Welcome to the 500 Women in Medicine Learning Center! This Learning Center is meant to be a curated, centralized collection of links to content and resources (ie. research papers, organizational reports, news articles, books, institutional websites, etc) on a variety of topics relevant to women in medicine.
Every month we hope to highlight a different topic pertinent to women in medicine and include a handful of resources. Follow 500WIM on Twitter (@500WIM) for our latest updates.
August’s theme -- Research on gender equity in medical sciences
This month, we highlight the work of three prominent people doing research on gender equity in the medical sciences: Drs. Molly Carnes, Reshma Jagsi, and Julie Silver. These distinguished scientists have each published many articles on gender disparities in medicine. We present their top three most cited papers on gender equity below.
Dr. Molly Carnes is a Professor in the Departments of Medicine, Psychiatry, and Industrial & Systems Engineerings at the University of Wisconsin- Madison, where she has been part of the faculty since 1985. Dr. Carnes completed her undergraduate studies at the University of Michigan, received her medical degree from the State University of New York at Buffalo, and completed her residency in Internal Medicine, fellowship in Geriatrics, and Master's in Population Health at the University of Wisconsin-Madison. Dr. Carnes currently holds the title of Jean Manchester Biddick Professor of Women's Health Research as she is the founder and Director of the Center for Women's Health Research at UW- Madison. Carnes is also the co-founder and co-Director of the Women in Science and Engineering Leadership Institute (WISELI) in the College of Engineering. Furthermore, she is the Director of the VA Women's Health Program at the William S. Middleton Veterans Hospital where she advocates for women veterans, particularly those returning from the on-going conflicts in Afghanistan and Iraq. Furthermore, Dr. Carnes has published over 100 articles to date, has received multiple awards for her work, and is a sought after speaker.
For over a decade Dr. Carnes has been studying how to increase the diversity of leadership in academic medicine, science, and engineering, with a particular focus on gender equity. Her current research is about how cultural stereotypes can influence judgments and decision-making processes at critical junctures in an academic career (at hiring, promotion, and competition for prestigious awards) in such a way that constrain career opportunities in academic medicine and STEMM? for women and other individuals from groups that have been historically underrepresented in these fields— particularly at the leadership level. This work has been supported by many sources, including the National Institute of Health and National Science Foundation. Recently, Dr. Carnes received a grant from the NIH to develop and conduct "Bias Literacy Workshops" in the departments of biology, physical sciences, and social sciences at UW-Madison. The goal of these workshops is to broadly increase awareness of the implicit biases about gender that we all have, and to reveal to faculty how, whether or not we explicitly endorse these assumptions about gender, these biases can disrupt the intent to hire the best applicant or fund the most creative science. The hope is to encourage faculty to engage in strategies to mitigate the impact of these assumptions on decision-making processes that continue to cumulatively disadvantage women scientists.
Read more about Dr. Molly Carnes work, especially the relatively recent paper Handersman et al. 2005 that calls out universities for not fully utilizing the pool of women scientists they have produced. Carnes and fellow authors show the discrepancy between the proportion of Ph.D.’s granted to women and the proportion of women in faculty positions in the biological and physical sciences, as well as in engineering. They explore possible reasons for this disparity and offer examples of strategies for recruitment, retention, and advancement that would mitigate barriers for women scientists at each of these stages.
In November 2008, the Journal of Women’s Health published an article by Dr. Carnes discussing the historical link between advances in women's health and women's leadership in academic medicine. In this article, Dr. Carnes delineated the slow progress of women into leadership in academic medicine and presented indications suggesting the advancement of women's health had stalled. She argues that deeply embedded unconscious gender-based biases and assumptions are at the root cause of the stalled advancement of women’s health and the stalled advancement of women into leadership in the sphere of academic medicine. The article concludes with recommendations on how to progress beyond the current glass ceiling situation, emphasizing the need to move beyond individual-centered “fix the women” programs to a systemic, institutional approach that acknowledges and addresses the impact of unconscious, gender-linked biases that devalue and marginalize women and issues associated with women, such as their health.
Receiving over 200 citations, Dr. Carnes’ article published in 2015 describes a pair-matched, single-blind, cluster-randomized, controlled study of a gender bias habit-changing intervention at Carne’s home institution, the University of Wisconsin-Madison. Because addressing structural issues alone has been insufficient to achieve gender equity in the sciences, an experimental intervention facilitated intentional behavioral change and helped faculty reduce gender biases and facilitated a change in department climate in ways that would support the advancement of women in academic medicine, science, and engineering.
