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Gottlieb AS, Roy B, Herrin J, Holaday LW, Weiss J, Salazar MC, Okoli N, Nagarkatti N, Otridge J, Pomeroy C. Why Are There So Few Women Medical School Deans? Debunking the Myth That Shorter Tenures Drive Disparities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:63-69. [PMID: 37418698 DOI: 10.1097/acm.0000000000005315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
PURPOSE Gender disparities among the senior echelons of academic medicine are striking and persistent. The role of medical school dean has been particularly immune to gender diversity, and limited prior research identified women's shorter decanal tenures as a potential driver. The authors assessed gender differences in tenure length of deanships in the current era to elucidate this finding. METHOD From October 2020 to June 2021, the authors collected information about medical school deanships that were held from January 1, 2006, to June 30, 2020. All schools were members of the Association of American Medical Colleges (AAMC). The authors collected data from online public records and augmented their findings via direct outreach to medical schools. They used time-to-event analyses before and after adjustment for interim vs permanent status of the initial appointment, school ownership (public/private), and school size to assess for gender differences in length of deanship tenure during the study period. The unit of analysis was deanships, and the primary outcome was length of deanships measured in years. RESULTS Authors included data on 528 deanships. Women held 91 (17%) of these terms. Men held the majority of permanent deanships (n = 352 [85%]). A greater percentage of the deanships held by women were interim only (n = 27 [30%]) compared with men (n = 85 [20%]). In unadjusted and adjusted analyses, there were no significant gender differences in length of deanship tenures. CONCLUSIONS Analysis of appointments of AAMC-member medical school deans from 2006 to 2020 revealed that women have remained in their deanships as long as their male counterparts. The myth about women deans' shorter longevity should no longer be promulgated. Academic medicine should consider novel solutions to addressing women's persistent underrepresentation in the dean role, including employing the gender proportionality principle used in the business and legal communities.
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Riche CT, Reif LK, Nguyen NT, Alakiu GR, Seo G, Mathad JS, McNairy ML, Cordeiro AA, Kinikar A, Walsh KF, Deschamps MM, Nerette S, Nimkar S, Kayange N, Jaka H, Mwaisungu HM, Morona D, Peter TY, Suryavanshi N, Fitzgerald DW, Downs JA, Hokororo A. "Mobilizing our leaders": A multi-country qualitative study to increase the representation of women in global health leadership. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000646. [PMID: 36962949 PMCID: PMC10021821 DOI: 10.1371/journal.pgph.0000646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Women play an essential role in health care delivery, and it is vital that they have equal representation in health leadership for equity, innovation, and the strengthening of health systems globally. Yet women remain vastly underrepresented in global health leadership positions, providing a clear example of the deeply rooted power imbalances that are central to the calls to decolonize global health. We conducted a multi-country study in Haiti, Tanzania, India, and the USA to examine gender-based challenges to career advancement for women in the global health workforce. Quantitative data on the type and prevalence of gender-based challenges has been previously reported. In this study, we analyze qualitative data collected through focus group discussions and in-depth interviews to understand women's experiences of gender-based obstacles to career advancement, their perceptions of underlying drivers, and perspectives on effective solutions. Guided by an adaptation of the Social Action Theory, we conducted focus group discussions and in-depth interviews with women at 4 major academic centers for clinical care and research in Haiti, India, Tanzania, and the United States. In total, 85 women participated in focus groups and 15 also participated in in-depth interviews. Discussions and interviews were conducted in the local language, by an experienced local facilitator unaffiliated with the participating institution, between 2017 and 2018. Discussions were recorded, transcribed, and translated. Data were analyzed by interpretive phenomenological methods for emergent themes. Three transcendent themes on gender-based challenges were identified: 1) cultural power imbalance, referring to the prevailing norms and engrained assumptions that women are less capable than men and that women's primary responsibility should be to their families; 2) institutional power imbalance, referring to the systematic gender bias upheld by existing leadership and power structures, and ranging from exclusion from career development opportunities to sexual harassment and assault; and 3) restricted agency, referring to women's limited ability to change their circumstances because of unequal cultural and institutional structures. Participants also described local, actionable solutions to address these barriers. These included: 1) formal reporting systems for sexual harassment and assault; 2) peer support and mentorship; and 3) accessible leadership training and mandatory gender equity training. Participants proposed feasible strategies to address gender-based challenges that could improve women's retention in health careers and foster their rise to leadership. Increasing the representation of women in global health leadership positions responds directly to efforts to decolonize global health and is integral to strengthening health systems and improving health outcomes for women and children worldwide.
