Bias Perpetuates Bias: ChatGPT Learns Gender Inequities in Academic Surgery Promotions.

OBJECTIVE: Gender inequities persist in academic surgery with implicit bias impacting hiring and promotion at all levels. We hypothesized that creating letters of recommendation for both female and male candidates for academic promotion in surgery using an AI platform, ChatGPT, would elucidate the entrained gender biases already present in the promotion process. DESIGN: Using ChatGPT, we generated 6 letters of recommendation for "a phenomenal surgeon applying for job promotion to associate professor position", specifying "female" or "male" before surgeon in the prompt. We compared 3 "female" letters to 3 "male" letters for differences in length, language, and tone. RESULTS: The letters written for females averaged 298 words compared to 314 for males. Female letters more frequently referred to "compassion", "empathy", and "inclusivity"; whereas male letters referred to "respect", "reputation", and "skill". CONCLUSIONS: These findings highlight the gender bias present in promotion letters generated by ChatGPT, reiterating existing literature regarding real letters of recommendation in academic surgery. Our study suggests that surgeons should use AI tools, such as ChatGPT, with caution when writing LORs for academic surgery faculty promotion.

Managing Career Transitions in Cardiothoracic Surgery.

Transitions during a career in cardiothoracic surgery include transition to practice following residency, multiple transitions over the course of the career, and transition to retirement. Each carries some degree of uncertainty and stress, and early preparation for each transition is key to success. A clear understanding of both professional and personal goals drives decisions and choices along the course of a career. It is crucial to seek legal counsel with expertise in physician employment contracts. Developing collegial and collaborative relationships should be a focus throughout one's career. This article outlines the key elements to successful career progression.

Abdominal Transplant Surgeons: The Lack of Female Surgeons and People From Underrepresented Racial and Ethnic Minority Groups in Academic and Clinical Leadership.

OBJECTIVES: The demographic disparities among surgeons in academic leadership positions is well documented. We aimed to characterize the present demographic details of abdominal transplant surgeons who have achieved academic and clinical leadership positions. MATERIALS AND METHODS: We reviewed the 2022-2023 American Society of Transplant Surgeons membership registry to identify 1007 active abdominal transplant surgeons. Demographic details (academic and clinical titles) were collected and analyzed using the chi-square test, the Fisher exact test, and t tests. Multinomial logistic regressions were conducted. RESULTS: Female surgeons (P < .001) and surgeons from racial-ethnic minorities (P = .027) were more likely to be assistants or associates rather than full professors. White male surgeons were more likely to be full professors than were White female (P < .001), Asian female (P = .008), and Asian male surgeons (P = .005). There were no Black female surgeons who were full professors. The frequency of full professorship increased with surgeon age (P < .001). Male surgeons were more likely to hold no academic titles (P < .001). Female surgeons were less likely to be chief of transplant(P = .025), chief of livertransplant (P = .001), chief of pancreas transplant (P = .037), or chair of surgery (P = .087, significance at 10%). Chief of kidney transplant was the most common clinical position held by a surgeon from a racial or ethnic minority group. Female surgeons were more likely to hold no clinical titles (P = .001). CONCLUSIONS: The underrepresentation of women and people from racial and ethnic minority groups in academic and clinical leadership positions in the field of abdominal transplant surgery remains evident. White male physicians are more likely to obtain full professorship, and they comprise most of the clinical leadership positions overall. A continued push for representative leadership is needed.

Career trajectories of MD-PhD physician scientists: The loss of women investigators.

Advances in biomedical research require a robust physician scientist workforce. Despite being equally successful at securing early career awards from the NIH as men, women MD-PhD physician scientists are less likely to serve as principal investigators on mid- and later careers awards. Here, we discuss the causes of gender disparities in academic medicine, the implications of losing highly trained women physician scientists, and the institutional and systemic changes needed to sustain this pool of talented investigators.

Women Surgeons: Barriers and Solutions.

