An Integrated Framework for Gender Equity in Academic Medicine

Abstract

In 2008, the National Institutes of Health funded 14 R01 grants to study causal factors that promote and support women's biomedical careers. The Research Partnership on Women in Biomedical Careers, a multi-institutional collaboration of the investigators, is one product of this initiative.A comprehensive framework is needed to address change at many levels-department, institution, academic community, and beyond-and enable gender equity in the development of successful biomedical careers. The authors suggest four distinct but interrelated aspects of culture conducive to gender equity: equal access to resources and opportunities, minimizing unconscious gender bias, enhancing work-life balance, and leadership engagement. They review the collection of eight articles in this issue, which each address one or more of the four dimensions of culture. The articles suggest that improving mentor-mentee fit, coaching grant reviewers on unconscious bias, and providing equal compensation and adequate resources for career development will contribute positively to gender equity in academic medicine.Academic medicine must adopt an integrated perspective on culture for women and acknowledge the multiple facets essential to gender equity. To effect change, culture must be addressed both within and beyond academic health centers (AHCs). Leaders within AHCs must examine their institutions' processes, resources, and assessment for fairness and transparency; mobilize personnel and financial resources to implement evidence-based initiatives; and assign accountability for providing transparent progress assessments. Beyond AHCs, organizations must examine their operations and implement change to ensure parity of funding, research, and leadership opportunities as well as transparency of assessment and accreditation.

Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union

“…Remarkably, hospital management now seems to be more permeable for women than academic management. Although changes in gender equality are driven by many different factors [10, 17–22], our findings call for a closer look at the effects of the new modes of hospital governance and clinical management [23] on gender equality. Hospital governance has moved decision-making powers to the level of organisational units and has engaged doctors in management more closely [24].…”

Compensation of Otolaryngologists in the Veterans Health Administration: Is There a Gender Gap?

“…This allowed for individuals to compare themselves to their colleagues for similar work loads. Individuals empowered with objective salary data can seek salary adjustments for work that is comparable to their colleagues . Designed to simplify and improve pay provisions for physicians employed by the Department of Veterans Affairs, the Department of Veteran Affairs Health Care Personnel Enhancement Act of 2004 established pay levels with minimum and maximum salaries .…”

Women in leadership and the bewildering glass ceiling

“…55,75,76 As part of developing more equitable hiring practices, organizations should use diverse search/hiring committees where applicable and provide training that addresses conscious and unconscious (implicit) gender bias. 60,76 Other strategies recommended for organizational consideration in efforts to improve representation by women in leadership roles include 45,72,73 • Setting targets for advancing women in leadership roles (for example, having a goal that 50% of executive positions will be filled by women), • Tracking leadership metrics (e.g., the number of women versus men in leadership roles relative to the entire work force) and studying and appropriately correcting detected inequities, • Identifying and cultivating potential women leaders early in their careers, • Sharing the success stories of women leaders to inspire others, 55 At the individual level, women must also act as their own advocates by seeking out networks, sponsors, and mentors; building social capital; and marketing themselves and their contributions to the organization. 6 Women in CEO and senior-level positions offer the following advice to women: 61,74,75,77,78 • Be appropriately assertive in promoting yourself.…”

“…43,60 The lack of role models, in particular, may feed into the lack of a leadership mentality among women; if they do not see other women successfully attaining leadership positions, they may not believe that they themselves can achieve such positions. Additionally, the importance of mentorship and sponsorship to the success of women pursuing executive and senior roles cannot be overstated.…”