Association for Academic SurgeryGender disparities in scholarly productivity of US academic surgeons
Introduction
Female applicants to medical schools reached a high of 50.8% in the 2003-2004 academic years. Along with this increase, the proportion of women in surgical training has risen from 25.6% in 2003 to a peak of 37.9% in 2013.1 Thus, women represent a large component of the current and future surgical workforce pipeline. However, women are still markedly absent at the more senior academic levels in surgery: 25% of assistant professors, 19% are associate professors, and only 10% of full professors are female. Furthermore, these numbers have been stagnant in academic medical centers (AMCs) for years, with the advancement and promotion of women and minorities remaining statistically below average.1 In addition, although the proportion of female faculty hires in AMCs has increased over the last decades, the attrition of female faculty has risen equally, resulting in an overall proportion of female faculty in surgery of only 22%. AMCs in the United States are leaking talented faculty—both men and women—at a rate of 38% over ten years with an upward tendency.2 Apart from the educational toll of losing experienced faculty, the replacement cost for a single surgeon in one AMC was calculated to be more than half a million dollars. Faculty turnover is therefore a significant business expense, representing up to 5% of the budget.3
The reasons behind the lack of retention and advancement of female faculty in academic surgery are not well understood. Some studies cite unconscious bias or the lack of mentorship for junior faculty as culprits for the difficulties faced by academic female surgeons in promotion.4 A gap in understanding the requirements for promotion may also contribute to this disparity, and women may not be as aware as men of the opportunities and steps required in career advancement.5 Another contributor may be academic productivity. Some studies note, that female faculty are less academically productive, as determined by publications and grants, whereas others argue that there is no difference when controlling for academic rank.6, 7, 8, 9 In surgery, the proportion of original research articles with female first or senior authors has increased over the last several decades; however, overall articles are still largely authored by men.10 Understanding and reconciling areas of disconnect in academic productivity has the potential to increase success and satisfaction and, possibly, improve retention for all faculty in surgery departments.
In this study, we draw from online academic surgeons' profiles from three AMCs in the United States to examine how academic productivity relates to faculty rank and gender in different cohorts, as determined by year of graduation from medical school. We address the following questions: (1) are there differences between male and female surgeons in productivity by academic rank? (2) do different cohorts of male and female academic surgeons show differences in productivity? and (3) at what career stage do these differences occur? In addition, we consider how faculty development may advance the strategic plans of a surgery department to improve prospects for all faculty members, including women, to succeed in their careers and possibly stem the exodus.
Section snippets
Methods
Faculty profiles listed on the websites of three AMCs were reviewed and used to collect data about gender, year of graduation from last residency or fellowship program, current faculty line and rank, and surgical specialty in the 2013-2014 academic years. All three institutions are ranked among the 10 best AMCs in the United States and are in the same peer group in terms of their academic reputation.11 One institution is in an urban east coast setting, one in an urban west coast setting, and
Sample demographics
We analyzed a total of 978 full-time surgeons (234 women and 744 men) from three US AMCs. The proportion of women of this sample (24%) is slightly higher than the overall representation of surgical faculty in the United States AMCs (22%).1 The urban west coast school had the highest percentage of female faculty (27.8%) followed by the urban east coast school (25.7%) and the suburban west coast school (16.7%). The year of graduation from medical or dental school ranged from 1952 to 2009
Conclusions
Women are making up an increasingly large proportion of the surgical workforce. However, female AMC faculty members in the United States continue to be less likely to be offered tenure and promotion, and advance through the academic ranks at a significantly slower rate than their male counterparts.1 We would argue that the limited prospects for promotion and success in AMCs in turn leads to a logical career decision of “opting out”—one that anyone, independent of gender and race, would make
Acknowledgment
Author's contributions: C.M.M. and S.G. contributed to the study design, data interpretation, and manuscript writing and/or editing, D.K.G. contributed to the study development, data analysis, and manuscript writing and/or editing, C.K. contributed to the study development and manuscript editing, and R.M. contributed to the data collection and analysis.
References (24)
- et al.
Gender differences in successful National Institutes of Health funding in ophthalmology
J Surg Educ
(2014) - et al.
A gender-based comparison of academic rank and scholarly productivity in academic neurological surgery
J Clin Neurosci
(2014) - et al.
Med Intensiva
(2013) - et al.
Gender differences in promotion and scholarly impact: an analysis of 1460 academic ophthalmologists
J Surg Educ
(2014) - et al.
Research productivity and gender disparities: a look at academic plastic surgery
J Surg Educ
(2014) - The State of Women in Academic Medicine: The Pipeline and Pathways to Leadership, 2013-2014....
The long-term retention and attrition of U.S. Medical school faculty
AAMC, Anal Brief
(June 2008)- et al.
Some hidden costs of faculty turnover in clinical departments in one academic medical center
Acad Med
(2009) - et al.
Is there still a glass ceiling for women in academic surgery?
Ann Surg
(2011) - et al.
Women in academic general surgery
Acad Med
(2004)
Gender differences in research grant applications and funding outcomes for medical school faculty
J Womens Health (larchmt)
Gender differences in successful NIH grant funding in otolaryngology
Otolaryngol Head Neck Surg
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