Dr. Reshma Jagsi is Professor, Deputy Chair, and Residency Program Director in the Department of Radiation Oncology and Director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan. She graduated first in her undergraduate class from Harvard College, and then went on to earn a doctorate/MSc degree in Comparative Social Research (now the MSc in Comparative Social Policy) at Oxford University as a British Marshall Scholar. Afterwards, she returned to pursue her medical school and residency training at Harvard, served as a fellow in the Center for Ethics at Harvard University, and completed a DPhi at Barnett House, under the supervision of Dr. Rebecca Surender. Since then, Dr. Jagsi has built a career in academic medicine publishing over 200 articles in peer-reviewed journals, including multiple high-impact publications in journals such as the New England Journal of Medicine and JAMA, and her research is actively funded by multiple independent grants from the National Institutes of Health, the Doris Duke Foundation, and other philanthropic foundations. Furthermore, Dr. Jagsi has served as a former member of the Steering Committee of the AAMC’s Group on Women in Medicine in Science, and now currently serves as the national PI of the program evaluation of the Doris Duke Charitable Foundation’s Fund to Retain Clinical Scientists, and is on the Board of Directors of the American Society of Clinical Oncology, the Steering Committee of the Early Breast Cancer Trialists Collaborative Group, the editorial boards of the Journal of Clinical Oncology and JAMA Oncology (as part of the advisory group for a Lancet theme issue on women in medicine), and numerous other influential national professional committees. Her contributions have been recognized with her election to the American Society of Clinical Investigation.
Dr. Jagsi is internationally recognized for her research on breast cancer and social policy. Her research aims to improve the quality of care received by breast cancer patients, both by advancing the ways in which breast cancer is treated with radiation and by advancing the understanding of patient decision-making, cost, and access to appropriate care. Dr. Jagsi has also devoted a substantial portion of her scholarly efforts into issues of bioethics arising from cancer care and investigations regarding gender equity, and women’s representation and success in academic medicine. She is a frequently invited lecturer on this subject at dozens of institutions and medical specialty organizations in the US and abroad. Her research in this area has been funded by grants from the National Institutes of Health (R01 HL-101997), the Robert Wood Johnson Foundation, the American Medical Association, the Burroughs Wellcome Fund, and the Institute for Research on Women and Gender. Furthermore, her research is frequently featured in the popular media, including coverage by the New York Times, Wall Street Journal, Washington Post, NPR, and national network nightly news. You can learn more about Dr. Reshma Jagsi work, but we present a few of her prominent papers below.
Published in 2006 in the New England Journal of Medicine and cited over 400 times, Dr. Jagsi and colleagues described the lack of gender equity in academic medicine. This study identified gender disparities in academic medicine by measuring the proportion of female physician-investigators among the authors of selected publications from six prominent medical journals during the past 35 years. The proportion of first authors who were women increased from 5.9 percent in 1970 to 29.3 percent in 2004, and the proportion of senior authors who were women increased from 3.7 percent to 19.3 percent during the same period. Overall, the participation of women in the medical profession has increased during the past four decades, but women authors remain outnumbered by male authors, an important gap that affects advancement within academic medicine, which is largely driven by peer-reviewed publications.
Published in 2014 in the Annals of Internal Medicine, Jolly and colleagues, including Dr. Jagsi, investigated the division of domestic labor (self-reported time spent on unprofessional responsibilities) by gender in a group of physician recipients of NIH K08 or K23 awards. focused specifically on the division of domestic labor and rates of early career success between men and women physicians. They found that women spent 8.5 more hours per week on domestic activities, were more likely than men to have spouses with full time employment, and more likely to take time off during disruptions of usual child care arrangements than men.
Published in the Annals of Internal Medicine in 2009, Dr. Jagsi and colleagues examined the difference in subsequent academic success (measured as a rate of R01 award attainment) of male and female recipients of a National Institutes of Health (NIH) career development award. They found that a fraction of awardees studied secured an R01 award during the period assessed, and within this select group, women were less likely to receive the R01 award than men.
Dr. Julie Silver is a physician, researcher, educator, innovator, author, and speaker. After graduating from the University of California at Davis she attended Georgetown University School of Medicine and continued on to the National Rehabilitation Hospital in Washington, D.C., for her residency training in Physical Medicine and Rehabilitation. She is now an Associate Professor and Associate Chair in the Department of Physical Medicine and Rehabilitation at Harvard Medical School and medical director of Spaulding-Framingham Rehabilitation Center in Massachusetts. She is also on the medical staff of Massachusetts General and Brigham & Women’s Hospitals in Boston.
