CV matrix aims to improve gender equity by ‘accounting for COVID time’
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COVID-19 has dramatically changed the ways in which health care professionals carry out their careers.
Some providers have switched to telehealth platforms or taken on new leadership roles in COVID units, and many are having to delay research projects or cancel their invited talks at medical conferences.
Such professional shifts may widen gender disparities for women, who are known to withstand a disproportionate share of child and family caregiving responsibilities at home and who also comprise 76% of essential workers in health care, Vineet Arora, MD, MAPP, said during a Women in Medicine Summit webinar entitled, “COVID and gender equity: Let’s not lose ground.”
An example of how COVID-19 has widened the gender gap can be seen in scholarly publications. Journal editors have noted a decline in submissions from female authors since the start of the pandemic, Arora said, citing data from Andersen and colleagues showing a 19% decline in female first authors on COVID-19 papers compared with 2019 papers in the same journals. However, she cautioned that these are early preprint data.
That potential to lose ground is what caused Arora, the Herbert T. Abelson professor of medicine, assistant dean for scholarship and discovery, and associate chief medical officer of clinical learning environment at UChicago Medicine, to think about creating a “CV matrix” to help everyone, but especially women, better capture and account for their time during the pandemic.
“We put researchers, educators and clinicians into their home environments, took away their child care and, lo and behold, it unmasked these gender inequities that have already long existed,” Arora told Healio. “Women have often survived those by basically just patching it together and going to work. Now, we see this bleeding of work and home that unmasks that inequity.”
The CV matrix — a product of a collaboration between Arora and Shikha Jain, MD, FACP; Mark Shapiro, MDAvital O’Glasser, MD, FACP, FHM; and Charlie Wray, DO, MS, a team that has thought about how to document impact on curriculum vitae in other realms — is a template that can be used to update a current CV to demonstrate how time is being spent differently during the COVID-19 crisis.
“The goal is to account for COVID time and hopefully utilize the successes and achievements that we aren’t necessarily able to capture on a traditional CV,” Jain, assistant professor of medicine in the division of hematology, oncology and cell therapy at University of Illinois Cancer Center, told Healio. “We’re also hoping that this work will be able to be utilized by promotions and tenure committees to better document impact of work that is not traditionally considered to be purely academic.”
'People should not be penalized for the pandemic'
The CV matrix prompts users to describe how the COVID-19 pandemic changed their clinical, research and educational responsibilities.
Changes in clinical work that should be documented include shifting to a home telehealth practice, for instance, and the time it took to set up such a practice. Anyone who was redeployed during the pandemic should make note of their new responsibilities and their preparation for that new role, Arora said.
“Many people have assumed leadership roles that may not be traditional, like a hospitalist leading a COVID unit or an oncologist trying to figure out how to keep their patients safe when coming in for their chemotherapy, for example,” she said. “If someone was doing 6 weeks of COVID unit service, that might be all that was in their matrix, and that’s OK. It’s important to understand this person was probably not focused on their scholarly work.”
In the education category, the CV matrix may include any transitions to virtual learning and the preparation that entailed.
“I know people who are spending hours trying to figure out how to convert fellowship or residency interviews to virtual,” Arora said. “All of that preparation and work should go into a CV, and currently there is no place for it. All of this is work that needs to be accounted for.”
Although the pandemic has impelled new research projects, many others have been disrupted. Arora said both should be accounted for on a CV.
Likewise, any talks or conferences that have been canceled due to the pandemic should still be included on a CV, Jain said.
“Any invitations to give talks should be identified because that is an opportunity where someone identified you as a leader and wanted you to come speak at a conference,” she said. “It shouldn’t be left off of the CV just because the conference was canceled due to COVID.”
Arora added that canceled opportunities should be given equal weight by promotion and tenure committees.
“Criteria for promotions really depend on impact and regional, national and international recognition,” she said. “If you were invited to give a talk, that is recognition in and of itself, even if you weren’t able to go because of COVID. That should be rewarded. People should not be penalized for the pandemic.”
Capturing 'outside-of-the-box activities'
Even before the pandemic, Arora, Jain and colleagues were discussing how social media activities should be documented on a CV.
“That’s where this all started,” Arora said. “We have already written about how to capture outside-of-the-box activities, like social media, on a CV. Now, there’s a lot of valuable education and dissemination that is happening on social media that we need to pay attention to. The people who are doing it well should get the credit for it.”
Many health care professionals also have taken on nontraditional service and advocacy roles during the pandemic, Jain said. For example, some have used social media to help coordinate allocation of personal protective equipment in their regions, she said.
