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Szczygiel LA, Greene AK, Cutter CM, Jones RD, Feldman EL, Paradis KC, Settles IH, Singer K, Spector ND, Stewart AJ, Ubel PA, Jagsi R. Professional Experiences and Career Trajectories of Mid- to Senior-Career Women Clinician-Scientists: A Qualitative Study. JAMA Netw Open 2024; 7:e246040. [PMID: 38602674 DOI: 10.1001/jamanetworkopen.2024.6040] [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: 04/12/2024] Open
Abstract
Importance Despite increasing evidence and recognition of persistent gender disparities in academic medicine, qualitative data detailing the association of gender-based experiences with career progression remain sparse, particularly at the mid- to senior-career stage. Objective To investigate the role gender has played in everyday professional experiences of mid- to senior-career women clinician-scientists and their perceptions of gender-related barriers experienced across their careers. Design, Setting, and Participants In this qualitative study, a total of 60 of 159 invited clinician-scientists who received National Institutes of Health K08 or K23 awards between 2006 and 2009 and responded to a survey in 2021 agreed to participate. Invitees were selected using random, purposive sampling to support sample heterogeneity. Semistructured in-depth interviews were conducted January to May 2022. For this study, interviews from 31 women were analyzed using the framework approach to thematic analysis. Data analyses were performed between August and October 2023. Main Outcomes and Measures Descriptive themes of participant experiences of gender and gender-based barriers in academic medicine. Results A total of 31 women clinician-scientists (8 identifying as Asian [25.8%], 14 identifying as White [45.2%], and 9 identifying as members of a minority group underrepresented in medicine [29.0%]; 14 aged 40-49 years [45.2%] and 14 aged 50-59 years [45.2%]) were included. Among them, 17 participants (54.8%) had children who required adult supervision or care, 7 participants (22.6%) had children who did not require supervision or care, and 6 participants (19.4%) did not have children. There were 4 dominant themes identified within participant experiences in academic medicine: the mental burden of gendered expectations at work and home, inequitable treatment of women in bureaucratic processes, subtle and less subtle professional exclusion of women, and value of communities built on shared identities, experiences, and solidarity. Conclusions and Relevance This study found that women perceived the institution of academic medicine as a male-centric system misaligned with the needs of women, with associated feelings of exclusion, disillusionment, and loss of trust in their institutions. Findings suggest that the confluence of domestic obligations and unaccommodating institutional environments may make it difficult for women clinician-scientists to achieve established timelines of career progression and productivity; these findings may have long-term implications for the well-being and retention of women in academic medicine.
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Affiliation(s)
| | - Amanda K Greene
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor
| | - Christina M Cutter
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Rochelle D Jones
- Department of Radiation Oncology, Emory University, Atlanta, Georgia
| | - Eva L Feldman
- Department of Neurology, University of Michigan Medical School, Ann Arbor
| | - Kelly C Paradis
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor
| | - Isis H Settles
- Department of Psychology, University of Michigan, Ann Arbor
- Department of Afroamerican and African Studies, University of Michigan, Ann Arbor
- Department of Women's and Gender Studies, University of Michigan, Ann Arbor
| | - Kanakadurga Singer
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Nancy D Spector
- Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Abigail J Stewart
- Department of Psychology, University of Michigan, Ann Arbor
- Department of Women's and Gender Studies, University of Michigan, Ann Arbor
| | - Peter A Ubel
- Duke University School of Medicine, Durham, North Carolina
| | - Reshma Jagsi
- Department of Radiation Oncology, Emory University, Atlanta, Georgia
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Webber S, Semia S, Nacht CL, Garcia S, Kloster H, Vellardita L, Kieren MQ, Kelly MM. Physician Work-Personal Intersection: A Scoping Review of Terms, Definitions, and Measures. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:331-339. [PMID: 38039978 DOI: 10.1097/acm.0000000000005579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
PURPOSE A substantial body of evidence describes the multidimensional relationship between the intersection of physicians' work and personal lives and health care quality and costs, workforce sustainability, and workplace safety culture. However, there is no clear consensus on the terms, definitions, or measures used in physician work-personal intersection (WPI) research. In this scoping review, the authors aimed to describe the terms and definitions used by researchers to describe physician WPI, summarize the measurement tools used, and formulate a conceptual model of WPI that can inform future research. METHOD The authors searched PubMed, CINAHL, Scopus, and Web of Science for studies that investigated U.S. practicing physicians' WPI and measured WPI as an outcome from January 1990 to March 2022. The authors applied thematic analysis to all WPI terms, definitions, and survey questions or prompts in the included studies to create a conceptual model of physician WPI. RESULTS Ultimately, 102 studies were included in the final analysis. The most commonly used WPI terms were work-life balance, work-life integration, and work-home or work-life conflict(s). There was no consistency in the definition of any terms across studies. There was heterogeneity in the way WPI was measured, and only 8 (7.8%) studies used a validated measurement tool. The authors identified 6 key driver domains of WPI: work and personal demands; colleague and institutional support and resources; personal identity, roles, health, and values; work schedule and flexibility; partner and family support; and personal and professional strategies. CONCLUSIONS The authors found significant variability in the terms, definitions, and measures used to study physician WPI. They offer a conceptual model of the WPI construct that can be used to more consistently study physician WPI in the future. Future work should further investigate the validity of this model and generate consensus around WPI terms, definitions, and measures.
