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Le Rhun E, Boele F, Minniti G, Galldiks N, Taphoorn M, Piil K, Rudà R, Niclou SP, Geurts M, Preusser M, Weller M, Short SC, Dirven L. Gender balance and suitable positive actions to promote gender equality among healthcare professionals in neuro-oncology: The EANO positive action initiative. Neurooncol Pract 2024; 11:46-55. [PMID: 38222048 PMCID: PMC10785600 DOI: 10.1093/nop/npad064] [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] [Indexed: 01/16/2024] Open
Abstract
Background The proportion of women among healthcare and biomedical research professionals in neuro-oncology is growing. With changes in cultural expectations and work-life balance considerations, more men aspire to nonfull-time jobs, yet, leadership positions remain dominated by men. Methods The European Association of Neuro-Oncology (EANO) disparity committee carried out a digital survey to explore gender balance and actions suitable to promote gender equality. The survey was distributed among EANO members in 2021, with responses analyzed descriptively. Results In total, 262 participants completed the survey (141 women, 53.8%; median age 43). Respondents were neurosurgeons (68, 26.0%); neurologists (67, 25.6%), medical oncologists (43, 16.4%), or other healthcare or research professionals; 208 participants (79.4%) worked full-time. Positive action to enforce the role of women in neuro-oncology was deemed necessary by 180 participants (68.7%), but only 28 participants (10.7%) agreed that women only should be promoted until gender balance is reached. A majority of respondents (162, 61.8%) felt that women with an equivalent CV should be prioritized over men to reach gender balance. If in the future the balance favored women at higher positions, 112 respondents (42.7%) agreed to apply positive action for men. The top indicators considered relevant to measure gender balance were: salary for similar positions (183/228, 80.3%), paid overtime (176/228, 77.2%), number of permanent positions (164/228, 71.9%), protected time for research (161/227, 70.9%), and training opportunities (157/227, 69.2%). Conclusions Specific indicators may help to measure and promote gender balance and should be considered for implementation among healthcare professionals in neuro-oncology.
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Affiliation(s)
- Emilie Le Rhun
- Departments of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Florien Boele
- Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
- Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Giuseppe Minniti
- Department of Radiological Sciences, Oncology, and Anatomical Pathology, Sapienza University of Rome, Rome, Italy
| | - Norbert Galldiks
- Department of Neurology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany
- Center for Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, Cologne, Germany
| | - Martin Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Roberta Rudà
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy
| | - Simone P Niclou
- Department of Cancer Research, Luxembourg Institute of Health, Strassen, Luxembourg
- Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Marjolein Geurts
- The Brain Tumour Center at the Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Matthias Preusser
- Division of Oncology, Department of Medicine 1, Medical University, Vienna, Austria
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Susan C Short
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
- Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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McDaniel LM, Molloy MJ, Blanck J, Beck JB, Shilkofski NA. The Chief Residency in U.S. and Canadian Graduate Medical Education: A Scoping Review. TEACHING AND LEARNING IN MEDICINE 2024:1-10. [PMID: 38247430 DOI: 10.1080/10401334.2023.2298870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024]
Abstract
PHENOMENON Despite the nearly universal presence of chief residents within U.S. and Canadian residency programs and their critical importance in graduate medical education, to our knowledge, a comprehensive synthesis of publications about chief residency does not exist. An understanding of the current state of the literature can be helpful to program leadership to make evidence-based improvements to the chief residency and for medical education researchers to recognize and fill gaps in the literature. APPROACH We performed a scoping review of the literature about chief residency. We searched OVID Medline, PsycINFO, ERIC, and Web of Science databases through January 2023 for publications about chief residency. We included publications addressing chief residency in ACGME specialties in the U.S. and Canada and only those using the term "chief resident" to refer to additional responsibilities beyond the typical residency training. We excluded publications using chief residents as a convenience sample. We performed a topic analysis to identify common topics among studies. FINDINGS We identified 2,064 publications. We performed title and abstract screening on 1,306 and full text review on 208, resulting in 146 included studies. Roughly half of the publications represented the specialties of Internal Medicine (n = 37, 25.3%) and Psychiatry (n = 30, 20.5%). Topic analysis revealed six major topics: (1) selection of chief residents (2) qualities of chief residents (3) training of chief residents (4) roles of chief residents (5) benefits/challenges of chief residency (6) outcomes after chief residency. INSIGHTS After reviewing our topic analysis, we identified three key areas warranting increased attention with opportunity for future study: (1) addressing equity and bias in chief resident selection (2) establishment of structured expectations, mentorship, and training of chief residents and (3) increased attention to chief resident experience and career development, including potential downsides of the role.
