ArticleLiterature Review

Impact of Mentoring on Academic Career Success for Women in Medicine: A Systematic Review

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Purpose: Research has shown that barriers to career success in academic medicine disproportionately affect women. These barriers include inadequate mentoring, which may perpetuate the underrepresentation of women in senior leadership positions. The purpose of this review was to summarize the qualitative and quantitative evidence of the impact of mentoring on women's career outcomes, as well as to inform future interventions to support the promotion and retention of women in academic medicine. Method: The authors conducted a systematic review of original research in English-language peer-reviewed journals through March 20, 2020. Search terms related to mentorship, women, and academic medicine. The authors searched MEDLINE, Embase, Scopus, Current Contents Connect via Web of Science, Cochrane Library, and PsycINFO. They excluded studies not specifically addressing women and those without gender-stratified outcomes. They extracted and analyzed the following data: study design, population, sample size, response rate, participant age, percent of women, mentoring prevalence, and outcomes. Results: Of 2,439 citations identified, 91 studies met the inclusion criteria, including 65 quantitative and 26 qualitative studies. Mentoring was associated with objective and subjective measures of career success. Women perceived mentorship to be more valuable to their career development yet were more likely to report having no mentor. Additionally, women were more likely to report lower levels of research productivity, less career satisfaction, and greater barriers to promotion. Qualitative results indicated that women had less access to informal mentoring and that family responsibilities had a greater effect on their career outcomes. Professional networking, female mentors, and relational aspects of mentoring were common themes. Conclusions: This review examined gender disparities in mentoring and the impact on research productivity, promotion success, and career satisfaction for women in academic medicine. Institution-supported mentoring programs are needed to facilitate identification of appropriate mentors and promotion of a more equitable academic career environment for women.

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... A large survey of both male and female members of the European Society of Medical Oncology published in 2018 revealed that it is not simply a matter of proportion, but rather opportunities that encourages female leadership, such as leadership training and mentoring, facilitating work life balance and provision of a flexible working environment (43). Many systematic reviews reported that strategies such as mentoring programs, education and professional development create positive outcomes in improving women's skills, however there is a dearth of appropriate mentors (44)(45)(46). Furthermore, it can only be fundamental institutional, cultural reform and perhaps even quotas, rather than individual training, that will bring about gender equality (16,(47)(48)(49). ...
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Physician-scientists and scientists in all the health professions are vital members of the U.S. biomedical workforce, but their numbers at academic health centers are declining. Mentorship has been identified as a key component in retention of faculty members at academic health centers. Effective mentoring may promote the retention of clinician-scientists in the biomedical workforce. The authors describe a holistic institutional mentoring program to support junior faculty members engaged in clinical and translational science at the University of Utah. The clinical and translational scholars (CATS) program leverages the resources of the institution, including the Center for Clinical and Translational Science, to augment departmental resources to support junior faculty investigators and uses a multilevel mentoring matrix that includes self, senior, scientific, peer, and staff mentorship. Begun in the Department of Pediatrics, the program was expanded in 2013 to include all departments in the school of medicine and the health sciences. During the two-year program, scholars learn management essentials and have leadership training designed to develop principal investigators. Of the 86 program participants since fiscal year 2008, 92% have received extramural awards, 99% remain in academic medicine, and 95% remain at the University of Utah. The CATS program has also been associated with increased inclusion of women and underrepresented minorities in the institutional research enterprise. The CATS program manifests institutional collaboration and coordination of resources, which have benefited faculty members and the institution. The model can be applied to other academic health centers to support and sustain the biomedical workforce.
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Introduction: Gender related inequality and disparity hinders efforts to develop a medical workforce that facilitates universal access to safe, just and equitable healthcare. Little is known about how medical students perceive the impact of their gender on their learning in clinical practice. Our aim in this study was to address this gap, establishing students’ perceptions of the impact of their gender on learning in the clinical context as part of the wider medical education community of practice. Methods: We undertook a qualitative study that simultaneously gathered data through narrative individual interviews and online case reports from male and female students (n=31) from different academic cohorts with prior experience of clinical practice in a Russell Group University medical school in the UK. Interviews were transcribed and analysed thematically alongside case report data. Results and Discussion: The participants revealed that there was a culture in clinical practice where their gender influenced how they were taught and supported by senior medical/surgical colleagues. Gender was also said to determine the clinical learning opportunities afforded to students especially with regards to the care of patients of a different gender. The mentorship and support for learning provided to students in clinical practice was also said to be influenced by the medical student’s gender. Conclusion: Our findings suggest that students undergo a gendered clinical apprenticeship within what are in effect gendered communities of practice with some distinct features. These findings underscore the imperative for further work to establish how medical students of all genders can be supported to fulfil their potential in clinical practice.
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Background: There are few African American students in medical school, and even fewer are choosing academic surgical careers. The objective of this study is to provide insight into what barriers URM students perceive when considering a career in academic surgery. Methods: This qualitative, descriptive study was conducted at the University of Pennsylvania. Sixteen African American students with an interest in surgery were recruited to participate in the study. The outcomes reported are themes of how participants perceive the challenges of pursuing an academic surgical career. Results: Barriers to pursuing a career in academic surgery cited by students included lifestyle concerns, financial pressures, having to work in a predominantly white environment, lack of mentorship, feelings of having to prove oneself, stressful environments and concerns of being a minority female in surgery. Conclusions: These study findings indicate that the persistent dearth of African-Americans in academic surgery is likely multi-factorial. Some ways surgical leadership can begin addressing these issues is through establishment of formal mentorship programs, ensuring non-discriminatory recruiting processes, having explicit goals of improving diversity and supporting pipeline programs.
