Dr. Martha Pitman, medical director of the Massachusetts General Hospital cytopathology lab, was recently promoted to full professor at Harvard Medical School. Pulse of Longwood takes you inside one of the nation’s largest hubs of hospitals and biomedical research. Something unusual just took place at Harvard Medical School: More women than men crossed a stage to join the rank of full professor. The December ceremony, featuring 22 women, was an anomaly, not a sign of parity. It highlighted how far Harvard has come — and how far it still has to go — as medical schools across the country seek to overcome years of entrenched gender inequality. At Harvard Medical School, 17 percent of full professors are women, or 207 out of 1,234. The number has inched up steadily since 1980, when it sat at just 3 percent. “It is very exciting seeing more women reaching that rank,” said Dr. Kathryn Rexrode, who directs the office of women’s careers at the Harvard-affiliated Brigham and Women’s Hospital. But “we are still making slow and incremental progress.” Nationally, women comprised 21 percent of full professors at medical schools during 2013-14, a rise of 7 percentage points over the previous decade, according to the Association of American Medical Colleges. As in many other fields, women are close to reaching parity in medical schools’ entry levels, but remain the minority in higher ranks. “Harvard is somewhere in the middle of the pack” in promoting women to full professorship, said Diana Lautenberger, director of women in medicine and science at AAMC. “There are a number of other schools that are continuing to do better in that area.” For instance, the University of California-Davis School of Medicine made big leaps in promoting women in part by training search committees and promotions panels in unconscious bias, Lautenberger said. And the University of Massachusetts Medical School has improved through a slew of mentoring and awards programs to support career development; 26 percent of its full professors were women in 2013-14. The AAMC tracks the number of full professors closely because it’s a stepping stone to future leadership, Lautenberger said: If you don’t become a full professor, you often can’t rise up to become a department chair or dean. HARVARD MEDICAL SCHOOL Typically, new groups of full professors at Harvard Medical School tend to be about 25 to 30 percent female, said Dr. Nancy Tarbell, the medical school’s dean for academic and clinical affairs. Gender parity has not been met: If you look at all of the new full professors over the past year, 45 percent were women. But the smaller group honored in December’s ceremony was 54 percent female. “There was just one woman after another coming up [to receive certificates], and it was just really nice to see,” said the medical school dean, Dr. Jeffrey Flier. Harvard Med has two sets of employees: a small group who work directly for the school, and a much larger pool of faculty, nearly 12,000, who are employed by Harvard’s 16 affiliated hospitals and clinical sites. For direct employees, earning the rank of full professor is do-or-die. They have 11 years, with possible extensions for raising kids, to secure tenure by meeting that rank. If not, they have to find a job elsewhere. Galit Lahav, an Israeli-born biologist, reached that benchmark last year after facing a significant personal challenge: Just over two years into her time at Harvard, she gave birth to premature twins. She spent three months shuttling between holding her babies at the neonatal intensive care unit at the Brigham and running her lab across the street. She spent another two months at home with her kids, who needed lots of extra attention, but even then, she carved out time to revise papers and work with colleagues. Lahav, who is 42, runs a 12-person lab studying cancer on a cellular level. She said that when she had her twins, she worried “whether it would be possible to succeed in such a demanding, competitive, and challenging environment.” But she said her workplace was very supportive, and she ended up not even needing to extend her tenure clock on account of her kids. For faculty at Harvard-affiliated hospitals, there’s no deadline for becoming a full professor. It’s a mark of prestige, with no extra job security. Promotion at Harvard is notoriously difficult: To reach full professor, faculty have to show they have a sustained national reputation, or sometimes an international reputation, in their field. Making it harder, Harvard adds an extra step of “instructor” before the usual climb through assistant professor, associate professor, and full professor. Only 11 percent of faculty ever make it all the way, according to Dean Tarbell. The system used to be notoriously opaque: It would take two to three years just for a promotion application to be approved, according to Harvard’s Tarbell. After the school revised the procedure a few years ago, it now takes a