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Affiliation(s)
- Lauren M McDaniel
- Department of Pediatrics, Division of Hospital Medicine, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - Matthew J Molloy
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jaime Blanck
- Informationist Services, Welch Medical Library, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jimmy B Beck
- Department of Pediatrics, Division of Hospital Medicine, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - Nicole A Shilkofski
- Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA
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Collazo A, Yu X, Jan Q, Xie CZ, Campbell KM. Trends Among Women in Academic Medicine Faculty Ranks. J Womens Health (Larchmt) 2024. [PMID: 38190298 DOI: 10.1089/jwh.2023.0886] [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: 01/10/2024] Open
Abstract
Introduction: Similar proportions of women and men have entered medical school since 2003. However, career advancement and promotion for women continues to be fraught with disparities and inequalities. Building on current literature, this study explores the rates of change of female faculty in faculty ranks over the last 10 years to gain a more comprehensive view of the faculty trends of women in academic medicine. Methods: Using the Faculty Administrative Management Online User System database, counts by gender and faculty rank at each Association of American Medical Colleges (AAMC) academic medical school were obtained. Statistical analysis was done using generalized estimating equations modeling to assess rates of change for each gender from 2012 to 2021. Results: Higher proportions of female faculty are concentrated at the Instructor and Assistant Professor level and lower proportions at the Associate Professor and Professor rank compared to male faculty. Over the study period, female faculty showed increased rate change compared to male faculty of 1.007 (95% confidence interval [CI]: 1.002-1.012) for Associate Professor rank and 1.012 (95% CI: 1.007-1.016) for Professor rank. At the Instructor and Assistant Professor levels, female faculty decreased at a relative rate of 0.980 (95% CI: 0.969-0.990) and 0.995 (95% CI: 0.992-0.997) each year, respectively. Conclusion: Female faculty continue to be concentrated at the junior faculty rank. Rate changes at the senior faculty rank for female faculty have slightly improved over the last 10 years compared to male faculty. However, this improvement is minimal, and work is still needed to achieve true gender equity in academic medicine.
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Affiliation(s)
- Ashley Collazo
- Department of Family Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Xiaoying Yu
- Department of Biostatistics and Data Science, University of Texas Medical Branch, Galveston, Texas, USA
| | - Quratulanne Jan
- Department of Family Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Cathy Z Xie
- Department of Family Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Kendall M Campbell
- Department of Family Medicine, University of Texas Medical Branch, Galveston, Texas, USA
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Lee MO, Flores B, Fassiotto M, Hobgood C. Career Advancement Among Women Physicians in Nine Academic Medicine Specialties. J Womens Health (Larchmt) 2023; 32:1073-1079. [PMID: 37192448 DOI: 10.1089/jwh.2022.0464] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
Objective: Gender parity lags in academic medicine. We applied the Rank Equity Index (REI) to compare the longitudinal progress of women's academic medicine careers. We hypothesized that women have different rank parity in promotion by specialty based on the proportion of women in the specialty. Materials and Methods: Aggregate data by sex for medical students, residents, assistant professors, associate professors, and professors in nine specialties were obtained from the Association of American Medical Colleges for 2019-2020. Specialties were clustered into terciles based on the proportion of women in the field: upper (obstetrics and gynecology, pediatrics, psychiatry), middle (internal medicine, emergency medicine, anesthesia), and lower (surgery, urology, and orthopedic surgery). We calculated the percentage representation by sex by specialty and rank to calculate REI. Specialty-specific REI comparisons between each rank were performed to assess parity in advancement. Results: Only specialties in the upper tercile recruited proportionally more women medical students to residency training. All specialties advanced women for the resident-to-assistant professor with psychiatry, internal medicine, emergency medicine, anesthesia, urology, and orthopedic surgery that promoted women faculty at rates above parity. No specialty demonstrated parity in advancement based on sex for the assistant professor-to-associate professor or associate professor-to-professor transitions. Conclusion: Gender inequity in advancement is evident in academic medicine starting at the assistant professor-to-associate professor stage, regardless of overall proportion of women in the specialty. This suggests a common set of barriers to career advancement of women faculty in academic medicine that must be addressed starting at the early career stage.