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Importance: Previous studies examined sex distributions in different medical faculties, especially because increasingly more women entered the medical field in recent decades. Little is known at present about the female representation in ophthalmic research. Objective: To clarify sex equalities in ophthalmic research by evaluating the representation of female authorships. Design and setting: This bibliometric analysis included original English-language articles published in ophthalmologic journals indexed in the Web of Science from January 2008 to August 2018. Authorships were assigned by sex according to first name. Main outcomes and measures: Outcomes included the proportion of female authorships, odds ratios of women holding prestigious first and last authorships compared with men (measured by the prestige index), citation rates, a productivity analysis, and cross-journal and transnational female representation within ophthalmic research. The hypothesis was formulated during data collection. Results: Bibliometric data were abstracted from 87 640 original articles published in 248 ophthalmologic journals. Of 344 433 total authorships, female scholars held 34.9% (120 305 of 344 433) of all authorships, 37.1% (24 924 of 67 226) of first authorships, 36.7% (77 295 of 210 372) of coauthorships, and 27.1% (18 086 of 66 835) of last authorships. The female-to-male odds ratio was 1.12 (95% CI, 1.10-1.14) for first authorships, 1.20 (95% CI, 1.18-1.22) for coauthorships, and 0.63 (95% CI, 0.62-0.64) for last authorships, with annual growth rates of 1.6% overall, 1.6% for first authorships, 1.3% for coauthorships, and 2.5% for last authorships. Women were underrepresented in prestigious authorships (prestige index = -0.22). The underrepresentation remains almost stable for articles with many authors (prestige index = -0.17 for articles with >9 authors per article). Articles with female key authors were cited slightly less frequently (95% CI for female vs male authors, 10.8-11.0 vs 11.5-11.7 citations/articles). Women published fewer papers than men (42.5% [n = 41 383]; women held 34.9% [n = 120 207] of the authorships), show cross-journal uniformity and differences among single countries (change in prestige index = 0.66 vs 1.96). Overall, 44.1% of female authorships and a sex-neutral distribution of prestigious authorships are prognosticated for 2028. Conclusions and relevance: This algorithm analysis suggests the integration of women into ophthalmic research is average compared with other disciplines. A sex-specific gap exists for last authorship, suggesting career inequalities. With a growing number of female researchers in ophthalmology, the number of women in senior ranks may increase in the future.
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Background: This qualitative study examines the roles of mentoring and gender in choosing and continuing in a surgical career for women across the continuum. Methods: Semi-structured interviews were held with a purposive sample of 24 female surgical faculty, residents, and aspiring medical students from one institution between November 2018 and January 2019. Interview transcripts were analyzed using traditional thematic analysis methods aided by computerized software. Results: The use of a mosaic approach in seeking mentoring to match one's personal and career-relevant support needs was described frequently. Same-gender role models were more important for early career women, while leadership mentoring and coaching were more desired by later career women. Gender differences in mentoring were identified but some of these differences may apply equally to women and men. Conclusions: Study findings contribute mentoring insights relevant to both women and men interested in pursuing and thriving in surgical careers.
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Background: The most recent demographic data reveal that only 6.5% of practicing orthopaedic surgeons are women, and as far as we know, only two women have held chair positions in academic orthopaedic programs in the United States. Furthermore, orthopaedic surgery is the least gender-diverse speciality recognized by the Accreditation Council for Graduate Medical Education. The factors that contribute to the lack of gender diversity in orthopaedics remain ill-defined. A lag in publication productivity may be a barrier to career advancement for women orthopaedic surgeons, but this has not been well studied. Questions/purposes: (1) What is the proportion of orthopaedic studies published in six major orthopaedic journals by women first or senior authors from 1987 to 2017? (2) Did men and women orthopaedic surgeons publish in equal proportions during the study period (measured in 5-year intervals)? (3) Are there differences in the characteristics (such as study type or subject focus) of orthopaedic publications authored by women and those authored by men? (4) Has the increased proportion of practicing women orthopaedic surgeons been matched by an equal increase in authorship by women orthopaedic surgeons during the study timeframe? Methods: A cross-sectional analysis was designed to characterize trends in authorship of orthopaedic studies by women over time. All publications from the first issue of each of six major orthopaedic journals were evaluated at seven time points (1987, 1992, 1997, 2002, 2007, 2012, and 2017). Characteristics of each first and senior author (including gender, academic degree, and specialty), and study category of each publication were collected. Articles for which this information was not available were excluded (35 of 1073, or 3.3% of published studies, no difference in proportion of excluded studies between journals). The proportions of women and men authors were compared at the seven time points and for six study categories (basic science, case report/technique article, clinical medicine, economics/practice management, editorial content [including true editorials, letters to the editor, commentaries, and book reviews] and review/meta-analysis) using a Fisher's exact test or chi-squared analysis. We compared the rates of change of women authorship, practicing women orthopaedic surgeons, and women orthopaedic residents during the study period using an ANOVA and Tukey's honestly significant difference (HSD) post-hoc test with Cohen's D measure of effect size. Results: From 1987 to 2017, only 1.7% (15 of 880) of senior authors and 4.4% (46 of 1038) of first authors of orthopaedic publications were women orthopaedic surgeons. Based on population proportions (that is, percent of practicing women orthopaedic surgeons compared with men), the proportion of women senior authors was less than would be expected at each time point after 1987 compared with men. There were no differences between the types of studies authored by women or men. Finally, during the study period, the rate of growth of women senior authorship was less than the rates of growth of both practicing women orthopaedic surgeons (d = 5.3, 95% CI, 4.8-5.6; p = 0.023) and women first authorship (d = -4.3, 95% CI -4.6 to -3.6, p = 0.030; estimated mean 3.3, p = 0.013). Conclusions: Women orthopaedic surgeons published a small proportion of academic orthopaedic research from 1987 to 2017, and women senior authors consistently published less than would be expected based on their population proportion compared with men orthopaedic surgeons. Furthermore, the growth of practicing women orthopaedic surgeons has not been matched by growth in senior authorship by women over the same timeframe. Clinical relevance: This discrepancy warrants further exploration because a low rate of publication may negatively impact the career advancement of women orthopaedic surgeons and contribute to the overall lack of gender diversity in orthopaedics. We suggest that journals and publishers review their editorial processes to ensure blinding of author names during peer review and editorial decision-making, and to disclose those review processes to authors. We also suggest that institutions encourage women trainees and junior faculty to participate in mentorship programs and specialty societies that promote academic productivity.