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Affiliation(s)
- Claudia T Riche
- The Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Lindsey K Reif
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Natalie T Nguyen
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - G Rinu Alakiu
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Grace Seo
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Jyoti S Mathad
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Margaret L McNairy
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Alexandra A Cordeiro
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Aarti Kinikar
- BJ Government Medical College and Sassoon Hospital, Pune, India
| | - Kathleen F Walsh
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Marie Marcelle Deschamps
- The Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Sandy Nerette
- The Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Smita Nimkar
- BJ Government Medical College-Johns Hopkins University Clinical Trials Unit, Pune, India
| | - Neema Kayange
- Department of Pediatrics, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Hyasinta Jaka
- Department of Medicine, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Department of Internal Medicine, Mwanza College of Health and Allied Sciences, Mwanza, Tanzania
| | - Halima M Mwaisungu
- Department of Medical Ethics, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Domenica Morona
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Thandiwe Yvonne Peter
- Department of Administration, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Nishi Suryavanshi
- BJ Government Medical College-Johns Hopkins University Clinical Trials Unit, Pune, India
| | - Daniel W Fitzgerald
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Jennifer A Downs
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Adolfine Hokororo
- Department of Pediatrics, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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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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Khader Y, Essaid AA, Alyahya MS, Al-Maaitah R, Gharaibeh MK, Dababneh AB, AbuAlRub RF. Women's career progression to management positions in Jordan's health sector. Leadersh Health Serv (Bradf Engl) 2022; ahead-of-print. [PMID: 35877554 DOI: 10.1108/lhs-05-2022-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aims to identify and explore experiences, perspectives, barriers and enablers to women's career progression to management positions in the health-care sector and to assess women's and men's perceptions of the policies and practices of the health-care system concerning gender equality and nondiscrimination between women and men. DESIGN/METHODOLOGY/APPROACH A cross-sectional survey was conducted among health-care professionals in ten selected hospitals, including physicians, registered nurses/midwives and pharmacists with or without managerial positions. FINDINGS This study included a total of 2,082 female and 1,100 male health-care professionals. Overall, 70% of women and men reported that opportunities for advancement are based on knowledge and skills in their institution. However, 58.9% of women (p < 0.001) reported that women are more likely to face barriers to career advancement than men do in their workplace. Lack of women in general/line management and discrimination against women by supervisors at the point of promotion were the main barriers to women's career progression, as they were reported by two-thirds of women. The main barrier, as perceived by men (62.3%) was that women have family and domestic responsibilities. PRACTICAL IMPLICATIONS To overcome barriers in women's career progression, there is a need to establish a career planning and capacity-building program for women in the health sector. ORIGINALITY/VALUE Jordanian female health-care professionals face different barriers that affect their career progression, including inequity and discrimination in the workplace, negative views about women's abilities, lack of qualifications and training, hostile cultural beliefs and family responsibilities.
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Affiliation(s)
- Yousef Khader
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Aida Asim Essaid
- Information and Research Center, King Hussein Foundation, Amman, Jordan
| | - Mohammad S Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rowaida Al-Maaitah
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Muntaha K Gharaibeh
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan and Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | | | - Raeda F AbuAlRub
- Community and Mental Health Nursing Department, College of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Krier CR, Quinn K, Kaljo K, Farkas AH, Ellinas EH. The Effect of COVID-19 on the Medical School Experience, Specialty Selection, and Career Choice: A Qualitative Study. JOURNAL OF SURGICAL EDUCATION 2022; 79:661-667. [PMID: 34863674 PMCID: PMC8606003 DOI: 10.1016/j.jsurg.2021.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/01/2021] [Accepted: 11/10/2021] [Indexed: 06/01/2023]
Abstract
OBJECTIVE While COVID-19 had a profound impact on healthcare, its effects on medical students are less clear. This study explored the effects of COVID-19 safety measures on medical students' specialty selection and career choices. It further considers the potential differential effects of COVID by gender. DESIGN Between June and November 2020 at a Midwestern medical university, medical students with an anticipated graduation in 2021 through 2023 participated in virtual focus group sessions, which explored students' transition to remote learning during COVID-19, perception of gender bias within medical education, and personal and professional goals. Nine focus groups were held, with two to six students per session (n = 22). Focus groups were video recorded, transcribed verbatim, and data were deidentified. Transcripts were coded and analyzed using consensual qualitative analysis to identify themes. RESULTS Our analysis captured 3 themes: (1) Impact of Institutional Decision-Making due to COVID-19, (2) Impact of Unstructured Time on Professional and Personal Decision Making, and (3) Impact of Societal Pressures, Gender Bias, and Mentorship on Career Planning. CONCLUSIONS COVID-19 disrupted important learning opportunities for medical students. Mentorship and shadowing are critical in helping students make career and specialty decisions, particularly for women. The loss of these opportunities may have lasting career impacts for all students.
