August 17th, 2018

Of those graduating from an American medical school in 1966, only 9% were women. And thankfully this number has gone up since then. According to the AAMC, there was almost a one to one ratio of men to women in the graduating class of 2015.

Unfortunately, this story does not extend to life after medical school, especially in the world of academic medicine. Based on the same 2015 AAMC survey, though 57% of medical school instructors were women, this number slowly tapered down as the survey moved up the ranks. 44% of all assistant professors were women, 35% of all associate professors were women, and finally, only 22% of all full time professors in US medical schools were women.

These numbers are disheartening for advocates of equal representation in science and medicine, because nationwide hiring practices are not easily malleable. Despite our best intentions, our biases get in the way of even the most well-designed decision-making processes. And when it comes to evaluating people, sometimes even objective data cannot be divorced from a subjective lens.

“The logic goes as follows: we promote and foster ‘the best’ regardless of gender, race or nationality. The problem is that there is no universal definition of what constitutes ‘the best.’”

---European women scientists in a response to the chronic underrepresentation of female speakers at the Bernstein conference, an annual computational neuroscience meeting. Read the full document here.

As outlined in the document, a female and male applicant could have identical resumes, and still be perceived in wildly different ways. If a male colleague and I were to apply for the same postdoc position, let's say, the qualities that set him apart from me are more likely to be valued over the qualities that are unique to me. If the male colleague and I have nearly identical resumes but he is more outspoken than I am, a hiring committee is more likely to regard outspokenness as a measure of confidence. Take these same qualities and flip em' around: I am more outspoken than the male applicant, and the same hiring committee is more likely to think outspokenness sets one up for unnecessary arguments and a stubborn mindset. Even the most die hard egalitarians have a biased interpretation of the world around them.

The solution then is institutional—a full systems-based approach to mitigate explicit and implicit biases. Instead of accusing or demanding institutions, we need to understand collectively that both men and women have certain ways of evaluating male and female applicants that are so ingrained in them, because of societal structures, the media and the status quo.

A group of physicians, scientists and physician scientists from various parts of the country came together to evaluate an educational intervention designed to mitigate gender leadership biases in academic medicine. Led by Dr. Hannah Valantine, the chief officer for scientific workforce diversity at NIH, the study measured pre-existing explicit and implicit biases using established tests, gave all participating faculty a 20 minute presentation called “Recruitment to Expand Diversity and Excellence” (REDE), and then retested biases using the same tests.

The Tests Explicit biases were measured via a survey with instructions to respond to general statements about female employees and their potential in the workplace compared to male employees with similar backgrounds and education.

Implicit biases were measured using the now famous Harvard Implicit Association Test (IAT). The IAT measures the latency between associating a word of interest with a negative or positive connotation. For example, in the version of the IAT that Valantine and her colleagues used, faculty were asked to associate words from a “Gender” category (woman,man,male or female) with words from a “Leadership” category (words like leader or follower). The amount of time it takes for someone to associate, say female with leader as opposed to male with leader, can, according to the IAT designers, be used to measure implicit attitudes about gender and leadership.

The Intervention  The REDE presentation is a 20 minute talk comprised of examples of gender bias and evidence that medical schools that participated in educational interventions about gender bias in hiring practices did report an increase in female faculty hires post-intervention. The authors recruited senior faculty to deliver the REDE talk to department chairs and other senior faculty within their departments. 281 professors from 13 out of 18 clinical departments at Stanford School of Medicine received the intervention.

And this is what happened: Implicit biases against women in roles of leadership were reduced post-intervention in male and female faculty, as well as in older (ages 55-59) and younger (ages 35-39) faculty. The intervention was not as effective in changing measures of explicit bias.

This study is notable for two reasons:

1.       Implicit biases can be changed by something as simple as a 20 minute presentation delivered by a respected and trusted colleague.