Dr. Silver is an expert in cancer prehabilitation & rehabilitation. She is well-known for her ground-breaking work on cancer prehabilitation and “impairment driven cancer rehabilitation” which was initially published in the journal CA: A Cancer Journal for Clinicians, a high impact-factor oncology journal produced by the American Cancer Society. After publication of this piece, “impairment-driven cancer rehabilitation” was incorporated into the American Cancer Society’s Facts & Figures. Furthermore, Dr. Silver’s skills as a social entrepreneur coupled with her commitment to improving gaps in the delivery of oncologic healthcare services for underserved populations, particularly cancer rehabilitation, led her to found a start-up company and develop highly recognized best practices models for cancer rehabilitation care. At the Spaulding-Framingham Rehabilitation Center in Massachusetts, she founded and directed RESTORE— which was, at the time, one of the only multidisciplinary oncology rehabilitation programs for cancer patients and survivors. RESTORE used a comprehensive team approach with caregivers from different specialties working together to help patients regain their strength and energy, alleviate pain, and improve their daily function and quality of life. Dr. Silver also developed the STAR Program certification, which is an evidence-based best practice model for cancer rehabilitation care which has been adopted by hundreds of hospitals throughout the US, and was featured on Discovery Channel’s TV show Innovations. Her work in cancer rehabilitation has been recognized by the American Cancer Society (Lane Adams Quality of Life Award), Massachusetts General Hospital (the one hundred), The Boston Globe (Top Innovator in Medicine), and Susan G. Komen Foundation (Local Hero). Furthermore, Dr. Silver is the co-founder and co-chair of the Cancer Rehabilitation Group for the American Congress of Rehabilitation Medicine — a research focused interdisciplinary professional society.
While much of Dr. Silver’s work has been on cancer rehabilitation, more recently, her work has focused on the mission and values of healthcare leaders, physician burnout, and improving diversity and workforce gender disparities within the medical workforce. She developed a unique approach to enhance workforce inclusion, advance equity, and promote wellness for faculty and staff through analyzing how employees are valued and respected for their important contributions. Dr. Silver found that faculty members were not equitably recognized by their own medical societies, and she revealed the near-zero representation of women physicians as recipients of recognition awards. Many would consider her a leading authority on topics related to women’s leadership, women in medicine and workforce gender equity. As such, Dr. Silver has led numerous high impact national strategic initiatives such as #SocietiesAsAllies, #WallsDoTalk and #QuoteHer.
In addition to publishing in many high impact journals, including the New England Journal of Medicine and JAMA network publications, she has written and/or edited nearly 100 books, including medical textbooks and popular press books, and was formerly the Chief Editor of Books for Harvard Health Publications—the official publishing division for Harvard Medical School. Her work has been featured in many prestigious media outlets including The New York Times, The Wall Street Journal, The Washington Post, The Boston Globe, The London Times and NPR. She has also appeared on numerous TV shows including the CBS Early Show, The Today Show, Fox News and ABC News.
Read more about Dr. Julie Silver work and we highlight a few of her recent papers below.
The Journal of PM&R published this article in 2017, focused on representation among recipients of awards recognizing achievement across medical specialities and found a shocking near-zero representation of women among award recipients.
Published in the New England Journal of Medicine in 2018, Dr. Silver and colleagues explore the rise in use of social media and online networks amongst physicians of all ages. This study finds that virtual communities benefit women physicians by providing additional venues for information exchange, sharing and validating experiences, and helping reduce the stigma associated with sexual harassment, burnout, and workplace culture.
Published in 2018 in JAMA Network, Dr. Silver and colleagues examine representation of women first authors in the four highest-impact general pediatric journals. Despite the fact that in 2015, women made up over 60% of pediatricians and over 50% of full-time physician pediatric faculty, women were underrepresented among first authors, especially in article categories described as more scholarly as opposed to narrative. This lack of representation translates to fewer opportunities for career advancement.
July’s theme -- Women Physicians: The Current State of Affairs
To kick off the creation of the 500 WIM Learning Center, this month’s theme is focused on exploring inequalities women physicians face in medicine.
Robyn Klein’s Research:
This research article is arguably what ignited the fire that spurred the creation of 500 Women in Medicine. It all began when Dr. Robyn Klein, Professor of Medicine, Anatomy & Neurobiology, Pathology & Immunology at Washington University in St. Louis, the home institution of five of the 500WIM co-founders, was invited to an international neuroimmunology conference that featured 85 male and only 13 female speakers. Dr. Klein pointed out this appalling discrepancy to the conference organizers to which they replied that there weren’t enough qualified, accomplished female neuroscientists to invite. Dr. Klein turned their statement into a hypothesis that she tested in her research paper. Dr. Klein’s work shows the importance of professional networks for the professional visibility of women physicians. The co-founders of what is now 500WIM approached the 500 Women Scientists leadership team with the idea to create a satellite organization—500 Women in Medicine— in order to more intentionally incorporate women in medicine into their impactful platform and already existing community of women in science.