Article
Purpose: Women remain underrepresented at all levels within the field of radiation oncology. We sought to study current female residents' experiences and concerns to inform interventions to promote gender equity. Furthermore, we evaluated interest in a professional society specifically for women radiation oncologists. Methods and materials: An anonymous 76-item survey was designed and distributed to current women residents in radiation oncology in 2017-2018. Analyses describe personal, program, and family characteristics and experiences before and after joining the field. Results: Of 170 female residents surveyed, 125 responded (74% response rate). Over one-quarter were in programs with ≤2 female residents (29%) and ≤2 female attendings (29%). One-third (34%) reported having children. Over half (51%) reported that lack of mentorship affected career ambitions. Over half (52%) agreed that gender-specific bias existed in their programs, and over a quarter (27%) reported they had experienced unwanted sexual comments, attention, or advances by a superior or colleague. Only 5% reported no symptoms of burnout. Almost all (95%) agreed that radiation oncology is perceived as family friendly; however, only 52% agreed that it actually is. An overwhelming majority (90%) expressed interest in joining a professional group for women in radiation oncology. Conclusions: In the first study to our knowledge to focus specifically on the experiences of women residents in radiation oncology, a number of areas for potential improvement were highlighted, including isolation and underrepresentation, mentorship needs, bias and harassment, and gender-based obstacles such as need for support during pregnancy and motherhood. These findings support the organization of groups such as the Society for Women in Radiation Oncology, which seeks to target these needs to promote gender equity.
Article
Background Women remain underrepresented in academic medicine, particularly in leadership positions. This lack of women in leadership has been shown to have negative implications for both patient care and educational outcomes. Similarly, the literature demonstrates that female physicians are less likely to have mentors, despite the proven benefits of mentorship for career advancement. The objective of this review is to identify and describe models of mentorship for women in academic medicine. Methods We searched PubMed, PsycINFO, Education Resources Information Center, and Cochrane Databases of Systematic Reviews following PRISMA guidelines in June 2017. We included original English language studies that described a mentorship program in the USA that involved academic medical doctorates and that were created for women or provided results stratified by gender. Results Our search returned 3625 results; 3309 references remained after removal of duplicates. Twenty articles met inclusion criteria. The majority of the programs were designed for junior faculty and used the dyad model of mentoring (i.e., one mentor/one mentee). Frequently cited objectives of these programs were to improve scholarship, promotion, and retention of female faculty. Program evaluations were primarily survey-based, with participant-reported satisfaction being the most frequent measured outcome. Most results showed very high satisfaction. Gender concordance between mentor and mentee did not impact satisfaction. Eight articles reported objective outcomes, including publications, retention, and promotion, and each of these demonstrated an improvement after program implementation. Discussion Our review suggests that mentorship programs designed for women, regardless of the model, are met with high satisfaction and can help promote and retain women in academic medicine. No clear best practices for mentorship emerged in the literature. Institutions, therefore, can individualize their mentorship programs and models to available resources and goals. These results demonstrate the importance of more widespread implementation of mentorship programs to more effectively facilitate professional development and success of women in academic medicine.
Article
Background: Women are currently underrepresented in academic psychiatry. As publication activity reflects both leadership and participation in academia, we examined temporal trends in women's authorship by conducting a large-scale bibliometric study of psychiatry journals. Methods: We examined changes in proportions of women in the first, last, and overall authorship positions over time; relationship to journal impact factor and editorial board makeup; and rates of transition to senior author status using original research articles published in the 24 highest-impact psychiatry journals between January 2008 and May 2018. Results: In 30,934 articles, women represented 40.0% of all authors in 2008 and 44.8% in 2018, with a significant increase in the percentage of women as first authors (2008: 43.5%, 2018: 49.5%; B = 0.64, p = .002) and last authors over time (2008: 30.0%, 2018: 35.7%; B = 0.64, p = 1 × 10-5). Articles with women as last authors were significantly more likely than those with men as last authors to have a woman as first author (χ21 = 126.1, p < 2.2 × 10-16). Women exhibited slower rates of transition to the last author position (log rank p = 2 × 10-16); time to 10% transition was 5 years for men and 9 years for women. Conclusions: These results indicate continued improvement in the representation of women authors in psychiatry journals, resulting in near parity in first authors. However, slower rates of transition to the senior author position and continued underrepresentation of women as senior authors suggest ongoing challenges in achieving gender parity in academic leadership. At the present rate of change for last authors (0.64% increase per year), women would achieve parity in senior authorship in ∼20 to 25 years.
Article
In academic emergency medicine, female gender has been associated with fewer scholarly opportunities, fewer awards, and lower salaries.[1] First authorship of original research helps to determine rank and salary in academic medicine. Current data suggests a general under‐representation of female first authors in medical literature from multiple specialties. Women are less likely to be listed as first author in the case of co‐first authorship in high‐impact medical journals.[2] Men outnumber women at all tiers of peer review, ranging from reviewers to editors.[3] With this background in mind, we sought to compare responses of male and female first authors regarding their perceptions of the factors that helped or hindered their first author status in Emergency Medicine. This article is protected by copyright. All rights reserved.
