In the fall of 2007, Dr. Nancy Andrews was appointed as the new dean of the Duke University School of Medicine. It may seem surprising that she is the first female to hold this prestigious office since the School of Medicine opened its doors in 1930. However, for American medical colleges, female deans are few and far between.
Currently, Andrews is one of 14 female deans presiding over 126 medical schools in the United States. Andrews notes in her article, “Climbing through Medicine’s Glass Ceiling” published in the New England Journal of Medicine, that only 9 percent of the chairs of all clinical departments in these schools are women. Andrews described the current inequality between men and women in medicine best when she wrote in “Climbing through Medicine’s Glass Ceiling”: “Given that the proportion of men and women in medical school classes have been similar for some time, it seems puzzling that there are not more women in leadership positions in academic medicine.”
Unfortunately, Andrews’ speculations are not limited to her personal experience. A study published by the Annals of Internal Medicine in 2004, confirmed that “although ample numbers of women have entered academic medicine for at least the past two decades, their representation among full professors was only slightly higher in 1998 (10.5 percent) than in 1978 (7 percent).”
Despite their abundant presence and a sufficient amount of time to achieve full professor rank, women in academic medicine show less advancement in rank and lower salaries, as noted in the 2004 study. A common concern among women in academic medicine is balancing work and family responsibilities. Even with the invention of paternity leave, women are still subject to the physical and emotional toll of pregnancy and required time off from work. In the 2001 study “Why aren’t there more women leaders in academic medicine? The views of clinical department chairs,” the authors examined factors constraining women’s advancement to leadership positions in academic medicine. They found three sources of common barriers: historical developments (e.g., shortage of women in the pipeline), broad social forces (e.g., gender roles and socialization patterns affecting women’s status), and the expression of these forces in the medical environment (e.g., sexism in recruitment and promotion practices, a shortage of effective mentors for women). Other common barriers included more organizational resources being devoted to men and increased family demands (e.g., women are less likely to have a spouse who stays at home).
Although the medical profession has placed greater importance on diversity in the past few decades, there is still a paucity of women and minorities in the grassroots structure of the health care system. Perhaps this gender difference in leadership and senior academic positions will equilibrate over time as more women achieve higher ranking offices and the stereotypes of women solely as homemakers dwindle. It seems apparent that to aid in this transition, medical academia must have an eye toward gender equality in promotion and recruitment of professors, as well as providing increased support for women who must balance career with motherhood.
Read Part 2 of “Pushing Out the Patriarch in Health Care” next week.