Sponsorship and Negotiation for Women Otolaryngologists at Midcareer: A Content Analysis

Abstract

Objective To explore challenges and opportunities for supporting midcareer women otolaryngologists in the areas of negotiation and sponsorship. Study Design Qualitative approach using semistructured interviews. Setting Online multi-institutional interviews. Methods This study was performed from June to August 2021. Women otolaryngologists representing diverse subspecialties, training, and practice environments were recruited via a purposive criterion-based sampling approach. Semistructured interviews were transcribed, coded, and analyzed via an inductive-deductive approach to produce a thematic content analysis. Results Among the 12 women interviewees, who represented 7 subspecialties, the majority were Caucasian (58%) and in academic practice (50%). The median residency graduation year was 2002 (range, 1982-2013). Participants expressed several challenges that women otolaryngologists face with respect to negotiation, including the absence of systematic formal negotiation training, gendered expectations that women experience during negotiations, and a perceived lack of power in negotiations. Obstacles to effective sponsorship included difficulty in the identification of sponsors and the influence of gender and related systemic biases that hindered sponsorship opportunities. Conclusion Notable gender disparities exist for negotiation and sponsorship in the midcareer stage for women otolaryngologists. Women start at a disadvantage due to a lack of negotiation training and access to sponsors, which is exacerbated by systemic gender bias and power differentials as women advance in their careers. This study highlights opportunities to improve negotiation and sponsorship for women, with the goal of promoting a more diverse workforce.

Sponsorship in Otolaryngology–Head and Neck Surgery

“…6,10,14,15 Despite the potential benefits of sponsorship, historically marginalized individuals continue to face barriers to receiving effective sponsorship, as outlined later and summarized in Figure 2. [10][11][12][13][16][17][18][19][20][21][22][23][24][25] Defining the Problem: Rationale for Sponsorship…”

“…22,23,28,29 Bias in Selecting Recipients and Types of Sponsorship While there are examples of sponsorship of individuals from historically marginalized communities within OHNS, such efforts are not enough to compensate for the systemic bias in who receives sponsorship. 16 Homophily, or the tendency for like groups to network, amounts to an unconscious affinity bias that perpetuates a lack of diversity; this phenomenon is associated with the tendency of White men to preferentially sponsor individuals with backgrounds similar to their own. 9,30 Homophily entails a high degree of inherent trust, 31 which makes it easier for sponsors to accept the risk to their reputation and sociopolitical power when they commit to a sponsee.…”

“…The literature suggests that individuals from historically marginalized communities often seek out or are given roles that are local or non-revenue-generating or confer little prestige or potential for upward mobility. [16][17][18]29 Even if the work is of high value for the organization, such as equity, diversity, and inclusion (EDI) activities, these undertakings have historically not been incorporated into the advancement paradigms of academic medicine. Thus, performing these tasks takes away time and effort that could have been devoted to more traditionally rewarded responsibilities.…”

“…Within the context of residency, a similar situation arises after graduation; natural structures that provide sponsorship fade away, thus leaving a void in the mid-career stage. 16,19,35 This situation can be proactively countered with programs for mid-career physicians. Some approaches to incentivizing sponsorship efforts include providing recognition, protected time, or resources for sponsors.…”

“…24,36 Additionally, fostering professional homes for different communities, such as the Women in Otolaryngology Section of the American Academy of Otolaryngology-Head and Neck Surgery, contributes to a culture of sponsorship. 16 Each intersectional sponsor and sponsee dyad can contribute to work satisfaction, diversity, and retention. Sponsorship contributes to a multiplier effect in which the sponsee eventually becomes a prolific sponsor and champion for a mutually reinforcing sponsorship culture.…”