Wondering If I’d Get There Quicker If I Was a Man: Factors Contributing to Delayed Academic Advancement of Women in Infectious Diseases

Abstract

Background Gender inequities in academic advancement persist in many specialties, including infectious diseases (ID). Prior studies of advancement disparities have been predominantly quantitative, utilizing large physician databases or surveys. We used qualitative methods to explore ID physicians’ experiences and beliefs about causes and ways to mitigate gender inequities in advancement. Methods We conducted semi-structured focus group discussions with academic ID physicians in the US at IDWeek 2019 to explore perceived barriers and facilitators to academic advancement. Participants were assigned to focus groups based on their academic rank and gender. We analyzed focus group transcripts using content analysis to summarize emergent themes. Results We convened 3 women-only focus groups (one for instructors/assistant professors, one for associate professors and one for full professors) and one men-only focus group of full professors (total N = 50). Our analyses identified several major themes on barriers to equitable academic advancement, including (1) interpersonal and institutional gender bias, (2) difficulty balancing the demands of family life with work life, and (3) gender differences in negotiation strategies. Conclusions Barriers to gender equity in academic advancement are myriad and enduring and span the professional and personal lives of ID physicians. In addition to swift enactment of policy changes directed at critical issues like ending workplace harassment and ensuring adequate parental leaves for birth and non-birth parents, leaders in academic medicine must shine a bright light on biases within the system at large and within themselves to correct these disparities with the urgency required.

Paying for Parenthood: Understanding Parental Leave Policies in Infectious Disease Fellowship

“…Interestingly, although PDs in our study frequently misinterpreted ABIM leave policies, most correctly identified that equal time is permitted for birth and nonbirth parents. However, in practice, many nonbirth parent leaves were much shorter than birth parent leaves, a finding documented by others and felt to reflect implicit bias minimizing the role of nonbirth parents in early childcare [ 9 , 10 ]. In addition to excluding nonbirth parents from fully sharing in this crucial time of parent-child bonding, these leave length disparities may establish an early and often perpetuated dynamic by which birth parents (often women) assume the greater burden of childcare from the time of the child's birth, having a potential downstream longer-term impact on their career opportunities as they continue to shoulder a disproportionate amount of dependent care responsibilities.…”

Advancing health equity through action in antimicrobial stewardship and healthcare epidemiology

“…48 Intentional efforts to address leadership and speaking opportunities for women have led to improvements in gender equity 44,46,49 ; however, gaps remain related to pay 48 and promotion. [50][51][52] Many of these gaps reported for physicians undoubtedly exist for other healthcare team members such as pharmacists, infection preventionists, advanced practice clinicians, etc; however, data from these professional groups are sparse. [53][54][55][56] Furthermore, there is a dearth of data describing the contribution and impacts of infectious disease healthcare workers from lesbian, gay, bisexual, transgender, queer and nonbinary gender (LGBTQþ) communities or healthcare workers with disabilities.…”

“…48 Intentional efforts to address leadership and speaking opportunities for women have led to improvements in gender equity 44,46,49 ; however, gaps remain related to pay 48 and promotion. 50–52…”

Demographic representation among speakers at the Society for Healthcare Epidemiology of America (SHEA) spring conferences

“…[1][2][3][4] Inequitable representation across various leadership domains can affect opportunities for promotion and academic career development across different specialties, including the field of infectious diseases. [5][6][7][8][9][10][11][12][13][14][15][16] Persistent inequities are often discussed in the context of sex, race, and ethnicity, however equity gaps can exist across other domains, and are often intersectional. 17 Professional medical organizations have varied approaches to addressing representation gaps; intentional initiatives have resulted in more equitable representation in some target groups but not others.…”