Barriers to success for female physicians in academic medicine

Abstract

Despite the fact that women now comprise half of the medical student and resident populations, women remain underrepresented in prominent leadership positions in academia. Women are challenging themselves to live up to the expectations of their professional peers, society, and their patients in order to 'have it all.' These pressures are leading to professional and personal dissatisfaction. Is this a problem that will resolve itself as the younger generations of female physicians graduate into faculty positions, or does it require more attention from both male and female medical professionals? T he inclusion of women in the medical field, shockingly , began as a prank. In 1847, Dr. Elizabeth Blackwell was accepted to Geneva Medical College, not based on her scholarly merit, but rather the 150 male students assumed that her application was a joke and went along with the charade, voting unanimously for her acceptance. They were certainly surprised when she arrived on campus changing the course of medicine forever (1). Women have become established members of the medical community comprising half of the medical student and residency populations. Despite this strength in numbers, women remain grossly underrepresented in academic leadership positions. Females comprise only 37% of full-time academic physicians. As of 2012, only 13% of full professors, 32% of associate professors, and 43% of assistant professors are female. In the past, this discrepancy could be explained by the smaller percentage of female students; however, this issue has not corrected itself despite the percentage of female residents increasing from 39 to 46% over the past 10 years (2). An exploration of the barriers preventing female physicians from advancement of their academic careers is fully warranted. Young women are being encouraged to strive against all odds to achieve both their professional and personal goals; however, these aims can often be at odds with each other. It is difficult to weave the traditional household and parenting duties expected of women into the hectic schedule of a medical professional. In a recent study that interviewed university hospital department chairs in a variety of medical specialties, a large majority (78%) agreed that the demands of the household were a barrier to the advancement of women in medicine. Many female physicians must '[delay their] rewards. .. by not getting married and/or having children while in college or in medical school or even residency' in order to pursue their chosen careers (3). On average, female physicians have their first child 7.4 years later than the general population (4). This delay may come at a significant cost. A woman's ability to conceive begins to decline in her early thirties with the most rapid decline seen after age 37. In a nationwide survey of young female physicians, it was found that a large majority, (80%), had attempted to conceive. Luckily, most were successful with 77% giving birth to at least one child; however, a quarter of respondents were unsuccessful and received an official diagnosis of infertility (4). This is significantly higher than the rate of infertility in the general population, (11%) (5). Despite their medical backgrounds, 44% of infertile female physicians were surprised by this diagnosis. Many of these women expressed regret not only for delaying the conception process, but also for their choice of medical specialty and even for choosing a career in medicine (4). Failure to achieve personal goals is leading to job dissatisfaction, proving how inseparable female physicians' personal and professional lives can be. Women, who successfully overcome the physiologic barriers of child bearing, encounter new barriers in child rearing. Despite the growing acceptance of the more modern perspective of shared domestic responsibility JOURNAL OF COMMUNITY HOSPITAL INTERNAL MEDICINE PERSPECTIVES ae