Academic Women for Equality Now!

This post continues our series of interviews with women who have made their mark in academia or have interesting thoughts for those of us in the Ivory Tower.

Janet Bickel

Janet Bickel’s work with the Association of American Medical Colleges (AAMC) led to the current Group on Women in Medicine and Science. She currently provides a variety of coaching and leadership development services  (www.janetbickel.com).

Question: What educational background and experiences shaped your career?

My background is kind of unusual. Upon graduating from the University of Missouri in 1971, fired up to teach high school English, I applied to every school district in Rhode Island to no avail (my husband and I had moved there so he could go to RISD).  The only job I could find was as a secretary in the office of the President at Brown University. I was about to die of boredom when Brown’s Program in Medical Sciences hired me as Student Affairs Assistant.  The program was in the process of becoming a full-fledged medical school, and there were no other staff besides the business and development officers. I became the   founding admissions, financial aid and student affairs officer, obtaining my “medical education” from the students. This rich grassroots experience turned out to be perfect preparation for staffing AAMC’s Organization of Student Representatives and  the medical school admissions, financial aid and student affairs deans  and for building bridges from  the students to the leaders of AAMC’s Councils of Deans, Teaching Hospitals, and Academic Societies. During this interval of 1977-87, I also led the first national studies of human values teaching programs in clinical education, medical students’ ethical dilemmas, and  HIV/AIDS Education.

Then in 1987, the new AAMC president Robert Petersdorf made funding available to create an Office of Women in Medicine (WIM) [more below]. During the next 13 years, I also spearheaded the first AAMC foci on faculty affairs and development and  published the first national studies of maternity leave policies for residents, parental leave policies for faculty, and promotion and personnel policies for part-time faculty.

What’s most significant about my story is the match-up between my strengths and the opportunities at Brown and at AAMC:  eagerness to learn from those I am serving; appetite for grappling with  the complexities of human development in academic medicine; desire to connect people across  functions and hierarchies;  risk-taker and self-starter able to work with little support. When your strengths align well with the opportunities and demands of your work, the sky’s the limit. I was truly fortunate to have intersected both Brown’s emerging medical school and the AAMC when I did!

Please describe your work at AAMC related to Women in Medicine and Science.

I initiated several activities: 1) Assembled a strong advisory committee; 2) Expanded the categories, publication and distribution of WIM statistics (we didn’t call it   “female faculty friendliness report cards”, but we got  medical school deans’ attention by making public  each school’s rankings, eg on their number of women department chairs) (also in 1989 my article  in The New England Journal of Medicine helped put the Office on the map); 3) produced a quarterly newsletter plus compendiums of examples of WIM programs; 4) searched out and connected with the WIM organizations of over 25 specialty societies and with staff at AMA, NSF, etc. and as they evolved, promoted and served as invited ELAM and NIH’s new Office of Research on Women’s Health; 5) first authored “Increasing Women’s Leadership in Academic Medicine” [Acad Med, 2002; 77:1043-61], the first report to articulate a  systems view of this challenge; and 6) and perhaps most influentially, organized annual junior (now called “early-career”) and senior (now called “mid-career”) WIM leadership development programs that have served as a model for many  specialty societies and medical schools (and were the first AAMC programs designed for medical school faculty).

What is your view of the work that remains for women in academic medicine?

Despite increasing numbers of women in all fields of science and medicine, we live in a half-changed world where women have equal access to education but, for instance, the 17 individuals honored this year by the National Academy of Sciences are all men.

While the challenges of combining career and family responsibilities remain more acute for women than men, perhaps even more significant is that gender remains a powerful social category although its effects are usually subliminal. For instance, the conjunction of “white men” and “power” seems natural–but to many the conjunction of “women” and “power” sounds unnatural. Women are required to make many more gender-related adaptations than men in order to succeed– for instance, if a woman physician speaks too firmly to a nurse, she risks being labeled “too big for her britches.”  Women, especially in health care, are expected to be nurturing and collaborative in ways that men are not. These double standards show little sign of diminution. During clinical clerkships many female students still default to stereotypically feminine behaviors (eg apologizing, doing the work of support staff).  Many form a “personal glass ceiling”—that is, internalizing as personal the cultural difficulties they face, hence underestimating their own abilities and limiting their goals.