Article
Objectives Organizations to promote career networking and mentorship among women are recommended as a best practice to support the recruitment and retention of women physicians; however, the impact of such organizations is unknown. Our primary objective is to describe the impact of a national woman‐focused organization for academic emergency physicians on retention and advancement. Methods We conducted semi‐structured interviews of past and present organization leaders, as well as members at varying stages in their careers. Physicians with experience in qualitative methods conducted interviews and coded all transcripts using inductive content analysis techniques. Themes were reviewed and discussed to ensure consensus. Results We performed 17 interviews lasting 20‐30 minutes each, resulting in 476 total minutes of transcript. Participants represented varying stages of career experience, ranging from 2 to 35 years since residency completion (median 9.5). Median years of participation in the woman‐focused organization was 10 (Table 1). Over half (53%) of participants were past presidents of the organization. The dominant themes encompassed facilitating academic advancement through scholarly productivity, leadership experiences, awards, and promotions; mentorship and sponsorship; peer support and collaborations; reduced professional isolation; and initiatives to address systemic gender inequities and challenges, including strategies to navigate bias, promote pay equity, and advocate for family‐friendly workplace policies. Discussion Active participation in a woman‐focused professional organization enhances members’ career retention and advancement by creating opportunities and relationships that facilitate leadership; enabling scholarly work to advance equity and inclusion; and cultivating a sense of belonging. While challenges and barriers persistent, the myriad benefits of a women‐focused professional organization reported by members and leaders represent important steps towards greater equity for women and other underrepresented groups in academic medicine. This article is protected by copyright. All rights reserved.
Article
Purpose: To understand how sponsorship functions as a professional relationship in academic medicine. Method: The authors conducted semi-structured interviews with Johns Hopkins University School of Medicine faculty in 2016: department chairs (sponsors) and faculty participants of an executive leadership development program (protégés). Using editing analysis style, the authors coded interview transcripts for thematic content; a coding framework and themes were derived using an iterative process. Results: Five themes were identified from 23 faculty interviews (12 sponsors, 11 protégés): (1) Mentorship is different: Sponsorship is episodic and focused on specific opportunities; (2) Effective sponsors are career-established and well-connected talent scouts; (3) Effective protégés rise to the task and remain loyal; (4) Trust, respect, and weighing risks are key to successful sponsorship relationships; (5) Sponsorship is critical to career advancement. Sponsorship is distinct from mentorship, though mentors can be sponsors if highly placed and well connected. Effective sponsors have access to networks and provide unequivocal support when promoting protégés. Effective protégés demonstrate potential and make the most of career-advancing opportunities. Successful sponsorship relationships are based on trust, respect, mutual benefits, and understanding potential risks. Sponsorship is critical to advance to high-level leadership roles. Women are perceived as being less likely to seek sponsorship but as needing the extra support sponsorship provides to be successful. Conclusions: Sponsorship, in addition to mentorship, is critical for successful career advancement. Understanding sponsorship as a distinct professional relationship may help faculty and academic leaders make more informed decisions about using sponsorship as a deliberate career-advancement strategy.
Article
Objectives: Although the importance of mentorship in training the next generation of cardiothoracic surgeons is widely recognized, the current state of mentorship remains undefined. Methods: Trainee responses to questions in the 2017 In-Training Examination regarding aspects of mentorship were analyzed. Response rate was 78% (288/370). Mentor-related and trainee-related characteristics were assessed. Results: The majority (84%) of residents had mentors, with a high impact on specialty choice (80%), and 91% of respondents viewed mentorship as critical to success. Nearly half (42%) had program-assigned mentors; 53% found them as productive, and 13% reported more consistent/frequent meetings than personally selected mentors, with 22% reporting less ideal personality match compared with personally selected mentors. Among residents with mentors, 36% lacked mentorship in work-life balance, 23% lacked mentorship in job assistance, and 22% lacked mentorship in career advice. Junior residents more often valued mentors as role models, whereas mentors chosen by senior residents were more impactful in technical training, job counseling, and societal involvement. Compared with men, women more often valued mentors as role models and assisting in networking. Men reported their mentors were more impactful in teaching technical skills and clinical ability than women. Conclusions: The majority of current cardiothoracic surgery trainees had mentorship; however, gaps remain: Many residents lacked career path guidance, assistance obtaining a job, and advice regarding life-work balance. The role of mentorship varied with program type, seniority, and gender, emphasizing the need to tailor mentorship to the individual and changing needs of the resident.
Article
Objective: The aim of the study was to (1) assess differences in how male and female general surgery residents utilize duty-hour regulations and experience aspects of burnout and psychological well-being, and (2) to explore reasons why these differing experiences exist. Background: There may be differences in how women and men enter, experience, and leave residency programs. Methods: A total of 7395 residents completed a survey (response rate = 99%). Logistic regression models were developed to examine the association between sex and resident outcomes. Semistructured interviews were conducted with 42 faculty and 56 residents. Transcripts were analyzed thematically using a constant comparative approach. Results: Female residents reported more frequently staying in the hospital >28 hours or working >80 hours in a week (≥3 times in a month, P < 0.001) and more frequently feeling fatigued and burned out from their work (P < 0.001), but less frequently "treating patients as impersonal objects" or "not caring what happens" to them (P < 0.001). Women reported more often having experienced many aspects of poor psychological well-being such as feeling unhappy and depressed or thinking of themselves as worthless (P < 0.01). In adjusted analyses, associations remained significant. Themes identified in the qualitative analysis as possible contributory factors to sex differences include a lack of female mentorship/leadership, dual-role responsibilities, sex blindness, and differing pressures and approaches to patient care. Conclusions: Female residents report working more, experiencing certain aspects of burnout more frequently, and having poorer psychological well-being. Qualitative themes provide insights into possible cultural and programmatic shifts to address the concerns for female residents.
