Physician’s Weekly, along with co-host Julie Silver, MD, addressed the important, timely, topic of gender disparities in medicine as part of our latest #PWChat. Topics discussed included studies indicating that women earned less than men regardless of rank, clinical hours or training, with other specialties having similar findings, what can be done to close the gender wage gap, gender disparities in rank, retention & leadership, as well as that women are less likely to attain senior-level positions than men.

View our upcoming schedule, or read our other #PWChat recaps here.

Below are the highlights from the chat. You can read the full transcript here.

 

 

 

Question 1

Madsen, et al. studied #emergencymedicine physicians and found women earned less than men regardless of rank, clinical hours, or training. Other specialties have similar findings.
Report link: https://t.co/jiPytp4Vhj #PWChat#WomenInMedicine#PROWD#HeForShe#EqualPayDay2018 pic..com/KGXxYtyXAV

— Physician’s Weekly (@physicianswkly) April 10, 2018

A1 This is the perfect study to share with colleagues on #EqualPayDay re the #medpaygap. I’m looking forward to hearing what solutions you all suggest! #PWChat #WomenInMedicine https://t.co/TP5XZZdkCB

— Julie Silver, MD (@JulieSilverMD) April 10, 2018

A1. Until we have standardized ways to ensure equitable salary for men and women, we need to disseminate effective negotiation strategies to women. Transparency in salary would also help immensely. #PWChat #WomenInMedicine #PROWD #HeForShe https://t.co/UAbAdK33bB

— Amy Oxentenko M.D. (@AmyOxentenkoMD) April 10, 2018

A1. Mentor female physicians to stay in
academic medicine to increase longevity and percentage of women professors.#PWChat #WomenInMedicine #PROWD #HeForShe #IlookLikeASurgeon https://t.co/oT8TjlHjeW

— ELAM (Executive Leadership in Academic Medicine) (@ELAMProgram) April 10, 2018

A1. Transparency in salary reporting by offers is the first way to start. When interviewing it was an awkward discussion. Effective negotiation skills training should be offered in training so that women are more comfortable with negotiating. #equalpayday #womeninmedicine

— Jasmine R Marcelin (@DrJRMarcelin) April 10, 2018

A1 ask what the starting salary is if a comparable male colleague! Someone who wants to promote #EqualPayDay2018 and minimize the #genderpaygap will not hesitate to answer #PROWD #PWChat

— Rena Malik, MD (@RenaMalikMD) April 10, 2018

 

 


Question 2

Carr, et al. found gender disparities in rank, retention & leadership, & that women were less likely to attain senior-level positions than men–even after adjusting for pub-related productivity.
Report link: https://t.co/NINb0z8XAJ #PWChat#WomenInMedicine#PROWD#HeForShe pic..com/ZFRx8N5ZlG

— Physician’s Weekly (@physicianswkly) April 10, 2018

A2 When I read this abstract, my heart broke. One solution is to focus on how #WomenInMedicine are able to build their professional REPUTATION & identify/correct disparities (eg recog awards, Grand Rounds). #PWChat https://t.co/12Rai7xi0P

— Julie Silver, MD (@JulieSilverMD) April 10, 2018

A2 #PWChat This is where women (and men) supporting and sponsoring women is essential. It should no longer be “an honor” to be the only woman Leader/chief/department head. #WomeninMedicine @ACCinTouch @MinnowWalsh

— Ami Bhatt (@AmiBhattMD) April 10, 2018

A2: Investigate individual depts to see where the root of the inequities lie#PWChat #WomenInMedicine #PROWD #HeForShe #IlookLikeASurgeon https://t.co/qIOanh6Dw1

— AAWR (@AAWR_org) April 10, 2018

A2 #implicitbias is a real problem. Consider starting with #bias training for your department. It may help promote more men to be #HeForShe and women to support other #WomenInMedicine #PWChat #PROWD #ilooklikeaurologist #ILookLikeASurgeon

— Rena Malik, MD (@RenaMalikMD) April 10, 2018

 


Question 3

Krause, et al. studied internal med residents & found pregnancy was less common in women trainees than partners of men, but in post-partum period, women got lower peer eval scores.
Report link: https://t.co/kTQ4wsKAlu #PWChat#WomenInMedicine#PROWD#HeForShe#EqualPayDay2018 pic..com/70M6VY6n21