median of less than one year, she said. So what’s stopping women from rising through the ranks? Dr. Ellen Grant, a newly promoted full professor who studies early brain development at Boston Children’s Hospital, said family duties posed a significant challenge. She gave birth to three kids during her career. “You get two months off, which is two months during which you figure out how you’re going to survive when you get back to work. It’s grueling.” “I definitely did lose time when I did have kids,” she said. “You can’t be on the national stage when you’ve got a bunch of babies around the house.” While she was at Massachusetts General Hospital, another Harvard affiliate, Grant got some help from a Claflin award, aimed at supporting junior faculty through childbearing years. It wasn’t a ton of money, Grant said, but it was “really key to show I was committed to research.” Grant, who is now 53, said she hadn’t previously focused much on promotion: “That’s more of a female thing — we just kind of put our nose down and get our work done.” Two years ago, she got around to compiling her application for promotion, which entails writing a very long CV and finding copious experts to vouch for your work. It took her six months to put it together, squeezed between lecturing, mentoring, clinical work, writing papers, and running her lab. Her big reward for earning the new rank? “I’ll get to be on more committees now” — panels at Harvard Medical School that are closed to professors of lower rank. She said she hopes to use the position to draw more attention to medical care during the first 1,000 days of life. Another recent promotee, Dr. Martha Pitman, took a slow-and-steady approach, restricting her working hours to 8 to 5 while raising three kids. She always wanted to become a full professor, but felt, “I’m not going to sacrifice my family to get there.” “It took my whole career to get to full professor,” said Pitman. At 56 years old, she is medical director of Massachusetts General Hospital’s cytopathology lab, specializing in early detection of pancreatic cancer. Dr. Barbara McNeil, chair of the health care policy department at Harvard Medical School, said she has seen immense progress at the school since she arrived as a student in 1962. At that time, there were “almost no” female role models for women. Now 11 out of 62 department chairs throughout Harvard Medical School are female, just over the national average of 15 percent. Those chairs are the gatekeepers controlling which faculty get put up for promotion. Dr. Joan Brugge, a former department chair at Harvard Medical School who now directs a cancer research center there, said as research grants become harder to get, financial pressures appear to be driving some women out of the field. “There’s a self-elimination of many young women,” who opt out of research careers because of the anticipation of not getting grants, Brugge said. She has also seen promising, motivated women opt out to have families. She suggested creating an additional child-care facility in the Longwood Medical Area could “make a huge difference.” Dr. Anne Klibanski, who directs the Center for Faculty Development at Mass General, said mentoring programs, networking opportunities, and grants for faculty with young kids have made a big difference for women at Harvard. But it’s not “simply a question of waiting long enough so that women catch up,” she said — Harvard and its affiliated hospitals need to keep taking proactive measures. Rexrode, of the Brigham’s office of women’s careers, noted that a lot more work remains: The number of female deans of medical schools nationally has stayed steady at 16 percent. Rexrode said subtle biases, among both men and women, still hurt women in promotion. Harvard Medical School requires search committees, but not promotion committees, to be trained to counter those biases. Rexrode said she is working to expand unconscious bias training at more points along the way, including among the program directors who choose new residents and fellows. She also compares promotion rates of men and women at the Brigham and shares that data with department heads. She called for the promotion criteria to be updated to reward mentorship, which women often do to the detriment of their productivity in other areas. Meanwhile, Rexrode said she has set a new personal goal: After 25 years at the Brigham, she aims to finally seek her own promotion to the rank of full professor. An associate professor at Harvard, she had previously sought to define success on her own terms. But she has come to realize the impact that high-ranking role models can have on younger women. “I do feel like it is a certain currency in our environment, an external validation of achievement,” she said. “If women disproportionately say it doesn’t matter, [it] has an impact on how women view their own future potential careers.” Source
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