Why women physicians choose academic medicine
Today, as many women as men attend medical school where academic medicine is a career option equally available to all. Yet, of the approximately 125,000 medical school faculty members in the U.S., only 35 percent are women, and until recently, no one knew why.
This question intrigued Amelia Grover, M.D., assistant professor in the division of surgical oncology at the VCU School of Medicine and a researcher at VCU Massey Cancer Center. She joined a small team to study how, why and when physicians choose to practice academic medicine. After an extensive literature review in which they found that gender differences play a role in the decision, the team continued on to discover the factors that influence women physicians specifically to choose academia.
The result of this investigation is the article "Women Physicians: Choosing a Career in Academic Medicine", published in Academic Medicine by Dr. Grover and co-investigators Nicole J. Borges, Ph.D., Wright State University Boonshoft School of Medicine, and Anita M. Navarro, M.Ed., Association of American Medical Colleges.
After interviewing 53 women physicians who had chosen careers in academic medicine, the researchers identified five main themes related to why the interviewees had made the choices they did. The broad factors are:
- Fit, defined as a sense of congruence between their lives and their careers.
- Aspects of the academic health center (AHC) environment, including intellectual stimulation, teaching, variety, training opportunities and lifestyle.
- The influence of people in their lives, including mentors and parents.
- Exposure to academic medicine.
- Interest in practicing clinical medicine.
"The environment in which one trains seems to be a substantial influence" on the decision, the researchers found. For example, those who trained in a teaching hospital were exposed to more of the factors and were more likely to have role models and mentors with a background in academic medicine.
Even so, women physicians do not choose academic medicine early in their career path. After identifying the stages relating to when the decision was made, the researchers found that, in all but three instances, study participants chose academia during residency, as a fellow or as a practicing physician. "Participants indicated overwhelmingly that as medical students they did not know enough about academic medicine to choose it as a career."
How the participants chose academic medicine was the third avenue studied. Career changes prompted some participants, whether due to changing interests or dissatisfaction with their former career. Other themes affecting the decision were "emotionality" (love of teaching, for example), "parental influence" and their "decision-making style."
The career decisions made by some interviewees came after chance encounters with one or more influencers who suggested, or exposed them to, academic medicine. The serendipitous nature of these decisions "may indicate that physician educators miss opportunities to cultivate the talents of trainees who have not necessarily been identified as having interests in academic medicine but who, nonetheless, may be - or could become - interested," the researchers write.
These insights suggest steps medical schools and residency programs can take to introduce careers in academic medicine to their trainees. Providing students with opportunities earlier in their training to determine whether the AHC environment is an appropriate fit, for example, can make a difference.
The team's findings are as important as they are timely. Knowing as much as possible about why physicians choose academic medicine is vital if the medical education community is to going to address the looming physician shortage effectively.
In addition, bringing more women into academic medicine will increase diversity and create more role models. "Each individual brings unique ideas and ways to address questions and problems," Grover reasons. "These are formed by their gender, ethnicity, generation, life experiences, etc. This diversity better enables us to understand and help our patients, ask and answer research questions and teach the future generations of health care workers. It is like Aesop's fable of the elephant," she concludes.
Women in Science, Dentistry and Medicine
In addition to increasing the recruitment of women, the academic medicine community needs to provide the support required for women to succeed in their field of practice. VCU embraces this tenet. One of many examples of this commitment is Women in Science, Dentistry and Medicine (WISDM).
Established in 1992, WISDM seeks to further the professional goals and career development of women physicians, scientists and dentists at the VCU Schools of Medicine and Dentistry. "Our objective is to help open communication channels that facilitate networking, mentoring and collaboration among faculty members," says Amelia Grover, M.D., this year's president. "In this way, we can promote scientific and teaching excellence in women faculty, which in turn will increase the participation and leadership of women within the organizational structure of the medical and dental schools.
WISDM sponsors an annual leadership conference that has been recognized by national executive leadership associations for its excellence. The 2012 conference celebrated WISDM's 20th year with the theme "Making a Difference: the Meaning of Service." Ann Maust, CEO of New Visions, New Ventures was the keynote speaker. Massey's Community Advisory Board member Becky Massey served as a panelist discussing the work and rewards of volunteerism.