— Physician’s Weekly (@physicianswkly) April 10, 2018

A3 Some colleagues suggested using locum tenens for #WomenInMedicine on maternity leave during training to decrease stress on those who cover & avoid problems in this study by @AmyOxentenko et al. What do you think? #PWChat https://t.co/l3t2B8JVle

— Julie Silver, MD (@JulieSilverMD) April 10, 2018

A3 I think that would depend on your practice setting. Some practices may not need that extra coverage and other may. If we build a system that allows for physician leave for pregnancy, paternity leave, illness, etc. then it should have redundancy. #PWChat

— Lillian Erdahl MD (@LillianErdahlMD) April 10, 2018

A3. To prevent lower peer evaluation scores, replace any subjective assessments with more objective, milestone-based questions on peer evaluations, which is key. Helps remove bias. #PWChat #WomenInMedicine #PROWD #HeForShe https://t.co/QH7GeKYMDd

— Amy Oxentenko M.D. (@AmyOxentenkoMD) April 10, 2018

 


Question 4

Silver, et al. studied recognition awards given by medical specialty societies and found that women physicians are often totally excluded (or nearly so) as recipients.
Report link: https://t.co/KBwE2JtEdF #PWChat#WomenInMedicine#PROWD#HeForShe pic..com/DxayDlixMS

— Physician’s Weekly (@physicianswkly) April 10, 2018

A4 There were barriers to publishing our study on recognition awards for #WomenInMedicine, but we #persisted and can now say that educating our colleagues about ZERO awards for women has led to change. #PWChat https://t.co/PUyEIrbVre

— Julie Silver, MD (@JulieSilverMD) April 10, 2018

A4 – Start with researching WHY women are not recognized – are low numbers nominated? It is bias? Are women really contributing less in productivity and publications?#PWChat #WomenInMedicine #PROWD #HeForShe #IlookLikeASurgeon https://t.co/u6onVmtOUc

— Kelly Cawcutt, MD (@kcawcutt) April 10, 2018

A4. Review of awards committee is required. Gender balance on committee? Unbiased approach to soliciting award nominees? Subjective scoring of nominees? Review of prior winners to identify patterns? Hard to ignore zero. #PWChat #WomenInMedicine #PROWD https://t.co/GKV4mP7zPP

— Amy Oxentenko M.D. (@AmyOxentenkoMD) April 10, 2018

Building a reputation as a scientist is
invaluable to the scientist and to her institution. Women need to be well-represented on award selection committees #PWChat#WomenInMedicine #PROWD #HeForShe #IlookLikeASurgeon https://t.co/z0I9PuhP2t

— ELAM (Executive Leadership in Academic Medicine) (@ELAMProgram) April 10, 2018

A4 Amplifying our colleagues successes is such an important part of being a leader in Medicine. We should amplify each other EVERY day- make it a habit. @feminemtweets does this a lot. If we all do this every day, it will be second nature when it comes around to awards

— EQ Consulting (@Equity_Quotient) April 10, 2018

 


Question 5

Mueller, et al. found qualitative differences in feedback men & women residents got & suggested attendings provide all trainees consistent feedback & guard against gender bias in perceptions of residents’ capabilities.
Report: https://t.co/FnN2m964t9 #WomenInMedicine#PWChat pic..com/TFhwxMJHSs

— Physician’s Weekly (@physicianswkly) April 10, 2018

A5 One soln to the problem in this report might be to have all medical educators undergo implicit bias training on a regular basis so they can recognize their unconscious tendencies to use gendered language that is unhelpful to #WomenInMedicine. #PWChat https://t.co/3bljEmygTg

— Julie Silver, MD (@JulieSilverMD) April 10, 2018

A5. Faculty Z-scores to correct for their typical bias. As Kelly said, the definition of implicit bias is that you don’t realize you’re doing it! Let computers help!

As an aside, one of my first residency evaluations said, “Amy needs to man up.”

It’s funny now!

