National organizations provide women with tools for overcoming barriers in medicine

Numerous barriers have resulted in unequal compensation, limited earning potential and fewer opportunities for career advancement for women in medicine, according to a speaker at the virtual Women in Medicine Summit.

However, active participation and engagement in professional organizations and networks provide an opportunity for women to overcome these barriers, Neelum T. Aggarwal, MD, FAMWA, associate professor in the department of neurological sciences and senior neurologist at Rush University’s Alzheimer’s Disease Center, told attendees. The ability to overcome these barriers is “now more important than ever,” as the COVID-19 pandemic has put an even greater focus on these disparities, she continued.

“Women physicians are underrepresented in faculty ranks. We see this across the board and we also see that this is related to earning potential and initial salaries. We are underpaid compared with men for providing the same work,” Aggarwal said. “Whenever I talk about this with my colleagues that are not in medicine, they shake their heads. How can that be when you are coming from such a stringent type of training where everybody, even in training, is doing the same thing? This is something we need to raise more awareness about.”

Women earn up to 30% less than men for the same work in multiple fields, including health care, according to Aggarwal. In medicine, the gap between women and men begins after residency and fellowship training. Women hold fewer “key leadership positions,” making up only 17% of department chairs and 20% of deans, and tend to hold administrative and support roles in an office, such as assistant deans (46%), associate deans (38%) and senior associate deans (34%), according to survey data from the Group on Women in Medicine and Science that Aggarwal shared in her presentation. She said one “really shocking statistic” demonstrated that the only academic rank with more women than men is that of instructor.

“We tend to be in office administrative roles,” she said, noting the difference between support vs. leadership. “They look good, the titles sound good, but if you look at it, it’s really a support role.”

Disparities represent ‘a double standard’

Multiple barriers have led to this discrepancy between men and women in medicine, according to Aggarwal. These barriers include conscious and unconscious biases, lack of sponsorship, lack of work/life integration and lack of negotiation skills, especially with male negotiators. These factors have a range of effects on one’s career, she continued, and impact women across the entire spectrum of their career, from medical student to attending physician.

Aggarwal highlighted specific ways in which the lack of work-life integration can impact a woman’s career, which she called “the environment effect.” First, she discussed the fact that caring for children and elderly family members falls to female physicians more often than male physicians; she also noted that caring for elderly family members “will take over as the major threat” to career advancement, even more than the glass ceiling. According to Aggarwal, the workplace “has not evolved to address these issues.”

She described unconscious bias as a “really important” factor that impacts women in medicine. Women face challenges with job retention because, in part, they are not equally valued or compensated, which results in fewer opportunities for career advancement and reduces earning potential, according to Aggarwal. They also have fewer opportunities for sponsorship, networking, mentorship and coaching.

Aggarwal demonstrated the impact of implicit bias, which also affects opportunities for women, by sharing words that managers used to describe men in performance reviews compared with women. Her presentation highlighted 10 positive terms and two negative terms to describe men compared with four positive terms and 12 negative terms to describe women. Aggarwal also pointed out that the terms used for men focused more on their ability to perform a task, such as “analytical” and “competent,” while the terms used for women focused more on personal qualities, including “inept,” “selfish,” “opportunistic” and “indecisive.”

The COVID-19 pandemic has exacerbated some of the discrepancies between men and women, Aggarwal noted. She pointed specifically to academic promotion and confidence about work opportunities.

Aggarwal called the disparities between men and women “a double standard” and encouraged the audience to consider why women begin to lose confidence about the opportunities available to them. She shared data from one survey that asked about why this happens, which demonstrated that women did not feel as though they matched the “stereotypical corporate ideal” or that they had support from their supervisor.

Organizations provide mentorship, support

The overall message of Aggarwal’s presentation focused on strategies to “surmount these barriers.” According to Aggarwal, involvement in professional societies and organizations enables women in medicine to further refine their skills and is “now more important than ever.”

She encouraged attendees to perform a self-assessment before getting involved with an organization. Specific factors to evaluate include: one’s opinions on the value of the team approach; the organization itself, such as the expertise offered and the opportunities provided to members; the personality of the organization; the climate of the organization and whether there is a climate of trust and respect; and the ability of the organization to provide tools for expanding one’s skills, mentorship and sponsorship.

“Self-reflection must occur,” Aggarwal said. “If you do not believe a team is required, there will be a lot of difficulty being in organizations.”

Aggarwal shared her personal experience to highlight the value of these organizations in helping women to advance their careers. She first joined the American Medical Women’s Association (AMWA) as a young faculty neurologist after realizing she did not have “that collaboration with other female physicians on a daily basis and on a professional basis, because we were so busy in the hospital.” Two stated values of AMWA — diversity and inclusion — were “very, very important” to her, she told attendees. She now serves as the chief diversity and inclusion officer of AMWA.

Aggarwal told attendees to look at organizational structure when deciding which ones to join. She highlighted another organization, Women in Bio, in this context, citing its commitment to women at “every step” of their journey, from young women, to women executives, to a mentorship program. She also noted the different educational backgrounds of its members, which range from bachelor’s degrees to PhDs, and the various sectors its members come from, including finance, government, media, biotech/pharmaceutical and academia, among others.

The Mentorship, Advisors, Peers and Sponsorship, or MAPS, program from Women in Bio represents a good example of another consideration for women before joining an organization, according to Aggarwal. She told attendees that mentorship programs lead to “wonderful circles of evolution.”

Aggarwal said her goal was for the attendees to “inspire each other” and, more specifically, for each attendee to become inspired themselves. She also noted that women should “complement and collaborate and not compete,” a phrase that she believes needs to be integrated into academic medical centers.

“We’re here to support each other,” Aggarwal said. “The world works in teams.”