Article
Objective: Risk-of-bias assessment is a central component of systematic reviews but little conclusive empirical evidence exists on the validity of such assessments. In the context of such uncertainty, we present pragmatic recommendations that promote transparency and reproducibility in processes, address methodological advances in the risk-of-bias assessment, and can be applied consistently across review topics. Study design: Epidemiological study design principles; available empirical evidence, risk-of-bias tools, and guidance; and workgroup consensus RESULTS: We developed recommendations for assessing the risk of bias of studies of health care interventions specific to framing the focus and scope of risk-of-bias assessment; selecting risk of bias categories; choosing assessment instruments; and conducting, analyzing, and presenting results of risk-of-bias assessments. Key recommendations include transparency and reproducibility of judgments, separating risk of bias from other constructs such as applicability and precision, and evaluating risk of bias per outcome. We recommend against certain past practices, such as focusing on reporting quality, relying solely on study design or numerical quality scores, and automatically downgrading for industry sponsorship. Conclusion: Risk-of-bias assessment remains a challenging but essential step in systematic reviews. We presented standards to promote transparency of judgments.
Article
Objective: To further evaluate the academic representation of female urology residents in the United States, we reviewed abstracts from the Mid-Atlantic American Urological Association (MA-AUA) sectional meetings to determine if the recent increase in the number of female urology residents mirrored an increase in this group's abstract authorship. Methods: Full text abstracts from the MA-AUA meetings were analyzed from 2008-2014 excluding one joint section meeting. First-author gender was determined by querying publicly available institutional websites, social media platforms, and the U.S. News & World Report. First-author gender was indeterminable in 10 abstracts based on search criteria and these were excluded. Individual abstracts were broadly categorized based on keywords into one of several topics. Chi-squared statistical tests examined the relationship between first-authorship gender, publication year, and abstract category. Results: The number of female urology residents in the MAAUA increased over the study period. A total of 484 abstracts were analyzed. Three hundred ninety-three abstracts (81%) included a male first-author, whereas 81 abstracts (17%) included a female first-author. Female first authorship ranged between 13% and 25% annually. Comparison of male-to-female first authorship was statistically significant at all years evaluated (P<0.001). There was a statistically significant difference between male and female first authorship in all topic categories (P<0.01) except Education/Other (P=0.56). Conclusions: Despite continued gains and increasing female representation within urology, these data highlight significantly fewer female first-authors at the regional Mid-Atlantic section meetings. Larger studies are necessary to identify contributing factors and further areas for improvement toward decreasing gender imbalances within the academic community.
Article
To the Editor: Bickel (Dec. 15 issue)¹ mentions that women receive higher marks than men for “humanistic attributes,” according to directors of residency training programs. It would be interesting to compare the humanistic qualities of female and male faculty members. I suspect that women would receive higher evaluations for humanistic concerns and activities, which I define as those involving a concern for the dignity, worth, and well-being of other humans. As I consider my female colleagues, I note that many of us participate in humanistic activities that account for a large portion of the time we spend in patient care,….
Article
Purpose: Understanding the careers of recent career development awardees is essential to guide interventions to ensure gender equity and success in academic medicine. Method: In 2010-2011 (T1) and 2014 (T2), 1,719 clinician-researchers who received new K08 and K23 awards in 2006-2009 were longitudinally surveyed. Multivariable analyses evaluated the influence of factors on success, including demographics, job characteristics, work environment, priorities, and domestic responsibilities. Results: Of 1,275 respondents at T1, 1,066 (493 women; 573 men) responded at T2. Men and women differed in job characteristics, work environment, priorities, and domestic responsibilities. By T2, women had less funding (mean $780,000 vs. $1,120,000, P = .002) and published fewer papers (mean 33 vs. 45). Using a composite measure that considered funding, publications, or leadership to define success, 53.5% (264/493) of women and 67.0% (384/573) of men were successful. Gender differences in success persisted after accounting for other significant predictors-K award type, specialty, award year, work hours, funding institute tier, feeling responsible for participating in department/division administration, importance of publishing prolifically, feeling responsible for contributing to clinical care, importance of publishing high-quality research, collegiality of the mentoring relationship, adequacy of research equipment, and departmental climate. A significant interaction existed between K award type and gender; the gender difference in success was most pronounced among K23 researchers (among whom the odds ratio for females = 0.32). Conclusions: Men and women continue to have different experiences and career outcomes, with important implications for the design of interventions to promote equity and success.
Article
Women and underrepresented racial/ethnic minority faculty (URM) are critical to developing inclusive learning environments. Career counselors can benefit from understanding the factors influencing women’s and URMs’ interest in academic careers, as this population remains markedly underrepresented in academic medicine. A mixed methods study was conducted among medical students and residents yielding 643 survey and 121 focus group participants. Participants were diverse by gender and race/ethnicity. Themes included (a) factors influencing career interest, (b) influential others, (c) timing of career interest, and (d) career expectations. Findings show differences among women, URM, and dominant-identity groups. Implications include how career development programs and institutional diversity policies and practices should consider developing and offering activities that support (a) mentoring—especially for women trainees, (b) learning how to align academia and community engagement and scholarship—especially for URM trainees, and (c) senior leadership development support for women and URM trainees.
