Clinical and Investigative Medicine

 

Women in biomedical research -- addressing the challenges

Catharine Whiteside, MD, PhD
Sophie Dessureault, MD
Jodi Dickstein, MSc
Lee Anne Tibbles, MD
Shona Torrance, MSc
Erin Boynton, MD
Mary Seeman, MD
Katherine Siminovitch, MD
Donna Stewart, MD

Clin Invest Med 1997;20(4):268-72.

Dr. Whiteside is Professor of Medicine and Graduate Coordinator, Institute of Medical Science; Dr. Dessureault, Ms. Dickstein, Dr. Tibbles and Ms. Torrance are PhD students in the Institute of Medical Science; Dr. Boynton is Assistant Professor of Surgery; Drs. Seeman and Stewart are Professors of Psychiatry; and Dr. Siminovitch is Professor of Medicine, University of Toronto, Toronto, Ont.

Contents

Introduction

 Historically, women in the United States were less likely to succeed in academic medical careers than men.1­4 Compared with men, women are still underrepresented in leadership roles in faculties of medicine in Canada5 and the United States.1,6,7 In many institutions, women of equal academic standing and achievement are likely to be promoted at a slower rate than men.7,8 Women frequently receive lower salaries than men in comparable academic positions.2,7,8 How can the playing field be levelled successfully for women in academia?

Specific challenges for women in academia were identified by a panel of senior women students and faculty members in the IMS, University of Toronto. Recommendations to address these challenges were presented by the panel at the annual IMS Scientific Day, May 16, 1997, for further input by the students and faculty of IMS and other graduate units in the Faculty of Medicine. These recommendations are strongly supported by recent publications from leading academic and professional organizations in Canada and the United States.5,7­11

Gender-based obstacles to career success

 There is one obvious and irrefutable characteristic distinguishing women scientists from their male colleagues: women have babies. Women also spend more time engaged in child care and domestic tasks.5 The critically important early publishing years and "prime" child-bearing years completely overlap for women as postdoctoral trainees and young faculty members. The biological time constraint for women who wish to have children does not exist for men. Women who decide to have children during postdoctoral years or during the first few years in a tenure-track position may meet gender-based obstacles to career success. A reduced publication rate is viewed unfavourably by external funding agencies at the time of grant renewal. Although grant review committees may take into account the time factor associated with parental leave, extra funds for support during this time are not provided. Hence, research productivity during and after parental leave may be compromised. When female faculty members take maternity leave, their professional colleagues may resent shouldering extra time-consuming teaching, administrative and clinical duties. Salary is usually reduced during parental leave, and some women may feel that they have to make up the loss by engaging subsequently in additional clinical work, to the detriment of their research. The only logical conclusion is that child-bearing may compromise job security for women in academia.

Institutional factors considered to be obstacles to career success or satisfaction for women in academic medicine, reported by the Provost's Committee on the Status of Women at the Johns Hopkins University, Baltimore, Md., focus on issues related to parenting.7 These include: meetings scheduled after 5 pm and on weekends; rigid promotion timelines; no provision for emergency child care; no part-time tenure track; no formal parental leave policy; and no on-site child care. The same gender-based obstacles are repeatedly reported in numerous surveys of women in research training and in early years on faculty.4,7,9 At Johns Hopkins University, interventions to correct these obstacles over 5 years were initiated by the chair of medicine, who appointed a Task Force on Women's Academic Careers in Medicine and hired a faculty development specialist with skills in organizational assessment and change management. Together, they initiated intensive evaluation of departmental and divisional structure and decision-making, in-depth analysis of women trainee and faculty problems, education of all the faculty about gender-based obstacles, measures to improved visibility of women's accomplishments and leadership, successful mentorship of new recruits and salary equity. Their action resulted in substantive change, with a 550% increase in the number of women at the associate professor level in 5 years.7 This strategy indicates that substantive improvements in the development of women's academic careers may be achieved by long-term commitment and interventions.

Recommendations

  1. Incorporate into the accreditation process review of departmental and faculty policies and practices to remove gender-based obstacles to career development.
  2. Assess the gender-based obstacles to career success of women trainees and faculty members and establish long-term intervention strategies to address these issues.
  3. Establish women's issues committees in every department and institute to meet the needs of women in academia continually. The chairs of these committees should be full members of the executive, who advise the departmental chairs and institute directors.
  4. Enhance the promotion of women to leadership roles in departments, institutes and faculties.
  5. Establish uniform policy for maternal/parental leaves. For women faculty in biomedical research, the system should be tailored to adequately meet the needs of child-bearing and should include:
    1. Flexible, part-time or shared tenure-track (or equivalent) positions with options for re-entry into full-time status.
    2. Increased time to achievement of tenure or promotion, accommodating appropriate parental leave.
    3. Maternity leave jointly offered and financially supported by granting agencies and departments. On request, the equivalent of up to 6 months of personal salary and reasonable compensation for laboratory and personnel costs (matched to peer-reviewed grants held) should be offered. The external agencies and the department should contribute equally to this bridge-funding package. Automatic delay in the time for renewal of peer-reviewed grants would allow the scientist time to recover from the early months of child-rearing before returning to full-time academic engagement.

