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Women Practicing in Pediatrics

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Abstract

The field of pediatrics has a high proportion of women. However, even in a field in which women outnumber men, women are underrepresented in certain pediatric subspecialties. Are women motivated to pursue certain fields, but, in the end, driven away due to obstacles? What are these obstacles, and what can be done to overcome them for future generations? Potential drivers may include gender bias and discrimination during medical school and residency training, availability of women faculty mentors and faculty allies who are men, as well as challenges to achieving work-life integration that are unique to women. In this chapter, we explore the current landscape of women in pediatrics, consider the barriers to achieving gender equity, and propose a path forward.

Keywords

  • Gender bias
  • Gender equity
  • Gender discrimination
  • Stereotype threat
  • Likability paradox
  • Tipping effect
  • Second-generation gender bias

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Notes

  1. 1.

    The word “sex” is the term used in the legislation.

References

  1. 2018 Survey of America’s Physicians. 2018.

    Google Scholar 

  2. AAMC. 2015–2016 the state of women in academic medicine statistics. 2015.

    Google Scholar 

  3. AAMC. Table A-6: Age of Applicants to U. S. Medical Schools at Anticipated Matriculation by Sex and Race / Ethnicity, 2014–2015 through 2017–2018 Table A-6: Age of Applicants to U. S. Medical Schools at Anticipated Matriculation by Sex and Race / Ethnici. 2018

    Google Scholar 

  4. AAMC. 2018–2019 The state of women in academic medicine: Exploring pathways to equity. 2019

    Google Scholar 

  5. AMA Data: Physicians in Private Practice Continue to Decline | HealthLeaders Media. n.d. Retrieved December 15, 2021, from https://www.healthleadersmedia.com/clinical-care/ama-data-physicians-private-practice-continue-decline.

  6. Amanatullah ET, Morris MW. Negotiating gender roles: gender differences in assertive negotiating are mediated by women’s fear of backlash and attenuated when negotiating on behalf of others. J Pers Soc Psychol. 2010;98(2):256–67. https://doi.org/10.1037/a0017094.

    CrossRef  PubMed  Google Scholar 

  7. Andriole DA, Whelan AJ, Jeffe DB. Characteristics and career intentions of the emerging MD/PhD workforce. JAMA. 2008;300(10):1165–73. https://doi.org/10.1001/jama.300.10.1165.

    CrossRef  CAS  PubMed  Google Scholar 

  8. Artz B, Goodall AH, Oswald AJ. Do women ask? Ind Relat. 2018;57(4):611–36. https://doi.org/10.1111/irel.12214.

    CrossRef  Google Scholar 

  9. Association Cullof American Medical Colleges (AAMC). 2020 physician specialty report data highlights. 2020.

    Google Scholar 

  10. Baker M, Halberstam Y, Kroft K, Mas A, Messacar D. Pay transparency and the gender gap. National Bureau of Economic Research. Cambridge, MA; 2021.

    Google Scholar 

  11. Baumhäkel M, Müller U, Böhm M. Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure in a cross-sectional study. Eur J Heart Fail. 2009;11(3):299–303. https://doi.org/10.1093/eurjhf/hfn041.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  12. Bickel J, Rosenthal SL. Difficult issues in mentoring: recommendations on making the “undiscussable” discussable. Acad Med. 2011;86(10):1229–34. https://doi.org/10.1097/ACM.0b013e31822c0df7.

    CrossRef  PubMed  Google Scholar 

  13. Bravender T, Selkie E, Sturza J, Martin DM, Griffith KA, Kaciroti N, Jagsi R. Association of salary differences between medical specialties with sex distribution. JAMA Pediatr. 2021;175(5):524–5. American Medical Association. https://doi.org/10.1001/jamapediatrics.2020.5683

    CrossRef  Google Scholar 

  14. Budig MJ, England P. The wage penalty for motherhood author ( s ): Michelle J. Budig and Paula England published by: American Sociological Association stable. URL: http://www.jstor.org/stable/2657415. Accessed: 02-03-2016 03: 11 UTC Your use of the JSTOR archive indicates. 2001a; 66(2), 204–225.