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Affiliation(s)
- Moon O Lee
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Brenda Flores
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California, USA
| | - Magali Fassiotto
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California, USA
| | - Cherri Hobgood
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Payne VL, Partridge B, Bozkurt S, Nandwani A, Butler JM. Accomplished women leaders in informatics: insights about successful careers. J Am Med Inform Assoc 2023; 30:1567-1572. [PMID: 37344150 PMCID: PMC10436152 DOI: 10.1093/jamia/ocad108] [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: 03/16/2023] [Revised: 05/22/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023] Open
Abstract
We sought to learn from the experiences of women leaders in informatics by interviewing women in Informatics leadership roles. Participants reported career challenges, how they built confidence, advice to their younger selves, and suggestions for attracting and retaining additional women. Respondents were 16 women in leadership roles in academia (n = 9) and industry (n = 7). We conducted a thematic analysis revealing: (1) careers in informatics are serendipitous and nurtured by supportive communities, (2) challenges in leadership were profoundly related to gender issues, (3) "Big wins" in informatics careers were about making a difference, and (4) women leaders highlighted resilience, excellence, and personal authenticity as important for future women leaders. Sexism is undeniably present, although not all participants reported overt gender barriers. Confidence and authenticity in leadership point to the value offered by individual leaders. The next step is to continue to foster an informatics culture that encourages authenticity across the gender spectrum.
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Affiliation(s)
- Velma L Payne
- Department of Community and Public Health, Kasiska Division of Health Sciences, Idaho State University, Meridian, Idaho, USA
| | | | - Selen Bozkurt
- Department of Medicine, Stanford University, Stanford, California, USA
| | | | - Jorie M Butler
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
- Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center of Innovation, Salt Lake City, Utah, USA
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Dorsey C, Arora VM, Carter K. Fixing Flexner: Disrupting and Rebuilding Academic Medicine for Women of Color to Lead. J Med Internet Res 2023; 25:e47773. [PMID: 37163317 DOI: 10.2196/47773] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/27/2023] [Indexed: 05/11/2023] Open
Abstract
In an effort to address the lack of compositional diversity seen in academic leadership, our generation has an opportunity to rebuild academic medicine in a way that welcomes, values, and supports the development and success of women of color.