BACKGROUND: Underrepresentation and undertreatment of women in surgery continues to be highly prevalent, with major barriers to improvement. The aim of the study was to review the current state of women surgeons in Poland. METHODS: Information from the various Polish databases on women surgeons in 9 medical universities in general, oncological, vascular, thoracic, and cardiac surgery was retrospectively evaluated. Demographics of residents and staff surgeons, academic ranks and leadership positions at universities, in surgical societies and on scientific journals editorial boards were analyzed. Descriptive statistics were used. RESULTS: In 2020, 61% of 3,668 graduates of Polish medical universities were women. In 5 surgical specialties, 11.9% (1,243 of 10,411) of the surgeons were women, with the lowest numbers in cardiac (5.6%), and in vascular surgery (6.4%); 40.4% of general surgery residents were women, less in vascular (18.4%) and thoracic surgery (24%), more in oncological surgery (28.7%). In 35 surgical departments of 9 universities, all department chairs were men, all full professors were men; 7% of associate professors and 16% of assistant professors were women. Rectors of all universities were men; 27% of the vice-rectors were women. In the senates and university councils, 39% and 35%, respectively, were women. Presidents, vice presidents, and secretaries of surgical societies and Editor-in-Chief of 4 surgical journals were all men. CONCLUSIONS: Polish women surgeons face major difficulties with representation in surgery, in departmental, institutional, and societal leadership, and on scientific journal editorial boards. A multifaceted approach to correct these serious inequalities is urgently needed.

Gender Disparity in Full Professor Rank Among Academic Physicians: A Systematic Review and Meta-Analysis.

PURPOSE: The gender gap in promotion in academic medicine is well established. However, few studies have reported gender differences in promotion adjusted for scholarly production and national or international reputation, namely, career duration, publications, grant funding, and leadership positions. The authors performed a systematic review and meta-analysis of the differences between men and women in achieving benchmarks for promotion and analyze where such differences lie geographically and within specialties. METHOD: A systematic search of Academic Search Premier, Business Source Complete, Cochrane Library, ERIC, GenderWatch, Google Scholar, Embase, MEDLINE, PubMed, Scopus, and Web of Science was conducted from inception to August 17, 2022. All studies that reported the number of male and female full professors on medical school faculty were included. The primary outcome was the adjusted odds ratio (AOR) for promotion to full professor for women compared with men. RESULTS: Two hundred forty-four studies met the inclusion criteria. The unadjusted OR for promotion to full professor for women was 0.38 (95% confidence interval [CI], 0.36-0.41). Sixteen studies reported an AOR. The pooled AOR of promotion for women to full professor was 0.60 (95% CI, 0.46-0.77). The AOR for promotion to full professor was 0.55 (95% CI, 0.34-0.88) in surgery and 0.80 (95% CI, 0.57-1.11) in internal medicine. Statistical heterogeneity was high ( Q = 66.6, I2 = 79.4%, P < .001). On meta-regression, 77% of the heterogeneity was from studies outside the United States, where more disparity was reported (AOR, 0.29; 95% CI, 0.22-0.38). CONCLUSIONS: Most studies continued to find decreased promotion of women. Gender disparity was particularly notable in surgery and in studies from outside the United States. The results suggest that differences in promotion were due to differences in productivity and leadership and to gender bias.

Surgeon Intersectionality and Academic Promotion and Retention in the US.

