Statistics look encouraging at the start of a career in medicine. Roughly equal numbers of men and women graduate medical school; Drexel University College of Medicine graduated an equal number of men and women in 2018. But when those students graduate, and further advance into their careers, the field is increasingly male. Women are 36 percent of physicians and 16 percent of medical school deans. In publishing, women make up one in five senior authors in academic medical literature (although the number is on the rise), and seven percent of editors-in-chief at major medical journals. Discrimination and bias against women in health care infiltrates hiring, pay, promotion, and other critical aspects of a career, reports a study earlier this year in The Lancet.
Combatting this and other persistent factors leading to these disparities, Drexel’s Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) program actively works to close gender gaps and prepare high achieving, qualified women for executive positions in academic and healthcare institutions worldwide.
Since 1995, ELAM has offered a one-year fellowship for senior level women faculty possessing the greatest potential for executive leadership at academic health centers within the next five years. In just the past year alone, 69 program graduates started a leadership role and 38 garnered an award or a board appointment.
To learn more about progress in gender equity and inclusion in medicine and the necessary next steps in this effort, the Drexel News Blog spoke with Nancy D. Spector, MD, executive director of ELAM and professor of Pediatrics at the College of Medicine.
Why does gender inequity matter in medicine?
Gender inequity in medicine is bad for women, bad for patients and bad for healthcare as an industry. Diverse teams are stronger, more productive and perform better financially. There is evidence that in some cases patients who are treated by female physicians have lower odds of death. So, all of us lose when women are held back.
This past winter, the Lancet published a groundbreaking issue focused on gender equality in science and medicine and the costs to society of inequity. Achieving gender equity can mean real and positive differences in health and healthcare and economic growth.
We’re seeing a rise in the number of women in health care, but that has not come with a comparable rise in gender inclusion. How can we advance more highly qualified women into leadership roles in academic medical centers?
Yes, it’s true that women account for the majority of the U.S. healthcare workforce, and that women are now the majority of medical school applicants and matriculants. But when it comes to leadership roles, women are lagging, and this is not because of a lack of qualified women. It is because of bias and discrimination, and study after study shows this. It has taken 53 years to get from zero women medical school deans to the 27 women deans who are now in this role.
It’s going to take a dual approach to achieve equity in leadership. We need to expand the leadership skills and network for women through leadership programs like ELAM. At the same time, we need to make systemic change in the policies and culture at our academic medical centers. This means that our institutional leaders, professional societies, journal editorial boards and hospital boards have to commit to making equity a priority, and back it up with the financial resources and standardized policies needed to make real change happen.
There are a number of ways institutions can move the needle towards equity:
· Make Implicit bias training mandatory for searches for leadership
positions and selection committees
· Include a diversity champion on every search committee
· Ensure that there are at least two women finalists in every search (The
odds of hiring a woman are 79 times greater if there are at least two
women in the finalist pool.)
· Establish policies and systems to allow people with family
responsibilities more time for promotion
· Use other open recruitment techniques
· Make performance evaluation objective
· Ensure a critical mass of women leaders
· Welcome women back who step away
How can institutions address persistent gender pay disparities in healthcare?
Metrics and transparency are key here. Institutions need to conduct salary analyses and form review boards to explain compensation differences or hire outside experts to do so. There needs to be a clear compensation philosophy and policies that articulate a vision of gender equity.
Institutions need to track and share faculty and clinical salaries and use benchmark data from organizations such as the American Association of Medical Colleges (AAMC) to determine starting salary. A useful tool that was recently published is the AAMC’s Promising Practices for Understanding and Addressing Salary Equity at U.S. Medical Schools which outlines the many ways to help implement salary-equity initiatives including the starting point of creating a plan to design and conduct a salary-equity study, and then committing to doing these salary-equity studies regularly.
In honor of ELAM celebrating its 25th anniversary in May 2020, what are some of the program’s major achievements and what is ahead for the program?
ELAM has grown so much in 25 years. What started out as a program with an initial class of 25 fellows from medical schools, has become today what is seen as the preeminent longitudinal leadership training program for senior women faculty at medical, dental, public health and pharmacy schools. We have a class of 61 fellows enrolled for 2019-20, and more than 1,000 alumnae in leadership positions at 259 academic institutions around the country. About half of the women deans of medical schools are graduates of our program.
We collaborate with national leaders and organizations in the gender equity movement like the Women Leaders in Global Health Initiative, which is supported by the Bill and Melinda Gates Foundation. As Executive Director of ELAM, I am one of the founding members of Time’s Up Healthcare, and thanks to Daniel Schidlow, MD, dean of the College of Medicine, Drexel became one of the first institutional signatories of Times Up Healthcare.
We’re incredibly excited to celebrate all of the program’s accomplishments, and the incredible accomplishments of its alumnae, at our anniversary on May 1, 2020. As we look to 2020 and beyond, we’re excited to explore the development of a second ELAM program that would be geared to women interested in C-suite executive (CMO, CEO) positions.
You explained recently in the Journal of Hospital Medicine that sponsorship can dramatically shape a woman’s career—to the benefit of all. Sponsorship goes beyond mentorship, right? How can leaders, regardless of gender, be a helpful sponsor to women in healthcare?
Sponsorship is recognized as a critical piece in the puzzle of how to help advance women’s careers, no matter their level. This is true for trainees, junior, mid-level and senior level women physicians. And you’re right – sponsorship is different from mentorship. A mentor provides feedback, strategies and advice. Sponsorship goes beyond this and focuses on the advancement of the protegee. Sponsors leverage their own power to publicly advocate for their protegees.
For women and underrepresented minorities, sponsorship is especially important. And sponsors don’t need to look like you. In fact, having sponsors of different genders and race and from different areas of medicine can be incredibly impactful because they offer diverse perspectives to the challenges you may encounter. There should be formalized sponsorship programs at institutions, and the top leadership should set the expectation that sponsorship is an essential component of good leadership.
Media interested in speaking with Spector should contact Greg Richter at firstname.lastname@example.org or 215.895.2614.