Athena SWAN Lecture London 31 October 2016

1. Institute of Clinical Sciences, Imperial College, London Athena SWAN Lecture London 31 October 2016 Women : Science, Careers, Leadership Dame Carol Black Expert Adviser on Health and Work NHSE and Public Health England Principal, Newnham College, Cambridge

2. My career – what I needed to learn • If you are passionate about a subject or a career, go for it – let your enthusiasm shine through ! • Try to fulfil your aspirations – trying, even if one fails, is so much better than “what if ? ” • Those who don’t apply for places or posts cannot get them. • Failure may feel painful, but it is important for us all to learn from it, so as to become resilient and press on. • What if I had not persevered and studied medicine? – I would have missed so much.

3. What if … • “ She was a ‘what if’ person, and because of that she never really happened.” • “ As long as we think that dug-out canoes are the only possibility – all that is real, or can be real – we will never see the ship, and never feel the wind blow.” I cannot tell you how many posts I applied for and did not get. Do not miss the moment.

4. Women and Higher Education • Worldwide, more women are going on to higher education, though in many places it is still a preserve of the elite. • Some warn against the ‘feminisation of education’ and the apparent alienation of men from schooling. • In many industrialised countries women are now a majority of all university students (but not in STEM subjects). • But the female proportion of faculty posts is still poor. • Academic progression for women is still poor in many countries, worse in science than humanities.

5. Women in Scientific Careers • Despite multiple initiatives to improve diversity, women remain under-represented at senior levels. • Currently only 13% of all UK STEM jobs are occupied by women, and only 17% of STEM professors are female. • The UK economy needs more STEM workers, and the demand cannot be met without more STEM women. • Women in scientific careers. • UKHouse of Commons Science and Technology Committee, Feb 2014 • Nature Special : Women in Science e.g. Science and Gender….. Comment by M.Urry, December 2015 • Lancet. Why do women choose or reject careers in academic medicine? L.Edmunds et al. April 2016

6. Cambridge University Statistics : Admissions, Examinations and Careers • At Admission – 69% of Males have three A*, only 49% of Females. • Some subjects male-dominated : Engineering 75%, Computer Sci 90%. • In examinations – more men gain Firsts; in Mathematics 35% of Males but only 14% of Females; in Natural Sciences 28% of M to 14% of F. • Careers Service : 71% attendees at a major Banking event were Male, but 73% of attendees at comparable Publishing event were Female. • Careers : • - average starting salary 6 months out, for first degree graduates : Males £29,858, Females £24,409 • - salarypremium for a First is £1,600, and Males gain more • - of those setting up their own business, only 25% are Female • - on a fixed-term contract of less than one year, 54% are Female.

7. Cambridge Equality and Diversity Report 2013-14 31 January 2015 Female students are 46% of all undergraduates (36% in STEMM subjects, 58% in AHSS) and 45% of all postgraduates. Women enter as undergraduates with similar school achievement grades to men. 20% of women gained First Class exam. results, 29% of males. Why is this – in almost all subjects ?

8. Cambridge Equality and Diversity Report 2013-14 31 January 2015 Females are 28% of all academics (35% of Lecturers and Senior Lecturers, but only 16% of Professors (14% in STEMM and 22% in AHSS – against 20% in Russell Group). STEMM = Science, Technology, Engineering, Mathematics, Medicine AHSS = Arts, Humanities, Social Science

9. Female entrepreneurs in digital technology Low female numbers in STEM subjects is a major bottleneck in getting women into entrepreneurship. Technology-literacy is critical – especially computer coding. Fewer than 20% of venture-backed businesses have a female founder (and of the 100 fastest-growing UK private tech companies, the first woman founder/CEO mentioned is in no. 50 ) (SUNDAY TIMES 6 September 2015) . When women do become entrepreneurs they outperform male peers – women-led companies do significantly better than average (First Round Capital). There are some phenomenal female entrepreneurial role models (Facebook, Yahoo). Courtesy Matt Clifford of Entrepreneur First

10. Addressing gender imbalance http://www.virgin.com/disruptors • We need to change our culture • “This is not a genetic issue, but a cultural one” • Coding should be in our curriculum • “Computer coding is OK, whether you are boy or girl.” • The tech world is broader than you think : “ People narrowly define technology as programming, but other exciting disciplines are essential to the digital industry” • Young women need tech. role models : • “ Confident female tech. founders need to speak up as women in technology – to show young women that if they want to they can do it too.” Courtesy Matt Clifford of Entrepreneur First

11. Where does this start ? Where should we begin to address this problem : • in early childhood ? • at school ? • at university ?