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Affiliation(s)
| | | | | | - Amy H Farkas
- Medical College of Wisconsin, Milwaukee, Wisconsin; MCW Center for the Advancement of Women in Science and Medicine, Wisconsin
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Bernstein DN, Mesfin A. What's Important: Cross-Cultural Mentorship in Orthopaedic Surgery: Reflections from a Black Mentor and White Mentee. J Bone Joint Surg Am 2022; 104:293-295. [PMID: 34157010 DOI: 10.2106/jbjs.21.00328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- David N Bernstein
- Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Addisu Mesfin
- University of Rochester School of Medicine and Dentistry, Rochester, New York
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Hirshfield LE. The promise of a health professions education imagination. MEDICAL EDUCATION 2022; 56:64-70. [PMID: 34438470 DOI: 10.1111/medu.14628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
CONTEXT Social factors play a key role in health professions education and are thus a foundational topic that medical trainees must be taught. Although medical educators have discussed the best ways to teach these concepts for decades, there are still significant barriers to full incorporation of 'the social' into medical training. FRAMEWORK Building upon previous scholarship in medical education, the author argues for the development in trainees of a 'health professions education imagination' or a unique 'quality of mind' that facilitates navigating competing ways of knowing. This concept borrows explicitly from 'the sociological imagination', which is briefly described. Next, some of the principles of thinking that might contribute to a similar 'imagination' in health professions education are identified. Finally, exemplars are provided highlighting how recent scholars have used their health professions education imaginations in recent research and teaching practice. IMPLICATIONS The health professions education imagination provides a useful framework to help guide clinical and research trainees to integrate the epistemologically diverse forms of knowledge they are exposed to and to break down the silos that these forms of knowledge are commonly taught within.
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Affiliation(s)
- Laura E Hirshfield
- Department of Medical Education, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
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Humphries BA, Hwang PY, Kendrick AA, Kulkarni RP, Pozzar RA, San Martin R. Overstretched and overlooked: solving challenges faced by early-career investigators after the pandemic. Trends Cancer 2021; 7:879-882. [PMID: 34462237 PMCID: PMC8391088 DOI: 10.1016/j.trecan.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/27/2021] [Accepted: 07/30/2021] [Indexed: 12/05/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a detrimental effect on research. However, little has been done to identify and solve the unique challenges faced by early career investigators (ECIs). As a group of American Cancer Society-funded ECIs, we provide recommendations for solving these challenges in the aftermath of the pandemic.
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Affiliation(s)
- Brock A Humphries
- Center for Molecular Imaging, Department of Radiology, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Priscilla Y Hwang
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
| | - Agnieszka A Kendrick
- Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA, USA.
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health and Science University (OHSU), Portland, OR, USA; Department of Biomedical Engineering, Oregon Health and Science University (OHSU), Portland, OR, USA; Cancer Early Detection Advanced Research Center (CEDAR), Knight Cancer Institute, Oregon Health and Science University (OHSU), Portland, OR, USA; Operative Care Division, VA Portland Health Care System (VAPORHCS), Portland, OR, USA.
| | - Rachel A Pozzar
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Rebeca San Martin
- Biochemistry & Cellular and Molecular Biology, University of Tennessee, Knoxville, TN, USA.
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Roberts LW. Going Extraordinary Distances With Physician-Scientists. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:477-478. [PMID: 33782227 DOI: 10.1097/acm.0000000000003923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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