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Gender Differences in Academic Medicine: Retention, Rank, and Leadership Comparisons From the National Faculty Survey.

ABSTRACT: PURPOSE:Prior studies have found that women in academic medicine do not advance or remain in their careers in parity with men. The authors examined a cohort of faculty from the 1995 National Faculty Survey to identify predictors of advancement, retention, and leadership for women faculty. METHOD:The authors followed 1,273 faculty at 24 medical schools in the continental United States for 17 years to identify predictors of advancement, retention, and leadership for women faculty. Schools were balanced for public or private status and the four Association of American Medical Colleges geographic regions. The authors used regression models to adjust for covariates: seniority, department, academic setting, and race/ethnicity. RESULTS:After adjusting for significant covariates, women were less likely than men to achieve the rank of professor (OR = 0.57; 95% CI, 0.43-0.78) or to remain in academic careers (OR = 0.68; 95% CI, 0.49-0.94). When number of refereed publications was added to the model, differences by gender in retention and attainment of senior rank were no longer significant. Male faculty were more likely to hold senior leadership positions after adjusting for publications (OR = 0.49; 95% CI, 0.35-0.69). CONCLUSIONS:Gender disparities in rank, retention, and leadership remain across the career trajectories of the faculty cohort in this study. Women were less likely to attain senior-level positions than men, even after adjusting for publication-related productivity. Institutions must examine the climate for women to ensure their academic capital is fully utilized and equal opportunity exists for leadership.

SUBMITTER: Carr PL

PROVIDER: S-EPMC6066448 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Gender Differences in Academic Medicine: Retention, Rank, and Leadership Comparisons From the National Faculty Survey.

Carr Phyllis L PL Raj Anita A Kaplan Samantha E SE Terrin Norma N Breeze Janis L JL Freund Karen M KM

Academic medicine : journal of the Association of American Medical Colleges 20181101 11

<h4>Purpose</h4>Prior studies have found that women in academic medicine do not advance or remain in their careers in parity with men. The authors examined a cohort of faculty from the 1995 National Faculty Survey to identify predictors of advancement, retention, and leadership for women faculty.<h4>Method</h4>The authors followed 1,273 faculty at 24 medical schools in the continental United States for 17 years to identify predictors of advancement, retention, and leadership for women faculty. S ...[more]

PMID: 29384751

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Project description:ObjectiveMany studies have analysed gender bias in academic medicine; however, no comprehensive synthesis of the literature has been performed. We conducted a pooled analysis of the difference in the proportion of men versus women with full professorship among academic physicians.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, Cochrane Central Register of Controlled Trials, Education Resources Information Center and PsycINFO were searched from inception to 3 July 2020.Study selectionAll original studies reporting faculty rank stratified by gender worldwide were included.Data extraction and synthesisStudy screening, data extraction and quality assessment were performed by two independent reviewers, with a third author resolving discrepancies. Meta-analysis was conducted using random-effects models.ResultsOur search yielded 5897 articles. 218 studies were included with 991 207 academic physician data points. Men were 2.77 times more likely to be full professors (182 271/643 790 men vs 30 349/251 501 women, OR 2.77, 95% CI 2.57 to 2.98). Although men practised for longer (median 18 vs 12 years, p<0.00002), the gender gap remained after pooling seven studies that adjusted for factors including time in practice, specialty, publications, h-index, additional PhD and institution (adjusted OR 1.83, 95% CI 1.04 to 3.20). Meta-regression by data collection year demonstrated improvement over time (p=0.0011); however, subgroup analysis showed that gender disparities remain significant in the 2010-2020 decade (OR 2.63, 95% CI 2.48 to 2.80). The gender gap was present across all specialties and both within and outside of North America. Men published more papers (mean difference 17.2, 95% CI 14.7 to 19.7), earned higher salaries (mean difference $33 256, 95% CI $25 969 to $40 542) and were more likely to be departmental chairs (OR 2.61, 95% CI 2.19 to 3.12).ConclusionsGender inequity in academic medicine exists across all specialties, geographical regions and multiple measures of success, including academic rank, publications, salary and leadership. Men are more likely than women to be full professors after controlling for experience, academic productivity and specialty. Although there has been some improvement over time, the gender disparity in faculty rank persists.Prospero registration numberCRD42020197414.