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Jansen CS, Sugiura A, Stalbow L, Nguyen C, Lever JP, Peiper A, Plaza-Jennings A, Varvel L, Williams MA, Zarrinpar A, Swartz TH. Physician-scientist trainees with parenting responsibilities need financial and childcare support. Nat Med 2023; 29:2990-2992. [PMID: 37853137 PMCID: PMC10842773 DOI: 10.1038/s41591-023-02606-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Physician–scientists who become parents during their long period of training need additional funding and support for lactation, childcare and healthcare, to ensure an equitable workforce.
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Affiliation(s)
| | - Ayaka Sugiura
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Lauren Stalbow
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Amy Peiper
- University of Florida College of Medicine, Gainesville, FL, USA
| | | | - Linda Varvel
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Ali Zarrinpar
- Division of Transplantation and Hepatobiliary Surgery at the University of Florida College of Medicine, Gainesville, FL, USA
| | - Talia H Swartz
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Shenvi C, Drake A, Pisano E, Girdler S, Nicholson W, Boggess K. Addressing the Gender Gap in Academic Success: A History of the University of North Carolina Association of Professional Women in the Medical Sciences. Cureus 2023; 15:e49660. [PMID: 38161937 PMCID: PMC10756327 DOI: 10.7759/cureus.49660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2023] [Indexed: 01/03/2024] Open
Abstract
Despite efforts at many institutions, nationally, women still lag behind their male counterparts in leadership, promotion, and seniority. In this paper, we describe the efforts to improve the environment for women faculty at one large academic medical center through the creation of an Association of Professional Women in Medical Sciences. Over the years, the group has helped influence policies that directly affect women faculty, provided high-yield programming on topics related to women's success, and created interprofessional networking opportunities for women faculty. We describe the challenges and successes of this group to serve as a model and inspiration for other institutions.
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Affiliation(s)
- Christina Shenvi
- Emergency Medicine, UNC (University of North Carolina) at Chapel Hill, Chapel Hill, USA
| | - Amelia Drake
- Otolaryngology, UNC (University of North Carolina) at Chapel Hill, Chapel Hill, USA
| | - Etta Pisano
- Radiology, American College of Radiology, Reston, USA
| | - Susan Girdler
- Psychiatry, UNC (University of North Carolina) at Chapel Hill, Chapel Hill, USA
| | - Wanda Nicholson
- Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Kim Boggess
- Obstetrics and Gynecology, UNC (University of North Carolina) at Chapel Hill, Chapel Hill, USA
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Feld LD, Oxentenko AS, Sears D, Charabaty A, Rabinowitz LG, Silver JK. Parental Leave and Return-to-Work Policies: A Practical Model for Implementation in Gastroenterology. Clin Gastroenterol Hepatol 2023; 21:2709-2715. [PMID: 37741653 DOI: 10.1016/j.cgh.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Indexed: 09/25/2023]
Affiliation(s)
- Lauren D Feld
- Division of Gastroenterology, Diversity, Equity, Belonging and Inclusion, Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts
| | - Amy S Oxentenko
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Dawn Sears
- U.S. Department of Veterans Affairs, Central Texas VA, Texas A&M School of Medicine, Temple, Texas
| | - Aline Charabaty
- IBD Center, Johns Hopkins School of Medicine, Division of Gastroenterology Sibley Memorial Hospital, Washington, District of Columbia
| | - Loren G Rabinowitz
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess, Harvard Medical School, Boston, Massachusetts
| | - Julie K Silver
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Feld LD, Oxentenko AS, Sears D, Charabaty A, Rabinowitz LG, Silver JK. Parental Leave and Return-to-Work Policies: A Practical Model for Implementation in Gastroenterology. Gastroenterology 2023; 165:813-818. [PMID: 37741651 DOI: 10.1053/j.gastro.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Affiliation(s)
- Lauren D Feld
- Division of Gastroenterology, Diversity, Equity, Belonging and Inclusion, Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts
| | - Amy S Oxentenko
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Dawn Sears
- U.S. Department of Veterans Affairs, Central Texas VA, Texas A&M School of Medicine, Temple, Texas
| | - Aline Charabaty
- IBD Center, Johns Hopkins School of Medicine, Division of Gastroenterology, Sibley Memorial Hospital, Washington, District of Columbia
| | - Loren G Rabinowitz
- Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess, Harvard Medical School, Boston, Massachusetts
| | - Julie K Silver
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Speer EM, Lee LK, Bourgeois FT, Gitterman D, Hay WW, Davis JM, Javier JR. The state and future of pediatric research-an introductory overview : The state and future of pediatric research series. Pediatr Res 2023:10.1038/s41390-022-02439-4. [PMID: 36694026 PMCID: PMC9873210 DOI: 10.1038/s41390-022-02439-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 01/26/2023]