Introduction: Efforts have been made to increase the number of women and physicians who are underrepresented in medicine (UIM). However, surgery has been slow to diversify, and there are limited data surrounding the impact of intersectionality. Objective: To assess the combined association of race and ethnicity and sex with rates of promotion and attrition among US academic medical department of surgery faculty. Design, Setting, and Participants: This was a retrospective cohort study using faculty roster data from the Association of American Medical Colleges. All full-time academic department of surgery faculty with an appointment any time from January 1, 2005, to December 31, 2020, were included. Study data were analyzed from September 2022 to February 2023. Exposures: Full-time academic faculty in a department of surgery with a documented self-reported race, ethnicity, and sex within the designated categories of the faculty roster of Association of American Medical Colleges. Main Outcomes and Measures: Trends in race and ethnicity and sex, rates of promotion, and rates attrition from 2010 to 2020 were assessed with Kaplan-Meier and Cox time-to-event analyses. Results: A total of 31 045 faculty members (23 092 male [74%]; 7953 female [26%]) from 138 institutions were included. The mean (SD) program percentage of UIM male faculty increased from 8.4% (5.5%) in 2010 to 8.5% (6.2%) in 2020 (P < .001), whereas UIM female faculty members increased from 2.3% (2.6%) to 3.3% (2.5%) over the 10-year period (P < .001). The mean program percentage of non-UIM females increased at every rank (percentage point increase per year from 2010 to 2020 in instructor: 1.1; 95% CI, 0.73-1.5; assistant professor: 1.1; 95% CI, 0.93-1.3; associate professor: 0.55; 95% CI, 0.49-0.61; professor: 0.50; 95% CI, 0.41-0.60; all P < .001). There was no change in the mean program percentage of UIM female instructors or full professors. The mean (SD) percentage of UIM female assistant and associate professors increased from 3.0% (4.1%) to 5.0% (4.0%) and 1.6% (3.2%) to 2.2% (3.4%), respectively (P =.002). There was no change in the mean program percentage of UIM male instructors, associate, or full professors. Compared with non-Hispanic White males, Hispanic females were 32% less likely to be promoted within 10 years (hazard ratio [HR], 0.68; 95% CI, 0.54-0.86; P <.001), non-Hispanic White females were 25% less likely (HR, 0.75; 95% CI, 0.71-0.78; P <.001), Hispanic males were 15% less likely (HR, 0.85; 95% CI, 0.76-0.96; P =.007), and Asian females were 12% less likely (HR, 0.88; 95% CI, 0.80-0.96; P =.03). Non-UIM males had the shortest median (IQR) time to promotion, whereas non-UIM females had the longest (6.9 [6.8-7.0] years vs 7.2 [7.0-7.6] years, respectively; P < .001). After 10 years, 79% of non-UIM males (13 202 of 16 299), 71% of non-UIM females (3784 of 5330), 68% of UIM males (1738 of 2538), and 63% of UIM females (625 of 999) remained on the faculty. UIM females had a higher risk of attrition compared with non-UIM females (HR, 1.3; 95% CI, 1.1-1.5; P = .001) and UIM males (HR, 1.2; 95% CI, 1.0-1.4; P = .05). The mean (SE) time to attrition was shortest for UIM females and longest for non-UIM males (8.2 [0.14] years vs 9.0 [0.02] years, respectively; P < .001). Conclusion and Relevance: Results of this cohort study suggest that intersectionality was associated with promotion and attrition, with UIM females least likely to be promoted and at highest risk for attrition. Further efforts to understand these vulnerabilities are essential.

Transforming the Future of Surgeon-Scientists.

