1
|
Matching Against Men: 5 Years of Residency Match Data Show Disparities Still Exist. South Med J 2024; 117:187-192. [PMID: 38569605 DOI: 10.14423/smj.0000000000001673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Despite progress toward equal representation by sex in medical practice, women remain underrepresented in many specialties. This study sought to examine the current state of gender equality among recently graduated doctors in multiple specialties. METHODS Deidentified demographics, standardized examination scores, and Match results were gathered for 829 graduates. Participants were selected from an allopathic medical school between 2016 and 2020. Nineteen students (2.29%) were excluded from the study. Descriptive statistics were calculated, and χ2 tests for independence were used to compare proportions between reported sex and specialty and program Match results. One-way analysis of variance was then performed to test for differences in US Medical Licensing Examination Step 1 and Step 2 scores between sexes. P < 0.05 was considered statistically significant. RESULTS Of the 829 individuals studied, 44.6% were women. A significantly smaller proportion of women matched into the most competitive specialties, despite no significant difference in US Medical Licensing Examination Step 1 scores between sexes. Furthermore, there was an overall significant trend of women matching into more competitive programs for any given specialty. CONCLUSIONS In this study, we found that men matched into more highly competitive specialties, whereas women matched into more competitive residency program locations. Further research is needed to determine why women matched into specific specialties at lower rates than their male peers and seek to understand how sex affects the narrative of specialty choice.
Collapse
|
2
|
Women in the Medical Physics Workforce: Insights from Membership Trends of the American Association of Physicists in Medicine, 1993 to 2023. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00318-3. [PMID: 38387813 DOI: 10.1016/j.ijrobp.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/15/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE Women remain underrepresented in medical physics in the United States, and determinants of persisting disparities remain unclear. Here, we performed a detailed investigation of American Association of Physicists in Medicine (AAPM) membership trajectories to evaluate trends in Full membership with respect to gender, age, and highest degree. METHODS AND MATERIALS Membership data, including gender, date of birth, highest degree, membership type, and years of active membership for 1993 to 2023 were obtained from AAPM. Group 1 included Full members who joined AAPM in 1993 or later. A subset of group 1 including only members who joined and left AAPM since 1993 (former members, group 1F) was used to calculate age at membership cessation and duration. Results were compared by gender and highest degree. A Kaplan-Meier analysis was also used to evaluate membership "survival" by age and highest degree. RESULTS Complete data were available for 6647 current and former Full members (group 1), including 2211 former members (group 1F). On average, women became Full members at a significantly younger age than men (34.6 vs 37.5 years of age, P < .001) and ended their memberships (if applicable) at a significantly younger age than men (46.1 vs 50.1 years of age, P < .001). The Kaplan-Meier "survival" analysis showed that for a given age, women were at a significantly greater risk of membership cessation than men, and women with master's degrees had the lowest membership survival of any gender/degree subgroup. When analyzing by membership duration, there was no difference in survival by gender alone. Still, women with PhDs were found to have the greatest membership survival among gender/degree subgroups. CONCLUSIONS Both gender and degree type influenced AAPM membership trajectories. Although we have offered a discussion of possible explanations, qualitative data collected from both continuing and departing AAPM members will be critical in the ongoing journey toward gender parity in the profession of medical physics.
