Gender Equity in PM&R
Written by Allison Wallingford, MD. Last updated 04/2022
Gender disparities in academic medicine
Despite the high proportion of women in medicine, large disparities continue to exist in academic medicine, including differences in compensation, the promotion of female physicians to leadership positions, the awarding of grant funding to female physicians, and more. (Silver 2018).
Women in academic medicine earn $16,98224 to $19,878 less than their male counterparts (in the same specialty, level of experience, academic rank, etc) annually (Shillcut et al 2019)
In 2018, 85% of top medical school dean positions were held by men (Silver 2018).
Female physicians across specialties, especially older women and women of color, report feeling more obligated to volunteer for and reports spending more time on citizenship tasks (work-related tasks that require outside time) compared to their male colleagues.
Citizenship tasks usually are duties that do not clearly further career advancement, and thus this burden may hinder women advancing in academia (Armijo et al 2021).
Musings from the editor: Our current resident leadership team as of 5/2022 is made up of ALL women. For some reason, only women have consistently shown up to meetings and been engaged with our leadership team. Arguably, our work with Representation in Rehab is considered a citizenship task.
Women currently represent 43% of academic physiatrists (Silver et al 2021)
Of the 264 physician recognition awards granted by the American Academy of Physical Medicine and Rehabilitation (AAPM&R) over the past 48 years, only 15.9% have been received by women at a consistently lower percentage than the percentage of women in the field any given year.
Women were more likely to receive these awards as part of a group rather than individual recognition.
Only 10% of lectureships were awarded to women (Silver 2017).
A report of female representation in the Association of Academic Physiatrists (AAP) showed similar numbers of men and women holding committee chair positions and being accepted into the Rehabilitation Medicine Scientist Training Program (RMSTP).
However, a disproportionately low percentage of women have received recognition awards from the AAP and women are underrepresented on the editorial board of the American Journal of Physical Medicine and Rehabilitation (AJPM&R) (Silver et al 2018)
Women are underrepresented as authors on Clinical Practice Guidelines in the field of PM&R (Verduzco-Gutierrez et al 2022).
What is part of the solution?
The Be Ethical campaign aims to advance gender workforce equity. Be Ethical outlines a process for leaders of healthcare organizations, national societies, journals, and funding organizations to determine areas and causes of gender disparities in order to design strategies to address them. The process specifies metrics within institutions, such as promotions, funding allocations, board representation to guide analysis of gender disparities (Silver 2018).
The AAP Women’s Task Force used its analysis of gender gaps to publish a set of recommendations for the AAP to promote gender equity, such as including more women as board of trustees members, identifying and recruiting qualified women to serve as editors of AJPM&R, and examining for implicit bias in the nomination and selection of recognition awardees (Silver et al 2018)
Encouraging volunteerism in others besides women
Sources
Silver JK. Be ethical: A call to healthcare leaders ending gender workforce disparities is an ethical imperative. Available at http://sheleadshealthcare.com/wp-content/uploads/2018/09/Be-Ethical-Campaign.pdf
Shillcutt SK, Silver JK. Barriers to Achieving Gender Equity. J Cardiothorac Vasc Anesth. 2019 Jul;33(7):1811-1818. doi: 10.1053/j.jvca.2019.02.007. Epub 2019 Feb 11. PMID: 30910263.
Armijo PR, Silver JK, Larson AR, Asante P, Shillcutt S. Citizenship Tasks and Women Physicians: Additional Woman Tax in Academic Medicine? J Womens Health (Larchmt). 2021 Jul;30(7):935-943.
Silver JK, Cuccurullo S, Weiss L, et al. Association of Academic Physiatrists Women's Task Force Follow-up Report. Am J Phys Med Rehabil. 2021;100(6):610-619. 5. Sanchez AN, Martinez CI, Stampas A, et al. Ethnic and Racial Diversity in Academic Physical Medicine and Rehabilitation Compared with All Other Medical Specialties. Am J Phys Med Rehabil. 2021;100(2S Suppl 1):S12-s16.
Silver JK, Bhatnagar S, Blauwet CA, Zafonte RD, Mazwi NL, Slocum CS, Schneider JC, Tenforde AS. Female Physicians Are Underrepresented in Recognition Awards from the American Academy of Physical Medicine and Rehabilitation. PM R. 2017 Oct;9(10):976-984.
Silver JK, Cuccurullo SJ, Ambrose AF, Bhatnagar S, Bosques G, Fleming TK, Frontera WR, Karimi DP, Oh-Park M, Sowa G, Visco C, Weiss L, Knowlton T. Association of Academic Physiatrists Women's Task Force Report. Am J Phys Med Rehabil. 2018 Sep;97(9):680-690. doi: 10.1097/PHM.0000000000000958. PMID: 29734233.
Verduzco-Gutierrez M, Katz NB, Fleming TK, Silver EM, Hunter TL, El Sayed N, Escalon MX, Lorello GR, Silver JK. Author Diversity on Clinical Practice Guideline Committees. Am J Phys Med Rehabil. 2022 May 1;101(5):493-503. doi: 10.1097/PHM.0000000000001932. Epub 2021 Nov 15. PMID: 34775456.
Odonkor CA, Leitner B, Taraben S, Adekoya P, Orhurhu V, Hirani S, Ike K, Lee R, Vanterpool S, Goree JH, Sully K, Poree L. Diversity of Pain Medicine Trainees and Faculty in the United States: A Cross-Sectional Analysis of Fellowship Training from 2009-2019. Pain Med. 2021 Apr 20;22(4):819-828. doi: 10.1093/pm/pnab004. PMID: 33502490; PMCID: PMC8599803.