OBJECTIVE: To create a blueprint for surgical department leaders, academic institutions, and funding agencies to optimally support surgeon-scientists. BACKGROUND: Scientific contributions by surgeons have been transformative across many medical disciplines. Surgeon-scientists provide a distinct approach and mindset toward key scientific questions. However, lack of institutional support, pressure for increased clinical productivity, and growing administrative burden are major challenges for the surgeon-scientist, as is the time-consuming nature of surgical training and practice. METHODS: An American Surgical Association Research Sustainability Task Force was created to outline a blueprint for sustainable science in surgery. Leaders from top NIH-sponsored departments of surgery engaged in video and in-person meetings between January and April 2023. A strength, weakness, opportunities, threats analysis was performed, and workgroups focused on the roles of surgeons, the department and institutions, and funding agencies. RESULTS: Taskforce recommendations: (1) SURGEONS: Growth mindset : identifying research focus, long-term planning, patience/tenacity, team science, collaborations with disparate experts; Skill set : align skills and research, fill critical skill gaps, develop team leadership skills; DEPARTMENT OF SURGERY (DOS): (2) MENTORSHIP: Chair : mentor-mentee matching/regular meetings/accountability, review of junior faculty progress, mentorship training requirement, recognition of mentorship (eg, relative value unit equivalent, awards; Mentor: dedicated time, relevant scientific expertise, extramural funding, experience and/or trained as mentor, trusted advisor; Mentee : enthusiastic/eager, proactive, open to feedback, clear about goals; (3) FINANCIAL SUSTAINABILITY: diversification of research portfolio, identification of matching funding sources, departmental resource awards (eg, T-/P-grants), leveraging of institutional resources, negotiation of formalized/formulaic funds flow investment from academic medical center toward science, philanthropy; (4) STRUCTURAL/STRATEGIC SUPPORT: Structural: grants administrative support, biostats/bioinformatics support, clinical trial and research support, regulatory support, shared departmental laboratory space/equipment; Strategic: hiring diverse surgeon-scientist/scientists faculty across DOS, strategic faculty retention/ recruitment, philanthropy, career development support, progress tracking, grant writing support, DOS-wide research meetings, regular DOS strategic research planning; (5) COMMUNITY AND CULTURE: Community: right mix of faculty, connection surgeon with broad scientific community; Culture: building research infrastructure, financial support for research, projecting importance of research (awards, grand rounds, shoutouts); (6) THE ROLE OF INSTITUTIONS: Foundation: research space co-location, flexible start-up packages, courses/mock study section, awards, diverse institutional mentorship teams; Nurture: institutional infrastructure, funding (eg, endowed chairs), promotion friendly toward surgeon-scientists, surgeon-scientists in institutional leadership positions; Expectations: RVU target relief, salary gap funding, competitive starting salaries, longitudinal salary strategy; (7) THE ROLE OF FUNDING AGENCIES: change surgeon research training paradigm, offer alternate awards to K-awards, increasing salary cap to reflect market reality, time extension for surgeon early-stage investigator status, surgeon representation on study section, focused award strategies for professional societies/foundations. CONCLUSIONS: Authentic recommitment from surgeon leaders with intentional and ambitious actions from institutions, corporations, funders, and society is essential in order to reap the essential benefits of surgeon-scientists toward advancements of science.

Disparities in Promotion and Retention Rates Among Underrepresented in Medicine Faculty in U.S. Ophthalmology Departments.

PURPOSE: This study examines the rates and trends of faculty promotions within the field of ophthalmology, with comparative emphasis on the rates of promotion among underrepresented in medicine (URiM) faculty. DESIGN: A retrospective panel study was conducted using the Association of American Medical Colleges Faculty Roster database. METHODS: We used the Association of American Medical Colleges Faculty Roster data to assess trends in academic faculty promotions within U.S. ophthalmology departments. Full-time assistant and associate professors appointed between 2000 and 2010 were included in the analysis, and tracked until November 2021 to determine promotion rates. Pearson χ2 and Fisher exact tests were used to evaluate differences in promotion and retention rates based on gender, race and ethnicity, advanced degree, and tenure status. RESULTS: The demographics of 1436 assistant and 680 associate faculty members were obtained for analysis through the Association of American Medical Colleges. Black faculty had lower promotion rates when compared with White faculty (20% vs 37%, P < .001). Faculty with MD and PhD degrees demonstrated higher promotion rates than faculty with MD degrees alone (59% vs 36%, P < .001). In addition, faculty not on tenure track had lower rates of promotion than those on tenure track (35% vs 48%, P < .001). With respect to faculty retention, among assistant and associate professors combined, Black faculty and faculty without tenure track appointments were more likely to leave academic medicine (46% vs 33%, P < .001) and (36% vs 27%, P < .001), respectively. CONCLUSION: In this study, promotion rates varied significantly by race/ethnicity. Specifically, Black faculty had lower rates of promotion and retention in academic medicine. These findings underscore the need to explore and implement strategies and policies to address equity in promotion rates and retention of URiM faculty within academic ophthalmology.