  15. Budig MJ, England P. The wage penalty for motherhood author ( s ): Michelle J. Budig and Paula England published by: American Sociological Association stable URL: http://www.jstor.org/stable/2657415 Accessed: 02-03-2016 03: 11 UTC Your use of the JSTOR archive indicates. 2001b;66(2), 204–225.

  16. Byrne BJ, Katakam SK, Frintner MP, Cull WL. Early career experiences of pediatricians pursuing or not pursuing fellowship training. Pediatrics. 2015;136(4):672–9. https://doi.org/10.1542/peds.2014-3973.

    CrossRef  PubMed  Google Scholar 

  17. Cain JM, Schulkin J, Parisi V, Power ML, Holzman GB, Williams S. Effects of perceptions and mentorship on pursuing a career in academic medicine in obstetrics and gynecology. Acad Med. 2001;76(6):628–34. https://doi.org/10.1097/00001888-200106000-00015.

    CrossRef  CAS  PubMed  Google Scholar 

  18. Camacci ML, Ikpoh B, Lehman EB, Bowie E, Scott IU, Pantanelli SM, Ely A. Gender disparities among United States academic pediatric ophthalmologists: an analysis of publication productivity, academic rank, and NIH funding. J AAPOS. 2020;24(6):337.e1–6. https://doi.org/10.1016/j.jaapos.2020.06.013.

    CrossRef  Google Scholar 

  19. Carnes M, Bartels C, Isaac C, Kaatz A, Kolehmainen C. Why is John more likely to become department chair than Jennifer? Trans Am Clin Climatol Assoc. 2015;126:197–214.

    Google Scholar 

  20. Carr PL, Ash AS, Friedman RH, Scaramucci A, Barnett RC, Szalacha L, Palepu A, Moskowitz MA. Relation of family responsibilities and gender to the productivity and career satisfaction of medical faculty. Ann Intern Med. 1998;129(7):532–8. https://doi.org/10.7326/0003-4819-129-7-199810010-00004.

  21. Catenaccio E, Rochlin JM, Simon HK. Differences in lifetime earning potential for pediatric subspecialists. Pediatrics. 2021a;147(4) https://doi.org/10.1542/peds.2020-027771.

  22. Catenaccio E, Rochlin JM, Simon HK. Differences in lifetime earning potential between pediatric and adult physicians. Pediatrics. 2021b;148(2) https://doi.org/10.1542/peds.2021-051194.

  23. Cooper M. For women leaders, likability and success hardly go hand-in-hand. Harvard Business Review, April 30th; 2013.

    Google Scholar 

  24. Correll SJ, Benard S, Paik I. Getting a job: is there a motherhood penalty? Am J Sociol. 2007;112(5):1297–338. https://doi.org/10.1086/511799.

    CrossRef  Google Scholar 

  25. Cull W, Caspary G, Olson L. Many pediatric residents seek and obtain part-time positions. Pediatrics. 2008;121(2):276–81. https://doi.org/10.1542/peds.2007-0311.

  26. Cusimano MC, Baxter NN, Sutradhar R, Mcarthur E, Ray JG, Garg AX, Vigod S, Simpson AN. Delay of pregnancy among physicians vs nonphysicians supplemental content. JAMA Intern Med. 2021;181(7):905–12. https://doi.org/10.1001/jamainternmed.2021.1635.

    CrossRef  PubMed  Google Scholar 

  27. Durfey, S. N. M., White, J., & Adashi, E. Y. (2021). Pregnancy and parenting in medical school: highlighting the need for data and support. Acad Med, 1259–1262. https://doi.org/10.1097/ACM.0000000000003988.