Abstract
IMPACT This is an introduction to an article series devoted to the current state and future of pediatric research. The role of public-private partnerships, influencing factors, challenges, and recent trends in pediatric research are described, with emphasis on funding, drug and device development, physician-scientist training, and diversity. Potential solutions and advocacy opportunities are discussed.
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Affiliation(s)
- Esther M Speer
- Department of Pediatrics, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
| | - Lois K Lee
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Florence T Bourgeois
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA
| | - Daniel Gitterman
- Public Policy, University of North Caroline, Chapel Hill, NC, USA
| | | | - Jonathan M Davis
- Department of Pediatrics and the Tufts Clinical and Translational Science Institute, Tufts Medical Center, Boston, MA, USA
| | - Joyce R Javier
- Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Jagsi R, Beeland TD, Sia K, Szczygiel LA, Allen MR, Arora VM, Bair-Merritt M, Bauman MD, Bogner HR, Daumit G, Davis E, Fagerlin A, Ford DE, Gbadegesin R, Griendling K, Hartmann K, Hedayati SS, Jackson RD, Matulevicius S, Mugavero MJ, Nehl EJ, Neogi T, Regensteiner JG, Rubin MA, Rubio D, Singer K, Tucker Edmonds B, Volerman A, Laney S, Patton C, Escobar Alvarez S. Doris Duke Charitable Foundation Fund to Retain Clinical Scientists: innovating support for early-career family caregivers. J Clin Invest 2022; 132:166075. [PMID: 36453546 PMCID: PMC9711869 DOI: 10.1172/jci166075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
| | | | - Kevin Sia
- Doris Duke Charitable Foundation, New York, New York, USA
| | | | - Matthew R. Allen
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Vineet M. Arora
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | | | | | - Hillary R. Bogner
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Gail Daumit
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Esa Davis
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Angela Fagerlin
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
| | - Daniel E. Ford
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | | | | | | | | | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Michael A. Rubin
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
| | - Doris Rubio
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | | | - Anna Volerman
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
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Raine G, Evans C, Uphoff EP, Brown JVE, Crampton PES, Kehoe A, Stewart LA, Finn GM, Morgan JE. Strengthening the clinical academic pathway: a systematic review of interventions to support clinical academic careers for doctors and dentists. BMJ Open 2022; 12:e060281. [PMID: 36691216 PMCID: PMC9462120 DOI: 10.1136/bmjopen-2021-060281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/21/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Evaluate existing evidence on interventions intended to increase recruitment, retention and career progression within clinical academic (CA) careers, including a focus on addressing inequalities. DESIGN Systematic review. DATA SOURCES Medline, Embase, Cochrane Controlled Register of Trials, PsycINFO and Education Resource Information Center searched October 2019. STUDY SELECTION Eligible studies included qualified doctors, dentists and/or those with a supervisory role. Outcomes were defined by studies and related to success rates of joining or continuing within a CA career. DATA EXTRACTION AND SYNTHESIS Abstract screening was supported by machine learning software. Full-text screening was performed in duplicate, and study quality was assessed. Narrative synthesis of quantitative data was performed. Qualitative data were thematically analysed. RESULTS 148 studies examined interventions; of which 28 were included in the quantitative synthesis, 17 in the qualitative synthesis and 2 in both. Studies lacked methodological rigour and/or were hindered by incomplete reporting. Most were from North America. No study included in the syntheses evaluated interventions aimed at CA dentists.Most quantitative evidence was from multifaceted training programmes. These may increase recruitment, but findings were less clear for retention and other outcomes. Qualitative studies reported benefits of supportive relationships, including peers and senior mentors. Protected time for research helped manage competing demands on CAs. Committed and experienced staff were seen as key facilitators of programme success. Respondents identified several other factors at a programme, organisational or national level which acted as facilitators or barriers to success. Few studies reported on the effects of interventions specific to women or minority groups. CONCLUSIONS Existing research is limited by rigour and reporting. Better evaluation of future interventions, particularly those intended to address inequalities, is required. Within the limits of the evidence, comprehensive multifaceted programmes of training, including protected time, relational and support aspects, appear most successful in promoting CA careers. SYSTEMATIC REVIEW REGISTRATION Open Science Framework: https://osf.io/mfy7a.
