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Experiencing the Culture of Academic Medicine: Gender Matters, A National Study

ABSTRACT

BACKGROUND

Energized and productive faculty are critical to academic medicine, yet studies indicate a lack of advancement and senior roles for women.

OBJECTIVE

Using measures of key aspects of the culture of academic medicine, this study sought to identify similarity and dissimilarity between perceptions of the culture by male and female faculty.

DESIGN

The C - Change Faculty Survey was used to collect data on perceptions of organizational culture.

PARTICIPANTS

A stratified random sample of 4,578 full-time faculty at 26 nationally representative US medical colleges (response rate 52 %). 1,271 (53 %) of respondents were female.

MAIN MEASURES

Factor analysis assisted in the creation of scales assessing dimensions of the culture, which served as the key outcomes. Regression analysis identified gender differences while controlling for other demographic characteristics.

KEY RESULTS

Compared with men, female faculty reported a lower sense of belonging and relationships within the workplace (T = −3.30, p < 0.01). Self-efficacy for career advancement was lower in women (T = −4.73, p < 0.001). Women perceived lower gender equity (T = −19.82, p < 0.001), and were less likely to believe their institutions were making changes to address diversity goals (T = −9.70, p < 0.001). Women were less likely than men to perceive their institution as family-friendly (T = −4.06, p < 0.001), and women reported less congruence between their own values and those of their institutions (T = −2.06, p < 0.05). Women and men did not differ significantly on levels of engagement, leadership aspirations, feelings of ethical/moral distress, perception of institutional commitment to faculty advancement, or perception of institutional change efforts to improve support for faculty.

CONCLUSIONS

Faculty men and women are equally engaged in their work and share similar leadership aspirations. However, medical schools have failed to create and sustain an environment where women feel fully accepted and supported to succeed; how can we ensure that medical schools are fully using the talent pool of a third of its faculty?

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REFERENCES

  1. 1.

    Pololi L, Krupat E, Civian JT, Ash AS, Brennan RT. Why are a quarter of faculty considering leaving academic medicine? A study of their perceptions of institutional culture and intention to leave in 26 representative medical schools. Acad Med. 2012;87:859–869.

    PubMed  Article  Google Scholar 

  2. 2.

    Corrice AM, Fox S, Bunton SA. Retention of full-time clinical M.D. faculty at US medical schools. Analysis in Brief. Washington DC: AAMC. 2011;11(2):1–2.

  3. 3.

    Association of American Medical Colleges (AAMC). https://www.aamc.org/download/170264/data/2009_table05.pdf Accessed August 5, 2012.

  4. 4.

    Association of American Medical Colleges (AAMC). https://www.aamc.org/download/170274/data/2009_table09a.pdf. Accessed August 5, 2012.

  5. 5.

    Association of American Medical Colleges (AAMC). 2011 AAMC data book: Medical schools and teaching hospitals by the numbers. https://www.aamc.org/data/databook. Accessed August 5, 2012.

  6. 6.

    Bickel J, Wara D, Atkinson BF, Cohen LS, Dunn M, Hostler S, Johnson TRB, Morahan P, Rubenstein AH, Sheldon GF, Stokes E. Increasing women’s leadership in academic medicine: report of the AAMC Project Implementation Committee. Acad Med. 2002;17:1043–1061.

    Article  Google Scholar 

  7. 7.

    Carr PL, Ash AS, Friedman RH, et al. Faculty perceptions of gender discrimination and sexual harassment in academic medicine. Ann Intern Med. 2000;132:889–896.

    PubMed  CAS  Google Scholar 

  8. 8.

    Schroen AT, Brownstein MR, Sheldon GF. Women in academic general surgery. Acad Med. 2004;79:310–318.

    PubMed  Article  Google Scholar 

  9. 9.

    Bakken L, Sheridan J, Carnes M. Gender differences among physician–scientists in self-assessed abilities to perform clinical research. Acad Med. 2003;78:1281–1286.

