Conquering the Invisible

Nancy Hopkins’ proved that women at MIT had less lab space and support than men, and brought that bias to the attention of both university leadership and the world with some help from the New York Times. Her Boston University Baccalaureate Address reviews the strides women have made over the past 50 years. It also reminds us that we still have an invisible enemy called unconscious bias that needs to be struck down.

If you asked me to name the greatest discoveries of the past 50 years, alongside things like the internet and the Higgs particle, I would include the discovery of unconscious biases and the extent to which stereotypes about gender, race, sexual orientation, socioeconomic status, and age deprive people of equal opportunity in the workplace and equal justice in society.

This speech is the most inspiring one I have read this year. Really, click here to go read the whole thing. It summarizes what this web site is all about quite nicely.

Results Matter: Why Women Get Stuck in the Middle

As a delegate to Vision 2020, I have enjoyed meeting Susan Colantuono, the founder of Leading Women™. I reviewed her book, Make the Most of Mentoring: Capitalize on Mentoring and Take Your Career to the Next Level at another site back in June.

She recently gave a talk at TEDxBeaconStreet, summarizing her message. Women get stuck in middle management (Assistant and Associate Chairs and Deans, perhaps?) because they are not mentored to focus on the bottom line. Here is the talk; I suspect this will whet your thirst to read her book. Go ahead; you won’t regret it!

Now You Can

By popular request, you can now download higher resolution jpg files of the scores for each college of medicine here:

And here is the URL:

Enjoy! And if you are attending the 2013 AAMC meeting in Philadelphia, say hi!

The Biggest Changers, 2013

Which medical colleges showed the largest jumps in overall score for female faculty from the AWEnow 2011 to 2013 reports? Three schools had above-average scores in 2011 and remained above the median this year:

Click to Enlarge

Click to Enlarge

  • University of South Carolina
  • Hawaii
  • Southern Illinois University

Two schools started out and finished below the median for both reports:

  • Medical University of South Carolina
  • Harvard

Five colleges fell below the median in 2011 and rose above it this year:

  • Oklahoma
  • SUNY-Buffalo
  • Vermont
  • Connecticut
  • University of Chicago

These overall scores are shown in the line graph. The next question asked was where the change occurred. Did any particular category of women leader change more than the others? The next box plot shows the changes in each score.

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Click to enlarge

Unlike the entire group, no score in these improved schools deteriorated, although a school had almost no improvement in Departmental or Full Professors Scores. The general pattern of score changes was similar; the improvement in Overall Score was clearly driven by big changes in women at the Associate and Assistant Dean level.

So why have Decanal scores showed so much change?

In part, it’s because of the low denominator. Adding a few new sub-deans can have an impact when the average college of medicine has 13 people in the category (range 0-30). Departmental positions averaged 80 (range 5-368), so a lot more positions have to change to create movement in this category. Full professors averaged 269 (range 11-1329), making any impact on this score even more difficult. Full professors also take a long time to develop. A dean can pretty much create an Assistant or Associate Dean at will.


Top, Bottom, and Middle: 2013 Gradecards

The AWEnow gradecards are listed alphabetically by state this year, the same order as the AAMC’s Women in U.S. Academic Medicine and Science: Statistics and Benchmarking Report 2011-2012. Over the coming weeks AWEnow will visit some of the data in more depth. Today, we examine the top ten and the bottom ten schools, shown in the table. Our Top Ten features 6 from the last set; most of the movement in-and-out of this group occurred with other schools from the top quartile. Some of these changes may reflect changes in faculty composition, while others may reflect better data reporting.

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Click to enlarge

The same pattern of small changes in rank occurred within the bottom quartile. Four colleges remained in this grouping as well.

So how do these schools differ?

The bottom figure shows box plots for the scores for these two sets. Decanal scores did not differ statistically for the top and bottom ten schools. Every other score showed striking differences.

The full set of gradecards can be found here. Feel free to download and share.

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Click to enlarge

Two Years Later: More Data, Minimal Change

Last November, the Association of American Medical Colleges released Women in U.S. Academic Medicine: Statistics and Benchmarking Report 2011- 2012. Since then the numbers have been crunched and analyzed and prettied-up for your edification.

