, Silver JK. Survey of Women Physicians' Experience with Elected Leadership Positions. Health Equity 2019; 3:162-168. [PMID: 31289775 PMCID: PMC6608691 DOI: 10.1089/heq.2018.0101] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Women physicians do not advance in academic promotion or leadership at the same rate as their male counterparts. One factor contributing to academic promotion and advancement is the experience of serving in elected leadership positions. Although >400 women are running for political office in 2018, fewer than a handful are physicians and there has never been a woman physician elected to the Congress. Yet, little is known about women physicians who run for elected positions within their institutions, medical/professional societies, or government. This study sought to examine how women physicians experience elections using a cross-sectional survey of women physicians to gain insight into patterns of reported experiences and perceived barriers to elected leadership positions. Methods: A cross-sectional survey study of 1221 women physicians. Results: 43.8% (N=535) of women physicians ran for an elected office from high school through medical school graduation, in contrast to only 16.7% (N=204) after graduating from medical school. Only 8.5% of women physicians surveyed reported a boss or supervisor encouraged them to run for an elected position. Conclusion: Women physicians are less likely to run for elected positions and for those with previous election experience, the most common barriers cited were lack of institutional time and support, experience, and mentorship.
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Affiliation(s)
- Sasha K Shillcutt
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Sareh Parangi
- Department of Surgery, Harvard Medical School, Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Sarah Diekman
- College of Law, Florida Agricultural and Mechanical University, Orlando, Florida
| | - Reem Ghalib
- Texas Clinical Research Institute, Arlington, Texas
| | - Robin Schoenthaler
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Linda M Girgis
- Department of Family Medicine, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Ranna Parekh
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,American Psychiatric Association, Washington, DC.,Morehouse School of Medicine, Atlanta, Georgia
| | - Hansa Bhargava
- Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Julie K Silver
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.,Brigham and Women's Hospital, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
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Harrington MA, Rankin EA, Ladd AL, Mason BS. The Orthopaedic Workforce Is Not as Diverse as the Population It Serves: Where Are the Minorities and the Women?: AOA Critical Issues Symposium. J Bone Joint Surg Am 2019; 101:e31. [PMID: 30994595 DOI: 10.2106/jbjs.18.01010] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The lack of sex and racial diversity of the physicians within the specialty of orthopaedic surgery was recognized decades ago, and formal steps to address these issues began in 1983 with the founding of the Ruth Jackson Orthopaedic Society and the J. Robert Gladden Orthopaedic Society. Despite the efforts of these organizations, the work of other interested groups, and the growing diversity in medical student demographics, physician diversity in orthopaedic surgery remains disproportionately poor relative to the populations that we serve as a specialty.
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Affiliation(s)
| | | | - Amy L Ladd
- Stanford University, Palo Alto, California
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Larson AR, Kan CK, Silver JK. Representation of Women Physician Deans in U.S. Medical Schools. J Womens Health (Larchmt) 2019; 28:600-605. [PMID: 30920332 DOI: 10.1089/jwh.2018.7448] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Among U.S. medical school deans, there is a wide gender gap, most prominent at the highest levels. We aimed to discover how well women physicians were represented within the pool of women deans compared with the pool of men deans. Materials and Methods: A cross-sectional study was performed on 149 allopathic medical schools in the United States. For each school, information was collected on deans' names, titles, genders, and degree(s). Chi-square analyses were performed to determine association between gender and dean ranks. Results: Of the 2559 deans included from 149 medical schools, 1649 (64.4%) were physicians, and of these, women physicians accounted for 634 (38.4%), a significant under-representation (p < 0.00001). In comparison, the 626 nonphysician doctorate-holders of which women accounted for 291 (46.5%, p = 0.061) were equally represented. Of the 284 deans with bachelor's or master's degrees, women accounted for 180 (63.4%), a significant over-representation (p < 0.00001). This difference was most profound at the lower tier (assistant) dean level. A lower tier physician dean was 1.25 times more likely to be a man than a woman, and a higher tier (dean of medical school, senior associate, vice, or associate) physician dean was 1.16 times more likely to be a man. Conclusions: Women physicians were under-represented among medical school deans compared with men. This disparity held among lower tier and higher tier deans.