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Affiliation(s)
- Gary Raine
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Connor Evans
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Jennifer Valeska Elli Brown
- Centre for Reviews and Dissemination, University of York, York, UK
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Paul E S Crampton
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - Amelia Kehoe
- Health Professions Education Unit, Hull York Medical School, York, UK
| | | | | | - Jessica Elizabeth Morgan
- Centre for Reviews and Dissemination, University of York, York, UK
- Department of Paediatric Haematology & Oncology, Leeds Children's Hospital, Leeds, UK
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Li QKW, Wollny K, Twilt M, Walsh CM, Bright K, Dimitropoulos G, Pires L, Pritchard L, Samuel S, Tomfohr-Madsen L. Curricula, Teaching Methods, and Success Metrics of Clinician-Scientist Training Programs: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1403-1412. [PMID: 36098782 DOI: 10.1097/acm.0000000000004764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To describe the literature on clinician-scientist training programs to inform the development of contemporary and inclusive training models. METHOD The authors conducted a scoping review, searching the PubMed/MEDLINE, CINAHL, and Embase databases from database inception until May 25, 2020. Studies presenting primary research that described and evaluated clinician-scientist training programs were identified for data abstraction. On the basis of deductive and inductive methods, information about program characteristics, curricula, teaching strategies, and success metrics was extracted. The extracted variables were analyzed using descriptive statistics. RESULTS From the initial 7,544 citations retrieved and 4,974 unique abstracts screened, 81 studies were included. Of the 81 included studies, 65 (80.2%) were published between 2011 and 2020, 54 (66.7%) were conducted in the United States, and 64 (79.0%) described programs that provided broad clinician-scientist training. Few programs provided funding or protected research time or specifically addressed needs of trainees from underrepresented minority groups. Curricula emphasized research methods and knowledge dissemination, whereas patient-oriented research competencies were not described. Most programs incorporated aspects of mentorship and used multiple teaching strategies, such as direct and interactive instruction. Extrinsic metrics of success (e.g., research output) were dominant in reported program outcomes compared with markers of intrinsic success (e.g., career fulfillment). CONCLUSIONS Although programs are providing clinician-scientists with practical skills training, opportunities exist for curricular and pedagogic optimization that may better support this complex career path. Training programs for clinician-scientists can address contemporary issues of wellness and equity by reconsidering metrics of program success and evolving the core tenets of their education models to include equity, diversity, and inclusion principles and patient-oriented research competencies.