Klein’s research demonstrates how qualified women scientists continue to be omitted from major meeting programs and makes a case for conference organizing committees to be gender balanced.
Here is an interview with Dr. Klein about the impact of her research paper.
Achieving Gender Equity in Physician Compensation and Career Advancement
This infographic put together by the American College of Physicians highlights gender inequalities at different levels of medical training. It also contains statistics about how compensation, gender bias, sexual harassment, and parenthood affects women and male physicians differently.
The State of Women in Academic Medicine: The Pipeline and Pathways to Leadership, 2015-2016
This report was created by the Association of American Medical Colleges in 2015 with data that provides insights into the state of women in academic medicine, including the distribution of full-time faculty, department chairs, deans, and promotions by gender, race/ethnicity, rank, and tenure.
Sympathy and Science
First published in 1985, Sympathy and Science, is arguably the most comprehensive study of the history of US American Women in Medicine. It traces the participation of women in the medical profession from the colonial period to the end of the 20th century. Author, Regina Morantz-Sanchez, examines women's roles as nurses, midwives, and practitioners of folk medicine in early US society, then recounts their struggles to enter medical schools and start their own institutions in the 19th century, and finally, follows female physicians into the twentieth century, exploring their efforts to achieve successful professional lives while still fulfilling the traditional demands and privileges of womanhood.
Medicine: A Career Conflict for Women
Published in the American Journal of Psychiatry in 2006, authors Notman and Nelson explore the issues involved in women's decisions to pursue a medical career. They make note that women medical students often have few acceptable role models available to demonstrate the variety of possible life and family patterns. In addition, they explain how women medical students must cope with the anxiety of medical school while defining their identity as women in a "man’s world." They describe some of the different responses to these challenges that women take, which they relate to differences in individual characterological and defensive styles. The authors finish by recommending several approaches to facilitating the participation of more women in medicine.
Career obstacles for women in medicine: an overview
This research article from the Department of Psychosocial Medicine at University Hospital Zurich, Switzerland, was published in 2008 in the Journal of Medical Education. Reed and Buddeberg-Fischer gathered material using a MEDLINE search for recent articles on women’s career progress in medicine and data from the Association of American Medical Colleges. They found that although women now make up a large proportion of the medical student body in industrialized nations, they are still under‐represented in a number of disciplines and in the higher echelons of medicine. They identified a number of possible obstacles to women’s career goals: domestic responsibilities, rigidity in career structures, and discrimination. Furthermore, they discuss how these barriers could even be acting synergistically to disadvantage women throughout their medical career. They conclude that medical schools and other institutions are taking the issue seriously based on the variety of government and institution‐based initiatives directed at improving the role of women in medicine. Their suggestion is that medical organizations look to the business world for ‘best practices’ aimed at advancing women and then incorporate these at their home institution.
Women Physicians in Academic Medicine— New Insights From Cohort Studies
This New England Journal of Medicine study from 2000 investigated the likelihood of male and female medical school graduates to pursue full-time careers in academic medicine and advance to senior faculty ranks. They investigated the outcomes of medical school graduates between 1979 and 1993. They found that women were significantly more likely than men to pursue an academic career during the study period. However, the numbers of women who advanced to the ranks of associate and full professor were significantly lower than expected.
Women in Medicine— Is there a problem? A literature review of the changing gender composition, structures, and occupational cultures in medicine
This literature review from the Medical Education Unit at the University of Leeds was published in the journal of Medical Education in 2006. The goal of Kilminster’s study was to better understand the broad reaching effects of shifting gender demographics amongst physicians over time. They discuss current literature findings related to gender differences (or lack thereof) across the domains of career motivations, academic performance, clinical skills, communication skills, and patient perceptions.
The purpose of the 500 Women in Medicine Learning Center is to have a centralized collection of information and resources that *we* think are relevant to women in medicine. 500 WIM is aware of the Learning Center’s limitations and in no way pretends that this is a comprehensive list. Instead, we hope the Learning Center provides users with a small, manageable sampler to start learning about some of the issues that women in medicine may face, as well as present some useful resources.
The works linked in the Learning Center are NOT our own, they are the property of a variety of other authors and organizations that are in no way affiliated to 500WIM. The works included in the Learning Center were selected based on recommendations from our mentors, colleagues, social media followers, and our own discovery. Furthermore, the views and opinions expressed in the collection of links do not necessarily reflect the position of 500 Women in Medicine or 500 Women Scientists. 500 WIM should not be affiliated with any of the included authors or organizations displayed in the Learning Center. Inclusion of links does not imply the endorsement or support by 500 WIM, nor does 500 WIM endorse or recommend any particular products, company, treatments, or services. 500WIM cannot control or guarantee the accuracy, relevance, timeliness or completeness of the information contained in a linked website.