Women comprise nearly half of all residents in training, yet there is a significant disparity of women in academic leadership. Surgical subspecialties are dominated by men in both percentages of ...physicians and leadership positions. We sought to examine the association of advanced non-medical degrees with academic rank and gender in academic surgery departments.
Faculty from 126 ACGME-accredited academic medical centers were analyzed to identify faculty gender as described in online biographical information, advanced non-medical degrees, academic rank, and additional leadership positions held. Descriptive statistics and logistic regression models were used for statistical analyses.
4536 surgeons were identified, 69.3% men, 27.3% female, and 3.3% unlisted. Female surgeons were more likely to hold advanced non-doctoral degrees than men (18.2% vs. 13.8%, p < 0.002). Among those with advanced degrees, PhDs were held by 3.3% of women and 5.7% of men (p < 0.001). Female surgeons were less likely to hold the rank of Professor than male surgeons (15.8% vs 30.3%, p < 0.001), and more likely to hold the rank of Assistant Professor than male surgeons (51.9% vs 36.1%, p < 0.001). This likelihood remained true when analyzing only surgeons with one or more advanced non-medical degrees. Men were more likely to be Chair of Surgery (3.0%), Division Chief (9.6%), and Research Chair (0.5%); compared to women (1.3%; 4.8%; 0.2%; p = 0.001, <0.001, 0.21 respectively).
There continues to be a significant male predominance in general surgery. Gender discrepancy is also seen in professional rank and academic title despite women holding more advanced degrees. Advanced degrees are currently considered academic qualifications, but this does not reflect surgical academic leadership roles or rank.
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•Causes of gender disparities in academic surgery are multifactorial.•Female surgeons are more likely to hold non-medical advanced academic degrees.•Female surgeons hold fewer leadership positions in academic surgery.•Female surgeons are likely to hold lower rank of professor than male surgeons.
There is a chronic gender imbalance in academic radiology departments, which could limit our field's ability to foster creative, productive, and innovative environments. We recently reviewed 51 major ...academic radiology faculty rosters and discovered that 34% of academic radiologists are women, but only 25% of vice chairs and section chiefs and 9% of department chairs are women.
Active intervention is needed to correct this imbalance, which should start with awareness of the issue, exposing medical students to radiology early in their training, and implementing better mentorship programs for female radiologists.
Endowed chairs and professorships are prestigious and financially important awards that symbolize individual faculty recognition. However, data about the gender distribution of these positions are ...lacking. The purpose of this study was to examine the gender distribution of endowed positions at U.S. medical schools and identify strategies that have been used to promote investiture of women into these positions.
The authors interrogated the websites for all U.S. medical schools for publicly available data. Of 38 schools that listed schoolwide information, they analyzed data from the 30 with at least 10 endowed positions. Then, they conducted interviews with deans of the 10 schools with the highest percentages of women holding endowed positions ("top 10") to understand the strategies they used to increase gender equity in this area.
The percentage of endowed positions held by women at the 30 schools analyzed ranged from 10.8% to 34.6%, with a mean of 21.6%. Themes that emerged from interviews with deans included (1) intentionality to identify women candidates in the selection process, (2) monitoring the numbers of women holding endowed positions, (3) inclusion of endowed positions as part of larger institutional goals on gender equity and diversity, (4) use of endowed positions to recruit, retain, and recognize women faculty, (5) purposeful fundraising to increase the number of endowed positions, and (6) institutional investment of resources to develop women faculty.
Analysis of the gender distribution of endowed positions across 30 representative U.S. medical schools revealed a significant gender disparity. Interviews with deans at the top 10 schools revealed strategies that they have used to promote equity in this important area. Implementation of a systematic national reporting process could provide schools with comparative data to gauge their progress.
ABSTRACT
BACKGROUND
Energized and productive faculty are critical to academic medicine, yet studies indicate a lack of advancement and senior roles for women.
OBJECTIVE
Using measures of key aspects ...of the culture of academic medicine, this study sought to identify similarity and dissimilarity between perceptions of the culture by male and female faculty.
DESIGN
The C - Change Faculty Survey was used to collect data on perceptions of organizational culture.
PARTICIPANTS
A stratified random sample of 4,578 full-time faculty at 26 nationally representative US medical colleges (response rate 52 %). 1,271 (53 %) of respondents were female.
MAIN MEASURES
Factor analysis assisted in the creation of scales assessing dimensions of the culture, which served as the key outcomes. Regression analysis identified gender differences while controlling for other demographic characteristics.
KEY RESULTS
Compared with men, female faculty reported a lower sense of belonging and relationships within the workplace (
T = −
3.30,
p <
0.01). Self-efficacy for career advancement was lower in women (
T = −
4.73,
p <
0.001). Women perceived lower gender equity (
T = −
19.82,
p <
0.001), and were less likely to believe their institutions were making changes to address diversity goals (
T = −
9.70,
p <
0.001). Women were less likely than men to perceive their institution as family-friendly (
T = −
4.06,
p <
0.001), and women reported less congruence between their own values and those of their institutions (
T = −
2.06,
p <
0.05). Women and men did not differ significantly on levels of engagement, leadership aspirations, feelings of ethical/moral distress, perception of institutional commitment to faculty advancement, or perception of institutional change efforts to improve support for faculty.
CONCLUSIONS
Faculty men and women are equally engaged in their work and share similar leadership aspirations. However, medical schools have failed to create and sustain an environment where women feel fully accepted and supported to succeed; how can we ensure that medical schools are fully using the talent pool of a third of its faculty?