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Affiliation(s)
- Queenie K W Li
- Q.K.W. Li is a clinical research coordinator, Department of Psychology, University of Calgary, Calgary, Alberta, Canada; ORCID: https://orcid.org/0000-0001-7318-1701
| | - Krista Wollny
- K. Wollny is instructor, Faculty of Nursing, University of Calgary, and at the time of writing was a PhD candidate, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, and trainee, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Marinka Twilt
- M. Twilt is a pediatric rheumatologist and associate professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Catharine M Walsh
- C.M. Walsh is staff gastroenterologist, Division of Gastroenterology, Hepatology, and Nutrition, an educational researcher, SickKids Learning Institute, a scientist, Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children (SickKids), a cross-appointed scientist, Wilson Centre for Research in Education, and associate professor of paediatrics, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-3928-703X
| | - Katherine Bright
- K. Bright is Health System Impact Postdoctoral Fellow, Canadian Institutes for Health Research, Addictions and Mental Health Strategic Clinical Network, Alberta Health Services and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Gina Dimitropoulos
- G. Dimitropoulos is a social worker and associate professor, Faculty of Social Work and Department of Psychiatry and Pediatrics, University of Calgary, Calgary, Alberta, Canada; ORCID: https://orcid.org/0000-0001-9487-0290
| | - Linda Pires
- L. Pires is research operations manager, Canadian Child Health Clinician Scientist Program, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Lesley Pritchard
- L. Pritchard is pediatric physical therapist and associate professor, Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada; ORCID: https://orcid.org/0000-0002-6684-376X
| | - Susan Samuel
- S. Samuel is pediatric nephrologist and professor, Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lianne Tomfohr-Madsen
- L. Tomfohr-Madsen is a clinical psychologist and associate professor, Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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Komlenac N, Stockinger L, Hochleitner M. Family Supportive Supervisor Behaviors Moderate Associations between Work Stress and Exhaustion: Testing the Job Demands-Resources Model in Academic Staff at an Austrian Medical University. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095769. [PMID: 35565163 PMCID: PMC9099746 DOI: 10.3390/ijerph19095769] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/20/2022] [Accepted: 05/06/2022] [Indexed: 01/21/2023]
Abstract
The time-intensive work of publishing in scientific journals is an important indicator of job performance that is given much weight during promotion procedures for academic positions. The current study applied the job demands–resources model and analyzed whether family supportive supervisor behaviors (FSSB) moderated associations between work stress and feelings of exhaustion as a job resource and whether feelings of exhaustion ultimately mediated the link between work stress and academic employees’ publication activity. The current online cross-sectional questionnaire study was conducted in 133 academic employees (65.4% women, 34.6% men; Mage = 41.9, SD = 10.1) at an Austrian medical university and assessed employees’ numbers of publications, H-index, work stress, feelings of exhaustion, FSSB, and work–family services used. Manifest path models revealed that FSSB moderated the link between experiencing high levels of work stress and strong feelings of exhaustion, especially in employees who had at least one child below the age of 18. Part-time employment was most strongly linked with lower numbers of publications and lower H-index levels. The finding that FSSB acted as a job resource mostly for employees with at least one child below 18 underlines the fact that FSSB is different from other forms of supervisor support. The current study supports recommendations to increase the amount of work–family services and to change organizational norms to be supportive of the successful management of family and work obligations.
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Ward HB, Levin FR, Greenfield SF. Disparities in Gender and Race Among Physician-Scientists: A Call to Action and Strategic Recommendations. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:487-491. [PMID: 34192723 DOI: 10.1097/acm.0000000000004224] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The size of the physician-scientist workforce has declined for the past 3 decades, which raises significant concerns for the future of biomedical research. There is also a considerable gender disparity among physician-scientists. This disparity is exacerbated by race, resulting in a compounding effect for women of color. Proposed reasons for this disparity include the time and expense physicians must devote to obtaining specialized research training after residency while at the same time burdened with mounting medical school debt and domestic and caretaking responsibilities, which are disproportionately shouldered by women. These circumstances may contribute to the overall gender disparity in research funded by the National Institutes of Health (NIH). Women apply for NIH grants less often than men and are therefore less likely to receive an NIH grant. However, when women do apply for NIH grants, their funding success is comparable with that of men. Increasing representation of women and groups underrepresented in medicine (UIM) requires not only improving the pipeline (e.g., through training) but also assisting early- and midcareer women-and especially women who are UIM-to advance. In this article, the authors propose the following solutions to address the challenges women and other UIM individuals face at each of these career stages: developing specific NIH research training programs targeted to women and UIM individuals in medical school and residency; creating institutional and individual grant initiatives; increasing student loan forgiveness; setting up robust institutional mentorship programs for individuals seeking to obtain independent funding; providing childcare stipends as part of NIH grants; and instituting an NIH requirement that funded investigators participate in efforts to increase diversity in the physician-scientist workforce. Enabling more women and UIM individuals to enter and thrive in the physician-scientist workforce will increase the size and diversity of this critical component of biomedical research.