  28. Edmunds LD, Ovseiko PV, Shepperd S, Greenhalgh T, Frith P, Roberts NW, Pololi LH, Buchan AM. Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence. Lancet. 2016;388(10062):2948–58. https://doi.org/10.1016/S0140-6736(15)01091-0.

    CrossRef  PubMed  Google Scholar 

  29. England P, Bearak J, Budig MJ, Hodges MJ. Do highly paid, highly skilled women experience the largest motherhood penalty? Am Sociol Rev. 2016;81(6):1161–89. https://doi.org/10.1177/0003122416673598.

    CrossRef  Google Scholar 

  30. Farkas AH, Bonifacino E, Turner R, Tilstra SA, Corbelli JA. Mentorship of women in academic medicine: a systematic review. J General Internal Med. 2019;34(7):1322–9. Springer New York LLC. https://doi.org/10.1007/s11606-019-04955-2

    CrossRef  Google Scholar 

  31. Fishman M, Williams WA, Goodman DM, Ross LF. Gender differences in the authorship of original research in Pediatric journals, 2001–2016. J Pediatr. 2017;191:244–249.e1. https://doi.org/10.1016/J.JPEDS.2017.08.044.

    CrossRef  PubMed  Google Scholar 

  32. Fox G, Schwartz A, Hart KM. Work-family balance and academic advancement in medical schools. Acad Psychiatry. 2006;30(3):227–34. https://doi.org/10.1176/appi.ap.30.3.227.

    CrossRef  PubMed  Google Scholar 

  33. Frank E. Career satisfaction of US women physicians. Arch Intern Med. 1999;159(13):1417. https://doi.org/10.1001/archinte.159.13.1417.

    CrossRef  CAS  PubMed  Google Scholar 

  34. Frank E, Zhao Z, Sen S, Guille C. Gender disparities in work and parental status among early career physicians. JAMA Netw Open. 2019;2(8):–e198340. https://doi.org/10.1001/JAMANETWORKOPEN.2019.8340.

  35. Freed GL, Moran LM, Van KD, Leslie LK. Current workforce of general pediatricians in the United States. Pediatrics. 2016;137(4) https://doi.org/10.1542/peds.2015-4242.

  36. Freed GL, Moran LM, Van KD, Leslie LK. Current workforce of pediatric subspecialists in the United States. Pediatrics. 2017;139(5) https://doi.org/10.1542/peds.2016-3604.

  37. Friedberg MW, Chen PG, Busum KRV, Aunon FM, Pham C, Caloyeras J, Mattke S, Pitchforth E, Quigley DD, Brook RH, Crosson FJ, Tutty M. RAND Study—Physician Satisfaction. 2013.

    Google Scholar 

  38. Frintner M, Mulvey H, Pletcher B,Olson L. Pediatric resident debt and career intentions. Pediatrics. 2013;131(2):312–8. https://doi.org/10.1542/peds.2012-0411.

  39. Frintner MP, Cull WL, Byrne BJ, Freed GL, Katakam SK, Leslie LK, Miller AA, Starmer AJ, Olson LM. A longitudinal study of pediatricians early in their careers: places. Pediatrics. 2015;136(2):370–80. https://doi.org/10.1542/peds.2014-3972.

    CrossRef  PubMed  Google Scholar 

  40. Frintner MP, Sisk B, Byrne BJ, Freed GL, Starmer AJ, Olson LM. Gender differences in earnings of early- and midcareer pediatricians. Pediatrics. 2019;144(4) https://doi.org/10.1542/peds.2018-3955.

  41. Gerull K, Loe M, Seiler K, McAllister J, Salles A. Assessing gender bias in qualitative evaluations of surgical residents. The American Journal of Surgery. 2019;217(2):306–13. https://doi.org/10.1016/j.amjsurg.2018.09.029.

  42. Gottlieb A.. Closing the Gender Pay Gap in Medicine | SpringerLink. Springer; 2021. https://link.springer.com/book/10.1007%2F978-3-030-51031-2.

