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Equity for women in medicine lagging

By Rebecca Arrington

Despite the progress of women in medicine nationally and at U.Va. over the last decade, numerous challenges remain, panelists agreed at a Medical Center Hour several weeks ago on "Women in Academic Medicine -- Toward Equity."

Only 10 percent of U.S. women medical faculty reach full professor status, said Janet Bickel, associate vice president for institutional planning and development and director for women's programs at the Association of American Medical Colleges. But 50 percent of the women faculty are at the assistant medical professor level, she said. Bickel attributes this directly to gender bias, a lack of mentoring, and "non-democratic practices," such as administrative procedures whose basis is known only to a few. This leads "inevitably to cronyism and unequal access to resources," she said.

Committee on Women seeks to improve environment for all U.Va. medical faculty
Dr. Dearing W. Johns

The Medical School's Committee on Women is working to improve the overall environment for all medical faculty at U.Va. As one effort, the committee is looking to other academic medical institutions for models for possible new programs here. It's also about to conduct a survey of U.Va. medical faculty, the findings of which will be reported by year's end. Both the external search and internal survey will be used as tools to propose alternatives or changes to existing policies and assure equity for all faculty in academic medicine, said Dr. Dearing W. Johns, chair of the 17-member committee.

Today, 226 of U.Va.'s 700-plus full-time medical faculty are women, but only 22, or 10 percent of these women are full professors. "I've been on the faculty for 30 years and had hoped we'd be further along by now," said committee member Dr. Sharon L. Hostler, the McLemore Birdsong Professor of Pediatrics and medical director of the Kluge Children's Rehabilitation Center.

Hostler praised Medical School Dean Dr. Robert M. Carey for his support, but said the "piecemeal efforts thus far need to be rethought if we are to become a top 10" medical center. To succeed in improving this environment, these efforts must be carried out by "men and women at all levels of the University on a continual basis."

The committee's top priorities to address such disparities include hiring and retaining more senior women faculty on staff; providing on-site, 24-hour, sick-and-well childcare; and creating an environment that better accommodates families, Johns said.

"In the last 10 years we've done a good job of getting, but not retaining" senior women faculty, Johns said. "There's nothing more discouraging than joining a staff [with certain expectations], then being disappointed." The Medical School also needs to place more women in leadership positions and in consideration for national committees, she said.

Johns Hopkins University is one of the medical institutions the committee is looking to for models. "They recognized they were losing women faculty and have made changes in their retention efforts to remedy this," Johns said.

The upcoming medical faculty survey, similar to one conducted in 1990, will seek faculty members' attitudes on such matters as professional development, representation, compensation, support systems, sexism, safety and sexual harassment.

Johns noted that progress had been made since the last survey. The biggest advance was a change in promotion and tenure several years ago, she said. The two elements, vital to medical faculty's progress in academe, were separated to allow for flexibility, she said. Dr. Hostler "deserves a huge amount of credit for this change," Johns said. Hostler, who is now chair of the Committee on Promotion and Tenure, in addition to her other duties, has been instrumental in preparing both surveys.

Johns also cited the creation of a faculty development program as another significant improvement in the Medical School environment over the past decade. It alerts young medical faculty to advancement opportunities and offers helpful career information.

In seeking answers as to why there are so few women in tenured positions at U.Va., Dr. Amy Tucker, a "fledgling faculty member" who came here as an intern 15 years ago, shared her own story with the audience. "Overall, I've had a good experience," said Tucker, a single mother of two children, who is an assistant professor of internal medicine in cardiology, with the tenure bar yet to clear. However, "I found that social bonding between men, though not intended to isolate women, does just that. Women are embraced as part of the work force but not culturally."

Women are often "thrust into the limelight too soon." There are "so few of us, we can be spread too thin," she said, urging women to first focus on research. Another point she stressed was that the role of a faculty member is not the same as that of a resident. The aim "is not to survive the training regimen, but to thrive. Do your homework. Set personal goals. And select a mentor who will support you," she said. Finally, "maintain balance in life to protect your personal and rest time," said Tucker, who sees U.Va. as a place trying to cultivate an environment where personal choices are part of career decisions.

Tucker's own findings correlated with those found in studies that Bickel's organization had conducted. They revealed that relationships occur most naturally between "like" individuals; that majority individuals find it difficult to empathize with minorities; that performance of minorities is scrutinized more closely; that society undervalues women's intellectual contributions; that cross-gender relationships are subject to suspicion; and that younger women faculty feel "personally betrayed" if a senior woman faculty member isn't helpful.

When the floor was opened to the audience, which was about 95 percent female, Dean Carey was the first to speak. He reported that a new mentoring program for clinical investigators would soon be launched. It may also "be time to reconsider our promotion and tenure" process again, he said. "There's no question that we've made progress" on improving the environment for women at the Medical School. "But there's no question that there's more progress to be made. ... We should bring more women [faculty] to U.Va."

Dr. Claudette Dalton, assistant dean for medical education, and a member of the Committee on Women since 1989, said she was throwing down a "gentle, white-gloved gauntlet" for more people to get involved. The committee desperately needs financial and staff support for its work. But it also needs "the perspective of the younger generation, those who are building their careers."


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