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4.
JAMA ; 324(22): 2261, 2020 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-33289824
6.
N Engl J Med ; 383(22): 2148-2157, 2020 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-33252871

RESUMO

BACKGROUND: In 2000, a landmark study showed that women who graduated from U.S. medical schools from 1979 through 1997 were less likely than their male counterparts to be promoted to upper faculty ranks in academic medical centers. It is unclear whether these differences persist. METHODS: We merged data from the Association of American Medical Colleges on all medical school graduates from 1979 through 2013 with faculty data through 2018, and we compared the percentages of women who would be expected to be promoted on the basis of the proportion of women in the graduating class with the actual percentages of women who were promoted. We calculated Kaplan-Meier curves and used adjusted Cox proportional-hazards models to examine the differences between the early cohorts (1979-1997) and the late cohorts (1998-2013). RESULTS: The sample included 559,098 graduates from 134 U.S. medical schools. In most of the cohorts, fewer women than expected were promoted to the rank of associate or full professor or appointed to the post of department chair. Findings were similar across basic science and clinical departments. In analyses that included all the cohorts, after adjustment for graduation year, race or ethnic group, and department type, women assistant professors were less likely than their male counterparts to be promoted to associate professor (hazard ratio, 0.76; 95% confidence interval [CI], 0.74 to 0.78). Similar sex disparities existed in promotions to full professor (hazard ratio, 0.77; 95% CI, 0.74 to 0.81) and appointments to department chair (hazard ratio, 0.46; 95% CI, 0.39 to 0.54). These sex differences in promotions and appointments did not diminish over time and were not smaller in the later cohorts than in the earlier cohorts. The sex differences were even larger in the later cohorts with respect to promotion to full professor. CONCLUSIONS: Over a 35-year period, women physicians in academic medical centers were less likely than men to be promoted to the rank of associate or full professor or to be appointed to department chair, and there was no apparent narrowing in the gap over time. (Funded by the University of Kansas Medical Center Joy McCann Professorship for Women in Medicine and the American Association of University Women.).


Assuntos
Mobilidade Ocupacional , Docentes de Medicina , Médicas , Centros Médicos Acadêmicos , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Modelos de Riscos Proporcionais , Faculdades de Medicina , Fatores Sexuais , Sexismo/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Estados Unidos , Equilíbrio Trabalho-Vida
8.
Med J Aust ; 213(8): C1-C2, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33070340
11.
Acad Med ; 95(10): 1485-1487, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33002905

RESUMO

In this Invited Commentary, the author applies a historical lens to explore a fundamental paradox in U.S. medical education: the fact that long after women gained parity with men in matriculation to medical school, women remain highly underrepresented in leadership positions in academic medicine. The reasons for this are many and complex, but at the core are the subtle but hurtful indignities ("microinequities") experienced by women physicians and an academic culture that expects single-minded dedication to work, regardless of the costs to faculty members' personal lives. Achieving parity for women in academic leadership will require changing the culture of medical schools and teaching hospitals to correct these 2 fundamental obstacles. In recent years, many medical schools and teaching hospitals have made efforts to improve opportunities and satisfaction for women trainees and physicians, enacting reforms to improve work-life balance for all faculty. It is plausible to imagine a future in which flexible time frames to achieve tenure and promotion are universally available to both women and men, with high scholarly standards firmly maintained. If this occurs, it will represent a profound legacy for women in academic medicine, for their generations of professional sacrifice and advocacy for a more equitable culture will have changed its culture.


Assuntos
Centros Médicos Acadêmicos/organização & administração , Docentes de Medicina/organização & administração , Cultura Organizacional , Médicas/organização & administração , Sexismo/história , Centros Médicos Acadêmicos/história , Docentes de Medicina/história , Feminino , História do Século XIX , História do Século XX , Humanos , Liderança , Médicas/história
12.
Acad Med ; 95(10): 1479-1482, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006867

RESUMO

The Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program for Women is designed to promote the careers of senior female leaders in academic health care in a way that ultimately seeks to transform culture and promote gender equity far beyond the careers of its participants. In an era of increased awareness of gender inequity within academic medicine, the longevity of the ELAM program raises several important questions. First, why is such a program still needed? Second, what exactly does it do, and what has been its influence on its participants and beyond? And third, what lessons can ELAM's example provide to help guide the medical profession as it strives to promote gender equity in the field? In this Invited Commentary, the authors seek to answer these questions from the perspective of a recent program participant and the current program director. The authors review the evidence that identifies how women, even today, face accumulating disadvantage over the course of their academic careers, stemming from repeated encounters with powerful unconscious biases and stereotypes, societal expectations for a gendered division of domestic labor, and still-present overt discrimination and sexual harassment. They describe ELAM's approach, which builds the knowledge and skills of the women who participate in the program, while also intentionally raising their visibility within their home institutions so that they have opportunities to share with institutional leaders what they have learned in ways that not only promote their own careers but also support gender equity in the broader environment. The authors conclude by offering thoughts on how ELAM's model may be leveraged in the future, ideally in partnership with the numerous professional societies, funding agencies, and other organizations that are committed to accelerating the rate of progress toward gender equity at all levels of academic medicine.


