ATLANTA – The number of women serving as professors and division directors of rheumatology has not changed for the past 30 years, a circumstance that should prompt a policy directive from the American College of Rheumatology, according to some of its leaders.
During an annual meeting session sponsored by the Committee on Rheumatology Training and Workforce Issues and the ACR Young Investigator Subcommittee of the Research Committee, Dr. Abby Goulder Abelson noted that women accounted for 60% of graduates of rheumatology fellowships in 2009. Yet women hold just 30% of all academic appointments and comprise 15% of full professors and 7% of division heads. Those figures have been virtually unchanged for the past 30 years, according to Dr. Abelson, who chairs the committee.
Findings from a 2009 benchmarking survey by the American Association of Medical Colleges showed that women accounted for 18% of full professors, 13% of department chairs, and 12% of medical school deans.
"If [the ACR’s Research and Education Foundation (REF)] had a policy that it would not support fellowship programs that did not have more women in leadership," the problem would fix itself, said Dr. David Wofsy, past president of the ACR. "A decade ago we were tremendously short of rheumatology fellows. So REF and ACR set a goal and achieved it. ... Let’s articulate the goals and decide what practices we need to achieve these goals."
Dr. Wofsy suggested the goal should be to increase by 25% the number of women division chiefs. Dr. Wofsy is professor of medicine and microbiology/immunology and chief of rheumatology at the San Francisco VA Medical Center as well as associate dean for admissions at the University of California at San Francisco.
"We need to communicate the message that having more women in leadership in academic programs is good for training and good for society," said Dr. Christy I. Sandborg, a pediatric rheumatologist who is associate chair of the department of pediatrics at Stanford (Calif.) University.
The lack of women in academic leadership positions in rheumatology training programs is not a woman’s issue. It is a rheumatology issue and an ACR issue, said Dr. Sandborg, who cautioned against tainting any effort to promote more women with even the hint that women are in some way damaged and need help.
Data gathered in 2008 showed that 9.1% of women left their academic posts early in their careers, compared with 7.7% of men. Women cited as their reasons for leaving their observation that their gender affected their salary, their rate of promotion, and the amount of their protected time for research and teaching. As pronounced as these problems were for women in general, they were more so for minority women, said Dr. Abelson, who is interim chair of the department of rheumatologic and immunologic disease at the Cleveland Clinic.
At the same time, there is a sea change in how both men and women approach their professional lives and look for work-life integration. "This is the first time that I have attended a session on gender where 50% of the audience is male," she said.
Most rheumatology divisions around the country are actively recruiting new faculty. But to many young rheumatologists, private practice feels like the better choice. Dr. David Karp, chief of the division of rheumatology at the University of Texas Southwestern Medical Center at Dallas, acknowledged that "my young fellows feel that an academic career lacks control."
Dr. Abelson noted that young male rheumatologists want more control and a less stressful lifestyle, which is also changing academic medicine. "They start early, work through lunch, and leave early to pick up their kids from day care."
In Dr. Sandborg’s experience, young men who ask for flexible work arrangements are stigmatized because older faculty consider them to be less than serious about their careers.
Another presenter, Anne C. Talley, urged the audience: "You can’t wait for the culture to change.
"People must feel free to ask for flexible arrangements such as job sharing, even at the director level. We must push through the stigma," said Ms. Talley of Merck & Co., who spoke representing the HealthCare Businesswomen’s Association, Pittsgrove, N.J.
None of the presenters reported any financial conflicts of interest.