Women Physicians and Promotion in Academic Medicine
Women Physicians and Promotion in Academic Medicine
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DOI：
10.1056/nejmsa1916935
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发表时间：
2020-11-26
影响因子：
158.5
通讯作者：
Simari, Robert D.
中科院分区：
文献类型：
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作者：
Richter, Kimber P.;Clark, Lauren;Simari, Robert D.
背景2000年，一项具有里程碑意义的研究表明，1979年至1997年毕业于美国医学院的女性比男性更不可能晋升到学术医疗中心的高级教师职位。目前还不清楚这些差异是否持续存在。MethodsWe合并了美国医学院协会1979年至2013年所有医学院毕业生的数据，以及2018年的教师数据，我们比较了女性在毕业班中的比例与实际晋升的女性比例。我们计算了Kaplan-Meier曲线，并使用调整后的考克斯比例风险模型来检查早期队列（1979-1997）和晚期队列（1998-2013）之间的差异。在大多数同龄人中，晋升为副教授或正教授或被任命为系主任的妇女人数少于预期。基础科学和临床部门的结果相似。在包括所有队列的分析中，在调整毕业年份，种族或族裔群体和部门类型后，女性助理教授比男性助理教授晋升为副教授的可能性更小（风险比，0.76; 95%置信区间[CI]，0.74至0.78）。晋升为正教授（风险比，0.77; 95%CI，0.74至0.81）和任命为系主任（风险比，0.46; 95%CI，0.39至0.54）也存在类似的性别差异。晋升和任命方面的性别差异并没有随着时间的推移而减少，而且在较晚的队列中并不比较早的队列小。性别差异甚至更大，在后来的队列方面，以促进全professor.ConclusionsOver 35年的时间，女医生在学术医疗中心不太可能比男性晋升为副教授或全教授或被任命为系主任，并没有明显的缩小差距随着时间的推移。（由堪萨斯大学医学中心Joy McCann医学女性教授和美国大学女性协会资助。在对1979年至2013年美国所有医学院毕业生数据的分析中，女性从助理晋升为副教授和从副教授晋升为正教授的可能性低于男性。妇女被任命为系主任的可能性也低于男子。性别差异并没有随着时间的推移而减少。
BackgroundIn 2000, a landmark study showed that women who graduated from U.S. medical schools from 1979 through 1997 were less likely than their male counterparts to be promoted to upper faculty ranks in academic medical centers. It is unclear whether these differences persist.MethodsWe merged data from the Association of American Medical Colleges on all medical school graduates from 1979 through 2013 with faculty data through 2018, and we compared the percentages of women who would be expected to be promoted on the basis of the proportion of women in the graduating class with the actual percentages of women who were promoted. We calculated Kaplan-Meier curves and used adjusted Cox proportional-hazards models to examine the differences between the early cohorts (1979-1997) and the late cohorts (1998-2013).ResultsThe sample included 559,098 graduates from 134 U.S. medical schools. In most of the cohorts, fewer women than expected were promoted to the rank of associate or full professor or appointed to the post of department chair. Findings were similar across basic science and clinical departments. In analyses that included all the cohorts, after adjustment for graduation year, race or ethnic group, and department type, women assistant professors were less likely than their male counterparts to be promoted to associate professor (hazard ratio, 0.76; 95% confidence interval [CI], 0.74 to 0.78). Similar sex disparities existed in promotions to full professor (hazard ratio, 0.77; 95% CI, 0.74 to 0.81) and appointments to department chair (hazard ratio, 0.46; 95% CI, 0.39 to 0.54). These sex differences in promotions and appointments did not diminish over time and were not smaller in the later cohorts than in the earlier cohorts. The sex differences were even larger in the later cohorts with respect to promotion to full professor.ConclusionsOver a 35-year period, women physicians in academic medical centers were less likely than men to be promoted to the rank of associate or full professor or to be appointed to department chair, and there was no apparent narrowing in the gap over time. (Funded by the University of Kansas Medical Center Joy McCann Professorship for Women in Medicine and the American Association of University Women.)In analyses of data on graduates from all U.S. medical schools from 1979 through 2013, women were less likely than men to be promoted from assistant to associate professor and from associate to full professor. Women were also less likely than men to be appointed to department chair. The sex differences have not diminished over time.