“There’s been a great deal of advocacy work on social media. For example, our local advocacy group, IMPACT [Illinois Medical Professionals Action Collaborative Team], has been able to get petitions and letters sent with hundreds and sometimes thousands of physicians’ signatures to the governor’s office and to the mayor,” she said. “Physicians are using social media to disseminate evidence-based information and to try to combat the misinformation and the confusion coming out. Social media also has been playing a very large role in how we are interacting with our colleagues from across the country and really across the world.”
Further, although family obligations traditionally are not considered an appropriate component of a CV, the COVID-19-adjusted matrix dictates that any new or heightened caregiving responsibilities should be noted.
“The matrix is important because it allows people to document the disruption of their work due to caregiving responsibilities, and that may include, especially for women, child care,” Arora said. “Our kids are home, and with women doing a disproportionate share of child care at home, that needs to be figured in. If a woman in medicine is redeployed doing telehealth and has her kids in the background, how is she going to be productive in her scholarly pursuits?”
Currently, CVs function as a “deficiency model,” Arora said. A promotions committee might review a woman’s CV and note a drop in productivity one year, and someone will randomly volunteer, if not formally documented, that she had a baby that year.
“The information is solicited voluntarily, and the committee says, ‘OK, we’ll give her a pass that year,’” Arora said. “But, this is an important concept: a CV packet for promotion and tenure should not just focus on your contributions, but what other personal and professional hurdles you were facing at the time. For example, what if you had to take FMLA to care for family members with COVID?
“These are all extenuating circumstances that need to be factored in,” she added. “Just like you’re clocking work hours, how many hours are you putting toward child care? By considering it formally, we get a better sense of someone’s whole life during COVID. It might be hard at first for promotions committees, but it’s like everything else. The COVID pandemic has unmasked these inequities that have already existed.”
A new tool
Jain and Arora said the reception to the CV matrix has been tremendous so far, with many leaders from national physician organizations offering to help promote and disseminate it.
“I think people are looking for tools,” Arora said. “This is a tool you can have in your toolbox to account for your time. There are many people feeling shame if they aren’t on the front lines, or if they’ve got their kids in the background while they’re doing telehealth, or if they’ve missed a deadline because they are doing COVID unit work. There is something about giving people a way to document their impact during this time — whatever that may be, including the disruptions that they’ve had — that makes people feel better.”
The matrix intends to document changes in work that occurred specifically during the pandemic, but it also can help demonstrate on a CV how one’s career might be changing.
“We’re going to see a lot of jobs pivot,” Arora said. “Your prior work may no longer have the relevance that it needs going forward, or perhaps your skill set is in such high demand that you need to pivot for that reason. CVs are often used to reflect a trajectory, so this can be used to help understand why your career pivoted in such a way.”
Ultimately, the matrix is intended to “prevent health care from taking a major backslide toward systemwide inequities,” Jain said.
“Not only tenure and promotions committees, but health care in general needs to be intentional in the decisions that are being made going forward and how we restructure health care systems to address these inequities and fix the system now,” she said. “It’s imperative that these disparities that we know have existed for so long will be addressed by improving the system.”
For more information:
Vineet Arora, MD, MAPP, can be reached at varora@medicine.bsd.uchicago.edu and on Twitter @FutureDocs.
Shikha Jain, MD, FACP, can be reached at sjain25@uic.edu and on Twitter @ShikhaJainMD.
References:
- Andersen JP, et al. Elife. 2020;doi:10.7554/eLife.58807.
- Arora V. “COVID-19 and equity: Let’s not lose ground.” Presented at: Women in Medicine Summit webinar; May 28, 2020. Available at: www.womeninmedicinesummit.org/webinars. Accessed June 22, 2020.
- Arora V, et al. COVID-19 contribution matrix addendum for CV. Available at: www.explorethespaceshow.com/white_papers/covid19-contributions-on-a-professional-cv/. Accessed June 22, 2020.
- Explore the Space. White papers. Available at: www.explorethespaceshow.com/white-papers/. Accessed June 22, 2020.
- IMPACT. Available at: hwww.impact4hc.com/. Accessed June 22, 2020.
- Shapiro M, et al. Social media, podcasts, and blogs on a professional curriculum vitae. Available at: www.explorethespaceshow.com/wp-content/uploads/2019/04/White-Paper-Social-Media-Podcasts-and-Blogs-on-a-Professional-Curriculum-Vitae.pdf. Accessed June 22, 2020.
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