    PubMed  Article  Google Scholar 

  10. 10.

    Foster SW, McMurray JE, Linzer M, Leavitt JW, Rosenberg M, Carnes M. Results of a gender-climate and work-environment survey at a Midwestern academic health center. Acad Med. 2000;75(6):653.

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Wright AL, Schwindt LA, Bassford TL, Reyna VF, Shisslak CM, St. Germain PA, Reed KL. Gender differences in academic medicine: patterns, causes, and potential solutions in one U.S. college of medicine. Acad Med. 2003;78:500–508.

    PubMed  Article  Google Scholar 

  12. 12.

    Kaplan SH, Sullivan LM, Dukes KA, Phillips CF, Kelch RP, Schaller JG. Sex differences in academic advancement. N Engl J Med. 1996;335:1282–1289.

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    National Academy of Sciences; National Academies of Engineering; Institute of Medicine Committee on Maximizing the Potential of Women in Academic Science and Engineering. Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering. Washington DC: National Academies Press; 2006.

  14. 14.

    Trix F, Psenka C. Exploring the color of glass: letters of recommendations for female and male medical faculty. Discourse Soc. 2003;14:191–220.

    Article  Google Scholar 

  15. 15.

    Wenneras C, Wold A. Nepotism and sexism in peer-review. Nature. 1997;387:341–343.

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Steinpreis RE, Anders KA, Ritzke D. The impact of gender on the review of the curricula vitae of job applicants and tenure candidates: a national empirical study. Sex Roles. 1999;41:509–528.

    Article  Google Scholar 

  17. 17.

    Jagsi R, Griffith KA, Stewart A, Sambuco D, DeCastro R, Ubel PA. Gender differences in the salaries of physician researchers. JAMA. 2012;307:2410–2417.

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Pololi L, Conrad P, Knight S, Carr P. A study of the relational aspects of the culture of academic medicine. Acad Med. 2009;84:106–114.

    PubMed  Article  Google Scholar 

  19. 19.

    Pololi LH, Jones SJ. Women faculty: an analysis of their experiences in academic medicine and their coping strategies. Gend Med. 2010;7:438–450.

    PubMed  Article  Google Scholar 

  20. 20.

    Pololi L, Kern DE, Carr P, Conrad P, Knight S. The culture of academic medicine: faculty perceptions of the lack of alignment between individual and institutional values. J Gen Intern Med. 2009;24(12):1289–1295.

    PubMed  Article  Google Scholar 

  21. 21.

    Carr P, Pololi L, Knight S, Conrad P. Collaboration in academic medicine: reflections on gender and advancement. Acad Med. 2009;84(10):1447–1453.

    PubMed  Article  Google Scholar 

  22. 22.

    Conrad P, Carr P, Knight S, Renfrew MR, Dunn M, Pololi L. Hierarchy as a barrier to advancement for women in academic medicine. J Women’s Health. 2010;19(4):799–805.

    Article  Google Scholar 

  23. 23.

    Pololi L, Kern DE, Carr P, Conrad P. Authors’ reply: faculty values. J Gen Intern Med. 2010;25(7):647.

    Article  Google Scholar 

  24. 24.

    Pololi LH. A prescription for diversifying medical faculties. Chron High Educ. September 24, 2010. B32–34.

  25. 25.

    Pololi L, Cooper LA, Carr P. Race, disadvantage and faculty experiences in U.S. academic medicine. J Gen Intern Med. 2010;25:1363–1369.

    PubMed  Article  Google Scholar 

  26. 26.

    Pololi LH. Changing the Culture of Academic Medicine. Perspectives of Women Faculty. Hanover: Dartmouth College Press; 2010.

    Google Scholar 

  27. 27.

    Schindler BA, Novack DH, Cohen DG, et al. The impact of the changing health care environment on the health and well-being of faculty at four medical schools. Acad Med. 2006;81:27–33.

