Structural inequities embedded in academic medicine persist across women’s careers
Key takeaways:
- Researchers identified four dominant themes experienced by women in academic medicine.
- The data may have long-term implications for the well-being and retention of women in medicine.
Women in medicine reported an overall perception of academic medicine as a “male-centric system misaligned with the needs of women,” according to study results published in JAMA Network Open.
The findings indicate that the combination of domestic obligations and “unaccommodating institutional environments” make it difficult for women clinician-scientists to progress in their careers, the researchers noted.
Scarce data
Qualitative data detailing the association of gender-based experiences with career progression, especially at the mid- to senior-career stage, remain scarce.
“Although women are now half of all medical students and have been well represented for many decades, women continue to be under-represented in the most influential leadership positions in medicine,” Reshma Jagsi, MD, DPhil, FASCO, FASTRO, Lawrence W. Davis professor, chair of the department of radiation oncology at Emory University School of Medicine and member of the Women in Oncology Peer Perspective Board, told Healio. “Understanding the mechanisms is important — this is a matter of equity and also affects the ability of the medical profession to serve its mission, as we want to have access to the full talent pool.”
For this reason, Jagsi and colleagues sought to examine the role gender has played in everyday professional experiences of mid- to senior-career women clinician-scientists and their perceptions of gender-associated barriers experienced across their careers.
The qualitative study included interviews from 31 female clinician-scientists (45.2% white; 29% identifying as members of a minority group underrepresented in medicine; 45.2% aged 40 to 49 years; 45.2% aged 50 to 59 years).
Dominant themes
Overall, 54.8% of women reported having children who required adult supervision or care, 22.6% had children who did not require supervision or care, and 19.4% did not have children.
Researchers identified four dominant themes experienced by women in academic medicine, including:
- mental burden of gendered expectations at work and home;
- inequitable treatment of women in bureaucratic processes;
- subtle and less subtle professional exclusion of women; and
- value of communities built on shared identities, experiences and solidarity.
“These findings suggest that structural inequities embedded in policies, processes, culture and norms of academic medicine may contribute to well-documented patterns of gender disparities in career advancement that persist across women’s careers,” Jagsi and colleagues wrote.
Researchers noted limitations of the study, including the fact that respondents who described experiencing academic medicine as “centered around male[s]” should not be interpreted to mean that academic medicine is hospitable for all men, as challenges described by women in the study also apply to men who deviate from traditional gendered roles and ideal worker norms.
Institutional efforts
Hearing the stories of these talented women, who had all held prestigious K-series career development awards from NIH earlier in their careers, was especially illuminating, Jagsi told Healio.
“We need to change the conversation away from a narrative about individual choices and towards one recognizing that family caregiving — one of the key challenges identified in this study and the focus of a recent report from the National Academies — is a broader societal obligation that must be supported,” she said. “Transforming culture to be more inclusive benefits us all and the talented people who will be able to contribute will undoubtedly advance health in our society. We are continuing this research with other observational survey and interview studies as well as a randomized trial of an intervention intended to promote gender equity in the field.”
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