Abstract NEW ENGLAND JOURNAL OF MEDICINE Women Physicians in Academic Medicine Lynn Nonnemaker, PhD Background: I conducted a study to determine whether women who graduate from medical schools are more or less likely than their male counterparts to pursue full-time careers in academic medicine and to advance to the senior ranks of medical school faculties. Methods: The rates of advancement to the ranks of assistant, associate, and full professor for all US medical school graduates from 1979 through 1993 and for all members of US medical school faculties from 1979 through 1997 were studied. Cohorts were defined on the basis of the year of graduation from medical school, track (tenure or nontenure), and academic department. Within each cohort, the number of women who advanced to a senior rank was compared with the number that would be expected on the basis of parity between men and women, and 95 percent confidence intervals were calculated. Results: Women were significantly more likely than men to pursue an academic career. During the study period, 634 more women became faculty members than expected. The numbers were higher in the older cohorts than in the younger cohorts. The numbers of women who advanced to the ranks of associate and full professor were significantly lower than the expected numbers. This was true for both tenure and nontenure tracks, even after adjustment for the department. A total of 334 fewer women advanced to associate professor than expected, and 44 fewer women advanced to full professor than expected. Conclusions: Disparities persist in the advancement of men and women on medical school faculties. However, the numbers of women physicians at all levels of academic medicine are increasing. N Engl J Med. 2000;342:399-405. Commentary NONNEMAKER1 EXAMINED the academic progress of women who graduated from medical school from 1979 to 1997. Her methods for analyzing the data provide a critical look at trends by sex, year of matriculation, and academic track, (ie, tenure vs nontenure). Since the data were pooled irrespective of specialty, there were adequate numbers to support meaningful conclusions. Nonnemaker's conclusions were 2-fold: (1) Between 1979 and 1997, approximately 10% more women than expected chose academic careers compared with men. (2) In all but 2 of 15 cohorts, women were significantly less likely to achieve the rank of associate professor compared with men. The difference was even greater when one considered the tenure track vs nontenure track. Approximately one third of those expected to make tenure or 205 women did not make tenure vs 151 fewer women on the nontenure track. Thus, it seems that the growing numbers of women in medical schools have yielded a greater representation on the faculties of medical schools; however, women still are having difficulty getting promoted. In ophthalmology since 1989, the Association of American Medical Colleges, Washington, DC, lists ophthalmology as 1 of 6 clinical disciplines that has experienced the greatest increase in women. Over a period of 9 years, the numbers increased by a factor of 1.6, from 14% to 23%. However, only 9.7% of these women are full professors.2 Given that the number of women choosing ophthalmology has substantially increased over the last 2 decades, there should be a continued growth of women faculty members.3 However, based on Nonnemaker's article, the careers of these women will advance more slowly than those of their male colleagues. In her editorial, which appeared in the same issue as the Nonnemaker article,1 Catherine D. DeAngelis, MD, MPH, who is now the editor of JAMA, recognizes the importance of mentors in the careers of junior faculty. She notes that women need not seek out just women mentors but male mentors as well.4 It is more critical to select an individual who is willing to assist a young faculty member who is establishing an appropriate research focus and networking with key influential colleagues in the field rather than simply to select a mentor by sex or ethnicity. In turn, it is important for all of us to develop the skills of an effective mentor. As one who is included in one of the cohorts studied by Nonnemaker,1 I can attest to the value of the input of key individuals, most of whom were men, in my career. Mentoring is the key strategy to foster the careers of talented individuals, and as stated by DeAngelis, "otherwise, we will waste half our genetic pool of intelligence, creativity, and critical insights and experience. [Ophthalmology] simply cannot afford that loss.''4(p427) Reprints: Lynn Nonnemaker, PhD, Center for the Assessment and Management of Change in Academic Medicine, Association of American Medical Colleges, 2450 North Street NW, Washington, DC 20037 (e-mail: firstname.lastname@example.org). Accepted for publication March 23, 2000. This study was supported in part by an unrestricted grant from Research to Prevent Blindness Inc, New York, NY. Corresponding author: Eve J. Higginbotham, MD, Department of Ophthalmology, 22 S Greene St, University of Maryland, Baltimore, MD 21201-1595. References 1. Nonnemaker L Women physicians in academic medicine: new insights from cohort studies. N Engl J Med. 2000;342399- 405Google ScholarCrossref 2. Association of American Medical Colleges, Women in US Academic Medicine Statistics. Washington, DC Association of American Medical Colleges1998; 3. Higginbotham EJ Celebrating women in ophthalmology. Arch Ophthalmol. 1998;1161227- 1228Google ScholarCrossref 4. DeAngelis C Women in academic medicine: new insights, same sad news. N Engl J Med. 2000;342426- 427Google Scholar
Archives of Ophthalmology – American Medical Association
Published: Sep 1, 2000
Keywords: new england,parity,physicians, women,health disparity,schools, medical
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