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Women in Academic Surgery: The Pipeline

is Busted

Sexton, KW; Hocking, K; Wise, E; Osgood, MJ; Cheung-Flynn, J; Komalavilas,

P;Campbell, K; Dattilo, JB; Brophy, CM

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DISCLAIMERS

No Financial Disclosures, unfortunately Some opinion, mostly data I am not a woman

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RA

TE

OF

CH

AN

GE

TIMESingularity

Stonetablets

Printingpress

Internet

Watson&Crick

Humangenome

Mendel

We are living in the most dynamic epoch of human history.

The rate of change is getting faster

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Diversity

Ecosystem stability depends on the ability of a community to contain functional groups with different responses to stressors.

McCann KS. The diversity-stability debate. Nature. May 11 2000;405(6783):228-233

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Elizabeth Blackwell

1821-1910 Bristol, England Geneva Medical

College 1/23/1849

wikipedia.org

Roth N. The personalities of two pioneer medical women: Elizabeth Blackwell and Elizabeth Garrett Anderson. Bull N Y Acad Med. Jan 1971;47(1):67-79.

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N Engl J Med. Feb 10 2000;342(6):399-405.

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The Pipeline

Women in U.S. Academic Medicine: Statistics and Benchmarking Report 1983-2010

Slopes are 0.75 and 0.99 Slope is 0.36

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The Pipeline

The year 50% of surgery residents will be women (R2=0.98)

The year 50% of professors of surgery will be women (R2=0.98)

2028

2096

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Women in U.S. Academic Medicine: Statistics and Benchmarking Report 1995-2009

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30 years of “progress”

1979-2009: Women in Academic Medicine

The trend for advancement of women in Academic Surgery is unchanged over the last 30 years.“ On one hand, the numbers of women faculty,

department chairs and deans have never been higher. However, this growth has not substantially reduced gender differences in advancement or sufficiently strengthened the pool of women candidates for administrative positions. Thus, the progress achieved over the last 25 years is incomplete and inadequate.”

Bickel J, Wara D, Atkinson BF, et al. Increasing women's leadership in academic medicine: report of the AAMC Project Implementation Committee. Acad Med. Oct 2002;77(10):1043-1061.

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Slope: 42.79 ± 7.930; R2= 0.70

Slope: 11.89 ± 0.9719; R2= 0.93

2 Way ANOVA: Gender p<.0001, Year p = .0782

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Conclusion

Women are not advancing to the senior ranks of Academic Surgery, despite

increasing numbers of women entering the field.

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Vanderbilt Dept of Surgery

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λ = 0.625; p = 0.0132% response rate

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Academic Medicine Hierarchy

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Employee Behavior

Determined by structure of an organization and not intrinsic character

Kanter RM. Men and Women of the Corporation. New York: Basic Books Inc.; 1977.

Perceived access to information, support, opportunity, and resources are related to position in organization.

Goddard MB, Laschinger HK. Nurse managers' perceptions of power and opportunity. Can J Nurs Adm. May-Jun 1997;10(2):40-66.

Wilson B, Laschinger HK. Staff nurse perception of job empowerment and organizational commitment. A test of Kanter's theory of structural power in organizations. J Nurs Adm. Apr 1994;24(4 Suppl):39-47.

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Relevance Job Strain Work Satisfaction Organizational Loyalty Trust in Management

Wilson B, Laschinger HK. Staff nurse perception of job empowerment and organizational commitment. A test of Kanter's theory of structural power in organizations. J Nurs Adm. Apr 1994;24(4 Suppl):39-47.

Kluska KM, Laschinger HK, Kerr MS. Staff nurse empowerment and effort-reward imbalance. Nurs Leadersh (Tor Ont). Mar 2004;17(1):112-128.

Laschinger HKF, J; Shamian, J. Promoting Nurses' Health: Effect of Empowerment on Job Strain and Work Satisfaction. Nursing Economics. 2001;19(2):42-58.

Laschinger HKF, J; Shamian, J. The Impact of Wokplace Empowerment, Organizational Trust on Staff Nurses' Work Satisfaction and Organizational Commitment. Health Care Management Review. 2001;26(3):7-23. Laschinger HKF, J;

Shamian, J.; Wilk, P. Workplace Empowerment as a Predictor of Nurse Burnout in Restructured Healthcare Settings. Longwoods Review. 2003;1(3):2-11.

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Solution

Average CEO Tenure < 7 years

Average Department Chair Tenure 9.6 + 7.8 years

37.5% in position > 10 years

What if there were term limits?

Kaplan SNM, B. How Has CEO Turnover Changed? Increasingly Performance Sensitive Boards and Increasingly Uneasy CEOs: National Bureau of Economic Research; August, 2006.

Kurichi JE, Sonnad SS. Authorship patterns of surgical chairs. Surgery. Feb 2007;141(2):267-271.

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“We are using imperfect data to perfect perfect-imperfection.”

-Mitchell Goldman

Resident Work Hours and Improved SafetyTight Glycemic ControlPeri-operative Beta Blockade

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Behavior can change.

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A Conversation with a Future Professor of

Surgery