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Affiliation(s)
- Heather Burrell Ward
- H. Burrell Ward was chief resident for research, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, at the time of writing. The author is associate director, Research Track, Psychiatry Residency Training Program, Department of Psychiatry, and Sidney R. Baer, Jr. Foundation fellow, Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0003-2901-8004
| | - Frances R Levin
- F.R. Levin is Kennedy-Leavy professor of psychiatry and chief, Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York; ORCID: https://orcid.org/0000-0003-4209-1329
| | - Shelly F Greenfield
- S.F. Greenfield is Kristine M. Trustey endowed chair in psychiatry, chief, Center of Excellence in Women's Mental Health, director, Alcohol, Drugs, and Addiction Clinical and Health Services Research Program, and chief academic officer, McLean Hospital, Belmont, Massachusetts, and professor of psychiatry, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-9387-1416
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Machut KZ, Kushnir A, Oji-Mmuo CN, Kataria-Hale J, Lingappan K, Kwon S, Dammann CE. Effect of Coronavirus Disease-2019 on the Workload of Neonatologists. J Pediatr 2022; 242:145-151.e1. [PMID: 34748740 PMCID: PMC8572527 DOI: 10.1016/j.jpeds.2021.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the impact of coronavirus disease-2019 (COVID-19) on the neonatology workforce, focusing on professional and domestic workloads. STUDY DESIGN We surveyed US neonatologists in December 2020 regarding the impact of COVID-19 on professional and domestic work during the pandemic. We estimated associations between changes in time spent on types of professional and domestic work and demographic variables with multivariable logistic regression analyses. RESULTS Two-thirds (67.6%) of the 758 participants were women. Higher proportions of women than men were in the younger age group (63.3% vs 29.3%), held no leadership position (61.4% vs 46.3%), had dependents at home (68.8% vs 56.3%), did not have a partner or other adult at home (10.6% vs 3.2%), and had an employed partner (88.1% vs 64.6%) (P < .01 for all). A higher proportion of women than men reported a decrease in time spent on scholarly work (35.0% vs 29.0%; P = .02) and career development (44.2% vs 34.9%; P < .01). A higher proportion of women than men reported spending more time caring for children (74.2% vs 55.8%; P < .01). Reduced time spent on career development was associated with younger age (aOR, 2.21; 95% CI, 1.20-4.08) and number of dependents (aOR, 1.21; 95% CI, 1.01-1.45). Women were more likely to report an increase in time spent time doing domestic work (aOR, 1.53; 95% CI, 1.07-2.19) and a reduction in time on self-care (aOR, 0.49; 95% CI, 0.29-0.81). CONCLUSIONS COVID-19 significantly impacts the neonatology workforce, disproportionately affecting younger, parent, and women physicians. Targeted interventions are needed to support postpandemic career recovery and advance physician contributions to the field.
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Affiliation(s)
- Kerri Z. Machut
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL,Division of Neonatology, Ann & Robert H. Lurie Children's Hospital, Chicago, IL,Reprint requests: Kerri Z. Machut, MD, Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, #45, Chicago, IL 60611
| | - Alla Kushnir
- Department of Pediatrics, Cooper Children's Regional Hospital, Camden, NJ
| | | | | | - Krithika Lingappan
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA,Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Soyang Kwon
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL,Division of Neonatology, Ann & Robert H. Lurie Children's Hospital, Chicago, IL
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Szczygiel LA, Jones RD, Drake AF, Drake WP, Ford DE, Hartmann KE, Libby AM, Marshall BA, Regensteiner JG, Yaffe K, Jagsi R. Insights from an Intervention to Support Early Career Faculty with Extraprofessional Caregiving Responsibilities. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:355-368. [PMID: 34476418 PMCID: PMC8409229 DOI: 10.1089/whr.2021.0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 12/03/2022]
Abstract
Background: Insufficient support for balancing career and family responsibilities hinders retention of physician-scientists. Programs to improve retention of this important group of faculty are crucial. Understanding the experiences of program implementers is key to refining and improving program offerings. Methods: We conducted an interpretive, descriptive, and qualitative study as part of an ongoing evaluation of the Doris Duke Charitable Foundation's Fund to Retain Clinical Scientists (FRCS) awards. We conducted telephone interviews with 12 program directors representing all 10 US medical schools who received the Doris Duke funding in 2016. Results: Of the 12 participants, 10 were women (83.3%). Participating program directors perceived the FRCS award as capable of producing paradigmatic changes regarding how responsibilities at home and work in academic medicine are viewed and integrated by early-career faculty members. The main qualitative themes that captured directors' experiences implementing the program were as follows: (1) championing a new paradigm of support, (2) lessons learned while implementing the new paradigm, (3) results of the new paradigm, and (4) sustaining the paradigm. Conclusions: These findings may help to inform development of similar programs to retain and support the career progress of physician-scientists with extraprofessional caregiving responsibilities. The interviews illuminate ways in which the Doris Duke FRCS award has driven institutional culture change by normalizing discussion and prompted reassessment of extraprofessional challenges and how best to aid early-career faculty members in overcoming these challenges.