Advanced degrees, gender, and professional rank in surgery, disparities in academic medicine.

INTRODUCTION: Women comprise nearly half of all residents in training, yet there is a significant disparity of women in academic leadership. Surgical subspecialties are dominated by men in both percentages of physicians and leadership positions. We sought to examine the association of advanced non-medical degrees with academic rank and gender in academic surgery departments. METHODS: Faculty from 126 ACGME-accredited academic medical centers were analyzed to identify faculty gender as described in online biographical information, advanced non-medical degrees, academic rank, and additional leadership positions held. Descriptive statistics and logistic regression models were used for statistical analyses. RESULTS: 4536 surgeons were identified, 69.3% men, 27.3% female, and 3.3% unlisted. Female surgeons were more likely to hold advanced non-doctoral degrees than men (18.2% vs. 13.8%, p â€‹< â€‹0.002). Among those with advanced degrees, PhDs were held by 3.3% of women and 5.7% of men (p â€‹< â€‹0.001). Female surgeons were less likely to hold the rank of Professor than male surgeons (15.8% vs 30.3%, p â€‹< â€‹0.001), and more likely to hold the rank of Assistant Professor than male surgeons (51.9% vs 36.1%, p â€‹< â€‹0.001). This likelihood remained true when analyzing only surgeons with one or more advanced non-medical degrees. Men were more likely to be Chair of Surgery (3.0%), Division Chief (9.6%), and Research Chair (0.5%); compared to women (1.3%; 4.8%; 0.2%; p â€‹= â€‹0.001, <0.001, 0.21 respectively). CONCLUSIONS: There continues to be a significant male predominance in general surgery. Gender discrepancy is also seen in professional rank and academic title despite women holding more advanced degrees. Advanced degrees are currently considered academic qualifications, but this does not reflect surgical academic leadership roles or rank.

Estresse ocupacional entre psicólogos atuantes na atenção primária à saúde no contexto pandêmico / Occupational stress in psychologists working in primary health care in the context of the pandemic / Estrés laboral entre los psicólogos que trabajan en atención primaria de salud en el contexto de la pandemia

Este estudo analisa o estresse ocupacional entre psicólogos que atuavam na Atenção Primária à Saúde durante a pandemia ocasionada pela covid-19, assim como as características sociodemográficas e laborais dos participantes e sua relação com o estresse ocupacional. Participaram da pesquisa 70 psicólogos atuantes em 51 unidades básicas de saúde das regiões Oeste e Extremo Oeste catarinense. Para coleta de dados, um questionário sociodemográfico e a versão reduzida da Job Stress Scale (JSS) foram aplicados. A análise dos dados foi realizada por meio da estatística descritiva e inferencial. Identificou-se que 35,7% dos psicólogos apresentaram alto desgaste no trabalho; 28,6% baixo desgaste; 27,1% se mostraram em trabalho passivo; e 8,6% em trabalho ativo. No modelo de regressão linear, os fatores associados à dimensão Demanda da JSS foram: possuir filho (a) (coeficiente -1,49; IC 95% -2,75 a -0,23) e afastamento do trabalho nos últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Os psicólogos com hipertensão arterial sistêmica autorreferida apresentaram, em média, 3,96 pontos a menos no escore de Apoio social (IC 95% -7,06 a -0,85), quando comparados aos não hipertensos, e entre os psicólogos que trabalhavam no turno da manhã identificou-se aumento de 4,46 pontos, em média, no escore de Apoio social (IC 95% 0,90 a 8,02) em relação aos profissionais do turno manhã e tarde. Evidenciou-se que um número significativo de psicólogos apresentava-se em alto desgaste no trabalho, com potenciais implicações para sua saúde e atuação profissional.(AU)