  43. Gottlieb AS, Jagsi R. Closing the gender pay gap in Medicine. N Engl J Med. 2021;NEJMp2114955 https://doi.org/10.1056/NEJMp2114955.

  44. Harris MC, Marx J, Gallagher PR, Ludwig S. General vs subspecialty pediatrics: factors leading to residents’ career decisions over a 12-year period. Arch Pediatr Adolesc Med. 2005;159(3):212–6). American Medical Association. https://doi.org/10.1001/archpedi.159.3.212.

    CrossRef  PubMed  Google Scholar 

  45. Horowitz E, Randis TM, Samnaliev M, Savich R. Equity for women in medicine—neonatologists identify issues. J Perinatol. 2021;41(3):435–44. https://doi.org/10.1038/s41372-020-00897-4.

    CrossRef  PubMed  Google Scholar 

  46. Isaac C, Chertoff J, Lee B, Carnes M. Do students’ and authors’ genders affect evaluations? A linguistic analysis of medical student performance evaluations. Acad Med. 2011;86(1):59–66. https://doi.org/10.1097/ACM.0b013e318200561d.

  47. Jagsi R, Tarbell NJ, Weinstein DF. Becoming a doctor, starting a family—leaves of absence from graduate medical education. N Engl J Med. 2007;357(19):1889–91. https://doi.org/10.1056/nejmp078163.

    CrossRef  CAS  PubMed  Google Scholar 

  48. Jolly S, Griffith KA, DeCastro R, Stewart A, Ubel P, Jagsi R. Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers. Ann Intern Med. 2014;160(5):344–53. https://doi.org/10.7326/m13-0974.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  49. Klein R, Julian KA, Snyder ED, Koch J, Ufere NN, Volerman A, Vandenberg AE, Schaeffer S, Palamara K. Gender bias in resident assessment in graduate medical education: review of the literature. J General Internal Med. 2019;34(5):712–9. Springer New York LLC. https://doi.org/10.1007/s11606-019-04884-0.

    CrossRef  Google Scholar 

  50. Kolehmainen C, Brennan M, Filut M, Issac C, Carnes M. Afraid of Being Witchy with a ‘B’”: A Qualitative Study of How Gender Influences Residents’ Experiences Leading Cardiopulmonary Resuscitation. Acad Med. 2014;89(9):1276–81. https://doi.org/10.1097/ACM.0000000000000372.

  51. Levanon A, England P, Paul Allison UOP. Occupational feminization and pay: assessing causal dynamics using 1950–2000 U.S. Census data. Soc Forces. 2009;88(2):865–91. https://doi.org/10.1353/sof.0.0264.

    CrossRef  Google Scholar 

  52. Levine R, Lin F, Kern D, Wright S, Carrese J. Stories from early-career women physicians who have left academic medicine: a qualitative study at a single institution. Acad Med 2011;86(6):752–8. https://doi.org/10.1097/ACM.0b013e318217e83b.

  53. Levine R, Mechaber H, Reddy S, … D. C.-A., & 2013, undefined. “A good career choice for women”: Female medical students’ mentoring experiences: A multi-institutional qualitative study. Journals.Lww.Com. n.d.-b.

    Google Scholar 

  54. Lo Sasso AT, Armstrong D, Forte G, Gerber SE. Differences in starting pay for male and female physicians persist; explanations for the gender gap remain elusive. Health Aff. 2020;39(2):256–63. https://doi.org/10.1377/hlthaff.2019.00664.

    CrossRef  Google Scholar 

  55. Lundberg S, Rose E. Parenthood and the earnings of married men and women. Labour Econ. 2000;7(6):689–710. https://doi.org/10.1016/S0927-5371(00)00020-8.

    CrossRef  Google Scholar 

  56. Macy ML, Leslie LK, Turner A, Freed GL. Growth and changes in the pediatric medical subspecialty workforce pipeline. Pediatr Res. 2021;89(5):1297–303. https://doi.org/10.1038/s41390-020-01311-7.