Score changes (2012 score - 2010 score)

Score changes (2012 score – 2010 score)
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First, we have good news. The quality of data reporting improved, with only 2 of 126 schools having incomplete grades this year. As the person collecting those data at my academic home, I have new-found respect for those who do this job. Data from both the previous and present cycle for 109 medical colleges allowed progress at those schools to be analyzed. Median Overall Score increased by 2 from 2010 to 2012. Fourteen schools saw this score fall by more than 2 points, while 41 colleges remained stable and 54 schools increased by more than 2 points.

Women advanced the most at the decanal level, even though the total number of female Deans fell from 17 to 13. The median score for the D-suite rose from 36 to 45, with 92 schools showing stability or growth in sub-deans. This change in score proved to be significantly greater than any other score change.

Departmental scores increased from 15.9 to 16.9 over the two year period. As in the last reporting period, many colleges did not supply data regarding sub-chairs or section chiefs. Median full professor scores also rose by 1, from 19 to 20, with most schools remaining within 2 points of their 2010 score.

The original report and gradecard set from 2011 can be found here.

Almost That Time

While not posting here, we have been busy behind the scenes crunching numbers from the AAMC’s report, Women in U.S. Academic Medicine and Science: Statistics and Benchmarking Report 2011-2012. The gradecards are assembled and will go up soon. Stay tuned!

Guest Post: Deborah Shlian

Deborah Shlian is a board certified Family Practitioner and MBA with over sixteen years of managed care experience as both a clinician and manager who brings a unique perspective to health care searches and consulting. She wrote a monograph for the American College of Physician Executives (ACPE) in 1995, Women in Medicine and Management: A Mentoring Guide. ACPE recently asked her to update the topic; the resulting book will be released in March.

Available in March

Last February, the American College of Physician Executives (ACPE) asked me to update a monograph I’d written in 1995 titled “Women in Medicine and Management: A Mentoring Guide”.  At that time, only about 19 percent of physicians in the US were women and I had great difficulty finding more than a few women physicians who held low or mid-management positions and almost none in top management. That was true across the entire healthcare system – academia, government, hospitals, managed care and corporate healthcare organizations.

I finally selected 17 representative women physicians and asked them to write their personal stories including how they chose medicine, why and how they transitioned from clinical medicine to management, and what obstacles they encountered along the way. It was clear from these narratives that for most of them, leadership positions had been unplanned and that few had found role models or mentors to help guide their career paths. There was also consensus that a thick glass ceiling existed within healthcare that was thwarting their ability to move into more senior positions.

When I agreed to update the original ACPE monograph almost two decades later, I expected the situation to be significantly improved. After all women have been entering medicine in increasing numbers since 1995, so that today 50 percent or more of the students enrolled in many medical schools  (including my alma mater) are female.  Unfortunately, as I researched the latest statistics, I discovered that women physicians are still underrepresented and underutilized in positions of power- especially at the most senior levels.

Barnard College president Debora Spar has labeled the marginalization of US women in senior leadership as a “16 percent ghetto.”  While she identified this phenomenon in aerospace, engineering, Hollywood film, higher education and Fortune 500 companies, I learned that Spar’s observations apply equally to women physicians. In 2012, no more than about 16 percent of the the top leadership positions in any area of the healthcare system are held by women doctors.

For my updated book I was able to find 24 exceptional female physicians who have defied the odds by rising to top management posts. The title is “Lessons Learned: Stories from Women in Medical Management” and will be released in March,  In it, women like Dr. Ora Pescovitz, CEO of the University of Michigan Healthcare System, Dr. Ellen Strahlman, Senior VP, Office of the CEO, Global Head, Tropical Diseases at GlaxoSmithKline, and Dr. Florence Haseltine, Emerita, Director of the Center for Population Health at the Eunice Kennedy Shriver National Institute for Child Health and Human Development at NIH share their career paths from clinical medicine to leadership within academia, pharma, government, hospitals, provider groups, managed care,  consulting and entrepreneurial ventures, including the obstacles and challenges faced in balancing work, family, and personal life.

