Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women

Abstract

Although women comprise half of all medical students, the number of female academic emergency medicine (EM) physicians remains at approximately 27%. In addition, despite having equivalent credentials, female EM faculty remain underrecognized and undercompensated when compared to their male counterparts. Recent studies have shown superior outcomes among patients treated by EM physicians who are women; however, disparities in advancement persist. This white paper, prepared on behalf of the Academy for Women in Academic Emergency Medicine, describes recent evidence demonstrating gender disparities in the EM workforce including content presented at the 2019 Society for Academic Emergency Medicine Annual Scientific Meeting. The authors describe strategies to address the identified problems. Specific recommendations include individual as well as institutional/systems-level approaches to creating directed programming and initiatives to recruit, support, and promote women at all aspects of the career continuum.

The Multifaceted Impact of COVID‐19 on the Female Academic Emergency Physician: A National Conversation

“…The burden of an increased clinical workload early in the pandemic response was felt by many panelists and audience members. Prior studies show that women physicians are underrepresented in executive leadership roles in many emergency medicine departments and are supported by fewer grants and funding sources, both of which serve to increase their proportionate clinical workload 1,2,8,10 . Women are more often involved in teaching and therefore involved in medical student and resident education, which may lead to greater clinical obligations through bedside teaching 21,22 .…”

“…Prior studies show that women physicians are underrepresented in executive leadership roles in many emergency medicine departments and are supported by fewer grants and funding sources, both of which serve to increase their proportionate clinical workload. 1,2,8,10 Women are more often involved in teaching and therefore involved in medical student and resident education, which may lead to greater clinical obligations through bedside teaching. 21,22 These additive factors often result in women physicians working heavier clinical workloads than their male counterparts, while facing the increased physical and mental load of working through the intricacies and unknowns of COVID-19.…”

“…Executive leadership roles are largely held by men in most health care institutions. 8,10 This leadership gender gap has been shown to affect policy, which subsequently leads to less sensitivity to the unique perspectives of women physicians. 26 As the understanding of COVID-19 has grown, the response and communication by leadership has also adapted.…”

“…Decreased research productivity of women early in their careers contributes to this discrepancy, a disparity that may result in the underrepresentation of women in advanced leadership roles and at the professor level 8,9 . Although a greater percentage of women are more likely to be fellowship trained, they are less likely to be core faculty or hold administrative roles, such as chair, vice chair, or emergency department (ED) director 2,10 . As a result of women holding fewer advanced academic and executive roles, they often have less protected time and a greater share of clinical duty hours, further reducing the time necessary to devote toward research productivity required for promotion.…”

“…8,9 Although a greater percentage of women are more likely to be fellowship trained, they are less likely to be core faculty or hold administrative roles, such as chair, vice chair, or emergency department (ED) director. 2,10 As a result of women holding fewer advanced academic and executive roles, they often have less protected time and a greater share of clinical duty hours, further reducing the time necessary to devote toward research productivity required for promotion. The mean salary for women also remains significantly less than men-a gap that has remained stable over the years even when controlling for race, region, rank, years of experience, clinical hours, administrative roles, board certification, and fellowship training.…”