Article
Purpose: Gender inequalities in the careers of faculty in academic medicine could partially be attributed to an organizational climate that can exclude or be nonsupportive of women faculty. This study explores the climate for women faculty from a systems perspective at the organizational and individual levels based on the perceptions of women faculty. Race differences were also investigated. Materials and methods: Cross-sectional survey data from women faculty (N?=?3127) at 13 purposively sampled medical schools and an institutional assessment of organizational characteristics were used. Organizational factors related to the climate for women were identified using bivariate statistics. The association between perceived climate for women and organizational characteristics, individual perceptions of the work environment and individual career, and personal characteristics with control variables were investigated using hierarchical linear regression models. Organizational effects by race/ethnicity were estimated using interaction terms. Results: The climate for women faculty varied across institutions and by classification as minority-serving institutions (MSIs). Respondent's report of existence of an office for women's affairs, trust in leadership, and satisfaction with mentoring were positively associated with the climate for women. Perceived workplace discrimination and work-family conflict were inversely associated with a positive climate. No race/ethnicity differences were observed in the multivariable analysis. Conclusions: The climate for women faculty in academic medicine should not be regarded constant across organizations, specifically between MSIs and non-MSIs. Efforts to advance a positive climate for women could focus on improving trust in leadership, increasing support for structures/offices for women, and mitigating perceived discrimination and work-family conflict.
Article
In order to meet the significant staffing challenges to health care provision in South Africa, the need to support the training and retention of Black medical specialists has been identified. This small qualitative study aimed to explore experiences of mentorship among a group of Black medical specialists in hopes of understanding the value and potential challenges that these relationships raise. Ten Black medical specialists were interviewed about their experiences of being mentored during their registrar training. The interview data was analysed using discourse analysis, and the results comprise of three main themes, namely: Difficulty accessing mentorship, a lack of Black and/or female role models and finally, experiences of feeling excluded from soft networks. The experiences explored in this study indicate the need for open dialogue within the mentorship dyad regarding certain taken-for-granted assumptions surrounding race, so as to aid the provision of more effective and satisfying mentorship outcomes.
Article
Objective: To describe the publication productivity of academic urologists in the United States by gender. Materials and methods: Gender inequality is prevalent in most surgical subspecialties, including urology. Despite small numbers of women in academic positions, differences in scholarly impact by gender are relatively unknown. We assembled a list of 1922 academic urologists (1686 male (87.7%), 236 female (12.3%)) at 124 academic institutions throughout the United States as of February 2016. Scopus and Google Scholar were queried for bibliometric data on each individual, including h-index and m-quotient. We analyzed these metrics for both genders by educational background, subspecialty, NIH funding, and academic rank. Results: Men had higher median h-indices than women overall (p<0.05), and by successive academic ranks (p<0.05). Proportionally fewer women attained senior academic ranking (professor/chair), (p<0.05). There was no difference in research productivity by successive rank after controlling for career duration (m-quotient). Women were more likely to choose a practice that specialized in pediatric urology or female urology/pelvic reconstructive surgery than their male counterparts (p<0.05). Conclusions and relevance: Women represent a growing proportion of academic urology faculty, but despite the recent increase in number entering the field, relatively few women occupy senior leadership positions. Improving psychosocial barriers to advancement such as lack of mentorship or discriminatory policies may help pioneering female urologists as they progress in their careers.
Article
Purpose: A formal residency advisory program was instituted in 2010 to assist psychiatry residents in achieving academic and personal goals and to help identify additional mentors. In this project the authors sought to evaluate and improve resident and faculty satisfaction with the residency advisory program. Methods: At the end of the 2013-2014 academic period, residents completed an anonymous survey to determine baseline satisfaction with the residency advisory program. A series of interventions were then implemented including the addition of a resident liaison to the program, formal recognition of faculty advisors, and email reminders regarding regular residency advisory meetings. Eight months later a follow-up survey was distributed to assess the impact of the interventions on resident and faculty satisfaction with the residency advisory program and mentoring within the residency program. Results: There were notable improvements in overall satisfaction with a 58% increase (p<0.05) in residents meeting with their advisors. After the intervention, residents were more likely to seek their resident advisor for help in facilitating relationships with potential career mentors (28% vs 72%, OR=6.64, 95% CI =1.83-24.08). Although 87% of all residents reported having mentors outside of the formal residency advisory program, approximately half of those who are in their first year post medical school (PGY1s) reported having no mentors outside of the residency advisory program (notably all women). Conclusions: Resident advisory programs benefit from continuous evaluation and quality improvement with enhanced structure, including a senior resident position, leading to improved satisfaction. Residency advisory programs may be particularly useful in helping to facilitate relationships with other mentors, which may be particularly important for women early in their training.
Article
Background Mentoring is important throughout a physician’s career and has been noted to be particularly important during residency training. Other studies suggest that women may experience difficulty in finding mentors. Purpose This study explored gender-specific differences in residents’ mentoring experiences. Methods The authors conducted two focus groups at the University of Pittsburgh in July, 2004. One group was composed of 12 female residents; the other was composed of nine male residents. Discussions were audiotaped and transcribed. Two investigators coded the transcripts and identified emerging themes. Results Residents of both genders cited multiple barriers to mentoring. Men´s strategies for find­ing mentors were more numerous than women´s and included identifying mentors through re­search, similar interests, friendship, and networking. Female strategies were limited and included identifying mentors through “word of mouth” and work experiences. Women described more pas­sive approaches for finding a mentor than men. Conclusions Female residents may lack strategies and initiatives for finding mentors. Residency programs should create opportunities for residents to develop mentoring relationships, with special attention paid to gender differences. Keywords: Residents, mentoring, gender
Article
Objective Greater numbers of women in medicine have not resulted in more women achieving senior positions. Programs supporting the recruitment, promotion, and retention of women in academic medicine could help to achieve greater advancement of more women to leadership positions. Qualitative research was conducted to understand such programs at 23 institutions and, using the social ecological model, examine how they operate at the individual, interpersonal, institutional, academic community, and policy levels. Methods Telephone interviews were conducted with faculty representatives (n = 44) of the Group on Women in Medicine and Science, Diversity and Inclusion, or senior leaders with knowledge on gender climate in 24 medical schools. Four trained interviewers conducted semistructured interviews that addressed faculty perceptions of gender equity and advancement, which were audiotaped and transcribed. The data were categorized into three content areas—recruitment, promotion, and retention—and coded a priori for each area based on their social ecological level of operation. Findings Participants from nearly 40% of the institutions reported no special programs for recruiting, promoting, or retaining women, largely describing such programming as unnecessary. Existing programs primarily targeted the individual and interpersonal levels simultaneously, via training, mentoring, and networking, or the institutional level, via search committee trainings, child and elder care, and spousal hiring programs. Lesser effort at the academic community and policy levels were described. Conclusions Our findings demonstrate that many U.S. medical schools have no programs supporting gender equity among medical faculty. Existing programs primarily target the individual or interpersonal level of the social ecological interaction. The academic community and broader policy environment require greater focus as levels with little attention to advancing women's careers. Universal multilevel efforts are needed to more effectively advance the careers of medical women faculty and support gender equity.
