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Gender Differences in Academic Medicine: Retention, Rank, and Leadership Comparisons From the National Faculty Survey

Carr, Phyllis L., MD; Raj, Anita, PhD; Kaplan, Samantha E., MD, MPH; Terrin, Norma, PhD; Breeze, Janis L., MPH; Freund, Karen M., MD, MPH

doi: 10.1097/ACM.0000000000002146
Research Reports

Purpose Prior studies have found that women in academic medicine do not advance or remain in their careers in parity with men. The authors examined a cohort of faculty from the 1995 National Faculty Survey to identify predictors of advancement, retention, and leadership for women faculty.

Method The authors followed 1,273 faculty at 24 medical schools in the continental United States for 17 years to identify predictors of advancement, retention, and leadership for women faculty. Schools were balanced for public or private status and the four Association of American Medical Colleges geographic regions. The authors used regression models to adjust for covariates: seniority, department, academic setting, and race/ethnicity.

Results After adjusting for significant covariates, women were less likely than men to achieve the rank of professor (OR = 0.57; 95% CI, 0.43–0.78) or to remain in academic careers (OR = 0.68; 95% CI, 0.49–0.94). When number of refereed publications was added to the model, differences by gender in retention and attainment of senior rank were no longer significant. Male faculty were more likely to hold senior leadership positions after adjusting for publications (OR = 0.49; 95% CI, 0.35–0.69).

Conclusions Gender disparities in rank, retention, and leadership remain across the career trajectories of the faculty cohort in this study. Women were less likely to attain senior-level positions than men, even after adjusting for publication-related productivity. Institutions must examine the climate for women to ensure their academic capital is fully utilized and equal opportunity exists for leadership.

P.L. Carr is associate physician, Department of Medicine, Massachusetts General Hospital, and associate professor, Harvard Medical School, Boston, Massachusetts.

A. Raj is professor and director, Center on Gender Equity and Health, Division of Global Public Health, School of Medicine, University of California, San Diego, San Diego, California.

S.E. Kaplan is assistant professor and assistant dean for diversity, Boston University School of Medicine, Boston, Massachusetts.

N. Terrin is professor and director, Biostatistics, Epidemiology and Research Design, Tufts Clinical Translational Science Institute and Tufts Medical Center, Boston, Massachusetts.

J.L. Breeze is assistant professor and epidemiologist, Biostatistics, Epidemiology and Research Design, Tufts Clinical Translational Science Institute and Tufts Medical Center, Boston, Massachusetts.

K.M. Freund is professor and vice chair of medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts.

Funding/Support: The project described was supported by award number R01 GM088470 from the National Institute of General Medical Sciences and Office of Research on Women’s Health, National Institutes of Health (NIH).

Other disclosures: None of the funders were involved in the design of the study; the collection, analysis, and interpretation of the data; or the decision to approve publication of the finished manuscript.

Ethical approval: This study was approved by the institutional review boards (IRBs) of Boston University School of Medicine (protocol #1.769575) on 04/24/2009 through 04/1/2015 and Tufts Health Sciences Campus (IRB #10372) on 05/15/2012 through 5/14/2015; Tufts IRB reviewed on behalf of Massachusetts General Hospital through the Master Common Reciprocal Agreement approved on 10/1/2013.

Previous presentations: NIH 25th Anniversary of the Office of Research on Women’s Health, June 7, 2016, Bethesda, Maryland; and Medical Women’s International Meeting, July 29, 2016, Vienna, Austria.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A526.

Correspondence should be addressed to Phyllis L. Carr, Women’s Health, Yawkey 4B, Massachusetts General Hospital, Boston, MA 02114; telephone: (617) 724-6700; e-mail: carr.phyllis@mgh.harvard.edu.

© 2018 by the Association of American Medical Colleges