    PubMed  Article  Google Scholar 

  28. 28.

    Butler JK. Toward understanding and measuring conditions of trust: evolution of a conditions of trust inventory. J Manag. 1991;17:643–663.

    Article  Google Scholar 

  29. 29.

    Pololi L, Price J. Validation and use of an instrument to measure the learning environment as perceived by medical students. Teach Learn Med. 2000;12(4):201–207.

    PubMed  Article  CAS  Google Scholar 

  30. 30.

    Pololi LH, Dennis K, Winn GM, Mitchell J. A needs assessment of medical school faculty: caring for the caretakers. J Contin Educ Health Prof. 2003;23:21–29.

    PubMed  Article  Google Scholar 

  31. 31.

    Women in Science and Engineering Leadership Institute. http://wiseli.engr.wisc.edu/pubtype.php Accessed 8/5/12.

  32. 32.

    University of Michigan ADVANCE program. http://www.advance.rackham.umich.edu/climatesurvey1.pdf. Accessed 8/5/12.

  33. 33.

    Raghunathan TE, Lepkowski JM, Van Hoewyk J, Solenberger PW. A multivariate technique for multiply imputing missing values using a sequence of regression models. Surv Methodol. 2001;27:85–95.

    Google Scholar 

  34. 34.

    Rubin DB. Multiple Imputation for Nonresponse in Surveys. New York: John Wiley and Sons, Inc.; 1987.

    Book  Google Scholar 

  35. 35.

    Hatcher L. A Step-by step Approach to Using the SAS System for Factor Analysis and Structural Equation Modeling. Cary: SAS Institute; 1994.

    Google Scholar 

  36. 36.

    Ely RJ, Meyerson DE. Theories of gender in organizations. A new approach to organizational anlaysis and change. Res Organ Behav. 2000;22:103–151.

    Article  Google Scholar 

  37. 37.

    Burgess DJ, Joseph A, van Ryan M, Carnes M. Does stereotype threat affect women in academic medicine? Acad Med. 2012;87:506–512.

    PubMed  Article  Google Scholar 

  38. 38.

    Lent R, Brown S, Larkin K. Self-efficacy in the prediction of academic performance and perceived career options. J Couns Psychol [serial online]. 1986;33(3):265–269. Available from: PsycINFO, Ipswich, MA. Accessed July 9, 2012.

  39. 39.

    Lent R, Brown S, Larkin K. Comparison of three theoretically derived variables in predicting career and academic behavior: self-efficacy, interest congruence, and consequence thinking. J Couns Psychol [serial online]. 1987;34(3):293–298. Available from: PsycINFO, Ipswich, MA. Accessed July 9, 2012.

  40. 40.

    Markus H, Nurius P. Possible selves. Am Psychol. 1986;14:954–969.

    Article  Google Scholar 

  41. 41.

    Lips HM. A New Psychology of Women: Gender, Culture and Ethnicity. 3rd ed. Boston: McGraw Hill; 2006:123.

    Google Scholar 

  42. 42.

    Eagly AH, Karau SJ. Role congruity theory of prejudice toward female leaders. Psychol Rev. 2002;109:573–598.

    PubMed  Article  Google Scholar 

  43. 43.

    Heilman ME, Wallen AS, Fuchs D, Tamkins MM. Penalties for success: reactions to women who succeed at male gender-typed tasks. J Appl Psychol. 2004;89:416–427.

    PubMed  Article  Google Scholar 

  44. 44.

    Heilman ME. Description and prescription: how gender stereotypes prevent women’s ascent up the organizational ladder. J Soc Issues. 2001;57:657674.

    Article  Google Scholar 

  45. 45.

    Rudman LA. Self-promotion as a risk factor for women: the costs and benefits of counter stereotypical impression management. J Pers Soc Psychol. 1998;74(3):629–645.

    PubMed  Article  CAS  Google Scholar 

  46. 46.