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Affiliation(s)
- Lauren A. Szczygiel
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Rochelle D. Jones
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Amelia F. Drake
- Division of Pediatric Otolaryngology, Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Wonder P. Drake
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Daniel E. Ford
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Katherine E. Hartmann
- Department of Obstetrics and Gynecology and Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Anne M. Libby
- Department of Emergency Medicine, Center for Women's Health Research, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Bess A. Marshall
- Division of Endocrinology and Diabetes, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Judith G. Regensteiner
- Department of Medicine, Center for Women's Health Research, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kristine Yaffe
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Reshma Jagsi
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
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Ha GL, Lehrer EJ, Wang M, Holliday E, Jagsi R, Zaorsky NG. Sex Differences in Academic Productivity Across Academic Ranks and Specialties in Academic Medicine: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e2112404. [PMID: 34185071 PMCID: PMC8243235 DOI: 10.1001/jamanetworkopen.2021.12404] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Despite equal numbers of men and women entering medical school, women are underrepresented in the upper echelons of academic medicine and receive less compensation and research funding. Citation-related publication productivity metrics, such as the h-index, are increasingly used for hiring, salary, grants, retention, promotion, and tenure decisions. Exploring sex differences in these metrics across academic medicine provides deeper insight into why differences are observed in career outcomes. OBJECTIVE To systematically examine the available literature on sex differences in h-index of academic faculty physicians across all medical specialties and all levels of academic rank. DATA SOURCES Medical literature with the term h-index found in PubMed and published between January 1, 2009, and December 31, 2018, was used. STUDY SELECTION A PICOS (Population, Intervention, Comparison, and Outcomes), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses), and MOOSE (Meta-analysis of Observational Studies in Epidemiology) selection protocol was used to find observational studies that published h-indexes for faculty physicians that were stratified by sex. Studies were excluded if they were review articles, retracted, or unavailable online. Ultimately, 14 of 786 studies (1.78%) met the inclusion criteria. DATA EXTRACTION AND SYNTHESIS Data from 9 studies across 16 specialties were examined using weighted random-effects meta-analyses. Five studies were excluded because of overlapping specialties with another study or because they were missing appropriate statistics for the meta-analysis. Four of these studies were included in qualitative synthesis to bring the total to 13 studies. MAIN OUTCOMES AND MEASURES The primary study outcome was the h-index. RESULTS The meta-analysis included 10 665 North American unique academic physicians across 9 different studies from the years 2009 to 2018. Of the 10 665 physicians, 2655 (24.89%) were women. Summary effect sizes for mean h-indexes of men and women and mean h-index difference between men and women were determined for all faculty physicians and at each academic rank. Overall, female faculty had lower h-indexes than male faculty (mean difference, -4.09; 95% CI, -5.44 to -2.73; P < .001). When adjusting for academic rank, female faculty still had lower h-indexes than male faculty at the ranks of assistant professor (mean difference, -1.3; 95% CI, -1.90 to -0.72; P < .001), associate professor (mean difference, -2.09; 95% CI, -3.40 to -0.78; P = .002), and professor (mean difference, -3.41; 95% CI, -6.24 to -0.58; P = .02). CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, women had lower h-indexes than men across most specialties and at all academic ranks, but it is unclear why these differences exist. These findings suggest that future investigation should be conducted regarding the causes of lower h-indexes in women and that interventions should be developed to provide a more equitable environment for all physicians regardless of sex.