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Equity -- recruitment and salaries

 To obtain a faculty position, tenure track or equivalent, requires rigorous training, an established publication record and the acquisition of communication and networking skills. These prerequisites for an academic position in biomedical research are gender-neutral. The paucity of new faculty positions in Canadian universities begs the question: Is there equal opportunity for all qualified Canadian biomedical scientists to seek and secure available jobs? In some departments, there appears to be a disparity between the policy and practice of recruiting new faculty into research positions. In the clinical departments, it is common practice to create a position when a rising "star" appears on the horizon, rather than to advertise the potential post. Full-time research positions constitute a major commitment of resources on the part of a department and faculty. A fair recruitment process requires wide advertisement and an appropriate, unbiased search. Women are concerned that fewer jobs are available to them if equitable search policies and practices are not implemented by the administrative leaders of every clinical and basic science department. Lack of suitable mentors for women and the fact that women are less likely to belong to powerful, informal academic networks put most women at a disadvantage when appropriate search procedures are not followed.

Pay equity is unquestionably necessary. Do women biomedical scientists receive financial support identical to that of their male colleagues for the same job description? Recently, the chair of the Women's Issues Committee in a large hospital-based clinical department at the University of Toronto requested that the department head compare the financial support given to women and men with equal job descriptions. Although he suggested there would be no difference, he discovered significant discrepancies in favour of men. This finding is in keeping with many reports examining gender bias in academic salary support.2,6­8 The department head immediately took measures to equalize the financial support, which is now under continual review. Inequity in salary support based on gender is morally unacceptable, yet it still exists.

Recommendations

  1. Establish, as part of the accreditation process, review of the recruitment policy and practice, and institute pay equity.
  2. Advertise academic jobs in biomedical research widely throughout Canadian universities.
  3. Ensure that search committees for academic research positions review all candidates without gender bias or any form of discrimination.
  4. Ensure that women and men receive equal financial support for equal job descriptions, with open disclosure of remuneration within departments and institutes.

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Structured mentorship

 The challenges of a new job are immense. The challenges of bearing and raising children are remarkable. The first 5 to 7 years of a young investigator's life are probably the most stressful, particularly if she decides to have children. Despite this obvious fact, the process of hiring and supporting young investigators does not take this into account. New faculty may be hired without appropriate understanding of their job descriptions or clarification of research time protection. They may not meet regularly with their department head, who may have delegated this important and necessary role to a divisional head, who in turn may or may not comply with the expected policies. Furthermore, there appears to be a significant discrepancy, even among divisions in the same clinical department, about the concept of time protection for full-time investigators. Women in academia are particularly vulnerable to isolation in a male-dominated environment in which they have few female role models.

Neither graduate school nor postdoctoral training prepares a young investigator for the realities of an academic career. In the current environment of reduced funding, there is no time for a "trial-and-error" approach to the establishment of an independent scientific career. All full-time investigators, young and old, must obtain and retain funding. The inexperience of younger investigators immediately reduces the probability of obtaining the first grant renewal in competition with more experienced senior investigators. A successful strategy on the part of the young investigator necessitates mentorship. Although many departments pay lip-service to this concept and may even have written a policy about establishing mentorship for new investigators, the reality is that it is hit and miss. Without mentorship, new investigators usually make the mistake of overcommitment to multiple tasks, resulting in lack of focus in their research career. There may be errors in strategy about scientific questions or feasibility and timing of publications. Grant-writing skills may need careful development in collaboration with more experienced investigators. Professional and personal time commitments must be carefully balanced. Department heads must ensure that each new investigator receives appropriate mentorship as an investment in the future of the investigator's career and the academic success of the department.

A recent survey in a large academic department of medicine revealed that, although men and women had the same frequency of mentoring, the perceived quality of mentoring differed according to gender.7 Men's mentors were significantly more likely to facilitate the external visibility of the new recruit, by involving them in chairing conferences or participating in manuscript writing. This may be because men see themselves in their junior male colleagues. Although it was probably not deliberate, 30% of the women surveyed reported that their mentors used the woman faculty member's work for the mentor's own career benefit, whereas only 10% of men reported similar experiences. A structured mentorship with careful monitoring of progress may ensure optimal success of new career scientists, especially women. There is a further necessary component. Women who enter academic positions must seek out appropriate mentorship and career-related information, particularly from senior women faculty. However, there are still too few women in senior mentorship positions and, therefore, supportive male mentors are vital.