    Levine RB, Lin F, Kern DE, Wright SM, Carrese J. Stories from early-career women physicians who have left academic medicine. Acad Med. 2011;86(6):752–758.

    PubMed  Article  Google Scholar 

  47. 47.

    Cropsey KL, Masho SW, Shiang R, Sikka V, Kornstein SG, Hampton CL. Committee on the Status of Women and Minorities. Why do faculty leave? Reasons for attrition of women and minority faculty from a medical school: four-year results. J Women’s Health. 2008;17:1111–1118.

    Article  Google Scholar 

  48. 48.

    Lowenstein SR, Fernandez G, Crane LA. Medical school faculty discontent: prevalence and predictors of intent to leave academic careers. BMC Med Educ. 2007;7(37):1–8.

    Google Scholar 

  49. 49.

    Linn LS, Yager J, Cope D, Leake B. Health status, job satisfaction, job stress, and life satisfaction among academic and clinical faculty. JAMA. 1985;254:2775–2782.

    PubMed  Article  CAS  Google Scholar 

  50. 50.

    Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–1136.

    PubMed  Article  CAS  Google Scholar 

  51. 51.

    Groves RM, Peytcheva E. The impact of nonresponse rates on nonresponse dias—a meta-analysis. Public Opin Q. 2008;72(2):167–189.

    Article  Google Scholar 

  52. 52.

    Stewart AJ, Dottolo AL. Socialization to the academy: coping with competing social identities. In: Downey G, Dweck C, Eccles J, Chatman C, eds. Navigating the Future: social Identity, Coping and Life Tasks. New York: Russell Sage; 2005:167–187.

    Google Scholar 

  53. 53.

    Turner CSV, Myers SL Jr, Creswell JW. Exploring underrepresentation: the case of faculty of color in the Midwest. J High Educ. 1999;70:27–59.

    Article  Google Scholar 

  54. 54.

    Tierney WG, Rhoads RA. Faculty socialization as a cultural process: a mirror of institutional commitment. ASHE-ERIC Higher Educ Rep. 1994;93:29.

    Google Scholar 

  55. 55.

    Weidman JC, Twale DJ, Stein EL. Socialization of graduate and professional students in higher education: a perilous passage? ASHE-ERIC Higher Educ Rep. 2001; 28.

  56. 56.

    Haraway D. Situated knowledges: the science question in feminism and the privilege of partial perspective. Fem Stud. 1988;14:575–599.

    Article  Google Scholar 

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Acknowledgements

Contributors

The authors wish to thank all the members of the C - Change research team who participated in developing items for the survey, data collection and supporting the process of C - Change work. The authors thank the AAMC for assisting in the initial phase of the project. The authors are indebted to the medical faculty who generously shared their perspectives in the survey.

Funders

The authors gratefully acknowledge the critical funding support of the Josiah Macy, Jr. Foundation and Brandeis University Women’s Studies Research Center. Funding supported the design and conduct of the study; and collection, management, analysis and interpretation of the data. Supplemental funds to support data analysis were provided by the U.S. Health and Human Services Office of Public Health and Science, Office on Women’s Health, and Office of Minority Health; National Institutes of Health, Office of Research on Women’s Health; the Agency for Healthcare Research and Quality; the Centers for Disease Control and Prevention and the Health Resources and Services Administration.

Prior Presentations

None

Other Disclosures

The C - Change Faculty Survey and its items, described in this report, are copyrighted by C - Change, Brandeis University. Please contact cchange@brandeis.edu to use this survey.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Correspondence to Linda H. Pololi MD.

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Pololi, L.H., Civian, J.T., Brennan, R.T. et al. Experiencing the Culture of Academic Medicine: Gender Matters, A National Study. J GEN INTERN MED 28, 201–207 (2013). https://doi.org/10.1007/s11606-012-2207-1

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KEY WORDS

  • culture
  • academic medicine
  • female faculty
  • gender