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Affiliation(s)
- Chelsea Dorsey
- Department of Surgery, University of Chicago Medicine, Chicago, IL, United States
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
| | - Vineet M Arora
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
- Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
| | - Keme Carter
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
- Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
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Martinez CI, Sanchez AN, Frontera J, Lee MY, Escalon MX, Verduzco-Gutierrez M. Training Characteristics, Academic Accomplishments, and Motivation of Current Program Directors in Physical Medicine and Rehabilitation. Am J Phys Med Rehabil 2023; 102:254-260. [PMID: 36730836 DOI: 10.1097/phm.0000000000002139] [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: 02/04/2023]
Abstract
ABSTRACT This study aimed to report the training characteristics, academic accomplishments, and motivation of current US academic physical medicine and rehabilitation program directors.A 22-question survey was developed and disseminated via email in May 2020 to 91 current residency program directors who are members of the Association of Academic Physiatrists Residency Fellowship Program Director Committee. Follow-up emails were sent 2 and 4 wks after initial distribution, and the survey was closed after 6 wks in June 2020. Data collected were deidentified. Descriptive analysis was performed.Response rate was 49.5% (45/91); 64.4% of program directors were men, and 35.6% were women. Of the respondents, 75.4% were White/Caucasian, 6.7% were Hispanic/Latinx, 15.6% were Asian, and 2.2% were Black/African American. Moreover, 56% (9/16) of female program directors vs. 0% (0/29) of male program directors reported experiencing sex discrimination in the workplace.Four percent of program directors were full professors in physical medicine and rehabilitation when first appointed, 17% were associate professors, and 72% were assistant professors. Thirty-four percent of program directors had at least six peer-reviewed publications when first appointed.This survey provides insight to the training characteristics, accomplishments, and motivation of current program directors for physiatrists aspiring to enter these ranks and highlights the underrepresentation of women/minorities among leadership positions in physical medicine and rehabilitation.
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Affiliation(s)
- Claudia I Martinez
- From the Departments of Physical Medicine and Rehabilitation (CIM, JF) and Internal Medicine (ANS), McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas; H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (MYL); Department of Rehabilitation and Human Performance, The Mount Sinai Hospital/Icahn School of Medicine at Mount Sinai, New York, New York (MXE); and Department of Rehabilitation Medicine, Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas (MV-G)
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Gottlieb AS, Dandar VM, Lautenberger DM, Best C, Jagsi R. Equal Pay for Equal Work in the Dean Suite: Addressing Occupational Gender Segregation and Compensation Inequities Among Medical School Leadership. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:296-299. [PMID: 36512834 DOI: 10.1097/acm.0000000000005087] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
In 2022, the Association of American Medical Colleges published data from its annual Dean's Office Staff Compensation and Dean's Compensation Surveys in a new report addressing salary equity among medical school leadership. These data, disaggregated by gender and race/ethnicity, represent earnings of the senior most leaders in the dean suite and have historically been shared only with medical school Deans and principal business officers. The report shows that the highest-ranking decanal positions in U.S. medical schools are filled along the lines of traditional gender stereotypes (with men in clinical affairs and research affairs deanships and women in admissions, diversity affairs, faculty affairs, and student affairs deanships) and that the roles held mostly by men carry grander titles (e.g., senior associate dean vs assistant dean) and significantly higher salaries than those typically held by women. Additionally, within the same decanal positions, women earn lower median compensation than men. In this commentary, the authors describe limited advancement and lower compensation as foregone conclusions for women in medicine and science due to a professional model that places a premium on activities traditionally pursued by men. They define and characterize the impact of this occupational gender segregation in the dean suite and offer a roadmap for an alternative value system that recognizes complementary leadership activities across the mission areas of academic medicine and ensures that the contributions of women in the profession are appropriately recognized, valued, and rewarded.