12. OECD Report on gender equality May 2015, focussing on teenage girls’ choice of subject. Assertion: There are no natural born differences in ability, but boys are more confident of their abilities, less anxious about performance – they go for gold and girls play safe. “ Parents can give their children equal encouragement.” Unconscious bias persists in parents. Evidence shows that parents expect a son to be more successful in science, even when their daughter has better grades;

13. “Barbie dolls will never inspire girls to be engineers”, says expert Dame Athene Donald Professor of Experimental Physics and Master of Churchill College Cambridge “We stereotype by what toys young boys and girls are given.” “If girls always play with dolls, worrying about hair style or making tea, how can they imagine themselves as engineers or chemists ? ” “Peer pressure at school : half of mixed-sex schools send no girls to do Physics A-level; girls at single-sex schools are 2.5 times more likely to do it” “Work experience is too often gendered – girls to a hairdressing salon, boys to the local vehicle garage.” THE TIMES Sept 4 2015

14. Building confidence in the young • Many girls learn to avoid taking risks and making mistakes. • Many psychologists believe that risk-taking, failure, and perseverance, are essential to confidence-building. • Boys tend to absorb more scolding and punishment, and in the process learn to take failure in their stride. • Girls and boys get different patterns of feedback. “Boys’ mistakes are attributed to lack of effort, girls see mistakes as reflecting their deeper qualities.” (Dweck: Mindset) Kay and Shipman, 2014

15. My own career - a shaky start … • from Barwell, Leics(an industrial shoe-making village in decline) • … to grammar school in Market Bosworth. • At school I was : • fat • working class • poor at games • not as good as some city students • initially lacking self-confidence • but I became Head Girl.

16. Home and School • My home : relatives worked in factories or shops, if lucky, • but we had a culture of music. • Grammar School – a great headmaster, committed teachers. • Initially I wanted to be a teacher of Domestic Science (lacking aspiration). • A teacher encouraged me to broaden my horizons – and aim higher • Uncertain as between arts and sciences • A sense of wanting to become something, but what ?

17. University • Studied, at Bristol, a subject wrong for me ! • Deflected into other activities – music, student union, societies – and became President of the Student Union • Wanted to do Medicine – but how ? Instead took a course on Medical Social Work – played safe • The ‘Cecily Saunders’ moment • The joy, the misery, escape to VSO in the Pacific

18. VSO and return • One year in the Gilbert and Ellice Islands, teaching young children. A coral island, and a wonderful memory. • A second chance : I risked returning to do Medicine • First MB, then Medicine proper – my subject ! • Becoming passionate about medicine ! • Partly self-funded, by work etc. • Pragmatic decision on specialisation – rheumatology.

19. A career in Medicine “ Medicine is brilliant. There is no other vocation that marries so well the adrenaline rush of providing fast-paced acute care …. …. with the satisfaction of helping a patient with multiple complex co-morbidities manage their care.” Clinical Fellow at the RCP RCP Commentary Feb 2016

20. Forget perfection : build self-confidence Research : should I, shouldn’t I ? Perfection is more a female issue, extending throughout life. “ Men usually don’t let doubts stop them, as women do.” “ The natural result of low confidence is inaction. Ambivalent holding back – taking no risks.” “ Perfection is the ‘enemy of the good’, leading to hours wasted. Striving to be perfect actually keeps us from getting much done.” The Confidence Code, 2014 Don’t edit exhaustively everything you think or write – if you do you may never finish it.

