News and Commentary Marking Women in Medicine Month With Cautious Optimism

At the beginning of 2020, I launched the Macy Notes blog with a post about women in leadership positions within the health professions and expressed my hopes for what women might achieve this year. The topic seemed fitting given some of the historic anniversaries taking place in 2020. We recently celebrated the 100th anniversary of the 19th Amendment, and this month, women physicians across the country are being recognized for their accomplishments thanks to the AMA’s Women in Medicine Month and several other initiatives celebrating women. The passing of Ruth Bader Ginsburg last week leads many of us to pause and reflect on the path she paved for the legal rights of women and for other groups historically excluded from the basic freedoms outlined by the Constitution.

I continue to feel optimism for the future of women in the health professions, but I must concede that the context and circumstances in which we find ourselves today are influencing the tone and the timeline for this future.

The women who worked so tirelessly to see the ratification of the 19th Amendment to fruition deserve our deep appreciation. So too does Ruth Bader Ginsburg, who championed inclusion throughout her long and distinguished career. Their work represents significant steps forward. However, it remains striking how long it took—and is taking—for true change to occur in many sectors of our society and within the house of medicine specifically.

Under “normal” circumstances, I might offer up my thoughts on how great responsibility falls to those who have certain rights or freedoms or privileges. Indeed, responsibility is woven into the fabric of the Macy Foundation. Our founder, Kate Macy Ladd, was born into great privilege and wealth, and she believed that she bore a responsibility to help others as a result of her station.

However, I know that many women in the health professions are currently shouldering an immense level of responsibility. The most difficult and challenging part of my own career was during those times when the needs of my children, ill family members, patients, students, and residents all escalated at the same time. Those seasons of life were exhausting. Without the strong support of my husband, colleagues, and mentors, I would have left medicine. Now, the COVID-19 pandemic has introduced additional stressors and upended many aspects of daily life. Many women are feeling a heightened struggle to manage the sometimes competing needs of work and family—responsibilities that are deeply important and rewarding, but may also feel overwhelming at times. Women of color experience the added weight of systemic racism and its myriad harmful effects.

Studies are also beginning to show COVID-19’s impact on women’s research productivity, an important facet of an individual’s path to promotion and, in turn, to leadership positions. A recently published research letter in JAMA Network Open highlights the potential for an expanded gender gap in corresponding authorship during the pandemic, as women in academia often spend more time on domestic responsibilities than men—a pattern that may be exacerbated by COVID-19’s disruptions to childcare and remote working and schooling.

So while I believe it is important—essential, even—for women in the health professions to lead, to seek and embrace opportunity, and to make their voices heard, I also believe it is okay to simply survive—especially now. Now is also a time when organizations like the Macy Foundation, organizations that are in a position to help, must redouble our efforts to support women in the health professions.

To that end, I continue to encourage those who have ideas for programs and projects that will improve the clinical learning environment—especially projects seeking to make improvements for women—to submit their ideas to President@MacyFoundation.org. As our first priority area states, the Macy Foundation is committed to promoting diversity, equity, and belonging for many groups of underrepresented communities, including women and women of color.

In looking ahead to a post-COVID world, one that offers a greater sense of stability as well as time to extend ourselves beyond the “simply survive” mindset, we should be heartened by the programming that exists for women in the health professions. These types of initiatives are making great strides to help women build skills, broaden networks, and amass the tools to thrive in leadership roles. Programs such as the Women in Medicine Leadership Summit, the University of Michigan’s Rudi Ansbacher Advancing Women in Academic Medicine Leadership Scholars Program (and its associated Leadership Summit for Women in Academic Medicine and Healthcare), and the AAMC’s Early Career Women Faculty Leadership Development Seminar offer opportunities for women at various levels in their respective careers.

The new leave policy announced by the American Board of Medical Specialties (ABMS) in July also offers an important, impactful means of supporting residents and fellows, and especially women. Once the policy goes into effect in July 2021, many training programs will offer the flexibility for their trainees to balance more easily the demands of work and family obligations such as the birth of a child or caring for a parent. I am encouraged by the strong move taken by the ABMS and look forward to watching the effects on the professional advancement of women in medicine.

I am also proud of the work emanating from recipients of grant funding from the Macy Foundation; these projects offer inspiration, awareness, and support—all with the goal of giving women and those who are underrepresented in the health professions and science a greater voice:

  • Changing the Face of STEM, led by Crystal Emery, MFA, brought together not only leaders from across multiple sectors for an “action-oriented” discussion aimed at increasing diversity and inclusion in the STEM fields, but also children and youth who benefited from inspired interactions with these noteworthy leaders.
  • Influence of Gender Bias on Learner Assessment (InGLAss) in Graduate Medical Education, led by Robin Klein, MD, MEHP, identified existing biases in assessment at the graduate level in six Internal Medicine training programs. One important finding was that of the “peak and plateau” pattern in female residents, suggesting a glass ceiling of sorts for women. The outcomes from this study provide a starting point for understanding women’s professional progress. The study also spurred an additional study on the Influence of Trainee Ethnicity Race (InTERsect) on Assessment in Graduate Medical Education.
  • Time’s Up: Closing the Gender Gap in Medicine and Science led to the creation of the Center for Women in Academic Medicine and Science (CWAMS), an organization I highlighted in my January blog post this year. The creation of the CWAMS organization has been a boon for supporting women in and aspiring to leadership positions.

We can make meaningful differences on an individual level as well. We can look out for one another, seek practical ways to make each other’s lives more manageable, and offer others our understanding and support. These seemingly small acts of kindness and compassion have potential to sustain our families, colleagues, and communities—and, indeed, ourselves—in mighty ways.

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