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Affiliation(s)
- Amy S Gottlieb
- A.S. Gottlieb is associate dean for faculty affairs and professor, Departments of Medicine and Obstetrics and Gynecology, UMass Chan Medical School-Baystate, Springfield, Massachusetts
| | - Valerie M Dandar
- V.M. Dandar is director of medical school operations, Association of American Medical Colleges, Washington, DC
| | - Diana M Lautenberger
- D.M. Lautenberger is director of gender equity initiatives, Association of American Medical Colleges, Washington, DC
| | - Cynthia Best
- C. Best is vice dean for finance and administration, University of Utah School of Medicine, Salt Lake City, Utah
| | - Reshma Jagsi
- R. Jagsi is the Newman Family Professor and deputy chair, Department of Radiation Oncology, and director, Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, Michigan
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Holladay CL, Cavanaugh KJ, Perkins LD, Woods AL. Inclusivity in Leader Selection: An 8-Step Process to Promote Representation of Women and Racial/Ethnic Minorities in Leadership. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:36-42. [PMID: 36044272 DOI: 10.1097/acm.0000000000004956] [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
At a systemic level, organizations need to take intentional steps to build inclusion, equity, and diversity at all levels. In accordance with this need, organizations have been catalyzed by national conversations surrounding gender and racial/ethnic discrimination to generate sustainable change that addresses the disenfranchisement of women and racial/ethnic minorities. Although progress toward addressing the systemic issues that perpetuate these inequities has been made in recent years, research indicates that underrepresentation at the leadership level persists in academic medicine. Further, those in more senior roles are more likely to select, sponsor, and/or mentor individuals like themselves, thereby depriving minority populations of experiences directly correlated with career development and advancement. Hence, the authors posit a focus on the characteristics and competencies of a leader along with a structured selection process is an effective intervention to reduce bias and support inclusion by recalibrating the representation of leadership within academic medical centers. To this end, the authors developed a sequential 8-step leader selection process informed by their model of leadership characteristics and competencies. This process includes a policy update, selection of interview panels, training of panelists, screening the candidate pool, structured interview guides, final candidate slates, assessments of final candidates, and development of newly selected leaders. By following this process, the authors' organization has seen an increase in the representation of women and racial/ethnic minority leaders, an increase in employees' favorable perceptions specific to representation, and data indicative of developing and maintaining an internal diverse leadership candidate pipeline. Ultimately, inclusion makes stronger and more resilient organizations. By following a standardized process grounded in leadership characteristics and competencies, academic medical centers can see changes in their leadership that mirror the populations they lead and serve. Using such processes can lead to the kind of systemic change needed to create inclusive environments.
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Affiliation(s)
- Courtney L Holladay
- C.L. Holladay is associate vice president, Leadership Institute, Human Resources, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Katelyn J Cavanaugh
- K.J. Cavanaugh is senior analyst, Leadership Institute, Human Resources, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Larry D Perkins
- L.D. Perkins was associate vice president of talent and diversity, Human Resources, University of Texas MD Anderson Cancer Center, Houston, Texas, at the time of writing. He is currently retired
| | - Amanda L Woods
- A.L. Woods is associate analyst, Leadership Institute, Human Resources, University of Texas MD Anderson Cancer Center, Houston, Texas
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Jarman AF, Hobgood CD, Madsen TE. Moving Beyond Gender Disparities: A Call to Action for Gender Parity and Equity. Ann Emerg Med 2022; 80:65-67. [PMID: 35717113 PMCID: PMC10046989 DOI: 10.1016/j.annemergmed.2022.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Angela F Jarman
- Department of Emergency Medicine, University of California-Davis School of Medicine, Sacramento, CA.
| | - Cherri D Hobgood
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Tracy E Madsen
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI
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11
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Martinez CI, Sanchez AN, Knecht K, Frontera J, Escalon MX, Verduzco-Gutierrez M, Lee MY. Training Characteristics, Academic Accomplishments, and Motivation of Current Chairs in Physical Medicine and Rehabilitation. Am J Phys Med Rehabil 2022; 101:S62-S70. [PMID: 34347630 DOI: 10.1097/phm.0000000000001858] [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: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to report the training characteristics, academic accomplishments, and motivation of current United States academic physical medicine and rehabilitation chairs. DESIGN The authors developed a 23-question survey that was disseminated via e-mail to 86 current chairs who were members of the Chairs Council from the Association of Academic Physiatrists in May 2020. Follow-up e-mails were sent 2 and 4 wks after the initial distribution, and the survey closed after 6 wks in June 2020. The data collected were deidentified. Descriptive analysis was performed. RESULTS Forty-nine chair responses were received, which had a response rate of 60%. A total of 69.4% of the chairs (32 of 49) were men and 30.6% (17 of 49) were women. A total of 75.5% (37 of 49) were White/Caucasian, 12.2% (6 of 49) Hispanic/Latinx, 10.2% (5 of 49) Asian, and 2% (1 of 49) were Black/African American. A total of 8.2% of the chairs (4 of 49) reported having a disability. Sixty-seven percent of the female chairs (10 of 15) reported experiencing gender discrimination in the workplace versus 3% of male chairs (1 of 34). Twenty-nine percent of the chairs were full professors in physical medicine and rehabilitation when first appointed, 57.1% associate professors, and 6% assistant professors. A total of 73.5% of the chairs had served as a reviewer for a peer-reviewed publication. Fifty-two percent of the chairs had a leadership role in a national physical medicine and rehabilitation organization. Fifty-eight percent of the chairs had at least 16 peer-reviewed publications when first appointed. CONCLUSIONS This survey provides insight to the training characteristics, accomplishments, and motivation of current chairs for physiatrists aspiring to enter these ranks. It also highlights the underrepresentation of women and minorities among leadership positions in physical medicine and rehabilitation.