Assuntos
Docentes de Medicina/educação , Previsões , Liderança , Diretores Médicos/educação , Médicas/organização & administração , Centros Médicos Acadêmicos/organização & administração , Docentes de Medicina/organização & administração , Feminino , Identidade de Gênero , Humanos , Diretores Médicos/organização & administração , Avaliação de Programas e Projetos de Saúde
13.
Acad Med ; 95(10): 1529-1538, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006870

RESUMO

Though overt sexism is decreasing, women now experience subtle, often unconscious, gender bias as microaggressions. The authors sought to explore the prevalence and impact of the sexist microaggressions female surgeons experience, using a sequential exploratory mixed methods approach (January 2018-April 2018), to identify opportunities for education and prevention. First, all resident, fellow, and attending female surgeons at the University of New Mexico Health Sciences Center (UNM HSC) were invited to participate in focus groups conducted by experienced moderators using a semistructured interview guide based on the 7 Sexist Microaggressions Experiences and Stress Scale (Sexist MESS) domains. Qualitative analysis was performed using line-by-line manual coding to identify themes aligned with the Sexist MESS domains as well as other gender bias experiences of female surgeons. Next, a survey was sent to all resident, fellow, and attending female surgeons at the UNM HSC, which included the Sexist MESS questionnaire and questions related to surgeon-specific experiences of gender bias that the authors developed based on major thematic categories from the focus groups.Four focus groups of 23 female surgeons were conducted, revealing 4 themes: exclusion, increased effort, adaptation, and resilience to workplace slights. The survey response rate was 64% (65/101 surgeons). Across Sexist MESS domains, the frequency and severity of microaggressions was higher for trainees than attendings. The variables of non-White race/ethnicity, having children under 18, and fellowship training generally did not demonstrate statistical significance. This exploratory study adds to the growing body of evidence that gender bias in surgery continues and frequently manifests as microaggressions. Trainees reported the highest rates and severity of microaggressions and bias experiences. Further research should investigate how to address microaggressions, the experiences of male surgeons, the perspectives of medical students and groups who were reported as often perpetuating gender bias, and the efficacy of possible interventions.


Assuntos
Médicas/psicologia , Sexismo/psicologia , Cirurgiões/psicologia , Local de Trabalho/psicologia , Adulto , Agressão/psicologia , Bullying/psicologia , Feminino , Grupos Focais , Humanos , New Mexico , Pesquisa Qualitativa , Inquéritos e Questionários
14.
Neurology ; 95(22): e3045-e3059, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33109622

RESUMO

OBJECTIVE: To determine whether women have been equitably represented among plenary speakers at the American Academy of Neurology (AAN) Annual Meeting by counting and categorizing speakers and comparing outcomes to AAN membership and US neurology workforce data. METHODS: Lists of plenary speakers between 1958 and 2019 (62 years) were obtained from the AAN. The primary outcome measures were numbers and proportions of men and women in aggregate and among physicians. RESULTS: We identified 635 plenary speakers, including 148 (23.3%) women. Specifically, women made up 14.6% (19 of 130) of presidential and 25.5% (129 of 505) of nonpresidential plenary session speakers. The inclusion of women plenary speakers was meaningfully higher (h = 0.33; difference 14.9%; 95% confidence interval 4.2%-26.7%) for nonphysicians (27 of 74 [36.5%]) than physicians (121 of 561 [21.6%]). Although at zero levels for Annual Meetings held between 1958 and 1990 and at mostly low but varying levels thereafter, the representation of women and women physicians has been at or above their proportions in the AAN membership and US neurology workforce since 2017. Comparison of representation by plenary session name revealed an unequal distribution of women, with women physicians concentrated in the Sidney Carter Award in Child Neurology presidential session. CONCLUSION: Historically and recently, women and women physicians were underrepresented among AAN plenary speakers. As the AAN has taken active steps to address equity, women have been included in more representative proportions overall. However, notable gaps remain, especially in specific prestigious plenary sessions, and further research is needed to determine causality.