Recommendations

  1. All new faculty should be mentored with respect to engagement in career activities which include:
    • establishing research goals and collaborations,
    • publishing original research in a timely fashion,
    • grant writing,
    • managing time and professional commitments, and
    • saying "no" to tasks not directly related to initial career goals.
  2. The department chair or institute director should interview new faculty members annually for a minimum of 5 years after recruitment to address their concerns and to ensure that appropriate mentorship is in place.
  3. Departments should ensure that there is no gender bias in teaching loads, clinical duties, protected time, laboratory space or start-up research funds.

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Advocacy -- implement zero tolerance of intimidation

 Administrative leaders must be the advocates for women and minority groups in their department or faculty by implementing zero-tolerance policies regarding intimidation or bias. All individuals working in the university and affiliated hospital and research institute settings must feel they can fully engage in their career activities in a nonthreatening environment. Women, minorities and students (including postgraduate students) are particularly vulnerable to intimidation by faculty members, who believe they are in positions of power and dominance.

The Royal College recently reported that all faculties of medicine across Canada have guidelines and policies about sexual harassment and intimidation.9 Some faculties have adopted university-based guidelines, whereas others (e.g., the University of Ottawa) have developed their own policies.9 A recent study from McMaster University provides convincing evidence that psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in clinical training.11 In the realm of research training, graduate and postdoctoral students may be unfairly treated by supervisors, who expect too high a level of productivity with too little guidance and remuneration. Fortunately, these issues are being addressed with greater frequency and success in our institutions. Nevertheless, continued initiatives in educating faculty, creating specific policy about ethical conduct and establishing an official institutional advocacy office are indicated.

Recommendations

  1. A written code of conduct emphasizing the necessity for zero tolerance of psychological abuse, discrimination on the basis of gender and sexual harassment must be widely publicized in all departments and institutes.
  2. Issues relating to this code of conduct should be incorporated in formal and informal curricula, participatory research and evaluations of students and faculty.
  3. An institutional office, accessible to all students and faculty, should be established and promoted to deal confidentially with problems of abuse, discrimination and harassment.

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Conclusion

 Improvements in the development of women's careers in biomedical research require critical review of current policies and practices in departments and institutes. Long-term interventions to remove gender-based obstacles and to promote women actively, particularly into roles of leadership, will assist in levelling the playing field for women in academia.

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References
  1. Bickel J, Galbraith A, Quinnie R. Women in US academic medicine: statistics. Washington: Association of American Medical Colleges; 1994.
  2. Koshland DR Jr. Women in science. Science 1993;260:275.
  3. Council on Graduate Medical Education. Fifth report: women in medicine: women in the physician workplace. Rockville (MD): US Dept of Health and Human Services, Public Health Service, Health Resources and Services Administration; 1995. Pub no HRSA-P-DM-95-1.
  4. Conley FK. Toward a more perfect world -- elimination of sexual discrimination in academic medicine. N Engl J Med. 1993;328:351-2.
  5. Canadian Medical Association. Women in medicine -- the Canadian experience. Ottawa: The Association; 1996.
  6. Tesch BJ, Wood HM, Helwig AL, Nattinger AB. Promotion of women physicians in academic medicine: Glass ceiling or sticky floor? JAMA 1995;273:1022-5.
  7. Fried LP, Francomano CA, MacDonald SM, Wagner EM, Stokes EJ, Carbone KM, et al. Career development for women in academic medicine: multiple interventions in a department of medicine. JAMA 1996;276:898-905.
  8. Carr PL, Friedman RH, Moskowitz MA, Kazis LE. Comparing the status of women and men in academic medicine. Ann Intern Med 1993;119:908-13.
  9. Royal College of Physicians and Surgeons of Canada Task Force on Equity Issues. Equity issues. Ann R Coll Physicians Surg Can 1997;30:20-4.
  10. Association of American Medical Colleges Project Committee. Report on increasing women's leadership in academic medicine. The Association; 1996.
  11. Cook DJ, Liutkus JF, Risdon CL, Griffith LE, Guyatt GH, Walter SD, for the McMaster University Residency Training Programs. Residents' experiences of abuse, discrimination and sexual harassment during residency training. Can Med Assoc J 1996;154:1657-65.

| CIM: August 1997 / MCE : août 1997 |
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