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Gender Differences in Academic Promotions: Plus Ca Change Plus C’est La Meme Chose

 

Despite the increase in the number of women entering medical schools worldwide[1] their percentage in higher academic ranks and academic leadership positions is lagging behind. In 2011, women accounted for 47% of US Medical school matriculants and 37% of full time faculty [2], while the percentage of women in senior academic ranks is around 15%.

Mayer et al. [2], in a recent article in Academic Medicine, evaluated (i) the gender distribution of US medical faculty on the Traditional Tenure Track (TTT) and the more recently introduced Clinician Educator Track (CET) and (ii) the likelihood of appointment by gender to each of these tracks. The CET is one of several academic tracks that were introduced in the1970’s and 1980’s to meet faculty needs as they faced increasing educational and clinical demands. Faculty on this track have the primary responsibility of patient care and teaching. Publication of original research in peer reviewed journals may not be required to qualify for promotion to this track, and faculty on this track lag behind their TTT colleagues in academic promotion.

In this paper, the authors evaluate data obtained from the AAMC 2011 faculty roster that included information from 134 US Medical schools representing 138,508 full time faculty (64% male and 36% females). The TTT was reported to be present in around 92% of the schools and the CET in 79%. Among the schools reporting CET (n=83), 77% reported a higher proportion of females. Whilst for the schools with the TTT (n=102) only 20% had higher proportion of female faculty.

The findings of this paper are not surprising but still disappointing. They clearly highlight the fact that increasing matriculation of female physicians into medical schools is not sufficient to lead to gender equity at higher ranks. But then what would? Mentorship[3] is considered an important catalyst for career success in academic institutions. Women who have mentors or have been enrolled in formal mentoring programs have increased satisfaction in academia, increased ability to submit papers to peer reviewed journals and are less likely to seriously consider leaving academia[4]. Mentorship, however, did not translate into more women in the most senior positions.

Sponsorship[5] is a new concept borrowed from the corporate world and is suggested as a new model that might promote equity. Sponsors are neither mentors nor coaches (Table-1-). They are senior powerful members of the organization and could affect decision-making. Sponsorship programs have been effective in several corporate organizations where an unknown leadership talent was recognized and advanced. No such programs are yet introduced in academic medicine.

In summary, gender equity in academic promotions in Medicine has not met expectations. For the few women who made it to the top, it would be important to understand their unique characteristics as well as the formal and informal environments that helped them succeed.

Helpful Definitions
Mentoring[3] A dynamic reciprocal relationship in a work environment between an advanced career incumbent (mentor) and a beginner (protégée) aimed at promoting the development of both
Sponsorship[5] Is the public support by a powerful person for the advancement of an individual within who, he or he sees untapped leadership talent or potential
Coaching A strategy that enhances performance through direct observation and feedback
Role Models[5] Persons who serve as a model in a particular behavior or social role to emulate
Table -1-

For further reading on these topics consider:

  1. Chouchane, L., et al., Medical education and research environment in Qatar: a new epoch for translational research in the Middle East. J Transl Med, 2011. 9: p. 16.
  2. Mayer, A.P., et al., Gender Distribution of U.S. Medical School Faculty By Academic Track Type. Acad Med, 2013.
  3. Sambunjak, D., S.E. Straus, and A. Marusic, Mentoring in academic medicine: a systematic review. JAMA, 2006. 296(9): p. 1103-15.
  4. Fried, L.P., et al., Career development for women in academic medicine: Multiple interventions in a department of medicine. JAMA, 1996. 276(11): p. 898-905.
  5. Travis, E.L., L. Doty, and D.L. Helitzer, Sponsorship: a path to the academic medicine C-suite for women faculty? Acad Med, 2013. 88(10): p. 1414-7.

Reviewed for January 2014 by
Thurayya Arayssi, MD, FACP, FACR, FRCP
Associate Professor of Medicine
Associate Dean for Graduate Medical Education
Weill Cornell Medical College in Qatar