Collapse
|
3
|
Sex equality in high-quality anaesthesiology research: A descriptive bibliometric study on scientific authorships. Eur J Anaesthesiol 2024; 41:70-72. [PMID: 37455646 DOI: 10.1097/eja.0000000000001886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
|
4
|
Sex disparities in parenteral and enteral nutrition societies' leadership worldwide: a 20-year retrospective analysis. Am J Clin Nutr 2024; 119:196-205. [PMID: 37956721 DOI: 10.1016/j.ajcnut.2023.11.004] [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] [Received: 05/26/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Despite advancements in the global dialog surrounding sex and gender equity, an important gap persists with women markedly underrepresented in major roles within health care leadership. OBJECTIVES We examined the extent of women's representation in prominent positions within parenteral and enteral nutrition (PEN) societies worldwide over a span of 2 decades. DESIGN This retrospective analysis explored the sex distribution of society chairs, conference presidents, and editor-in-chief positions across 64 PEN societies between 2003 and 2022. Additionally, data on the first and last authors of endorsed clinical guidelines were collected from the 2 leading societies. RESULTS Over the past 20 y, women held society chair positions in 34.4% of cases. The representation shifted from 30% during the decade from 2003 to 2012 to 40.5% from 2013 to 2022. Throughout these years, the numbers consistently ranged from 0 to 10; however, the median shifted upward from 1 during the first decade to 4 in the subsequent decade (P = 0.04). Of 420 congress presidencies, ∼30% were women. In endorsed guidelines, women were the first authors in 27.1% of cases (P < 0.001) and the last in 28.9% (P < 0.001) compared with men. Of the 123 journal editor-in-chief positions, women occupied 23 (18.7%). CONCLUSION Over the last 2 decades, women have been consistently underrepresented in prominent leadership roles in PEN societies globally. Although there has been a noticeable shift toward more women in chair positions, true sex equality remains elusive. Moreover, sex disparities are even more pronounced in positions, such as conference presidents, authors of major guidelines, and editors-in-chief of society-affiliated journals. These data underscore the pressing need to enhance efforts toward sex equality across these domains.
Collapse
|
5
|
Gender Distribution of Authors of Evaluation Letters for Promotion at One Medical School. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1816-1823. [PMID: 35794809 DOI: 10.1097/acm.0000000000004803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Women remain underrepresented in key leadership positions and advanced ranks in academic medicine. This study examines the numbers of men and women letter writers for promotion candidates during a 5-year period across departments, tracks, ranks, and candidate gender. METHOD A descriptive study characterized the gender of evaluation letter writers for candidates for promotion to associate or full professor at the University of Minnesota Medical School between 2015 and 2020. Letter writer and candidate gender were characterized by self-identified pronouns in the faculty biography or dossier. Letter writer gender was described by candidate department, promotion track, rank, terminal degree, and gender. RESULTS Among 299 candidates for promotion, 172 (58%) were men and 127 (42%) were women; dossiers included 3,995 evaluation letters. Across all years, men wrote more letters than women (external letters, range, 69% in 2019-2020 to 75% in 2015-2016; internal letters, range, 67% in 2018-2019 to 77% in 2015-2016). Candidates in the family medicine and pediatrics departments had the highest percentages of letters written by women (44% and 40%, respectively). No differences were found in the number of women letter writers by candidate promotion track; however, differences were found by candidate rank (associate professor, 30%; full professor, 23%) and terminal degree (MD/DO, 25%; PhD, 33%; MD-PhD, 20%). Regardless of candidate gender, most evaluation letters were written by men. Women candidates had 15% to 20% more letters authored by women than men candidates (34%-40% vs 18%-23%). CONCLUSIONS The gender pattern of letter writers may reflect implicit biases regarding gender and perceived leadership status, expertise, and success. Adopting policies that promote or require gender diversity among letter writers for promotion candidates may provide an opportunity to encourage faculty to seek diverse networks and recognize the achievements of women faculty.
Collapse
|
6
|
Beyond tokenism and objectivity: theoretical reflections on a transformative equity, diversity, and inclusion agenda for higher education in Canada. SN SOCIAL SCIENCES 2022; 2:209. [PMID: 36187203 PMCID: PMC9510219 DOI: 10.1007/s43545-022-00509-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022]
Abstract
Universities, the sites for objective knowledge, apolitical and legitimized to contribute to human and intellectual capacity, find themselves in a tenuous position on issues of merit, equality, and fairness. On one hand, social forces have demonstrated how universities have been institutions for the production and reproduction of systemic inequality. On the other hand, universities maintain that they are well positioned, as part of their institutional renewal practices, to address contemporary calls for Equity, Diversity, and Inclusion (EDI). Since universities are now eager to embrace EDI principles, it is appropriate to demonstrate their historical failures and provide some recommendations towards institutional renewal. Drawing on critical pedagogy, the paper examines selected academic contributions and knowledge claims that have reproduced systemic inequality, specifically on the discourse on human classification. The broader question is whether universities are simply going through the motions and hope EDI is a fad or are serious about institutional renewal and transformative changes. The study offers some ideas on how universities can pursue transformative changes grounded on EDI principles.
