Addressing Microaggressions in Academic Medicine
Academic Medicine, 96:927, 2021
Poorsattar et al. provide an infographic describing the types and effects of microaggressions and the Ackerman-Barger and Jacobs (2020) Microaggressions Triangle Model that provides a human interaction perspective to help participants construct responses to begin to rebuild relationships and restore justice.
Toward Gender Equity in Academic Promotions
Leah M. Marcotte, MD1; Vineet M. Arora, MD, MAPP2; Ishani Ganguli, MD, MPH3
Marcotte et al. (2021) conclude that “…..women physicians face slower promotional timelines and are less likely to reach associate or full professorship compared with their male counterparts, a gap that has not meaningfully changed in more than 3 decades …. and the COVID-19 pandemic has caused a worrisome backslide.”
Gender Disparity in Citations in High-Impact Journal Articles
Paula Chatterjee, MD, MPH; Rachel M. Werner, MD, PhD
Chatterjee and Werner report that “…..articles written by women in high-impact medical journals had fewer citations than those written by men, particularly when women wrote together as primary and senior authors. These differences may have important consequences for the professional success of women and achieving gender equity in academic medicine.”
Kronzer et al. (2020) conclude that “Female gender and European, non-Hispanic surname origin are associated with increased physician clinical load—even more than race. While these disparities may have serious consequences, they are also addressable.”
Despite significant progress in recent decades, the recruitment, advancement, and promotion of women in academia remain low. Women represent a large portion of the talent pool in academia, and receive >50% of all PhDs, but this has not yet translated into sustained representation in faculty and leadership positions. Cardel et al. (2020) describe the ‘‘chutes’’ that impede women’s promotion at all stages of their careers and provide feasible recommendations or ‘‘ladders’’ for addressing these issues.
By Fassiotto et al.
Fassiotto et al. (2020) reported that “…. women did not attain parity at any pairwise rank comparison, while men were above parity at all ranks. Similar results were observed across all departments surveyed: women in the basic sciences had REIs closest to parity, women in pediatrics had the highest representation but had REIs that were further from parity than REIs in the basic sciences, and women in surgery demonstrated the lowest REIs. Nationally, REIs were below 1.00 for all racial/ethnic group rank comparisons except for White and, in one case, multiple-race non-Hispanic/Latinx.”
By Stacy Weiner, Senior Staff Writer
Experts are working to address the ways the pandemic threatens progress for women in medicine. Here are some of their suggestions.
By Merin Oleschuk
This report identifies 10 strategies that tenure and promotion committees and university administrators can consider to address the disparities outlined in this report. As a whole, these recommendations highlight the need for institutional flexibility and creative decision‐making to account for the needs of instructional faculty that are caring for children, elders, and/or other dependents with special needs.
By Ozlem Sensoy and Robin DiAngelo
Chang et al. (2020) conclude that the “higher rates of promotion for women participating in national CDPs [career development programs] support the effectiveness of these programs in building capacity for academic medicine.”
By Shine Chang, Michele Guindani, Page Morahan, Diane Magrane, Sharon Newbill, Deborah Helitzer
“The reason we don’t have more faculty of color among college faculty is that we don’t want them. We simply don’t want them.” Marybeth Gasman
by Erin A. Cech and Mary Blair-Loy
We found substantial attrition of new parents; nearly one-half of new mothers and nearly one-quarter of new fathers leave full-time STEM employment after having children. Thus, parenthood is an important driver of gender imbalance in STEM employment, and both mothers and fathers appear to encounter difficulties reconciling caregiving with STEM careers.
Where are all the women deans?
by Amy Paturel, MS, MPH
Women now outnumber men in most medical school classrooms. But they still represent just a fraction of deans, department chairs, and full professors. Here’s why — and what’s being done to change the equation.
Working mothers face a ‘wall’ of bias—but there are ways to push back
by Lesley Evans Ogden
Troy Vettese states “There are plenty of factors more significant than the biological fact of childbirth for men’s continued dominance in the academy, but one should emphasize that they are more zealous about safeguarding time for research, they are skeptical of women’s competence, and they endanger and demoralize female scholars through sexual harassment.…….” and that “Academic patriarchy is too well entrenched and vicious to be defeated by piecemeal reform. Academic feminism needs a Cerberus-headed politics combining a social movement, activist scholarship, and new radical bureaucratic structures.”
David Peterson and colleagues suggest that a simple intervention informing students of the potential for gender biases can have significant effects on the evaluation of female instructors.
Working mothers face a ‘wall’ of bias—but there are ways to push back
Lesley Evans Ogden
“Universities and other organizations have a responsibility to combat maternal wall bias and provide a level playing field for their workers—for instance, by implementing strong antidiscrimination policies, by providing bias training, and by taking a closer look at hiring practices. At the same time, at an individual level, it can be helpful for mothers—and prospective mothers—to be aware of tools and strategies that may help them ward off biases that they may encounter in the workplace.
With the latter goal in mind, Williams teamed up with other experts—all professional mothers studying bias from a legal, sociological, or business context—to develop online learning modules, with scenarios and recommendations to help women navigate maternal wall bias.”