    CrossRef  PubMed  Google Scholar 

  57. Matulevicius S, Kho K, Reisch J, Open, H. Y.-J. Network, & 2021, undefined. Academic medicine faculty perceptions of work-life balance before and since the COVID-19 pandemic. Jamanetwork.Com. n.d.

    Google Scholar 

  58. McMurray JE, Linzer M, Konrad TR, Douglas J, Shugerman R, Nelson K. The work lives of women physicians: results from the physician work life study. J Gen Intern Med. 2000;15(6):372–80. https://doi.org/10.1046/j.1525-1497.2000.9908009.x.

    CrossRef  CAS  PubMed  PubMed Central  Google Scholar 

  59. McNamara MC, McNeil MA, Chang J. A pilot study exploring gender differences in residents’ strategies for establishing mentoring relationships. Med Educ Online. 2008;13(1):4476. https://doi.org/10.3402/meo.v13i.4476.

    CrossRef  Google Scholar 

  60. Merritt Hawkins, & The Physicians Foundation. 2018 Survey of America’s physicians practice patterns & perspectives. Physicians Foundation; 2018. p. 1–82.

    Google Scholar 

  61. Morales-Lemieux K. How compensation is determined and potential pitfalls for pay equity. In: Gotttlieb A, editor. Closing the gender pay gap in medicine: a roadmap for healthcare organizations and the women physicians who work for them. Springer; 2021. p. 17–28. https://doi.org/10.4018/978-1-5225-9599-1.ch008.

    CrossRef  Google Scholar 

  62. O’Meara KA, Kuvaeva A, Nyunt G, Waugaman C, Jackson R. Asked more often: gender differences in faculty workload in research universities and the work interactions that shape them. Am Educ Res J. 2017;54(6):1154–86. https://doi.org/10.3102/0002831217716767.

    CrossRef  Google Scholar 

  63. Pan J. Gender segregation in occupations: the role of tipping and social interactions. J Labor Econ. 2015;33(2):365–408. https://doi.org/10.1086/678518.

    CrossRef  Google Scholar 

  64. Pediatrics AB of. Yearly growth in general pediatrics residents by demographics and program characteristics. n.d. Retrieved January 6, 2022, from https://www.abp.org/content/yearly-growth-general-pediatrics-residents-demographics-and-program-characteristics.

  65. Pediatrics, T. A. B. of. The American Board of Pediatrics, Research Department. 2021.

    Google Scholar 

  66. Pelley E, Carnes M. When a specialty becomes “women’s work”: trends in and implications of specialty gender segregation in Medicine. Acad Med. 2020;95(10):1499–506. https://doi.org/10.1097/ACM.0000000000003555.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  67. Perumalswami CR, Takenoshita S, Tanabe A, Kanda R, Hiraike H, Okinaga H, Jagsi R, Nomura K. Workplace resources, mentorship, and burnout in early career physician-scientists: a cross sectional study in Japan. BMC Med Educ. 2020;20(1):1–10. https://doi.org/10.1186/s12909-020-02072-x.

    CrossRef  Google Scholar 

  68. Richter KP, Clark L, Wick JA, Cruvinel E, Durham D, Shaw P, Shih GH, Befort CA, Simari RD. Women physicians and promotion in academic Medicine. N Engl J Med. 2020;383(22):2148–57. https://doi.org/10.1056/nejmsa1916935.

    CrossRef  PubMed  Google Scholar 

  69. Ross DA, Boatright D, Nunez-Smith M, Jordan A, Chekroud A, Moore EZ. Differences in words used to describe racial and gender groups in medical student performance evaluations. PLoS One. 2017;12(8) https://doi.org/10.1371/journal.pone.0181659.