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Affiliation(s)
- Claudia I Martinez
- From the Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas (CIM, JF); Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas (ANS); Boonshoft School of Medicine at Wright State University, Dayton, Ohio (KK); Department of Rehabilitation and Human Performance, The Mount Sinai Hospital/Icahn School of Medicine at Mount Sinai, New York, New York (MXE); Department of Rehabilitation Medicine, Long School of Medicine at the University of Texas Health Science Center at San Antonio, San Antonio, Texas (MV-G); and H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (MYL)
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12
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Linden JA, Baird J, Madsen TE, Rounds K, Lall MD, Raukar NP, Fang A, Lin M, Sethuraman K, Dobiesz VA. Diversity of leadership in academic emergency medicine: Are we making progress? Am J Emerg Med 2022; 57:6-13. [PMID: 35462120 DOI: 10.1016/j.ajem.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Faculty who identify as women or racial/ethnic groups underrepresented in medicine (URiM) are less likely to occupy senior leadership positions or be promoted. Recent attention has focused on interventions to decrease this gap; thus, we aim to evaluate changes in leadership and academic promotion for these populations over time. METHODS Successive cross-sectional observational study of six years (2015 to 2020) of data from the Academy of Administrators/Association of Academic Chairs of Emergency Medicine- Benchmark Survey. Primary analyses focused on gender/URiM differences in leadership roles and academic rank. Secondary analysis focused on disparities during the first 10 years of practice. Statistical modeling was conducted to address the primary aim of assessing differences in gender/URiM representation in EM leadership roles/rank over time. RESULTS 12,967 responses were included (4589 women, 8378 men). Women had less median years as faculty (7 vs 11). Women and URiM were less likely to hold a leadership role and had lower academic rank with no change over the study period. More women were consistently in the early career cohort (within 10 years or less as faculty) : 2015 =-75.0% [95% CI:± 3.8%] v 61.4% [95% CI:± 3.0%]; 2020 =-75.1% [95% CI: ± 2.9%] v 63.3%, [95% CI:: ± 2.5%]. Men were significantly more likely to have any leadership role compared to women in 2015 and 2020 (2015 = 54.3% [95% CI: ± 3.1%] v 44.8%, [95% CI: ± 4.3%]; 2020 = 43.1% [95% CI:± 2.5%] v 34.8 [95% CI:± 3.1%]). Higher academic rank (associate/professor) was significantly more frequent among early career men than women in 2015 (21.1% [95% CI:± 2.58%] v 12.9%; [95% CI:± 3.0%]) and 2020 (23.1% [95% CI:± 2.2%] v 17.4%; [95% CI:± 2.5%]). CONCLUSIONS Disparities in women and URiM faculty leadership and academic rank persist, with no change over a six-year time span. Men early career faculty are more likely to hold leadership positions and be promoted to higher academic rank, suggesting early career inequities must be a target for future interventions.