Disarming Racial Microaggressions: Microintervention Strategies for Targets, White Allies, and Bystanders
Derald Wing Sue, Sarah Alsaidi, Michael N. Awad, Elizabeth Glaeser, Cassandra Z. Calle, and Narolyn Mendez
This article introduces a new strategic framework developed for addressing microaggressions that moves beyond coping and survival to concrete action steps and dialogues that targets, allies, and bystanders can perform (microinterventions).
Gender Equity: Addressing recruitment at the departmental level
Christiana J McDonald-Spicer, Benjamin Schwessinger, and Susan Howitt suggest five ways departments can improve their hiring processes in order to achieve gender equity in their workforce.
Rationale and Models for Career Advancement Sponsorship in Academic Medicine – The Time Is Here; the Time Is Now
Amy Gottlieb and Elizabeth Travis note that for upward career mobility, mentorship is limited in scope. Sponsorship, on the other hand, directly targets career advancement and is anchored in the sponsor’s awareness of organizational structures and critical professional opportunities for junior faculty. Men are more likely to garner sponsors informally, and these sponsors tend to be male. They issue a call to action for much broader implementation of sponsorship programming to cultivate the advancement of all talented medical faculty and provide recommendations for such endeavors.
The Decanal Divide: Women in Decanal Roles at U.S. Medical Schools
Dr. Nina Schor tested the hypotheses that women in medical school dean-level (decanal) positions occupy lower-rank and more image- and education-focused positions than men, and that state and woman-led schools have more women in decanal positions.
Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine. A Consensus Study Report of the National Academies of Sciences, Engineering, and Medicine
Paula A. Johnson, Sheila E. Widnall, and Frazier F. Benya, Editors
“………we are encouraged by the research that suggests that the most potent predictor of sexual harassment is organizational climate—the degree to which those in the organization perceive that sexual harassment is or is not tolerated. This means that institutions can take concrete steps to reduce sexual harassment by making systemwide changes that demonstrate how seriously they take this issue and that reflect that they are listening to those who courageously speak up to report their sexual harassment experiences.”
What’s Holding Women in Medicine Back from Leadership
By Christina Mangurian, Eleni Linos, Urmimala Sarkar, Carolyn Rodriguez, and Reshma Jagsi
For over 25 years, women have made up at least 40% of U.S. medical students. This past year, more women than men were enrolled in U.S. medical schools. Yet gender parity is still not reflected in medical leadership.
Jennifer Tsai writes in Scientific American
“More students are coming from marginalized groups, but when they arrive they’re often told to hide what makes them different.”
Go beyond bias training
Ambiguity in expectations and evaluations harms progress, say Rodolfo Mendoza-Denton and colleagues.
The Hallway Ask
KerryAnn O’Meara comments on service work in academia.
Paid Family and Childbearing Leave Policies at Top US Medical Schools
Retaining women during childbearing years is central to retaining women in academic medicine.
Gender Differences in Academic Medicine: Retention, Rank and Leadership Comparisons From the National Faculty Survey
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 national cohort of faculty to identify predictors of advancement, retention, and leadership for women faculty.
Work-Family Conflict and the Sex Difference in Depression Among Training Physicians
This study identifies work-family conflict as an important potentially modifiable factor that is associated with elevated depressive symptoms in training physicians. Depressive symptoms increase substantially during the internship year for men and women, but this increase is greater for women.
It is Time for Zero Tolerance for Sexual Harassment in Academic Medicine
Bates et al. (2017)
“While there are more women in leadership positions in academic medicine now than ever before in our history, evidence from recent surveys of women and from graduating medical students demonstrates that sexual harassment continues in our institutions. Our ability to change the culture is hampered by fear of reporting episodes of harassment, which is largely due to fear of retaliation. We describe some efforts in scientific societies that are addressing this and working to establish safe environments at national meetings. We must also work at the level of each institution to make it safe for individuals to come forward, to provide training for victims and for bystanders, and to abolish “locker room” talk that is demeaning to women.”
Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians
By Tsugawa et al. (2017)
“There is evidence that men and women may practice medicine differently. Literature has shown that female physicians may be more likely to adhere to clinical guidelines, provide preventive care more often, use more patient-centered communication, perform as well or better on standardized examinations, and provide more psychosocial counseling to their patients than do their male peers. Although studies suggest differences in practice patterns and process measures of quality between male and female physicians, these studies have not examined patient outcomes, what we arguably care about the most. In fact, whether patient outcomes differ between male and female physicians is largely unknown”
Women in Academic Medicine Leadership: Has Anything Changed in 25 Years?
Despite the roughly equal numbers of men and women graduating each year from medical schools in the United States and Canada, women continue to face challenges in moving into academic leadership positions. In this commentary, the authors share lessons learned from their own careers relevant to academic medicine.
Reducing Bias in Academic Search Committees
“Faculty members are often called on to serve and participate on search committees for deans, department chairs, leaders of centers of excellence, and senior level positions in medical schools, academic hospitals, and health systems. These search committees are generally charged not only to find qualified candidates but also to consider diversity and inclusion in the process.”
Women in Academic Medicine
“More than a decade ago, women achieved parity with men in the number of matriculants to medical school, nearly one-third of the faculty of medical schools were women, and there were some women deans and department chairs. These trends were promising, but today there are still significant differences in pay, academic rank, and leadership positions for women compared with men in academic medicine. Though there has been progress in many areas, the progress is too slow to achieve previously recommended goals, such as 50% women department chairs by 2025 and 50% women deans by 2030.”