Gender Representation in Fellowship Program Director Positions in ACGME-Accredited Chronic Pain and Acute Pain Fellowship Programs

Abstract

Objective To quantify the representation of female program directors (PDs) and assess their respective demographics, academic metrics, and program-related characteristics in chronic pain and acute pain medicine fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Methods The authors identified chronic and acute pain PDs on the ACGME website on 11/15/2020. We abstracted data from public databases and performed comparisons of demographics, academic metrics, and program-related characteristics between female and male PDs. Results We identified 111 chronic pain programs and 35 acute pain programs. Overall, there were 35 (31.5%) chronic pain programs with a female PD and 76 (68.5%) chronic pain programs with a male PD. Female chronic pain PDs published fewer peer-reviewed articles (4.0 publications, 2.0-12.0 IQR) compared to male chronic pain PDs (9.0 publications, 4.0-27.0 IQR, P=0.050), although there was no difference in the H-index score (3.0 vs 4.0 publications, respectively; P=0.062) or senior academic rank status (57.1% vs 50.0%, respectively; P=0.543). There were 10 (28.6%) acute pain programs with a female PD and 25 (71.4%) acute pain programs with a male PD. Similar to the chronic pain cohort, there was no difference in senior academic rank status based on gender in acute pain PDs (50.0% vs 24.0%, respectively; P=0.227). Conclusion Our study highlights gender differences in the PD role in ACGME-accredited chronic and acute pain fellowships. Female PDs remain under-represented and have fewer peer-reviewed publications. Senior academic rank status was similar across genders, contradicting the current evidence in academic medicine.

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“…Just over half of the ACGME-accredited chronic pain medicine fellowship PDs participated. The response rate of this study was similar to other published survey studies on the specialty and superior to studies on other fellowship disciplines 9 24–28. However, it is prudent to acknowledge that the overall data may not appropriately represent all PDs preferences, and generalizability of the data cannot be assumed to avoid dogmatic conclusions.…”

An International Survey on the Practice of Lumbar Radiofrequency Ablation for Management of Zygapophyseal (Facet)-Mediated Low Back Pain

“…There was also a preponderance of male respondents in the survey, which is expected as there are several prior studies highlighting that male health-care providers and male leaders tend to comprise the vast majority in the pain medicine field. 14–16 …”

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“…2 Yet, gender inequalities persist in academic institutions, 3 as highlighted by fewer women achieving professorship rank, holding chairperson appointments, receiving invitations to journal editorial roles, or occupying other leadership roles. [4][5][6][7][8] While these disparities are evident across most medical disciplines, they are even more prominent in interventional and surgical subspecialties, such as interventional pain medicine. 4,5 A significant issue is the "leaky pipeline" where women fall from the academic ladder, which in turn depletes the potential pool of female candidates for senior academic ranks and leadership positions.…”

“…[4][5][6][7][8] While these disparities are evident across most medical disciplines, they are even more prominent in interventional and surgical subspecialties, such as interventional pain medicine. 4,5 A significant issue is the "leaky pipeline" where women fall from the academic ladder, which in turn depletes the potential pool of female candidates for senior academic ranks and leadership positions. 9 Prior studies have proposed potential explanations including inadequate time for women to rise through the ranks, significant family responsibilities, domestic responsibilities, lack of role models, inadequate mentoring, discrimination, and implicit biases in hiring and promotion.…”