Project description:BACKGROUND:Studies demonstrate that women physicians are less likely than men to be full professors. Comprehensive evidence examining whether sex differences in faculty rank exist in academic cardiology, adjusting for experience and research productivity, is lacking. Therefore, we evaluated for sex differences in faculty rank among a comprehensive, contemporary cohort of US cardiologists after adjustment for several factors that impact academic advancement, including measures of clinical experience and research productivity. METHODS:We identified all US cardiologists with medical school faculty appointments in 2014 by using the American Association of Medical Colleges faculty roster and linked this list to a comprehensive physician database from Doximity, a professional networking website for doctors. Data on physician age, sex, years since residency, cardiology subspecialty, publications, National Institutes of Health grants, and registered clinical trials were available for all academic cardiologists. We estimated sex differences in full professorship, adjusting for these factors and medical school-specific fixed effects in a multivariable regression model. RESULTS:Among 3810 cardiologists with faculty appointments in 2014 (13.3% of all US cardiologists), 630 (16.5%) were women. Women faculty were younger than men (mean age, 48.3 years versus 53.5 years, P<0.001), had fewer total publications (mean number: 16.5 publications versus 25.2 publications; P<0.001), were similarly likely to have National Institutes of Health funding (proportion with at least 1 National Institutes of Health award, 10.8% versus 10.4%; P=0.77), and were less likely to have a registered clinical trial (percentage with at least 1 clinical trial, 8.9% versus 11.1%; P=0.10). Among 3180 men, 973 (30.6%) were full professors in comparison with 100 (15.9%) of 630 women. In adjusted analyses, women were less likely to be full professors than men (adjusted odds ratio, 0.63; 95% confidence interval, 0.43-0.94; P=0.02; adjusted proportions, 22.7% versus 26.7%; absolute difference, -4.0%; 95% confidence interval, -7.5% to -0.7%). CONCLUSIONS:Among cardiology faculty at US medical schools, women were less likely than men to be full professors after accounting for several factors known to influence faculty rank.

Project description:BackgroundGender inequities are documented in academic medicine. Within General Internal Medicine (GIM), there are fewer female division directors and first and last authors on publications. With gender parity in US medical school graduates and with Academic Hospital (AH) medicine being a relatively newer discipline, one might postulate that AH would have less gender inequity.DesignA national survey of AH programs was developed via literature review and expert recommendations. Domains included program and faculty information. Gender of the leader was determined via website or telephone call.ParticipantsLeaders of AH programs associated with the American Association of Medical Colleges (AAMC). Programs without a primary teaching hospital or hospitalist program and those not staffed by university-affiliated physicians were excluded.Main measuresDescription and characteristics of leaders and programs including a multivariable analysis of gender of hospitalist leaders and the portion of female faculty.Key results59% response rate (80 of 135); there were no differences between responders/non-responders in NIH funding (p = 0.12), type of institution (p = 0.09), geographic region (p = 0.15), or year established (p = 0.86). Reported number of female and male faculty were approximately equal. 80% of hospitalist leaders were male; 37% of male hospitalist leaders were professors, no female leaders were professors. In univariate and multivariate analysis only the number of hospitals staffed was a significant predictor of having a female hospitalist leader. There were no significant predictors of having fewer female faculty.ConclusionThis study demonstrated gender inequality in academic hospital medicine regarding leadership and rank. Though there was equal gender distribution of faculty, among leaders most were men and all "full professors" were men. As diversity benefits the tripartite mission research on methods, initiatives and programs that achieve gender equity in leadership are needed.

Project description:BackgroundFaculty productivity is essential for academic medical centers striving to achieve excellence and national recognition. The objective of this study was to evaluate whether and how academic Departments of Medicine in the United States measure faculty productivity for the purpose of salary compensation.MethodsWe surveyed the Chairs of academic Departments of Medicine in the United States in 2012. We sent a paper-based questionnaire along with a personalized invitation letter by postal mail. For non-responders, we sent reminder letters, then called them and faxed them the questionnaire. The questionnaire included 8 questions with 23 tabulated close-ended items about the types of productivity measured (clinical, research, teaching, administrative) and the measurement strategies used. We conducted descriptive analyses.ResultsChairs of 78 of 152 eligible departments responded to the survey (51% response rate). Overall, 82% of respondents reported measuring at least one type of faculty productivity for the purpose of salary compensation. Amongst those measuring faculty productivity, types measured were: clinical (98%), research (61%), teaching (62%), and administrative (64%). Percentages of respondents who reported the use of standardized measurements units (e.g., Relative Value Units (RVUs)) varied from 17% for administrative productivity to 95% for research productivity. Departments reported a wide variation of what exact activities are measured and how they are monetarily compensated. Most compensation plans take into account academic rank (77%). The majority of compensation plans are in the form of a bonus on top of a fixed salary (66%) and/or an adjustment of salary based on previous period productivity (55%).ConclusionOur survey suggests that most academic Departments of Medicine in the United States measure faculty productivity and convert it into standardized units for the purpose of salary compensation. The exact activities that are measured and how they are monetarily compensated varied substantially across departments.