2.       The authors of the study were Dr. Sabine Girod, MD, DDS, PhD, Dr. Magali Fassiotto, PhD, Dr. Daisy Grewal, PhD,  Dr. Manwai Candy Ku, PhD, Dr. Natarajan Sriram, PhD, Dr. Brian A. Nosek, PhD, and Dr. Hannah Valantine, MD. This diverse group of advocates for women in science and medicine is inspiring and should encourage similar groups of like minded individuals to come together for studies just like this one.

So congratulations! You are part of the solution, regardless of who you are and where you come from. Advocates are advocates, and all advocates are AAWSM.


Reference: Girod, S., Fassiotto, M., Grewal, D., Ku, M. C., Sriram, N., Nosek, B. A., & Valantine, H. (2016). Reducing Implicit Gender Leadership Bias in Academic Medicine With an Educational Intervention. Academic Medicine, 91(8), 1143-1150. doi:10.1097/acm.0000000000001099

July 24th, 2018

 Hi! Welcome to AAWSM. My name is Shreya and I am a first year PhD student in the Medical Scientist Training Program (MD/PhD) at UAB. On this day in 1848, I'd probably still be thinking about the proceedings of a ground-breaking conference that happened just a few days ago. Take yourself back to 1848. Imagine reading an announcement in a local newspaper about a gathering dedicated to discussing women's rights and grievances, and marking off your calendar for July 19th and 20th. It's fitting I think, to begin this blog with the beginning of the beginning, and I invite you to come along for the ride.

"I poured out that day the torrent of my long accumulating discontent with such vehemence and indignation that I stirred myself, as well as the rest of the party, to do or dare anything." -Elizabeth Cady Stanton, on her meeting with Lucretia Mott. They were both denied seating and voting rights in the 1840 World Antislavery Convention in London, only because they were women.

Mott was rightfully frustrated that, despite being the founder of the Philadelphia Female Anti-Slavery Society and a passionate abolitionist for over a decade, she had been shunned as though her opinions were superfluous. Stanton was tired of raising her three children alone to let her husband pursue his political agenda as an aspiring Free Soil politician. 

After a long hearty talk, Mott and Stanton decide to organize a meeting dedicated to discussing women's rights. They issued an announcement in the local paper inviting members of the public to participate in a two day conference. The first day was only for women, while the second day was open to the public. Over 100 men and women attended (and this was before the days of incessant Facebook invites)!

"We hold these truths to be self-evident: that all men and women are created equal." 

The Declaration of Sentiments was modeled after the Declaration of Independence to reference the same rights that the Founding Fathers demanded of the British. In a pretty clever move, Mott, Stanton and the other women at the convention intentionally referenced an argument that was already celebrated as "self-evident" by the entire young country of Americans. 

The Declaration of Sentiments was by no means a polite document however. In addition to repeatedly asserting that man had exercised nothing but "tyranny" over woman, the women also declared that:

" Woman had been denied "her inalienable right to the elective franchise"; she had no voice in the making of laws; she was deprived of other rights of citizenship; she was declared civilly dead upon marriage; deprived of her property and wages; discriminated against in case of divorce, and in payment for work. Women were denied equal access to education and were kept out of the professions, held in a subordinate position in Church and State and assigned by man to the domestic sphere. Man has endeavored to destroy woman's self-respect and keep her dependent. "

It is gratifying to note that things have come a long way since the time of Lucretia Mott and Elizabeth Cady Stanton. Women have the right to vote and own property. Women today hold leadership positions in law, politics, business and medicine. However is it truly undeniable that women have equal access to education and faculty positions in science and medicine? It is unequivocal that the glass ceiling has been cracked, but hasn't been shattered.

The Seneca Falls Convention was the beginning of something incredible: an honest request for change. And most importantly, the Seneca Falls Convention is a reminder that conferences of people with similar beliefs, interests and passions can bring change. I invite you all to be a part of it. 


Reference/Further Reading: Lerner, Gerda. "The Meaning of Seneca Falls: 1848-1998." Dissent (00123846), vol. 45, no. 4, Fall98, pp. 3541.