Year: 2019
Type: article
Abstract: Now is the critical time to consider the pipeline of women in medicine: for the past two years, 51% matriculants into medical school were women1—a milestone—and an increasing volume of data demonstrate the value of women in terms of providing high-quality health care, innovative leadership, bottom-line financial results, and groundbreaking research. Nonetheless gender disparities in compensation,2, 3 promotion,4 and leadership5 in medicine persist even after accounting for a wide variety of potential explanatory factors, and these data parallel common narratives of discouraging and demoralizing gender-based experiences among women physicians.6 Medicine has a compelling impetus to understand and improve the health care workplace for all women. This concept inspired the AEM Senior Editorial Board to dedicate this issue of AEM to the careers of women in academic emergency medicine. This issue is about women, but it is for the entire readership. Women in medicine are not alone in caring about this issue, as reflected in the mixed-gender authorship of the manuscripts. Many men in academic medicine understand that gender inequities exist and seek to be part of the solution. Not only do their personal connections to women—as sons, husbands, fathers, and colleagues—mean that they share empathetically in the downstream effects of inequities, but in this age of team science, team-based clinical care, and team problem solving, inequity for one group often sabotages opportunity and productivity for all. In addition, as prior research has shown, when initiatives are put into place that benefit women, men often benefit too.7 Everyone has a need to better understand gender-based career disparities and to commit to being part of the solution. The papers in this issue highlight how much more progress is needed to solve the fundamental and indisputable issue of equal pay and advancement for equal work. Research by Wiler et al.8 and Bennett et al.9 demonstrates the persistence of unexplained gender-based salary and rank disparities despite the fact that this gap has been an established problem for many years. Further, some of our workplaces continue to signal “mothers not welcome,”10 a message that is actually better seen as “parents not welcome,” as men increasingly share child care responsibilities. And yet there are positive signals: we are moving from simply documenting the problem to exploring change. One study in this issue presents a family leave policy that normalizes parenting as a common, expected experience of both male and female resident physicians.11 Another describes a departmental promotion process aimed at advancing faculty in an objective fashion, leading to increased promotion of women,12 and Lin et al.13 describe the value and power of existing and growing women's professional networks (also see commentary by Sethuraman et al.14)—such groups are using the available literature on what holds women back from promotion and advancement and pay equity and are working to provide multiple approaches to fill in the gaps. In the near future, we hope to see our specialty move from descriptions of gender gaps to innovative interventions—experiments that can move us along to best practices based on good evidence—to dissemination of interventions that achieve gender equity. We need to make change, not just measure causal factors. We also need to work with our funding sources—federal funders, foundations, other—to help them recognize the need for allocating grant dollars to support and stimulate this important research. In the meantime, the themes in this issue call men and women in academic emergency medicine to commit to being part of the change. Within a team, department, institution, or organization, all of us can take actions—such as elucidating unconscious bias or leading an institutional change in the approach to parental leave, in the recruitment process for leadership positions, or in the oversight of salaries—to begin to address the inequities, rather than merely being a witness to them. Whether with small bystander interventions or bold systemic changes, we don't need to wait for FDA approval or an IRB protocol to change culture. We can begin, today. The baby boomers brought in the first wave of significant numbers of women in medicine, who entered the profession and survived despite marked, overt sexism. Some even thrived, but the costs for these women to disrupt the traditional culture were, at times, significant. This generation of “millennials” and “Gen Xers,” the future leaders of health care, are taking the evolution of the changing face of medicine to the next logical step: they are rightfully expecting to use their talent, training, and ambition to make meaningful contributions at the highest level and to receive equal compensation and opportunities at every step of the way. If we do not assure a culture conducive to women's academic success, all of health care will suffer—patient care, education, and research. Only with the determination of women and men who understand this fundamental principle and are willing to make explicit individual, local, and institutional changes can we forge the path to a future in which equitable workplaces are the norm.
Source: Academic Emergency Medicine
DOI: 10.1111/acem.13715
Language: English
Subfield: Gender Studies
Field: Social Sciences
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W2916170339