This study analyzed occupational stress among psychologists who worked in Primary Health Care during the COVID-19 pandemic and participants' sociodemographic and work characteristics and their relationship with occupational stress. In total, 70 psychologists working in 51 basic health units in the West and Far West regions of Santa Catarina participated in this research. A sociodemographic questionnaire and the short version of the Job Stress Scale (JSS) were applied to collect data. Data were analyzed by descriptive and inferential statistics. In total, 35.7% of psychologists showed high stress at work; 28.6%, low burn out; 27.1%, passive work; and 8.6%, active work. The factors in the linear regression model that were associated with the JSS demand dimension referred to having children (coefficient −1.49; 95% CI −2.75 to −0.23) and absence from work in the last 12 months (coefficient 1.88; 95% CI 0.60 to 3.15). Psychologists with self-reported systemic arterial hypertension showed, on average, 3.96 points lower in the Social Support score (95% CI −7.06 to −0.85) than non-hypertensive ones and psychologists who worked in the morning shift, an average increase of 4.46 points in the Social Support score (95% CI 0.90 to 8.02) in relation to professionals working in the morning and afternoon shifts. A significant number of psychologists had high stress at work, with potential implications to their health and professional performance.(AU)

Este estudio evalúa el estrés laboral entre los psicólogos que trabajaron en la atención primaria de salud durante la pandemia provocada por la COVID-19, así como las características sociodemográficas y laborales de ellos y su relación con el estrés laboral. En la investigación participaron setenta psicólogos que trabajan en 51 unidades básicas de salud en las regiones oeste y lejano oeste de Santa Catarina (Brasil). Para la recolección de datos se aplicó un cuestionario sociodemográfico y la versión corta de la Job Stress Scale (JSS). El análisis de los datos se realizó mediante estadística descriptiva e inferencial. Se identificó que el 35,7% de los psicólogos presentaban alto estrés en el trabajo; el 28,6% tenían poco desgaste; el 27,1% se encontraban en trabajo pasivo; y el 8,6% en trabajo activo. En el modelo de regresión lineal, los factores asociados a la dimensión demanda de la JSS fueron: tener hijo (coeficiente -1,49; IC 95% -2,75 a -0,23) y baja laboral en los últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Los psicólogos con hipertensión arterial sistémica autoinformada presentaron un promedio de 3,96 puntos más bajo en la puntuación de apoyo social (IC 95% -7,06 a -0,85) en comparación con los no hipertensos, y entre los psicólogos que trabajaban en el turno de la mañana, se identificó un aumento promedio de 4,46 puntos en la puntuación de apoyo social (IC 95% 0,90 a 8,02) con relación a los profesionales que laboran en el turno de mañana y tarde. Quedó evidente que un número significativo de psicólogos se encontraba en situación de alto estrés en el trabajo, con posibles implicaciones para su salud y desempeño profesional.(AU)

Attitudes toward ophthalmology as a prospective career among pre-clinical medical students in China.

BACKGROUND: A questionnaire was developed and administered to 450 medical students at the Xiangya Medical College, Central South University in Changsha, China to understand the attitudes among medical students in China toward different medical specialties and to find the factors that influenced their choice of career in ophthalmology. PARTICIPANTS: Fourth-year medical students in the five-year program and sixth-year medical students in the eight-year program. METHODS: All the students were asked to rate the importance of nine possible factors in choosing a specialty as their vocation and their first ranked future specialty career choice. RESULTS: When asked about the reasons for choosing to go to medical school, the top four reasons are the ability to help patients, interesting and challenging work, prestige, and job stability. When asked about the reasons for choosing a specialty, the top four reasons are the ability to find employment, financial reward, career upward mobility, and professional pressure. About the first career choice of the future specialty, for clinical medicine students, ophthalmology is the fifth ranked choice for clinical medicine students. 5.6% (five-year) and 3.4% (eight-year) of them choose ophthalmology as their top ranked specialty for their career. For anesthesia medicine and oral medicine students, most of them preferred to choose the same specialty as before. 1.5% (anesthesia) and 4.5% (oral) of them chose ophthalmology as their top ranked specialty. CONCLUSIONS: Medical students in China have numerous factors that motivate their choice in a specialty. Ophthalmology is the fifth ranked choice among clinical medicine students.