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Affiliation(s)
- Judith A Linden
- Boston University School of Medicine, Boston, MA, United States of America.
| | - Janette Baird
- Warren Alpert School of Medicine at Brown University, Providence, RI, United States of America.
| | - Tracy E Madsen
- Warren Alpert School of Medicine at Brown University, United States of America.
| | - Kirsten Rounds
- Warren Alpert School of Medicine at Brown University, Providence, RI, Colorado Animal Specialty & Emergency, United States of America.
| | - Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States of America.
| | - Neha P Raukar
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States of America.
| | - Andrea Fang
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States of America.
| | - Michelle Lin
- Departments of Emergency Medicine and Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Kinjal Sethuraman
- Department of Emergency Medicine, University of Maryland, Baltimore, MD, United States of America.
| | - Valerie A Dobiesz
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
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13
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Wiler JL, Wendel SK, Rounds K, McGowan B, Baird J. Salary disparities based on gender in academic emergency medicine leadership. Acad Emerg Med 2022; 29:286-293. [PMID: 34689369 DOI: 10.1111/acem.14404] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There are significantly fewer women than men in leadership roles in health care. Previous studies have shown that, overall, male physicians earn nearly $20,000 more annually than their female physician colleagues after adjusting for confounding factors. However, there has not been a description of physician leadership compensation in relation to gender. METHODS This was a successive cross-sectional observation study design of 154 emergency departments in the United States from 5 years (2013, 2015-2018) using Association of Academic Chairs in Emergency Medicine and Academy of Administrators in Academic EM survey data. The primary variable of interest, leadership role, was attained by recoding the survey responses to assign primary job duty into four main categories: no leadership role, operations leadership, education leadership, and executive leadership. RESULTS Overall, 8820 responses were included. Across all survey years, the mean (±SD) percentage of women in any leadership role was significantly less than men (44.5% [95% CI: 42.8, 46.2%] vs. 55.3% [95% CI: 54.1, 56.5%]). Women in leadership roles worked more clinical hours than men in the same position (female median = 1008, male median = 960). Women also had significantly lower salaries than men at each of the 5-year time points that data are reported, with unadjusted mean salary differences of -$54,409 per year for executives, -$27,803 for operational leaders, and -$17,803 for education leaders. CONCLUSIONS Female physicians hold fewer leadership roles in academic emergency medicine (EM), and when they do, they work more clinical hours and are paid less than male physicians. As a specialty, EM should continue to investigate and report on gender achievement disparities as work is done to rectify the system inequalities.
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Affiliation(s)
- Jennifer L. Wiler
- Department of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA
- University of Colorado School of Medicine and UCHealth Denver Colorado USA
| | - Sarah K. Wendel
- Department of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA
| | | | - Becky McGowan
- Department of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA
| | - Janette Baird
- Department of Emergency Medicine Alpert Medical School of Brown University Providence Rhode Island USA
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14
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Chisolm‐Straker M, Quest T, Kline JA. AEM special issue on (in)equity in emergency medicine. Acad Emerg Med 2021; 28:946-948. [PMID: 34363646 DOI: 10.1111/acem.14364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
The year of 2020 was a momentous one for the United States. A confluence of purposely-designed systems' outcomes and deep histories of schism converged with a viral mutation to force the topic of (in)justice to re-enter mainstream conversation. Not since the Civil Rights Movement has the matter of (in)equity been in the homes of so many U.S. families and the (virtual) offices of so many workplaces. The disproportionate deaths of Indigenous, Black, Asian, and Latinx peoples in relation to Whites is long-known in communities of color and is well documented in public health.
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Affiliation(s)
- Makini Chisolm‐Straker
- Emergency Medicine Institute for Health Equity Research Icahn School of Medicine at Mount Sinai New York New York USA
| | - Tammie Quest
- Division of Palliative Medicine Emergency Medicine Emory Palliative Care Center Emory University School of Medicine Atlanta Georgia USA
| | - Jeffrey A. Kline
- Emergency Medicine Wayne State University School of Medicine Detroit Michigan USA
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