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Affiliation(s)
- Giang L. Ha
- Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Eric J. Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ming Wang
- Department of Public Health Sciences, Division of Biostatistics and Bioinformatics, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Emma Holliday
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor
- Center for Bioethics and Social Sciences, University of Michigan, Ann Arbor
| | - Nicholas G. Zaorsky
- Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania
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Jones RD, Miller J, Vitous CA, Krenz C, Brady KT, Brown AJ, Daumit GL, Drake AF, Fraser VJ, Hartmann KE, Hochman JS, Girdler S, Kalet AL, Libby AM, Mangurian C, Regensteiner JG, Yonkers K, Jagsi R. From Stigma to Validation: A Qualitative Assessment of a Novel National Program to Improve Retention of Physician-Scientists with Caregiving Responsibilities. J Womens Health (Larchmt) 2020; 29:1547-1558. [PMID: 32286931 PMCID: PMC7864110 DOI: 10.1089/jwh.2019.7999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Research is needed to improve understanding of work-life integration issues in academic medicine and to guide the implementation of the Doris Duke Charitable Foundation's Fund to Retain Clinical Scientists (FRCS), a national initiative offering financial support to physician-scientists facing caregiving challenges. Materials and Methods: In 2018, as part of a prospective program evaluation, the authors conducted a qualitative study to examine FRCS program participants' initial impressions, solicit descriptions of their career and caregiving experiences, and inquire how such factors might influence their professional advancement. The authors invited all 33 awardees who had been granted FRCS funding in the first year of the program to participate in the study, of whom 28 agreed to complete an interview. Analysts evaluated de-identified transcripts and explicated the data using a thematic analysis approach. Results: While participants described aspects of a culture that harbor stigma against caregivers and impede satisfactory work-life integration, they also perceived an optimistic cultural shift taking place as a result of programs like the FRCS. Their comments indicated that the FRCS has the potential to influence culture if institutional leadership simultaneously fosters a community that validates individuals both as caregivers and as scientists. Conclusions: Insights garnered from this qualitative study suggest that there is a pressing need for institutional leaders to implement programs that can foster awareness and normalization of caregiving challenges. In addition to providing funding and other tangible resources, interventions should strive to reinforce a broader culture that affirms the presence of work-life integration challenges and openly embraces solutions.
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Affiliation(s)
- Rochelle D. Jones
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacquelyn Miller
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - C. Ann Vitous
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan, USA
| | - Chris Krenz
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kathleen T. Brady
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ann J. Brown
- Department of Endocrinology, Metabolism, and Nutrition, Duke University School of Medicine, Durham, North Carolina, USA
| | - Gail L. Daumit
- Departments of Health Policy and Management and Epidemiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amelia F. Drake
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Victoria J. Fraser
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Katherine E. Hartmann
- Department of Obstetrics and Gynecology & Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Judith S. Hochman
- Division of Cardiology, NYU Langone Medical Center, New York, New York, USA
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Adina L. Kalet
- Stephen and Shelagh Roell Endowed Chair of the Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anne M. Libby
- CU School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Christina Mangurian
- Department of Psychiatry, University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Judith G. Regensteiner
- CU School of Medicine, Judith and Joseph Wagner Chair of Women's Health Research, and University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kimberly Yonkers
- Departments of Psychiatry, Epidemiology, and of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
| | - Reshma Jagsi
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
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Jagsi R, Spector ND. Leading by Design: Lessons for the Future From 25 Years of the Executive Leadership in Academic Medicine (ELAM) Program for Women. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1479-1482. [PMID: 33006867 DOI: 10.1097/acm.0000000000003577] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program for Women is designed to promote the careers of senior female leaders in academic health care in a way that ultimately seeks to transform culture and promote gender equity far beyond the careers of its participants. In an era of increased awareness of gender inequity within academic medicine, the longevity of the ELAM program raises several important questions. First, why is such a program still needed? Second, what exactly does it do, and what has been its influence on its participants and beyond? And third, what lessons can ELAM's example provide to help guide the medical profession as it strives to promote gender equity in the field? In this Invited Commentary, the authors seek to answer these questions from the perspective of a recent program participant and the current program director. The authors review the evidence that identifies how women, even today, face accumulating disadvantage over the course of their academic careers, stemming from repeated encounters with powerful unconscious biases and stereotypes, societal expectations for a gendered division of domestic labor, and still-present overt discrimination and sexual harassment. They describe ELAM's approach, which builds the knowledge and skills of the women who participate in the program, while also intentionally raising their visibility within their home institutions so that they have opportunities to share with institutional leaders what they have learned in ways that not only promote their own careers but also support gender equity in the broader environment. The authors conclude by offering thoughts on how ELAM's model may be leveraged in the future, ideally in partnership with the numerous professional societies, funding agencies, and other organizations that are committed to accelerating the rate of progress toward gender equity at all levels of academic medicine.
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Affiliation(s)
- Reshma Jagsi
- R. Jagsi is Newman Family Professor, Department of Radiation Oncology, and director, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0001-6562-1228
| | - Nancy D Spector
- N.D. Spector is professor, Department of Pediatrics, Drexel University, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0001-6576-4560
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