Here's a "fun" activity: Go to your institution's website and find the page with all of the department heads. Count the number of women and count the number of men. Now—stay with us—count the number of men with facial hair. What do your numbers look like? If the pattern at your institution resembles the trend that Wehner and colleagues found in the top 50 medical schools in the United States, just the men with facial hair might have outnumbered all of the women. However, as medical students, when we look around at our peers, we see equal numbers of women and men. So why does the representation of women look so different at the start of the academic medicine path compared with that seen during a career? The percentage of women medical students has been higher than 40% since the 1995 to 1996 academic year. In fact, looking back to the 1988 to 1989 academic year, one third of the graduates from medical schools were women; about 30 years later, in the 2016 to 2017 academic year, only 17% of medical school department chairs and 17% of deans were women. These numbers are even lower for women of color. The decreasing representation of women at each higher rank within academic medicine is at least partly a result of the phenomenon referred to as the "leaky pipeline." Whereas previous explanations of gender inequity focused on the lack of women going into medicine (the "pipeline problem"), the leaky pipeline model acknowledges that women have made up a significant portion of medical students for a couple of decades but are leaving academic medicine at multiple points, resulting in gender disparities, particularly in leadership. Different Standards One of our first introductions to this issue was through Robyn Klein, MD, PhD, during a talk in which she discussed her work in studying and combating the omission of qualified women from major academic conferences in neuroimmunology. When she surveyed conference organizers as to why women were so underrepresented, one of the reasons given was that "there was a lack of women with the appropriate expertise." Klein's research found this statement to be false. Similarly, other studies have demonstrated that women's grant proposals may be held to higher standards than those of men, and men are more likely than women to be described with words like "pioneer" and "innovative." Women's successes, in contrast, are often attributed to their environment or effort, as opposed to their talent. Studies using CVs have found that those with a man's name are more likely to be judged favorably than those with a woman's name. Why do we tolerate different standards? A Loss for the Profession The systemic biases hinted at in these studies may be pushing women out of academic medicine. For any profession, a decrease in the diversity of thought brought by employees of different demographics is a loss. Furthermore, research has indicated that women physicians may engage in more patient-centered communication and are more likely to follow evidence-based guidelines. These may be the underlying reasons for the lower readmission rates and perioperative mortality of patients cared for by women physicians. These data suggest that women leaving academic medicine is a loss not only for the profession but also for the patients these women would have treated. To be sure, for the most part, these sex disparities are not a result of the malicious actions of a person or group of people. Gender inequity is a societal issue, and we have all, at some point, been complicit in perpetuating it. But striving to improve and effect change in society is fundamental to humanity. This is how we improve care for our patients and improve opportunities for future generations. 500 Women in Medicine Along with three other medical students, we decided to connect. Together, we started 500 Women in Medicine, a subsidiary of 500 Women Scientists, aimed at improving gender equity in medicine and addressing matters such as the leaky pipeline. We hope to increase the visibility and networks of women in medicine, both of which are important in academic career advancement. We created this organization to give us, and other women in medicine, a platform to take action and make change. One of our main projects with 500 Women in Medicine is the creation of a database with profiles of women across the various fields of medicine. Conference organizers and members of the media can use the database to find experts to speak on their panels and serve as sources for their articles or reports. With this resource, and many others, we intend to help women expand their networks and heighten their visibility as experts in the field of medicine, two factors identified as being important for career advancement. 500 Women in Medicine is focused on developing and sharing tangible resources focused on solutions to not only provide ways for women to improve their visibility and advance in a disadvantageous system but also work at reimagining the system as a whole. If the outpouring of support we've received since our launch is any indication, 500 Women in Medicine is a much-needed organization. Source
