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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Cutter CM, Szczygiel LA, Jones RD, Perry L, Mangurian C, Jagsi R. Strategies to Support Faculty Caregivers at U.S. Medical Schools. Acad Med 2023; 98:1173-1184. [PMID: 37257023 DOI: 10.1097/acm.0000000000005283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To describe the policies, processes, and programs at U.S. medical schools to support faculty caregivers before and in response to the COVID-19 pandemic. METHOD In 2021, the Doris Duke Charitable Foundation and founding members of the COVID-19 Fund to Retain Clinical Scientists (FRCS) Collaborative launched and supported the COVID-19 FRCS program to recognize medical schools and their efforts to strengthen policies, processes, and programs supporting biomedical faculty with family caregiving responsibilities in the context of COVID-19-related impacts. The authors conducted a qualitative conceptual content analysis of the deidentified, open-ended responses submitted by institutions in their applications to the COVID-19 FRCS program and summarized the reported strategies using recurring patterns and common approaches. RESULTS Fifty-four institutions applied to the COVID-19 FRCS program in 2021 and were included in this study. COVID-19-related impacts on biomedical faculty included stymied career progression and academic productivity, exacerbated career-caregiving time conflicts, adverse effects on family and personal well-being and mental health, increased financial hardships, and amplified faculty caregiver stigma. The described policies, processes, and programs to support faculty caregivers fell into 4 domains: support for dependent care, career and workplace flexibility, career development support, and institutional culture change to reduce stigma. COVID-19-related modifications spanned these domains with remote and flexible work manifesting as disruptive changes. Strategies to support women and underrepresented in medicine faculty, who bear a disproportionate burden of caregiving responsibilities, centered on career development support and institutional culture change. The projected durability of the enacted changes varied by institution and across strategies. CONCLUSIONS The COVID-19 pandemic presents a disruptive opportunity to translate lessons learned into positive change to better support faculty caregivers, particularly women and underrepresented in medicine faculty. This study's findings provide a framework to guide sustainable change to support equity, diversity, and vitality in the academic biomedical workforce.
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Affiliation(s)
- Christina M Cutter
- C.M. Cutter is assistant professor, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
| | - Lauren A Szczygiel
- L.A. Szczygiel is qualitative analyst, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
| | - Rochelle DeCastro Jones
- R.D. Jones is research area specialist senior, Center for Bioethics & Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan
| | - Lydia Perry
- L. Perry is research area specialist associate, Center for Bioethics & Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan
| | - Christina Mangurian
- C. Mangurian is professor, Departments of Psychiatry & Behavioral Sciences and Epidemiology & Biostatistics, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Reshma Jagsi
- R. Jagsi is the Lawrence W. Davis Professor and chair, Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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. Womens Health Rep (New Rochelle) 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] [What about the content of this article? (0)] [Affiliation(s)] [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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