By Pascale Lane, Vision 2020 Oklahoma Delegate and is a pediatric nephrologist.
A recent paper on gender equity caught my eye:
As a pediatric sub-specialist this study had personal interest. It also fed my interest in women’s leadership in academia, particularly academic medicine.
Pediatrics has long attracted a large number of women physicians, although the number of women faculty during my training in the 1980′s still seemed low. The pediatrics department in question, at University of Colorado, had achieved nearly 50% female faculty in the decade prior to their study. However, disparities in senior-level faculty and leadership positions persisted. They audited a number of records to test two potential, non-exclusive hypotheses:
- The department has treated women and men unequally and has failed to adequately advance the careers of female faculty
- Female faculty entered academic medicine more recently than male faculty and has just begun to catch up in seniority, tenure and leadership roles.
Five factors that affect faculty equity were examined after data collection and de-identification. These included promotion, tenure, leadership roles, retention, and salary. Only faculty on a promotion tract (assistant professor or higher rank) was included. Part-time work was “corrected” to the full-time equivalent (FTE), so someone who was full-time for 3 years and 0.6 FTE for 3 years had a duration at rank of 4.8 years. Similar calculations were used to compare salaries to available standards. Salary was examined as a categorical variable based on national standards and as a continuous variable.
Of 543 faculty in 2009, 263 met the inclusion criteria. Of these faculty, 118 (45%) were women. 60 women (54%) were assistant professors, 39 (56%) were associate professors, and 19 (23%) were full professors. No significant difference in time to promotion was noted in the study. Of the full professors who had also been promoted to associate professor at Colorado, the average time for the first promotion was 1 year longer for women than for men. Male full professors had been in rank nearly twice as long as women. Only 18% of tenured faculty was women. Changes in the tenure process 2 years before this study resulted in tenure not being awarded until promotion to full professor in most cases. Tenure awards were still predominantly to men, but the gender disparity was less pronounced after the change.
Women held 62% of medical directorships but men composed 75% of section/division chief and 86% of sub-chair positions. Medical directorships are clinical positions, while chiefs and sub-chairs are academic leaders. The chiefs and sub-chairs had held their positions, for the most part, for 10 years or more. Most had been appointed in an era when fewer women met leadership criteria.
Similar numbers of men and women left the department over the decade studied, and the numbers did not differ from nationally reported data. No systematic exit interviews or surveys were available.
Now for the fun part: salary. At all faculty ranks more women than men received pay below the median matched for rank, years at rank, and subspeciality, as shown in the graph. The heavy horizontal line shows the percentage of faculty by gender paid above and below the national median. For men, this hits at 51%, about what you would expect. For women, 72% received salaries below the median. Remember, these salaries had been corrected to 1.0 FTE levels for the analysis; these findings are not directly the result of women with part-time employment!
When considering pay as a continuous variable for multivariate analysis, the average woman faculty member received 98% of the median, while men averaged 105%. When faculty with leadership roles was examined, female leaders received an average of 93% of median pay and male leaders averaged 112%. (No national standards have been gathered for salaries with leadership positions of clinical and academic types.)
What does this mean in actual dollars? Depending on specialty and rank, the difference in annual compensation would be $8,000 to $16,500 less for women than men. Since benefits, like retirement plan contributions, are usually calculated as a percentage of salary, these women will suffer from this salary lag for the rest of their lives.
The authors conclude that both of their hypotheses are correct. Women are just beginning to catch up to men in seniority and tenure; however, gender disparities exist, possibly hindering the advancement of the careers of women faculty. They note that one important limitations of their study is lack of root cause analysis; how do disparities in tenure, leadership positions, and salary occur? Could it be bias or sexism, both in and out of academic medicine?
The authors do let us in on the changes the department made as a result of their endeavor. To address the tenure gap, they implemented mandatory referral of all candidates for promotion to professor to the departmental committee for simultaneous tenure consideration. The department began reviewing their leadership roles, in hopes of understanding the disparities identified and, perhaps, restructuring the department in the future. They have also implemented exit interviews and a comprehensive annual review process to understand why faculty leave or become dissatisfied. Finally, they implemented immediate salary corrections and ongoing monitoring of compensation in relation to national data.
Every department in academia should do this sort of analysis in my opinion, especially the salary assessment. As women make up half of all graduating physicians, they should become half of our medical faculty and, eventually, half of our academic leadership. That will not happen if women remain systematically devalued in the Ivory Tower.