Project description:INTRODUCTION:Gender-based discrimination and sexual harassment of female physicians are well documented. The #MeToo movement has brought renewed attention to these problems. This study examined academic emergency physicians' experiences with workplace gender discrimination and sexual harassment. METHODS:We conducted a cross-sectional survey of a convenience sample of emergency medicine (EM) faculty across six programs. Survey items included the following: the Overt Gender Discrimination at Work (OGDW) Scale; the frequency and source of experienced and observed discrimination; and whether subjects had encountered unwanted sexual behaviors by a work superior or colleague in their careers. For the latter question, we asked subjects to characterize the behaviors and whether those experiences had a negative effect on their self-confidence and career advancement. We made group comparisons using t-tests or chi-square analyses, and evaluated relationships between gender and physicians' experiences using correlation analyses. RESULTS:A total of 141 out of 352 (40.1%) subjects completed at least a portion of the survey. Women reported higher mean OGDW scores than men (15.4 vs 10.2; 95% confidence interval [CI], 3.6-6.8). Female faculty were also more likely to report having experienced gender-based discriminatory treatment than male faculty (62.7% vs 12.5%; 95% CI, 35.1%-65.4%), although male and female faculty were equally likely to report having observed gender-based discriminatory treatment of another physician (64.7% vs 56.3%; 95% CI, 8.6%-25.5%). The three most frequent sources of experienced or observed gender-based discriminatory treatment were patients, consulting or admitting physicians, and nursing staff. The majority of women reported having encountered unwanted sexual behaviors in their careers, with a significantly greater proportion of women reporting them compared to men (52.9% vs 26.2%, 95% CI, 9.9%-43.4%). The majority of unwanted behaviors were sexist remarks and sexual advances. Of those respondents who encountered these unwanted behaviors, 22.9% and 12.5% reported at least somewhat negative effects on their self-confidence and career advancement. CONCLUSION:Female EM faculty perceived more gender-based discrimination in their workplaces than their male counterparts. The majority of female and approximately a quarter of male EM faculty encountered unwanted sexual behaviors in their careers.

Project description:IntroductionDespite the increasing diversity of individuals entering medicine, physicians from racial and sexual minority groups continue to experience bias and discrimination in the workplace. The objective of this study was to determine the current experiences and perceptions of discrimination on the basis of race and sexual orientation among academic emergency medicine (EM) faculty.MethodsWe conducted a cross-sectional survey of a convenience sample of EM faculty across six programs. Survey items included the Overt Gender Discrimination at Work (OGDW) Scale adapted for race and sexual orientation, and the frequency and source of experienced and observed discrimination. Group comparisons were made using t-tests or chi-square analyses, and relationships between race or sexual orientation, and we evaluated physicians' experiences using correlation analyses.ResultsA total of 141 out of 352 (40.1%) subjects completed at least a portion of the survey. Non-White physicians reported higher mean racial OGDW scores than their White counterparts (13.4 vs 8.6; 95% confidence interval (CI) for difference, -7.7 - -2.9). Non-White EM faculty were also more likely to report having experienced discriminatory treatment based on race than were White EM faculty (48.0% vs 12.6%; CI for difference, 16.6% - 54.2%), although both groups were equally likely to report having observed race-based discrimination of another physician. EM faculty who identified as sexual minorities reported higher mean sexual minority OGDW scores than their heterosexual counterparts (11.1 vs 7.1; 95% CI for difference, -7.3 - -0.6). There were no significant differences between sexual minority and heterosexual faculty in their reports of experiencing or observing discrimination based on sexual orientation.ConclusionEM faculty from racial and sexual minority groups perceived more discrimination based on race or sexual orientation in their workplace than their majority counterparts. EM faculty regardless of race or sexual orientation were similar in their observations of discriminatory treatment of another physician based on race or sexual orientation.

Dataset Information

Gender Differences in Academic Medicine: Retention, Rank, and Leadership Comparisons From the National Faculty Survey.

Publications

Gender Differences in Academic Medicine: Retention, Rank, and Leadership Comparisons From the National Faculty Survey.

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