Article
Objectives The ‘gender gap’ in academic medicine remains significant and predominantly favours males. This study investigates gender disparities in research performance in an Academic Health Science Centre, while considering factors such as mentoring and scientific collaboration. Materials and methods Professorial registry-based electronic survey (n=215) using bibliometric data, a mentoring perception survey and social network analysis. Survey outcomes were aggregated with measures of research performance (publications, citations and h-index) and measures of scientific collaboration (authorship position, centrality and social capital). Univariate and multivariate regression models were constructed to evaluate inter-relationships and identify gender differences. Results One hundred and four professors responded (48% response rate). Males had a significantly higher number of previous publications than females (mean 131.07 (111.13) vs 79.60 (66.52), p=0.049). The distribution of mentoring survey scores between males and females was similar for the quality and frequency of shared core, mentor-specific and mentee-specific skills. In multivariate analysis including gender as a variable, the quality of managing the relationship, frequency of providing corrective feedback and frequency of building trust had a statistically significant positive influence on number of publications (all p<0.05). Conclusions This is the first study in healthcare research to investigate the relationship between mentoring perception, scientific collaboration and research performance in the context of gender. It presents a series of initiatives that proved effective in marginalising the gender gap. These include the Athena Scientific Women's Academic Network charter, new recruitment and advertisement strategies, setting up a ‘Research and Family Life’ forum, establishing mentoring circles for women and projecting female role models.
Article
Purpose: To investigate which mentor-similarity characteristics women faculty in academic medicine rate most important and to determine whether the importance of similarity differs among women faculty on the basis of current and prior mentoring, demographic and personal factors, and career factors. Method: Cross-sectional survey data from 3,100 women faculty at 13 purposively sampled U.S. medical schools were collected in 2012. The preferences of participants regarding the importance of mentor similarity in terms of race/ethnicity, gender, personal and career interests, and department and institution were studied. Analysis entailed chi-square tests and multivariable ordered logistic models. Results: Overall, respondents ranked having a mentor in the same department and institution as most important. Same department and institution were less important for those without a current mentor and for senior faculty, and were more important for Asian faculty. Same career and personal interests were less important for older faculty and more important for those with a doctorate only. Same gender was more important for black faculty, faculty at the rank of instructor, and those without current mentoring. Overall, same race/ethnicity was rated least important; however, it was more important for racial-ethnic minorities, U.S.-born faculty, and those who had never had a mentor. Conclusions: Mentor preferences, as indicated by level of importance assigned to types of mentor similarity, varied among women faculty. To advance effective mentoring, characterized by good mentor-mentee fit, the authors provide recommendations on matching strategies to be used in academic medicine when considering the diverse mentor preferences of women faculty.
Article
Purpose: Female representation in academic medicine is increasing without proportional increases in female representation at senior ranks. The purpose of this study is to describe the gender representation in academic gastroenterology (GI) and compare publication productivity, academic rank, and career duration between male and female gastroenterologists. Method: In 2014, the authors collected data including number of publications, career duration, h-index, and m-index for faculty members at 114 U.S. academic GI programs. Results: Of 2,440 academic faculty, 1,859 (76%) were men and 581 (24%) were women. Half (50%) of men held senior faculty position compared with 29% of women (P < .001). Compared with female faculty, male faculty had significantly (P < .001) longer careers (20 vs. 11 years), more publications (median 24 [0-949] vs. 9 [0-438]), and higher h-indices (8 vs. 4). Higher h-index correlated with higher academic rank (P < .001). The authors detected no difference in the h-index between men and women at the same rank for professor, associate professor, and instructor, nor any difference in the m-index between men and women (0.5 vs. 0.46, respectively, P = .214). Conclusions: A gender gap exists in the number and proportion of women in academic GI; however, after correcting for career duration, productivity measures that consider quantity and impact are similar for male and female faculty. Women holding senior faculty positions are equally productive as their male counterparts. Early and continued career mentorship will likely lead to continued increases in the rise of women in academic rank.