Collapse
|
7
|
Becoming an anti-racist interprofessional healthcare organization: Our journey. JOURNAL OF INTERPROFESSIONAL EDUCATION & PRACTICE 2022; 27:100509. [PMID: 35284657 PMCID: PMC8898662 DOI: 10.1016/j.xjep.2022.100509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/17/2022] [Accepted: 02/24/2022] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic amplified the egregious disproportionate burden of disease based on race, ethnicity, and failure of organizations to address structural racism. This paper describes a journey by members of the National Academies of Practice (NAP) who came together to address diversity, equity, and inclusion (DEI). Through collaborative efforts, a virtual, interactive workshop was designed and delivered at NAP's 2021 Virtual Forum to facilitate discussions about DEI priorities across professions and to initiate a sustainable action plan toward achieving inclusive excellence. Resulting discoveries and reflections led us to the essential question: can we truly become an anti-racist interprofessional healthcare organization?
Collapse
|
8
|
Empowering Student Antiracist Work to Overcome Inertia in Academic Health Centers. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:818-823. [PMID: 34879009 DOI: 10.1097/acm.0000000000004557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The national struggles for social justice that have dominated headlines since 2020 are reflected in the challenges academic health centers are confronting as they strive to become more antiracist. One of the largest challenges for these institutions may be the inertia of the status quo. While faculty may have become accustomed to a status quo that perpetuates inequity, students provide perspectives that can disrupt this inertia and lead to positive change. Students, however, face barriers to antiracist work, including power gradients (i.e., different amounts of power people possess according to their position in a hierarchy) and a need to be accepted as part of the physician profession. In this article, the authors examine these challenges to student antiracist advocacy. They identify student empowerment, faculty allyship, and sustainability as essential principles for student antiracist work. They suggest this work could be operationalized through sequential student-led task forces focused on addressing the most pressing antiracist issues. The authors further recommend an approach to professionalism and development of a physician professional identity based on the values of antiracism rather than on existing norms. With this foundation, students may be able to engage in antiracist work, build professional identities that are more antiracist, and become physicians who can ensure a more just health care environment for their patients and communities.
Collapse
|
9
|
Advancing consideration of gender within health profession education: What is required? MEDICAL EDUCATION 2022; 56:250-252. [PMID: 34741335 DOI: 10.1111/medu.14685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/15/2021] [Indexed: 06/13/2023]
|
10
|
2022 ACC Health Policy Statement on Building Respect, Civility, and Inclusion in the Cardiovascular Workplace. J Am Coll Cardiol 2022; 79:2153-2184. [DOI: 10.1016/j.jacc.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
|
12
|
Abstract
Women continue to be underrepresented in medicine, especially in senior leadership positions, and they experience challenges related to gender bias and sexual harassment. Women who are members of multiple groups that experience marginalization, including, for example, women who are American Indian, Alaskan native, indigenous, Black, or Hispanic, face a compounded challenge. In this article, we explore how institutions and professional organizations in medicine can use metrics to better understand the structural disparities that create and promote gender inequity in the work environment and how to employ these metrics to track progress in narrowing these gaps. Examples in health care (clinical medicine, scientific organizations, scientific publishing), business, and law are used to illustrate how impactful metrics can promote accountability when coupled with transparent reporting.
