Sex Differences in Faculty Rank Among Academic Cardiologists in the United States

Abstract

Background Studies demonstrate that women physicians are less likely than men to be full professors. Comprehensive evidence examining whether sex differences in faculty rank exist in academic cardiology, adjusting for experience and research productivity, is lacking. Therefore, we evaluated for sex differences in faculty rank among a comprehensive, contemporary cohort of United States (US) cardiologists after adjustment for several factors that impact academic advancement, including measures of clinical experience and research productivity. Methods We identified all US cardiologists with medical school faculty appointments in 2014 using the American Association of Medical Colleges (AAMC) faculty roster, and linked this list to a comprehensive physician database from Doximity, a professional networking website for doctors. Data on physician age, sex, years since residency, cardiology sub-specialty, publications, National Institutes of Health (NIH) grants, and registered clinical trials were available for all academic cardiologists. We estimated sex differences in full professorship, adjusting for these factors and medical school-specific fixed effects in a multivariable regression model. Results Among 3810 cardiologists with faculty appointments in 2014 (13.3% of all US cardiologists), 630 (16.5%) were women. Women faculty were younger than men (mean age: 48.3 years vs 53.5 years, p<0.001), had fewer total publications (mean number: 16.5 publications vs. 25.2 publications, p<0.001), were similarly likely to have NIH funding (proportion with at least one NIH award: 10.8% vs. 10.4%, p=0.77), and were less likely to have a registered clinical trial (percentage with at least one clinical trial: 8.9% vs. 11.1%, p=0.10). Among 3180 men, 973 (30.6%) were full professors compared to 100 (15.9%) of 630 women. In adjusted analyses, women were less likely to be full professors than men (adjusted OR: 0.63, 95% CI: 0.43, 0.94, p = 0.02; adjusted proportions 22.7% vs. 26.7%, absolute difference −4.0%; 95% CI: −7.5% to −0.7%). Conclusions Among cardiology faculty at US medical schools, women were less likely than men to be full professors after accounting for several factors known to influence faculty rank.

How do we attract and retain women in cardiology?

“…Even with a growing number of female cardiologists in the last 20 years, major sex differences in professional advancement persist. A study of 3810 cardiologists with faculty appointments in 2014 found that women were much less likely to be full professors than men (hazard ratio: 0.63, 95% confidence interval: 0.43‐0.94, P = 0.02), consistent with earlier findings across all specialties . The study was a retrospective cross‐sectional study, so causation cannot be established.…”

Women Are Less Likely Than Men to Be Full Professors in Cardiology

“…We applaud Blumenthal et al 1 for conducting this methodologically sound and compelling study that clearly outlines the disparity that women face in academic cardiology. Their research should stimulate additional data gathering and implementation studies with the goal of ensuring that academic cardiology has the ability to foster the career of each individual cardiologist – regardless of their gender – to their full potential to contribute to a vibrant future of research, teaching, and clinical care.…”

“…Blumenthal et al 1 found considerable institutional variation in the gap between female and male cardiology professors. Relevant to this observation is research on institutional culture and gender bias in personnel decision-making.…”

“…External primes for objectivity such as wearing a white coat, carrying a stethoscope, or using honorific titles could foster gender bias – however unintentionally or unwittingly – in judgments about equally performing men and women that would advantage men. Blumenthal et al 1 found that infectious disease was the only other medical subspecialty with significantly lower odds of female than male full professors. If the gender gaps in cardiology and infectious disease occur at the same institutions, it might be fruitful to examine their institutional messaging and practices that might prime objectivity.…”

“…Often outside of conscious awareness, stereotypes can shape the decisions of those who determine who to admit, hire, promote, fund, and mentor in academic cardiology, and also influence individual cardiologists as they decide whether they “fit” in interventional or non-invasive cardiology, in research or clinical practice, or into the top leadership strata of academic cardiology. After adjusting for age, clinical experience, cardiology subspecialty, and multiple measures of research and clinical productivity, Blumenthal and colleagues, 1 in this issue of Circulation , found the odds of being a full professor were 37% lower among female than male U.S. academic cardiologists. Given that women comprise nearly half of medical school matriculates, in the face of the current and projected cardiology workforce shortage, with over half of current cardiologists over age 55, identifying barriers for women’s career advancement in academic cardiology is critical to attract women to the cardiology workforce.…”