Article
Background Although women account for approximately half of the medical students in the United States, they represent only 13% of orthopaedic surgery residents and 4% of members of the American Academy of Orthopaedic Surgeons (AAOS). Furthermore, a smaller relative percentage of women pursue careers in orthopaedic surgery than in any other subspecialty. Formal investigations regarding the gender discrepancy in choice of orthopaedic surgery are lacking. Questions/purposes (1) What reasons do women orthopaedic surgeons cite for why they chose this specialty? (2) What perceptions do women orthopaedic surgeons think might deter other women from pursuing this field? (3) What role does early exposure to orthopaedics and mentorship play in this choice? (4) What professional and personal choices do women in orthopaedics make, and how might this inform students who are choosing a career path? Methods A 21-question survey was emailed to all active, candidate, and resident members of the Ruth Jackson Orthopaedic Society (RJOS, n = 556). RJOS is the oldest surgical women’s organization incorporated in the United States. An independent orthopaedic specialty society, RJOS supports leadership training, mentorship, grant opportunities, and advocacy for its members and promotes sex-related musculoskeletal research. Although not all women in orthopaedic practice or training belong to RJOS, it is estimated that 42% of women AAOS fellows are RJOS members. Questions were formulated to determine demographics, practice patterns, and lifestyle choices of women who chose orthopaedic surgery as a specialty. Specifically, we evaluated the respondents’ decisions about their careers and their opinions of why more women do not choose this field. For the purpose of this analysis, the influences and dissuaders were divided into three major categories: personal attributes, experience/exposure, and work/life considerations. Results The most common reasons cited for having chosen orthopaedic surgery were enjoyment of manual tasks (165 of 232 [71%]), professional satisfaction (125 of 232 [54%]), and intellectual stimulation (123 of 232 [53%]). The most common reasons indicated for why women might not choose orthopaedics included perceived inability to have a good work/life balance (182 of 232 [78%]), perception that too much physical strength is required (171 of 232 [74%]), and lack of strong mentorship in medical school or earlier (161 of 232 [69%]). Respondents frequently (29 of 45 [64%]) commented that their role models, mentors, and early exposure to musculoskeletal medicine were influential, but far fewer (62 of 231 [27%]) acknowledged these in their top five influences than they did the more “internal” motivators. Conclusions To our knowledge, this is the largest study of women orthopaedic surgeons regarding factors influencing their professional and personal choices. Our data suggest that the relatively few women currently practicing orthopaedics were attracted to the field because of their individual personal affinity for its nature despite the lack of role models and exposure. The latter factors may impact the continued paucity of women pursuing this field. Programs designed to improve mentorship and increase early exposure to orthopaedics and orthopaedic surgeons may increase personal interest in the field and will be important to attract a diverse group of trainees to our specialty in the future.
Article
Background: The purpose of this study was to explore career satisfaction and advancement for women in academic surgery. Methods: A 48-item web-based survey was emailed to women surgeons in academic centers across Canada, exploring career advancement, family planning, mentorship, discrimination, and career satisfaction. Results: The survey response rate was 38% (81 of 212); 18% of participants felt they experienced gender discrimination in medical school, 36% in residency, 12% in fellowship, and 41% as staff surgeons. More than half felt that their gender had played a role in the career challenges they faced. Responses to open-ended questions suggested that many surgeons struggled to balance their academic careers with family life. Despite this, participants rated their career satisfaction very highly. Conclusions: There remain ongoing challenges for women in academic surgery including lack of gender equality, appropriate mentorship, and accommodations for surgeons with families. Continued advancement of women in academic surgery is dependent on addressing these concerns.
Article
Introduction: The aims of this study were to a) describe the quantity and quality of faculty mentoring in U.S. academic health centers, b) measure associations between mentoring and 12 dimensions that reflect the culture of academic health centers, and c) assess whether mentoring predicts seriously contemplating leaving one’s institution. Methods: During 2007–2009, the National Initiative on Gender, Culture and Leadership in Medicine (C-Change) conducted a cross-sectional study of faculty from 26 representative AHCs in the U.S. using the 74-item C-Change Faculty Survey to assess relationships of faculty characteristics and various aspects of the institutional culture (52% response rate). Among the 2,178 eligible respondents (assistant, associate, and full professors), we classified their mentoring experience as either inadequate, neutral (eg, did not want a mentor), , or positive. Results: In this national sample, 43% of the 2,178 faculty respondents had inadequate mentoring; only 30% had a positive assessment of mentoring. There was no statistical difference by sex, minority status or rank. The remainder were neutral. Inadequate mentoring was most strongly associated with less institutional support, lower self-efficacy in career advancement, and lower scores on the trust/relationship/inclusion scale. The percent of faculty who had seriously considered leaving their institution was highest among those who had inadequate mentoring (58%), compared to those who were neutral (28%) or had positive mentoring (14%) (all paired comparisons, P<.001). Discussion: In a national survey of faculty of U.S. AHCs, mentoring was frequently inadequate and this was associated with faculty contemplating leaving their institutions. Positive mentoring, although less prevalent, was associated with many other positive dimensions of AHCs.
Article
Mentorship in medicine is associated with increased career satisfaction and personal development. Despite these benefits, little is known about mentorship in anesthesiology training programs. Our objectives were to determine (1) the prevalence of formal mentorship programs among anesthesiology training programs in Canada, (2) the prevalence of informal and formal mentorship among anesthesiology residents in Canada, and (3) the predictors of having an identified mentor among anesthesiology residents in Canada. We conducted a cross-sectional web-based survey of residents and program directors from Canadian anesthesiology residency programs. Program directors were questioned about formal mentorship programs, and residents were asked to provide demographic data and information about their mentorship relationships. We analyzed the relationship between resident characteristics and mentorship. Our survey response rates were 76% and 39% for the Program Director Survey and the Resident Survey, respectively. Formal mentorship programs were present in 54% of residency training programs, and 94% of residents agreed that mentorship was important. Seventy-four percent of residents identified at least one mentor, although 42% of these residents did not interact regularly with their mentor. Mentors and mentees were more likely to be of the same gender. If a formal mentorship program was present, residents were more likely to identify a mentor (82 vs 17%) and interact regularly with their mentor (70 vs 46%). Formal mentorship programs were present in half of anesthesiology training programs. Although 74% of the residents identified a mentor, 42% did not interact regularly with their mentor. The presence of a formal mentorship program was positively associated with mentorship.