Assuntos
Congressos como Assunto/estatística & dados numéricos , Neurologia/estatística & dados numéricos , Médicas/estatística & dados numéricos , Sociedades Médicas/estatística & dados numéricos , Mulheres Trabalhadoras/estatística & dados numéricos , Academias e Institutos , Humanos , Estados Unidos
16.
J Card Surg ; 35(10): 2539-2542, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33043661

RESUMO

BACKGROUND: A major difference exists between the rate of females and males entering cardiac surgery (CSx) residency in Canada. The objective of this study was to investigate the concerns and perceived obstacles of medical students with regards to CSx residency training to identify potential modifiable factors. METHODS: A 15-question web-based survey was designed to compare male to female medical students' perceptions with regards to CSx training. The survey was distributed to all 682 medical students at Western University (London, ON, Canada) enrolled during 2018 to 2019 academic year. A total of 153 students (63 males vs 90 females) completed the survey. RESULTS: More females perceived significant levels of difficulties to getting accepted in CSx residency programs (44/63 [63.8%] males vs 77/90 [85.6%] females, P = .03). As for their perception of the most difficult aspect about a career in CSx, more males expressed significant concerns about finding a job after completing the residency training (16/63 [25.3%] males vs 10/90 [11.0%] females, P = .02). A similar proportion of students expressed a strong interest in applying to a CSx residency (12/63 [19.0%] males vs 15/90 [16.7%] females, P = .83). Of these, more males expressed concerns about maintaining a work-life balance (6/12 [50%] males vs 1/15 [6.67%] female, P = .02), and more females expressed fears of not getting matched to CSx residency (3/12 [25%] males vs 11/15 [73.3%] females, P = .02). CONCLUSION: Despite showing a strong interest in completing a residency in CSx, female medical students perceive a significant fear of not getting matched to the speciality, which limits them from applying.


Assuntos
Medo , Identidade de Gênero , Internato e Residência , Candidatura a Emprego , Seleção de Pessoal , Médicas/psicologia , Estudantes de Medicina/psicologia , Cirurgia Torácica/educação , Adulto , Canadá , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
18.
JAMA Netw Open ; 3(10): e2019843, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33030551

RESUMO

Importance: Gender differences in interprofessional conflict may exist and precipitate differential achievement, wellness, and attrition in medicine. Objective: Although substantial attention and research has been directed toward improving gender equity in surgery and addressing overall physician wellness, research on the role of interprofessional conflict has been limited. The objective of this study was to understand scenarios driving interprofessional conflict involving women surgeons, the implications of the conflict on personal, professional, and patient outcomes, and how women surgeons navigate conflict adjudication. Design, Setting, and Participants: A qualitative approach was used to explore the nature, implications, and ways of navigating interprofessional workplace conflict experienced by women surgeons. The setting was a national sample of US women surgeons. Purposive and snowball sampling were used to recruit women surgeons in training or practice from annual surgical society meetings. Participants were eligible if they were currently in a surgical training program or surgical practice. Nearly all participants had experienced at least 1 workplace conflict with a nonphysician staff member resulting in a formal write-up. Exposures: A workplace conflict was defined as any conflict resulting in the nonphysician staff member taking action such as confronting the woman surgeon, reporting the event to supervisors, or filing a formal report. Main Outcomes and Measures: Interviews were conducted between February 19, 2019, and June 21, 2019. Recordings were transcribed and deidentified. Inductive thematic analysis was used to examine data in relation to the research questions. Results: Thirty US women surgeons (8 [27%] age 25-34 years, 16 [53%] age 35-44 years, 5 [17%] age 45-54 years, and 1 [3%] age 55-64 years) of varying surgical specialties were interviewed. Conflicts were often reported as due to a breakdown in communication or from performance-related disputes. Participants perceived personal and professional implications including self-doubt, depression, frustration, anxiety, loss of sleep, reputational harms, and delays to advancement. Participants also described potential patient safety implications primarily due to decreased communication resulting from some surgeons being hesitant to engage in subsequent interactions. Participants described a variety of navigation strategies including relationship management, rapport building, and social capital. The success of these processes tended to vary by individual circumstances, including the details of the conflict, practice setting, level of support of leadership, and individual personality of the surgeon. Conclusions and Relevance: This qualitative study highlights women surgeons' experiences with interprofessional workplace conflict. Interprofessional culture building, broader dissemination of implicit bias training, and transparent and equitable adjudication systems are potential strategies for avoiding or mitigating the implications of these conflicts.


Assuntos
Conflito Psicológico , Relações Interprofissionais , Médicas/psicologia , Cirurgiões/psicologia , Local de Trabalho/psicologia , Adulto , Idoso , Atitude do Pessoal de Saúde , Feminino , Humanos , Satisfação no Emprego , Pessoa de Meia-Idade , Padrões de Prática Médica , Pesquisa Qualitativa , Estados Unidos
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