Health system leaders are calling for reform of medical education programs to meet evolving needs of health systems. U.S. medical schools have initiated innovative curricula related to health systems ...science (HSS), which includes competencies in value-based care, population health, system improvement, interprofessional collaboration, and systems thinking. Successful implementation of HSS curricula is challenging because of the necessity for new curricular methods, assessments, and educators and for resource allocation. Perhaps most notable of these challenges, however, is students' mixed receptivity. Although many students are fully engaged, others are dissatisfied with curricular time dedicated to competencies not perceived as high yield. HSS learning can be viewed as "broccoli"-students may realize it is good for them in the long term, but it may not be palatable in the moment. Further analysis is necessary for accelerating change both locally and nationally.With over 11 years of experience in global HSS curricular reform in 2 medical schools and informed by the curricular implementation "performance gap," the authors explore student receptivity challenges, including marginalization of HSS coursework, infancy of the HSS field, relative nascence of curricula and educators, heterogeneity of pedagogies, tensions in students' perceptions of their professional role, and culture of HSS integration. The authors call for the reexamination of 5 issues influencing HSS receptivity: student recruitment processes, faculty development, building an HSS academic "home," evaluation metrics, and transparent collaboration between medical schools. To fulfill the social obligation of meeting patients' needs, educators must seek a shared understanding of underlying challenges of HSS innovations.
Grit has been defined as "perseverance and passion for long-term goals" and is characterized by maintaining focus and motivation toward a challenging ambition despite setbacks. There are limited data ...on the impact of grit on burnout and psychologic well-being in orthopaedic surgery, as well as on which factors may be associated with these variables.
(1) Is grit inversely correlated with burnout in orthopaedic resident and faculty physicians? (2) Is grit positively correlated with psychologic well-being in orthopaedic resident and faculty physicians? (3) Which demographic characteristics are associated with grit in orthopaedic resident and faculty physicians? (4) Which demographic characteristics are associated with burnout and psychologic well-being in orthopaedic resident and faculty physicians?
This study was an institutional review board-approved interim analysis from the first year of a 5-year longitudinal study of grit, burnout, and psychologic well-being in order to assess baseline relationships between these variables before analyzing how they may change over time. Orthopaedic residents, fellows, and faculty from 14 academic medical centers were enrolled, and 30% (335 of 1129) responded. We analyzed for the potential of response bias and found no important differences between sites in low versus high response rates, nor between early and late responders. Participants completed an email-based survey consisting of the Duckworth Short Grit Scale, Maslach Burnout Inventory-Human Services (Medical Personnel) Survey, and Dupuy Psychological Well-being Index. The Short Grit Scale has been validated with regard to internal consistency, consensual and predictive validity, and test-retest stability. The Psychological Well-being Index has similarly been validated with regard to reliability, test-retest stability, and internal consistency, and the Maslach Burnout Inventory has been validated with regard to internal consistency, reliability, test-retest stability, and convergent validity. The survey also obtained basic demographic information such as survey participants' age, gender, race, ethnicity, marital status, current year of training or year in practice (as applicable), and region of practice. The studied population consisted of 166 faculty, 150 residents, and 19 fellows. Beyond the expected age differences between sub-populations, the fellow population had a higher proportion of women than the faculty and resident populations did. Pearson correlations and standardized β coefficients were used to assess the relationships of grit, burnout, psychologic well-being, and continuous participant characteristics.
We found moderate, negative relationships between grit and emotional exhaustion (r = -0.30; 95% CI -0.38 to -0.21; p < 0.001), depersonalization (r = -0.34; 95% CI -0.44 to -0.23; p < 0.001), and the overall burnout score (r = -0.39; 95% CI -0.48 to -0.31; p < 0.001). The results also showed a positive correlation between grit and personal accomplishment (r = 0.39; 95% CI 0.29 to 0.48; p < 0.001). We also found a moderate, positive relationship between grit and psychologic well-being (r = 0.39; 95% CI 0.30 to 0.49; p < 0.001). Orthopaedic surgeons with 21 years or more of practice had higher grit scores than physicians with 10 to 20 years of practice. Orthopaedic surgeons in practice for 21 years or more also had lower burnout scores than those in practice for 10 to 20 years. Married physicians had higher psychologic well-being than unmarried physicians did.
Among orthopaedic residents, fellows, and faculty, grit is inversely related to burnout, with lower scores for emotional exhaustion and depersonalization and higher scores for personal accomplishment as grit increases.
The results suggest that grit could be targeted as an intervention for reducing burnout and promoting psychologic well-being among orthopaedic surgeons. Other research has suggested that grit is influenced by internal characteristics, life experiences, and the external environment, suggesting that there is potential to increase one's grit. Residency programs and faculty development initiatives might consider measuring grit to assess for the risk of burnout, as well as offering curricula or training to promote this psychologic characteristic.
This article shares our experiences and surprises as we developed, implemented and evaluated a 12-week faculty development program for registrars as clinical supervisors over three cohorts. The ...program has consistently been rated highly by participants. Yet, following a comprehensive curriculum review, we were surprised that our goal of encouraging identity development in clinical supervisors seemed to be unmet. Whilst our evaluation suggests that the program made important contributions to the registrars’ knowledge, application and readiness as clinical supervisors, challenges linked to developing a supervisor identity and managing the dual identity of supervisor and clinician remain. In this article we describe our program and argue for the importance of designing faculty development programs to support professional identity formation. We present the findings from our program evaluation and discuss the surprising outcomes and ongoing challenges of developing a cohesive clinical educator identity. Informed by recent evidence and workplace learning theory we critically appraise our program, explain the mechanisms for the unintended outcomes and offer suggestions for improving curricular and pedagogic practices of embedded faculty development programs. A key recommendation is to not only consider identity formation of clinical supervisors from an individualist perspective but also from a social perspective.