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Affiliation(s)
- Allison R Larson
- 1 Department of Dermatology, Boston University, Boston, Massachusetts
| | - Carolyn K Kan
- 2 Boston University School of Medicine, Boston, Massachusetts
| | - Julie K Silver
- 3 Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
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Larese Filon F, Paniz E, Prodi A. The gender gap in Italian academic medicine from 2005 to 2015: still a glass ceiling. LA MEDICINA DEL LAVORO 2019; 110:29-36. [PMID: 30794246 PMCID: PMC7810006 DOI: 10.23749/mdl.v110i1.7617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/23/2019] [Indexed: 11/04/2022]
Abstract
Background: Although women make up half of the population of medical students and residents, they are still under-represented in prominent leadership positions in academia. The disparity is greatest at the highest levels and represents a loss of talent for academic health centers, showing that women must choose between career advancement and personal life. Objectives: The aim of this study was to analyze gender distribution in Italian medical academia in all hierarchical roles (researchers in tenure track positions, associate and full professors) in different disciplinary scientific fields (SSD) in 2015 compared to 2005. Methods: Medical faculties were considered at 31/12/2005 and 30/09/2015, and analyzed using Excel data sheet (Office for Windows 2007). Database was analyzed using STATA software (Texas, Inc. 2014). Results: Women are under-represented in all careers: in 2005 they made up 36.2% of researchers, 21.7% of associate professors and only 9.4% of full professors. The percentage of women researchers increased significantly (p<0.0001) in 2015 to 41.9%, but the percentages of female associate professors (25.3%) and full professors (14.2%) were still extremely low. Discussion: Our study shows that women are under-represented in Italian academia, with only a slight increase in presence in 2015 compared to ten years before. More action is needed to create a supportive environment, increase awareness and monitor potential discrimination.
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Hughes F, Bernstein PS. Sexism in obstetrics and gynecology: not just a "women's issue". Am J Obstet Gynecol 2018; 219:364.e1-364.e4. [PMID: 30017680 DOI: 10.1016/j.ajog.2018.07.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/17/2018] [Accepted: 07/02/2018] [Indexed: 11/24/2022]
Abstract
Women in medicine have made strides towards equality and yet the gender gap continues to exist. Despite being the specialty dedicated to the promotion of women's health, obstetrics and gynecology is also marred by gender disparity. Obstetrician-gynecologists who are women continue to face barriers to advancement to leadership positions and earn $36,000 per year less than men in obstetrics and gynecology according to a recent study. Similarly, men in obstetrics and gynecology may be negatively affected by unconscious bias and socially prescribed roles for men and women, resulting in patient preferences for providers who are women. Both men and women have a vested interest in promoting greater gender parity in obstetrics and gynecology, and participation of men is critical for realization of this goal. For the obstetrician-gynecologist, sexism is not just a "women's issue".
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Affiliation(s)
- Sasha K Shillcutt
- From the Department of Anesthesiology, University of Nebraska Medical Center, Omaha (S.K.S.); and the Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston (J.K.S.)
| | - Julie K Silver
- From the Department of Anesthesiology, University of Nebraska Medical Center, Omaha (S.K.S.); and the Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston (J.K.S.)