21. Sir William Osler (1849-1919) pre-eminent physician • “ Women are better adapted to scientific work” – but for wrong reasons • “That a larger proportion of women than of men are unfit for medical practice will, I think, be acknowledged: on the other hand a larger proportion of women are adapted to scientific work. • It is most encouraging to see so many women taking up laboratory life. • Here they meet men as equals: what they lack in initiative and independence is counterbalanced by a more delicate technique, greater patience with minutiae, and greater mastery of detail. • In the scientific life, too, a woman escapes those little rebuffs and slights so trying to a sensitive nature, and to which it is not good for a woman to become so hardened that they do not hurt. ”

22. Connective tissue diseases … • Scleroderma, a rare and dangerous disease, became my passion • Excess collagen in skin produces deformities • In internal organs, this can be life-threatening • Began research, set up an international centre. • Provided a national service for the UK • Led a growing team, enjoyed it, seemed good at it …….

23. Leadership Myths • Leaders are born, not made — some people come out of the womb ready to lead others. • Leadership is the act of a lone genius, often thought of as the person at the top of an organization. • Leaders must be charismatic extroverts to motivate and inspire others to get them to follow their vision. • Leadership requires formal authority • All leaders have a common set of personality traits.

24. Role models for Scientific Careers • Oxford University: “ lack of women perpetuates the masculine culture of many science departments, deterring females from academia.” • Russell Group : “distinct lack of successful female role models with families means that graduates see academia as somewhere not to have a successful career and a family. ” • “low numbers of women in senior positions often lead to perceived ‘invisibility’ of successful women in academic STEM careers.” • Role models are essential to ‘evidence the possibility of success’ and to ‘encourage women to advance their own careers actively’. • Women in scientific careers. • House of Commons Science and Technology Committee, Feb 2014

25. Women in Academic Scientific Careers • Research Grants : • ….. current research suggests that women are not put forward or encouraged to put themselves forward [for European Research Council grants] because the criteria stipulate excellence and future leadership, and women are less confident about making such claims for themselves at an early career stage. • by applying for smaller grants, women researchers have less money to engage additional researchers in their projects to provide statistical or data analysis support. • Publication : • Publication is key to successful career development, but evidence shows that women are less likely to get published or be first author. • Open University

26. Women and Medical Careers • Meritocracy has been achieved at medical school. • No report yet provides independent evidence of systematic barriers against women’s advancement in the profession. • Many specialty choices : women doing well, with a growing range of sub-specialties to choose from. • Progress to consultant, for those full-time, is equal to men’s. • Female intake and retention both high. Common pay scale. BUT • Too few women reach top positions • Women in Academic Medicine : still not enough.

27. Prominent leadership roles : the extra dimension High Resilience, confidence, risk-taking, single-mindedness Low Specialty Matrix : More People Oriented Leadership dimension in each specialty More‘Plan-able’ Less ‘Planable’ More Technology Oriented Paul Coombes 2009, RCP Working Party

28. Women’s Leadership in medicine and science Women choosing this route need encouragement and support – role models, mentors, sponsors. • They need resilience, self-confidence, risk-taking, aspiration. • It requires ‘trade-offs’, and accepting competition. • It requires investing time “over and above”. • As in every profession, the “top 200 leadership positions” will naturally go to those who pursue their career goals with a high degree of single-mindedness and speak out.

29. I moved to a different career Medical Director, Royal Free Hospital – governance, leadership President, Royal College of Physicians Chairman, Academy of Medical Royal Colleges; Chair, Nuffield Trust on health policy Advising Government as National Director for Health and Work ; and then Principal, Newnham College Cambridge

30. Expanding Leadership I was deeply involved in clinical and research leadership till 1999, leading my own Centre, BUT hospital policy and strategy was different. At an institutional level it was about: • population health • seeing what was needed in an organisation, and making it happen • recognising and accepting the link between improvement and change, managing threats, disturbance, disruptions. Change upset my medical colleagues. Many thought that as Medical Director I had joined the dark side !

31. LeadingRCP and the Academy President 2002-06. Skills required : • understanding a wide landscape • consensual leadership • standing ground when necessary • negotiating with Whitehall • building trust. RCP, est. 1518 : promoting highest standards in medicine • Academy Chair 2006 – 09 • Group of 21 independent medical organisations. • Leadership lay in one’s ability to persuade, align forces, not be in a rush. • We managed to gain the ear of Government, attracted funding, and did work on policy.