Collapse
|
13
|
Midcareer Medical School Research Faculty Perspectives on Vitality and Professionalism During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2120642. [PMID: 34387678 PMCID: PMC8363912 DOI: 10.1001/jamanetworkopen.2021.20642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/07/2021] [Indexed: 11/23/2022] Open
Abstract
Importance As medical faculty have central roles during the COVID-19 pandemic, it is important to study the pandemic's association with the vitality and careers of medical school faculty. Objective To examine how the COVID-19 pandemic affected midcareer research faculty in academic medicine. Design, Setting, and Participants This qualitative study included medical school faculty who participated in the C-Change Mentoring and Leadership Institute. All US medical school faculty recipients of recent National Institutes of Health (NIH) RO1, RO1-equivalent, and K awards were invited to apply to the institute. The 99 applicants who met inclusion criteria were stratified by degree (MD or MD/PhD vs PhD), gender, and race/ethnicity. Enrollment was offered to applicants randomly selected for 40 spots, demographically balanced by sex, underrepresented in medicine minority (URMM) status, and degree. In April 2020, an inquiry was emailed to faculty enrolled in the institute requesting responses to questions about meaning in work, career choice, and values. A qualitative analysis of narrative data responses, using grounded theory, was undertaken to determine key themes. This study is part of a NIH-funded randomized trial to test the efficacy of a group peer mentoring course for midcareer faculty and study the course's mechanisms of action. Main Outcomes and Measures Key themes in data. Results Of 40 enrolled participants, 39 responded to the inquiry, for a response rate of 97%. The analytic sample included 39 faculty members; 19 (47%) were women, 20 (53%) identified as URMM, and 20 (53%) had an MD or MD with PhD vs 19 (47%) with PhD degrees. Key themes in the data that emerged describing faculty lived experience of the pandemic included increased meaningfulness of work; professionalism and moral responsibility; enhanced relationships with colleagues; reassertion of career choice; disrupted research; impact on clinical work; attention to health disparities, social justice and advocacy; increased family responsibilities; psychological stress; and focus on leadership. Conclusions and Relevance During the pandemic, diverse PhD and physician investigators reported increased meaningfulness in work and professionalism and enhanced relationships, all intrinsic motivators associated with vitality. Working during the pandemic appears to have produced intrinsic rewards positively associated with vitality, in addition to adverse mental health effects. These findings have implications for combatting burnout and retaining investigators in the future.
Collapse
|
14
|
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.
Collapse
|
15
|
The National Institutes of Health Should Extend the Systems-Level Approach to Include Extramural Research. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:934. [PMID: 34183482 DOI: 10.1097/acm.0000000000004086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
|
16
|
Recommendations for Reducing Inequalities Experienced by Female and Ethnic Minority Doctors in the United Kingdom. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:934-935. [PMID: 34183483 DOI: 10.1097/acm.0000000000004054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
|
17
|
A Pioneer in Transplantation Genomics, Inclusion, and Diversity: A Conversation With Hannah Valantine, MBBS, MD. Circulation 2021; 143:2321-2326. [PMID: 34125565 DOI: 10.1161/circulationaha.121.055501] [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: 11/16/2022]
|
18
|
Introducing the MAVEN Leadership Training Initiative to diversify the scientific workforce. eLife 2021; 10:e69063. [PMID: 34032569 PMCID: PMC8149121 DOI: 10.7554/elife.69063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Addressing gender and racial-ethnic disparities at all career stages is a priority for the research community. In this article, we focus on efforts to encourage mid-career women, particularly women of color, to move into leadership positions in science and science policy. We highlight the need to strengthen leadership skills for the critical period immediately following promotion to associate/tenured professor - when formal career development efforts taper off while institutional demands escalate - and describe a program called MAVEN that has been designed to teach leadership skills to mid-career women scientists, particularly those from underrepresented groups.
Collapse
|
19
|
Women and Academic Medicine, 2020. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1459-1464. [PMID: 33002898 DOI: 10.1097/acm.0000000000003617] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
|