Read on Twitter
Advancement of women in academic medicine, and academia in general. A thread.
Women Physicians and Promotion in Academic Medicine | NEJM https://www.nejm.org/doi/full/10.1056/NEJMsa1916935#.X7_9GFR0aKg.twitter
Women Physicians and Promotion in Academic Medicine | NEJM https://www.nejm.org/doi/full/10.1056/NEJMsa1916935#.X7_9GFR0aKg.twitter
1. Lots of things factor into the problem. Implicit bias, labels, etc. are all important. These are deeply ingrained in our society, and very hard to fix. But there are also process and systems factors that contribute, and there, it is easier to see how to make improvements.
2. The first thing to understand is that promotion is all about your “reputation as an expert.” As a first approximation, to be an assistant prof, you need to prove a locoregional one. For associate prof, a regional/national one, for full prof, a national/international one.
3. So how is “reputation” assessed – the answer is in a lot of ways. But, a combination of grant funding, first and senior author papers (other authorship positions do not count as much), proof that you have given lectures on a regional, national, or international level,
4. and other miscellaneous factors, such as honors, awards, review papers, etc. Recently things like being “twitter verified” also sometimes make the cut, but that’s new. “Experts” who are higher up the ladder than you need to write letters saying that you, too, are an expert.
5. So, we need to address ways that women and minorities in academic medicine can establish a local/regional/national reputation. What can be done to help with this? There are easier things and harder things.
6. In order to get a national reputation, first, you need a local reputation. How is this established? Things like grand rounds lectures. Local grand rounds lectures mean a lot to assistant professors, and nothing to full professors. So…
7. If you are in charge of things like grand rounds, preferentially pick from a pool of junior faculty members. This will help with diversity across the board.
8. Full profs are far more likely to be men (particularly white men) and the talk does nothing to advance their career. Conversely, a local grand rounds talk can be the thing that makes the difference between “instructor” and “assistant professor” for a junior faculty member.
9. If you are a full professor, and you are approached about something like a grand rounds talk, think about recommending a junior faculty member instead. That person will benefit far more than you from the opportunity.
10. If you are someone who has the opportunity to promote grand rounds as interesting, exciting, definitely something to go to, make sure you cheerlead for the junior faculty members, and the women and minorities, at least as much as you do for the celebrity full professors.
11. Again, these are the people who need to establish themselves as “experts” in order to move up the ladder. If they aren't given one opportunity, they can't get another one, because they aren't a proven "expert."
12. Similarly, if you are a journal editor, invite junior faculty to write reviews. If you are a book editor, ask junior faculty to write book chapters. If you are a twitter verified expert, re-tweet others who are not, and fight for those people to be twitter-verified, too.
13. We also need to re-think how we think about authorship as a metric, and move away from the concept that the “only papers that count” are the first and last author ones.
14. Research in 2020 is collaborative, and collaborations should be celebrated, not penalized. This issue of authorship placement disproportionally negatively impacts the advancement of women.
15. The best research is interdisciplinary research with lots of people with different talents, ideas, and backgrounds. This is what we want to encourage.
16. Women are good at this. The current system discourages it. That has to change. We need to find better ways to reward all members of the team, not just the ones whose names are at the beginning and end of the paper.
17. One's “reputation” is assessed through letters obtained from people who are at least an academic level above you. Those on your level do not “count.” This is also something that needs to be re-imagined.
18. Those at the top are the ones who were rewarded by the current system. This biases them toward not seeing a reason to change it. The problem of: it worked for me, why doesn’t it work for you? How science gets done has changed, but the way we evaluate success has not.
19. Let’s all work together to do better. Happy Thanksgiving. [End].
@sigal_md @ElissaPerkins @eliowa @KimberlyBlumen1 @UmaAyyala @preeyakgupta @rayyalamd @atkins_hsrd @UREssien @hjmull @RendaWiener @rbganatra @tony_breu @LWestafer @ranielwy @meganranney @GermHunterMD
@sigal_md @ElissaPerkins @eliowa @KimberlyBlumen1 @UmaAyyala @preeyakgupta @rayyalamd @atkins_hsrd @UREssien @hjmull @RendaWiener @rbganatra @tony_breu @LWestafer @ranielwy @meganranney @GermHunterMD
