Energized and productive faculty are critical to academic medicine, yet studies indicate a lack of advancement and senior roles for women.
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.
The C - Change Faculty Survey was used to collect data on perceptions of organizational culture.
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.
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.
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.
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?
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
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.
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.
Association of American Medical Colleges (AAMC). https://www.aamc.org/download/170264/data/2009_table05.pdf Accessed August 5, 2012.
Association of American Medical Colleges (AAMC). https://www.aamc.org/download/170274/data/2009_table09a.pdf. Accessed August 5, 2012.
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.
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.
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.
Schroen AT, Brownstein MR, Sheldon GF. Women in academic general surgery. Acad Med. 2004;79:310–318.
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.
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.
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.
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.
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.
Trix F, Psenka C. Exploring the color of glass: letters of recommendations for female and male medical faculty. Discourse Soc. 2003;14:191–220.
Wenneras C, Wold A. Nepotism and sexism in peer-review. Nature. 1997;387:341–343.
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.
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.
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.
Pololi LH, Jones SJ. Women faculty: an analysis of their experiences in academic medicine and their coping strategies. Gend Med. 2010;7:438–450.
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.
Carr P, Pololi L, Knight S, Conrad P. Collaboration in academic medicine: reflections on gender and advancement. Acad Med. 2009;84(10):1447–1453.
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.
Pololi L, Kern DE, Carr P, Conrad P. Authors’ reply: faculty values. J Gen Intern Med. 2010;25(7):647.
Pololi LH. A prescription for diversifying medical faculties. Chron High Educ. September 24, 2010. B32–34.
Pololi L, Cooper LA, Carr P. Race, disadvantage and faculty experiences in U.S. academic medicine. J Gen Intern Med. 2010;25:1363–1369.
Pololi LH. Changing the Culture of Academic Medicine. Perspectives of Women Faculty. Hanover: Dartmouth College Press; 2010.
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.
Butler JK. Toward understanding and measuring conditions of trust: evolution of a conditions of trust inventory. J Manag. 1991;17:643–663.
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.
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.
Women in Science and Engineering Leadership Institute. http://wiseli.engr.wisc.edu/pubtype.php Accessed 8/5/12.
University of Michigan ADVANCE program. http://www.advance.rackham.umich.edu/climatesurvey1.pdf. Accessed 8/5/12.
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.
Rubin DB. Multiple Imputation for Nonresponse in Surveys. New York: John Wiley and Sons, Inc.; 1987.
Hatcher L. A Step-by step Approach to Using the SAS System for Factor Analysis and Structural Equation Modeling. Cary: SAS Institute; 1994.
Ely RJ, Meyerson DE. Theories of gender in organizations. A new approach to organizational anlaysis and change. Res Organ Behav. 2000;22:103–151.
Burgess DJ, Joseph A, van Ryan M, Carnes M. Does stereotype threat affect women in academic medicine? Acad Med. 2012;87:506–512.
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.
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.
Markus H, Nurius P. Possible selves. Am Psychol. 1986;14:954–969.
Lips HM. A New Psychology of Women: Gender, Culture and Ethnicity. 3rd ed. Boston: McGraw Hill; 2006:123.
Eagly AH, Karau SJ. Role congruity theory of prejudice toward female leaders. Psychol Rev. 2002;109:573–598.
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.
Heilman ME. Description and prescription: how gender stereotypes prevent women’s ascent up the organizational ladder. J Soc Issues. 2001;57:657674.
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.
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.
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.
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.
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.
Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–1136.
Groves RM, Peytcheva E. The impact of nonresponse rates on nonresponse dias—a meta-analysis. Public Opin Q. 2008;72(2):167–189.
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.
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.
Tierney WG, Rhoads RA. Faculty socialization as a cultural process: a mirror of institutional commitment. ASHE-ERIC Higher Educ Rep. 1994;93:29.
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.
Haraway D. Situated knowledges: the science question in feminism and the privilege of partial perspective. Fem Stud. 1988;14:575–599.
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.
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.
The C - Change Faculty Survey and its items, described in this report, are copyrighted by C - Change, Brandeis University. Please contact firstname.lastname@example.org to use this survey.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
About this article
Cite this article
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
- academic medicine
- female faculty