BOX 3-3Academic Medicine

DEFINING THE ISSUES

During the last 30 years the share of women graduating from medical colleges has nearly reached parity with the share of male graduates. However, as shown in Figure B3-1, while the share of women students and faculty members was similar before 1974, since then, increases in the proportion of women medical school graduates have not translated into similar increases in the proportion of women in faculty positions.

A Snapshot of the Current Situation for Female Faculty Members in Medicine a

  • The growth trajectories of women students and women faculty are now similar, but the dramatic increase in women students in the years 1974-1980 was not matched by any change in the rate of growth of women faculty (Figure B3-1).
  • The proportion of women in senior faculty positions in 2004 matched the proportion of women graduates in 1980 (Figure B3-2).
  • Across all levels of seniority, women medical faculty earn significantly lower salaries than male faculty. Minority-group faculty earn less than white faculty.
  • Women do not gain in academic rank at a rate that is proportional to their representation in medical school faculties.

Reasons for Differences

Brown and colleaguesb note that a number of factors may contribute to women’s slower advancement, but a pipeline problem is not among them. They conclude that the supply of women graduating from medical schools is adequate and that “the culture of academic medicine, not the numbers of available women, drives the lopsided numbers.” Cultural issues include a lack of high-ranking female role models; gender stereotyping that works to limit opportunities; exclusion from career development opportunities; differences in workplace expectations for men and women; social and professional isolation; and gender differences in the amount of funding, space, and staff support provided. Those factors have been found to adversely affect female faculty members’ career satisfaction and advancement. In addition, traditional constructs of reward and hierarchy within departments have been found to impede advancement of women faculty because they are inherently gender-biased. Bickel et al. point out “medicine tends to over-value heroic individualism” with the result that “women will not ‘measure up’ as easily as men do.”c

A second difficulty is related to tensions between professional and personal life which seem to be especially acute for women in academic medicine. Brown et al. report that “the demands of career and personal life [are] each great enough to extract compromise from the other, and, further, that anticipated support from a partner, the community, and medical center was inadequate to make it possible to succeed in multiple roles at once.” Bickel and colleagues note that academic medicine tends to “reward unrestricted availability to work (i.e., neglect of personal life).” Furthermore, as in other fields, the pressures of the tenure timeline in academic medicine often coincide with decisions (and associated pressures) to start a family.

Potential Policy Options

Potential policy actions to redress those problems focus on adjusting the institutional environment in a way that improves the experiences of both male and female faculty. Improving the quality of professional development programs for all faculty has proven effective in addressing culture and climate issuesd (Chapter 4 and Box 6-3). Other suggestions are to:

  • Improve department mentoring programs, including providing guidance to male faculty on how to be effective mentors for female faculty.
  • Address the tensions between work and personal lives and obligations.
  • Identify which institutional practices tend to favor men’s over women’s professional development and rebalance them to value the institution’s goals in a gender-neutral way.
  • Recognize models of career success based on quality rather than quantity, so that people can craft careers that both serve the institution’s needs and harmonize with their own core values.
  • Place more value on accomplishments accruing from collaborative work.
  • Provide more flexibility for part-time work.
  • Adjust tenure policies.
  • Provide options for partner hiring programs and childcare.
FIGURE B3-1. Representation of women MDs in academic medicine faculty positions, 1965-2004.

FIGURE B3-1

Representation of women MDs in academic medicine faculty positions, 1965-2004.

FIGURE B3-2. Proportion of women in academic medicine, by educational stage and rank.

FIGURE B3-2

Proportion of women in academic medicine, by educational stage and rank.

a

AS Ash, PL Carr, R Goldstein, and RH Friedman (2004). Compensation and advancement of women in academic medicine: Is there equity? Annals of Internal Medicine 141(3):205-212.

b

A Brown, W Swinyard, and J Ogle (2003). Women in academic medicine: A report of focus groups and questionnaires, with conjoint analysis. Journal of Women’s Health 12(10):999-1008.

c

J Bickel, D Wara, BF Atkinson, LS Cohen, M Dunn, S Hostler, TRB Johnson, P Morahan, AH Rubenstein, GF Sheldon, and E Stokes (2002). Increasing women’s leadership in academic medicine: Report of the AAMC project implementation committee. Academic Medicine 77(10):1043-1061.

d

LP Fried, CA Francomano, SM MacDonald, EM Wagner, EJ Stokes, KM Carbone, WB Bias, MM Newman, and JD Stobo (1996). Career development for women in academic medicine: Multiple interventions in a department of medicine. Journal of the American Medical Association 276(11):898-905; S Mark, H Link, PS Morahan, L Pololi, V Reznik, and S Tropez-Sims (2001). Innovative mentoring programs to promote gender equity in academic medicine. Academic Medicine 76:39-42.

From: 3, Examining Persistence and Attrition

Cover of Beyond Bias and Barriers
Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering.
National Academy of Sciences (US), National Academy of Engineering (US), and Institute of Medicine (US) Committee on Maximizing the Potential of Women in Academic Science and Engineering.
Washington (DC): National Academies Press (US); 2007.
Copyright © 2007, National Academy of Sciences.

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