32. Public Voice of Women : Prof. Mary Beard (Newnham) “ Contrast the ‘deep-voiced’ man with all the connotations of profundity that the simple word ‘deep’ brings. Hearing a female voice, people don’t hear a voice that connotes authority, nor a voice of expertise outside the traditional spheres of women’s sectional interests. Being Minister for Women (or Education or Health) is fine – but no woman has ever been Chancellor of the Exchequer. How can we make ourselves more aware of the processes and prejudices that make us not listen to women ? ” Lecture: The Public Voice of Women, January 2014

33. Even bigger risk: The ‘light bulb’ moment 2006 – the social determinants of health (Marmot) • I became National Director for Health and Work 2006 - 12 (then an adviser) • I have become : • -a worker across boundaries (between Deptsetc) - a champion for the ‘cause’ of Health and Work - an ambassador - a source (I hope) of honest independent advice - a writer of three reviews for Government.

34. Newnham – a great surprise • I chose to have a go at a completely different role ! • My vision for the College: - a place in which women can develop their potential and self-confidence, - and leave with aspiration and ambition for leadership.

35. Newnham is home to students who are largely educated in the co-educational environment of the wider University. Nor is it a ‘nunnery’ barring male friends or tutors. Times Higher Education Supplement, Nov. 2014 Dame Carol Black, Principal of Newnham, says : “ I am particularly keen that students learn risk-taking and leadership skills. An all-female College gives them that opportunity because women have to chair and develop everything we do.” All-female colleges should play a greater role in advocating women’s education globally, and speak out on women’s issues. We are warm and nurturing, but not a hiding-place to retreat from the fray.”

36. Newnham : Curriculum to Career • Career Seminars in Principal’s Lodge • Courses on presenting oneself (Veronica Crighton) • Support from 60 successful alumnae – ‘Associates’ – on CVs, interviews, internships • SPRINT programme since 2014 – self awareness and confidence • Life Skills course – started October 2015 • Also in pilot, with Oxford University Careers Service, ‘Ignite’ career confidence courses for schools.

37. Sprint Programme for Women Personal and Work Development, at Newnham Designed for undergraduates, over 3.5 days of Workshops, with role models, guest speakers, group sessions etc. • Subjectscovered include : • building personal power • emotional intelligence • goals from core values • assessing personal potential • leveraging successes • achieving peak performance • positive assertiveness • managing pressure • setting compelling objectives • developing personal brand • powerful networking • practical strategies • implementing action plans. Who are you dancing for ?

38. Newnham : Life Skills Course 2015-16 Topics, Autumn Term 2015, Mondays at 6 pm • Resilience and Wellbeing • Interacting with Media and Press • Public Speaking • Dealing with failure, staying motivated • Taking charge of your own development • Effective membership or chairing of committees. Topics all chosen by students, undergraduate and graduate

39. The Meaning of Success “ This book is a potent reminder that there is no unique path to ‘success’ , which is not a single thing that we can all agree upon, but a complex multi-dimensional set of factors which are frequently different from those commonly ascribed to the successful in life.” “ These factors must always be consistent with the woman’s own belief systems if they are to provide fulfilment. Only then can they ensure that the woman herself believes in her success.”

40. University of Cambridge Strategic approach to advancing change Key elements: • Support at the most senior levels within the University, Gender Equality Champions and Senior GE Network • Integrated and embedded Governance structures • Core Equality and Diversity and Human Resources policies and practices • Commitment to Athena SWAN Charter – benchmarking . • Significant additional resources (~£500k per annum), for workshops, mentoring programmes, Returning Carer’s Scheme, funding to the STEMM Schools.

41. Athena SWAN - National Benchmarking of Universities Scheme established 2005 to encourage and recognise commitment to advancing careers of women employed in STEMM higher education and research. Expanded 2015 to cover all subjects. Currently 137 Athena SWAN members, holding 536 awards Cambridge is one of only seven UK Universities to hold a Silver institutional award 1 Gold, 1 Silver, 16 Bronze Departmental awards Key component : develop gender action plans Award renewal depends on delivery against action plans

42. What is emerging as needed • In the beginning : - in the home : stop stereotyping - in school : build resilience, self-confidence encourage study of STEMM subjects • At University : - encourage aspiration & risk-taking, downplay perfection - learn from failure - develop Life Skills • At work : - ensure workplaces give women equal opportunity - withpersonal and organisation’s values aligned - mentors, sponsors, role models - encourage networks.