Sponsorship in Otolaryngology-Head and Neck Surgery: A Pathway to Equity, Diversity, and Inclusion.

Importance: Sponsorship, distinct from mentorship or coaching, involves advancing the careers of individuals by nominating them for roles, increasing the visibility of their work, or facilitating opportunities. Sponsorship can open doors and enhance diversity; however, achieving desirable outcomes requires equitable approaches to cultivating potential in sponsees and promoting their success. The evidence on equitable sponsorship practices has not been critically examined, and this special communication reviews the literature, highlighting best practices. Observations: Sponsorship addresses an unmet need for supporting individuals who have historically been afforded fewer, less visible, or less effective opportunities for upward career mobility. Barriers to equitable sponsorship include the paucity of sponsors of underrepresented identity; smaller and underdeveloped networks among these sponsors; lack of transparent, intentional sponsorship processes; and structural inequities that are associated with recruitment, retention, and advancement of diverse individuals. Strategies to enhance equitable sponsorship are cross-functional, building on foundational principles of equity, diversity, and inclusion; patient safety and quality improvement; and insights from education and business. Equity, diversity, and inclusion principles inform training on implicit bias, cross-cultural communication, and intersectional mentoring. Practices inspired by patient safety and quality improvement emphasize continuously improving outreach to diverse candidates. Education and business insights emphasize minimizing cognitive errors, appreciating the bidirectional character of interactions, and ensuring that individuals are prepared for and supported in new roles. Collectively, these principles provide a framework for sponsorship. Persistent knowledge gaps are associated with timing, resources, and systems for sponsorship. Conclusions and Relevance: The nascent literature on sponsorship is limited but draws on best practices from various disciplines and has potential to promote diversity within the profession. Strategies include developing systematic approaches, providing effective training, and supporting a culture of sponsorship. Future research is needed to define best practices for identifying sponsees, cultivating sponsors, tracking outcomes, and fostering longitudinal practices that are sustainable at local, regional, and national levels.

Career Advancement Among Women Physicians in Nine Academic Medicine Specialties.

Objective: Gender parity lags in academic medicine. We applied the Rank Equity Index (REI) to compare the longitudinal progress of women's academic medicine careers. We hypothesized that women have different rank parity in promotion by specialty based on the proportion of women in the specialty. Materials and Methods: Aggregate data by sex for medical students, residents, assistant professors, associate professors, and professors in nine specialties were obtained from the Association of American Medical Colleges for 2019-2020. Specialties were clustered into terciles based on the proportion of women in the field: upper (obstetrics and gynecology, pediatrics, psychiatry), middle (internal medicine, emergency medicine, anesthesia), and lower (surgery, urology, and orthopedic surgery). We calculated the percentage representation by sex by specialty and rank to calculate REI. Specialty-specific REI comparisons between each rank were performed to assess parity in advancement. Results: Only specialties in the upper tercile recruited proportionally more women medical students to residency training. All specialties advanced women for the resident-to-assistant professor with psychiatry, internal medicine, emergency medicine, anesthesia, urology, and orthopedic surgery that promoted women faculty at rates above parity. No specialty demonstrated parity in advancement based on sex for the assistant professor-to-associate professor or associate professor-to-professor transitions. Conclusion: Gender inequity in advancement is evident in academic medicine starting at the assistant professor-to-associate professor stage, regardless of overall proportion of women in the specialty. This suggests a common set of barriers to career advancement of women faculty in academic medicine that must be addressed starting at the early career stage.