  70. Rotbart HA, McMillen D, Taussig H, Daniels SR. Assessing gender equity in a large academic Department of Pediatrics. Acad Med. 2012;87(1):98–104. https://doi.org/10.1097/ACM.0b013e31823be028.

    CrossRef  PubMed  Google Scholar 

  71. Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication: a meta-analytic review. J Am Med Assoc. 2002;288(6):756–64. https://doi.org/10.1001/jama.288.6.756.

    CrossRef  Google Scholar 

  72. Schor NF. The decanal divide. Acad Med. 2018;93(2):237–40. https://doi.org/10.1097/ACM.0000000000001863.

    CrossRef  PubMed  Google Scholar 

  73. Silver JK, Poorman JA, Reilly JM, Spector ND, Goldstein R, Zafonte RD. Assessment of women physicians among authors of perspective-type articles published in high-impact Pediatric journals. JAMA Netw Open. 2018;1(3):e180802. https://doi.org/10.1001/jamanetworkopen.2018.0802.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  74. Spector ND, Asante PA, Marcelin JR, Poorman JA, Larson AR, Salles A, Oxentenko AS, Silver JK. Women in pediatrics: Progress, barriers, and opportunities for equity, diversity, and inclusion. Pediatrics. 2019;144(5) https://doi.org/10.1542/peds.2019-2149.

  75. Spencer SJ, Logel C, Davies PG. Stereotype threat. Annu Rev Psychol. 2016;67:415–37. https://doi.org/10.1146/annurev-psych-073115-103235.

    CrossRef  PubMed  Google Scholar 

  76. Starmer AJ, Frintner MP, Matos K, Somberg C, Freed G, Byrne BJ. Gender discrepancies related to pediatrician work-life balance and household responsibilities. Pediatrics. 2019;144(4) https://doi.org/10.1542/peds.2018-2926.

  77. Stentz NC, Griffith KA, Perkins E, Jones RD, Jagsi R. Fertility and childbearing among American female physicians. J Women's Health. 2016;25(10):1059–65. https://doi.org/10.1089/jwh.2015.5638.

    CrossRef  Google Scholar 

  78. Trotter RG, Zacur SR, Stickney LT. The new age of pay transparency. Bus Horiz. 2017;60(4):529–39. https://doi.org/10.1016/j.bushor.2017.03.011.

    CrossRef  Google Scholar 

  79. Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. Comparison of hospital mortality and readmission rates for medicare patients treated by male vs female physicians. JAMA Intern Med. 2017;177(2):206–13. https://doi.org/10.1001/jamainternmed.2016.7875.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  80. United WB, Chakravorty A, Murdoch J, Nisar H. Gender-based pay disparity study. 2019.

    Google Scholar 

  81. Wade M, Fiorentino S. Gender pay inequality: an examination of the Lilly Ledbetter fair pay act six years later. Adv Women Leadersh. 2017;37:29–36.

    Google Scholar 

  82. Wallis CJ, Ravi B, Coburn N, Nam RK, Detsky AS, Satkunasivam R. Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. BMJ (Online). 2017;359 https://doi.org/10.1136/bmj.j4366.

  83. West CP, Drefahl MM, Popkave C, Kolars JC. Internal medicine resident self-report of factors associated with career decisions. J Gen Intern Med. 2009;24(8):946–9. https://doi.org/10.1007/s11606-009-1039-0.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  84. Whaley CM, Koo T, Arora VM, Ganguli I, Gross N, Jena AB. Female physicians earn an estimated $2 million less than male physicians over a simulated 40-year career. Health Aff. 2021;40(12):1856–64. https://doi.org/10.1377/hlthaff.2021.00461.

    CrossRef  Google Scholar 

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Sharp, E., Forster, C., Shah, S., Morton, K. (2022). Women Practicing in Pediatrics. In: Spector, N.D., O'Toole, J.K., Overholser, B. (eds) Women in Pediatrics . Springer, Cham. https://doi.org/10.1007/978-3-030-98222-5_3

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