Because women who downsize themselves tend to quietly disappear, even though this waste is not a “women’s issue,” the costs associated with women’s wasted potentials remain invisible. Who is addressing this loss?  Men feel like they don’t have it so great these days either, and many are concluding that women who don’t climb the ranks simply prefer to devote more of themselves to their families or lack the necessary appetite for competition. With women outnumbering men in universities, most young women expect equity as a right and are unprepared for the work that remains. And pointing with pride at all these bright young women, most leaders are acting as if the “WIM problem” is solved. More than one has told me “I’m surrounded by women” –without noticing that these women do not feel empowered enough to ever disagree with him! Leaders unwilling to look at how the culture facilitates the participation and growth of some more than others perpetuate the patterns.

The resulting organizational silence means that key questions remain unaddressed. For example:

• How can we counter the tendency of many men to categorize any issue related to gender as a “women’s issue” and therefore of low concern? (or to give it lip service, which may be worse since hypocrisy begets cynicism, perhaps the deadliest of  organizational outcomes).
• While women’s interactions with each other are largely positive, at some time in their careers a large percentage of women feel undermined or cut by a trusted woman in a way that plunges them into turmoil, exacting a toll on their careers and spirits and on the relational environment.

• Since a central tenet of inclusion is the immense diversity of humans and since men and women are more alike than different, what unintended message does “counting” women chairs and deans convey?
• In a capitalistic society and hierarchical culture, what does “equity” mean? Have any of us ever experienced it? If not, is it a useful concept?

How can we address these challenges? What do we need to get better at?

I’ll begin with an inflammatory observation of what we DON”T need: more studies. I believe that analysis has become a substitute for action. We have decades’ worth of studies that are neither producing important new findings nor contributing to culture change.

So how can we address these challenges?

• Clearly there’s a continuing need for ELAM, which has been tremendously influential in so many ways, and for AAMC’s GWIMS programs, and for resources and stimuli such as Academic Women for Equality Now.
• Institutional WIM advocates should keep working with other leaders to create forum (such as Grand Rounds and faculty retreats) devoted to learning to detect perceptual filters and to communicate relationally across differences.
• Established men and women professionals can improve their organizations and extend their own legacies by coaching young women who are entering competitive cultures unprepared to handle many of the tasks (eg negotiation) or to make sense of all the constraints and opportunities.
• Individuals who notice gendered assumptions interfering with a process can skillfully draw attention to this. For example asking, “Are we holding women to a higher standard than men on this behavior?“ and “When writing letters for trainees, do you experience a tendency to focus more on the skills of the men and on the personalities of the women?” By respectfully drawing attention to the advantages of assuring fair processes, such conversations shift the culture in ways that benefit everyone.
• Like Page Morahan, I take every opportunity to remind women to support each other (when a woman puts down another woman, she does many forms of damage) and to build a community of colleagues who give each other useful feedback and affirm each other’s strengths.

What are you doing now, and what are your plans?

In 2003 after 25 years, I left AAMC because I couldn’t see the next way to make a big difference and sensed it was a bigger risk to stay and not grow than to start my own business. So I traded that wonderful security and status for autonomy and leapt into the emerging field of coaching –a resource that most academics still regard with skepticism. I partner primarily with academic physicians and scientists to further their development in the ways most important to them. This work is an enormous privilege and I find as much meaning in it as I did in leading programs at the national level. I intend to keep coaching until I’m decrepit!

I also continue to design career and leadership development programs for institutions and professional societies and to write about tough issues  (eg  “Difficult issues in mentoring: Recommendations on making the “undiscussable” discussable” with Susan L.Rosenthal; Acad Med. 2011; 86:1229-34).

In recent years I have benefited more than I can express from participating in the Courage to Lead and Leading Organizations to Health programs offered by Relationship Centered Health Care (http://www.rchcweb.com/).  Almost every day I bike or walk and am finally taking a yoga class and am reading more Buddhist authors. From these synergistic activities and from my family and friends,  I gain inspiration and support for my continuing exploration of  human beings’ profound potentials and connectedness and of how we can keep opening and deepening our hearts in the face of so many opposing forces. I believe with the great teacher Parker J Palmer that:  “The heart is where we integrate the intellect with the rest of our faculties such as intuition and emotion. It is where we learn how to think the world together and find the courage to act on what we know.”

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