— Amy Pearson, MD (@AmyPearsonMD) April 10, 2018

A5 – The statistic of 65% F vs 32% M residents criticized for lacking valued personality traits was striking. Agree with #implicitbias training. Feedback should focus on actionable items with measurable outcomes. #MedEd #PWChat #WomenInMedicine https://t.co/F7LcCXISJi

— Allison Larson, MD (@AllisonLarsonMD) April 10, 2018

 


Question 6

Bates, et al. wrote “It is Time for Zero Tolerance for Sexual Harassment in Academic Med” & described efforts in societies to address sexual harassment & establish safe environments at national meetings.
Report: https://t.co/nnevqb4VIJ #PWChat#WomenInMedicine#PROWD#HeForShe pic..com/1YvPZtqwbF

— Physician’s Weekly (@physicianswkly) April 10, 2018

A6 This report could be used as a training tool & assigned reading for medical society current/future leaders because it calls for zero tolerance at conferences re sexual harassment. #PWChat #WomenInMedicine #MeToo https://t.co/XwCBlRH5w7

— Julie Silver, MD (@JulieSilverMD) April 10, 2018

 


Question 7

Salles, et al. found women surg residents had significantly more concerns w/ gender judgment than men & that degree of such concern was significantly associated w/ worse well-being
Report link: https://t.co/i1KEdkebkG #PWChat#WomenInMedicine#PROWD#HeForShe pic..com/AATm4xyZj4

— Physician’s Weekly (@physicianswkly) April 10, 2018

A7 One solution might be to educate everyone in #MedEd–including the educators AND trainees–about implicit bias and stereotype threat, so they understand it and recognize it when it happens to them or others. #PWChat #WomenInMedicine https://t.co/0yfOg80bl5

— Julie Silver, MD (@JulieSilverMD) April 10, 2018

A7. Increasing awareness among faculty members and education leaders about the impact of gender-based judgement and the potential impact on trainee well-being is an important first step. #PWChat #WomenInMedicine #PROWD #HeForShe #IlookLikeASurgeon https://t.co/y1xu6Zy73N

— Amy Oxentenko M.D. (@AmyOxentenkoMD) April 10, 2018

A7: Tough, as this is so deeply embedded in the culture of #Medicine. Accountability is key, but often, insight is lacking. Blinded applications can help with admissions procedures.#PWChat #WomenInMedicine #PROWD #HeForShe #IlookLikeASurgeon https://t.co/6oa0cIJmps

— AAWR (@AAWR_org) April 10, 2018

A7. Addressing all trainees as Dr. in front of patients, care team etc. demonstrates professional respect and role models this for all team members to address male and female trainees the same. https://t.co/QeCe8pb3AD #PWChat #WomenInMedicine #PROWD #HeForShe #IlookLikeASurgeon

— Susie Moeschler MD (@SMoeschlerMD) April 10, 2018

A7: As women leaders, we need to ask publicly, “what would you think if I/she were a man?” pick the right situations, but try it! You can do it with a smile and not as an accusation. It’s not a conversation unless we start it. #PWChat #WomenInMedicine @MinnowWalsh @KBerlacher

— Ami Bhatt (@AmiBhattMD) April 10, 2018

 


Question 8

Docs from 4 specialties reported 6 steps med societies could take to ensure women members treated fairly.
1-examine inclusion
2-report results
3-investigate gaps
4-implement strategies
5-track outcomes
6-publish resultshttps://t.co/uk5ShQLihA#WomenInMedicine #PWChat pic..com/dtHp6rr6uu

— Physician’s Weekly (@physicianswkly) April 10, 2018

A8 After we published this report, approx 100 doctors from different specialties signed a letter calling on US med societies to use metrics & analyze inclusion w/transparency to stakeholders. Some are doing it. All should. #PWChat #WomenInMedicine https://t.co/UnokVdCJNE

— Julie Silver, MD (@JulieSilverMD) April 10, 2018

A8. How about 7. opening up committee assignments more frequently and reaching out to newer graduates (of which there are likely to be more women than previously due to med school matriculation data)? #PWChat #womeninmedicine

— Jasmine R Marcelin (@DrJRMarcelin) April 11, 2018

A8. Societies not only need to look at gender metrics of achievement award winners, but also for committee appointment/chair roles, speaker panels, session moderators, course directors, board positions, leadership roles. #PWChat #WomenInMedicine #PROWD https://t.co/IgqQP3KTPT

— Amy Oxentenko M.D. (@AmyOxentenkoMD) April 10, 2018

A8 #Physiatry teamed up with #WomenInMedicine from 3 other specialties & proposed that med societies should share with all members the data for the attached list of metrics in this report: https://t.co/JNLiRvlB4b. #PWChat pic..com/81yArywGnd

— Women In PM&R (@WomenInPMR) April 10, 2018