Women in medicine have come a long way since the days of Elizabeth Blackwell—at least one-half of all medical school classes today are women. But significant disparities remain in academic medicine. New research uncovers the experiences of former women chief residents and why they stay in—or leave—this field of medicine.

As a 2013 recipient of the AMA Foundation’s Joan F. Giambalvo Fund for the Advancement of Women, Juliet Lee, MD (pictured right), and her team surveyed women chief residents in surgery, emergency medicine and internal medicine for the last 10 years.


Dr. Lee, director of undergraduate surgical education, division director of surgical education in the department of surgery and the associate program director of the general surgery residency program at the George Washington University School of Medicine and Health Sciences, said she wanted to investigate the culture of academic medicine for women.

“Even in 2014, sexism exists in medicine,” she said. “It’s not as overt as in the past, but this undercurrent of gender inequity affects salary, benefits, career advancement and satisfaction.”

Women still hold lower academic positions than men, Dr. Lee said. Studies also show that even though more women are entering academic medicine than men, they aren’t advancing at the same rate.

Dr. Lee’s research found that, for women who previously served as chief residents:

  • Education and teaching were the primary—but not the only—reasons for choosing their current positions. Respondents who stayed in academic medicine, either as faculty or voluntary faculty, said they enjoyed the collegial environment, the chance to stay at the forefront of medicine and the intellectual challenges of teaching.
  • Reasons for leaving academic medicine have more to do with professional factors than personal considerations. Respondents who left said they felt unsupported by their institutions, or needed more direction from mentors.
  • Personal considerations start to impact those considering leaving academic medicine. Some respondents pointed to work-life imbalance, and others said having a family and working in academic medicine is like having two full-time jobs.
  • Women have inadequate mentorship, are uncomfortable talking to superiors and uncertain of how to meet promotion criteria. Respondents said they need more direction and did not feel confident in tackling advancement opportunities.
  • Challenges continue to exist, including backlash, unclear policies and a lack of role models. Respondents said they needed more mentorship, from both men and women, and felt the institutions’ cultures mattered greatly in how women are viewed.

Dr. Lee said there are some things that need to be changed, including providing salary equity, protected time for administrative or scholarly activities, and alternative pathways to promotion. But to take immediate action, individuals can participate in formal mentoring programs.

“I hope formal mentoring programs can be developed for both men and women to give faculty in their early years an understanding of what it takes to advance,” Dr. Lee said. “This may mean more intensive mentoring …. How these mentoring programs would develop would be dependent on the institution and the resources an institution can invest.”

Learn more about how the AMA aims to increase the number and influence of women physicians in leadership roles through the AMA Women Physicians Section.

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