In the Overview chapter, I explore the barriers women physicians continue to confront in seeking leadership roles. For example, in academic medicine, where only 16 percent of medical school faculty are at the full professor rank and only 13 out of 137 deans of US medical schools are women, productivity (i.e. research publications) is generally cited as the primary reason for the gender gap.  Yet in a study by Darcy Reed, MD and colleagues at the Mayo Clinic in the January 2011 issue of the journal Academic Medicine, the authors found that although the academic productivity of women lagged behind men in the early and middle stages of their careers, publication rates were similar between genders in the later stages.  Reed concluded that academic productivity in mid-career may not be an appropriate measure of leadership skills for women, stating that: “a paucity of qualified women in leadership positions both deprives organizations of the unique skills and perspectives women bring to such roles.”

The commonly cited reason, apart from sexism, for the relatively  poor representation of women physicians in leadership positions in other areas of healthcare -both private and public- has been that women choose not to be leaders, that they lack interest and/or skill in leadership, and that they prefer devoting their time to their families rather than concentrating their attention on professional advancement. While past studies justifying male physicians as administrators claimed that men liked wielding power more than women, there is agreement today that when women have an opportunity to be decision makers as medical managers, they enjoy the role and are successful leaders.

Certainly the women in my book “Lessons Learned: Stories form Women in Medical Management” reflect this attitude. They say they opted for management as part of “their overall career advancement”. Most want to be policy makers, to have an opportunity to provide top management support for medical practitioners and to influence the big picture (how  groups of patients receive care as well as the environment in which services are delivered).

At a time when virtually everyone agrees that the US healthcare delivery system needs fundamental change, this book ultimately makes the case for talented women physician executives, articulate in the language of health care policy and business, to be among those leading the way.

As an offshoot of the book, I decided to start a blog called Creative Leaders Forum, inviting anyone interested in exploring leadership issues to either volunteer to guest blog or comment on the posts, hopefully initiating some interesting discussion.


Coaching, Mentoring and Sponsorship: What’s the Difference?

We all need a number of helpers to fully develop as professionals and achieve our highest career goals. Coaches, mentors and sponsors are all necessary, but the difference among these individuals can be unclear. Ida Abbott Consulting has a nice document that discusses each position, and I have pulled excerpts below:

Coaching deals with performance. It is functional and results-oriented. Coaching helps someone become more productive and effective at a specific set of functions, tasks or practices. A coach helps you identify and set goals in a particular area (or function) and develop a plan to achieve those goals. Then the coach gives you support while you implement your plan and achieve your desired results. Because you check in with the coach as your plan moves forward, the coach also keeps you disciplined and focused.

So what is a mentor? Can a mentor be a coach?

Mentoring is broader in scope and purpose than coaching, and is based on a deeper, more meaningful relationship than coaching. It is relational in nature and career-oriented. Both the quality of the mentoring relationship and the factors that determine quality – trust, mutual respect, and mutual learning – are critical to the mentoring process. Mentoring covers more wide-ranging career issues than coaching because it deals with mentees’ overall professional development and advancement, not simply performance goals. Although mentor and mentee might spend time on improving performance, the relationship usually expands to larger and longer-term personal and professional career issues. Mentors often employ coaching as one of their tools, along with confidence building, role modeling, counseling and advocacy.

Finally what does sponsorship involve?

A sponsor is a strong advocate who has power and influence and uses that advocacy to produce positive career results for you. Sponsors publicly endorse your qualifications and take risks on your behalf, arguing that you should move up to a higher compensation tier or urging their partners that you are ready for equity partnership or a significant leadership position. They alert you to opportunities and appoint you to key posts. Sometimes they call in favors, put pressure on colleagues, or put their reputation and credibility on the line for you. Partners become sponsors when they perceive special value in you and actively help you advance. It can occur for any number of reasons: they might see you as a natural successor, as having rainmaking potential that could benefit them, or as having expertise necessary to support their clients. Sponsors and champions may not guarantee success, but they make it easier and improve your odds of receiving a coveted leadership appointment, a fatter paycheck or a new client.

The full post contains concrete examples, and you should read the entire thing. These positions all help you get ahead; understanding the differences can help you get what you need.


Congratulations, Dr. Abriola

Linda Abriola, PhD

Linda Abriola, Dean of the School of Engineering at Tufts, was named the 2013 Engineering Leader of the Year.

In addition to her expertise in civil and environmental engineering, Dr. Abriola serves on the Advisory Board for ELATE, Drexel’s development program for women leaders in academic  science, technology, and engineering.

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