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Bendels MHK, Müller R, Brueggmann D, Groneberg DA. Gender disparities in high-quality research revealed by Nature Index journals. PLoS One 2018; 13:e0189136. [PMID: 29293499 PMCID: PMC5749692 DOI: 10.1371/journal.pone.0189136] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 11/20/2017] [Indexed: 11/18/2022] Open
Abstract
Background The present study aims to elucidate the state of gender equality in high-quality research by analyzing the representation of female authorships in the last decade (from 2008 to 2016). Methods Based on the Gendermetrics platform, 293,557 research articles from 54 journals listed in the Nature Index were considered covering the categories Life Science, Multidisciplinary, Earth & Environmental and Chemistry. The core method was the combined analysis of the proportion of female authorships and the female-to-male odds ratio for first, co- and last authorships. The distribution of prestigious authorships was measured by the Prestige Index. Results 29.8% of all authorships and 33.1% of the first, 31.8% of the co- and 18.1% of the last authorships were held by women. The corresponding female-to-male odds ratio is 1.19 (CI: 1.18–1.20) for first, 1.35 (CI: 1.34–1.36) for co- and 0.47 (CI: 0.46–0.48) for last authorships. Women are underrepresented at prestigious authorships compared to men (Prestige Index = -0.42). The underrepresentation accentuates in highly competitive articles attracting the highest citation rates, namely, articles with many authors and articles that were published in highest-impact journals. More specifically, a large negative correlation between the 5-Year-Impact-Factor of a journal and the female representation at prestigious authorships was revealed (r(52) = -.63, P < .001). Women publish fewer articles compared to men (39.0% female authors are responsible for 29.8% of all authorships) and are underrepresented at productivity levels of more than 2 articles per author. Articles with female key authors are less frequently cited than articles with male key authors. The gender-specific differences in citation rates increase the more authors contribute to an article. Distinct differences at the journal, journal category, continent and country level were revealed. The prognosis for the next decades forecast a very slow harmonization of authorships odds between the two genders.
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Affiliation(s)
- Michael H. K. Bendels
- Division of Computational Medicine, Institute of Occupational, Social, and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany
- * E-mail:
| | - Ruth Müller
- Division of Computational Medicine, Institute of Occupational, Social, and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany
| | - Doerthe Brueggmann
- Division of Computational Medicine, Institute of Occupational, Social, and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany
| | - David A. Groneberg
- Division of Computational Medicine, Institute of Occupational, Social, and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany
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Geographic Comparison of Women in Academic Obstetrics and Gynecology Department-Based Leadership Roles. Obstet Gynecol 2017; 130:853-861. [PMID: 28885431 DOI: 10.1097/aog.0000000000002265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe and compare geographic representation of women in obstetrics and gynecology department-based leadership roles across American Congress of Obstetricians and Gynecologists (ACOG) districts and U.S. Census Bureau regions while accounting for the proportion of women practicing in each area. METHODS We conducted a cross-sectional observational study. To more meaningfully quantify representation of women as leaders in ACOG districts and U.S. Census Bureau regions, we calculated representation ratios-the proportion of department-based leaders who were women divided by the proportion of obstetrician-gynecologists who were women. A ratio of 1.0 indicates proportionate representation and less than 1.0 indicates underrepresentation. We calculated 95% CIs to compare representation of women in leadership roles across geographic areas. The gender of major department-based leaders (chair, vice chair, division director) and educational leaders (fellowship, residency, associate residency, medical student clerkship director) was determined from websites. RESULTS The proportion of department chairs who were women was highest in the West and lowest in the South Census Bureau regions. Representation ratios for women in major department-based leadership roles demonstrated underrepresentation relative to the practicing base nationally and in all four regions. Although women were underrepresented in major department-based leadership throughout the country, there was significantly higher women's representation in major department-based leadership roles in the West (ratio 0.82, 95% CI 0.68-0.99) compared with the Northeast (ratio 0.50, 95% CI 0.42-0.59) and the South (ratio 0.45, 95% CI 0.36-0.57). Similarly, in the division director role, the West (ratio 0.85, 95% CI 0.68-1.1) had significantly higher representation of women compared with the Northeast (ratio 0.50, 95% CI 0.40-0.62). Nationally, women were underrepresented as fellowship directors, proportionately represented as residency program directors, and overrepresented as medical student clerkship directors. CONCLUSION Representation ratios of women in major department-based leadership roles, which account for the proportion of women practicing in each geographic area, suggest that women were more likely to advance to the department-based leadership roles of chair, vice chair, or division director in the western United States.
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