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Women in Academic Surgery: The Pipeline is Busted. Sexton, KW; Hocking, K; Wise, E; Osgood, MJ; Cheung-Flynn, J; Komalavilas, P;Campbell, K; Dattilo, JB; Brophy, CM. DISCLAIMERS. No Financial Disclosures, unfortunately Some opinion, mostly data I am not a woman. Internet. Printing press.
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Women in Academic Surgery: The Pipeline is Busted Sexton, KW; Hocking, K; Wise, E; Osgood, MJ; Cheung-Flynn, J; Komalavilas, P;Campbell, K; Dattilo, JB; Brophy, CM
DISCLAIMERS • No Financial Disclosures, unfortunately • Some opinion, mostly data • I am not a woman
Internet Printing press Stone tablets We are living in the most dynamic epoch of human history. Human genome Watson &Crick RATE OF CHANGE Mendel TIME Singularity The rate of change is getting faster
Diversity Ecosystem stability depends on the ability of a community to contain functional groups with different responses to stressors. McCann KS. The diversity-stability debate. Nature. May 11 2000;405(6783):228-233
Elizabeth Blackwell • 1821-1910 • Bristol, England • Geneva Medical College • 1/23/1849 Roth N. The personalities of two pioneer medical women: Elizabeth Blackwell and Elizabeth Garrett Anderson. Bull N Y Acad Med. Jan 1971;47(1):67-79. wikipedia.org
The Pipeline Slope is 0.36 Slopes are 0.75 and 0.99 Women in U.S. Academic Medicine: Statistics and Benchmarking Report 1983-2010
The Pipeline 2028 The year 50% of surgery residents will be women (R2=0.98) The year 50% of professors of surgery will be women (R2=0.98) 2096
Women in U.S. Academic Medicine: Statistics and Benchmarking Report 1995-2009
30 years of “progress” 1979-2009: Women in Academic Medicine The trend for advancement of women in Academic Surgery is unchanged over the last 30 years. “ On one hand, the numbers of women faculty, department chairs and deans have never been higher. However, this growth has not substantially reduced gender differences in advancement or sufficiently strengthened the pool of women candidates for administrative positions. Thus, the progress achieved over the last 25 years is incomplete and inadequate.” Bickel J, Wara D, Atkinson BF, et al. Increasing women's leadership in academic medicine: report of the AAMC Project Implementation Committee. Acad Med. Oct 2002;77(10):1043-1061.
Slope: 42.79 ± 7.930; R2= 0.70 Slope: 11.89 ± 0.9719; R2= 0.93 2 Way ANOVA: Gender p<.0001, Year p = .0782
Conclusion Women are not advancing to the senior ranks of Academic Surgery, despite increasing numbers of women entering the field.
λ = 0.625; p = 0.01 32% response rate
Employee Behavior Kanter RM. Men and Women of the Corporation. New York: Basic Books Inc.; 1977. Perceived access to information, support, opportunity, and resources are related to position in organization. Goddard MB, Laschinger HK. Nurse managers' perceptions of power and opportunity. Can J Nurs Adm. May-Jun 1997;10(2):40-66. Wilson B, Laschinger HK. Staff nurse perception of job empowerment and organizational commitment. A test of Kanter's theory of structural power in organizations. J Nurs Adm. Apr 1994;24(4 Suppl):39-47. Determined by structure of an organization and not intrinsic character
Relevance • Job Strain • Work Satisfaction • Organizational Loyalty • Trust in Management Wilson B, Laschinger HK. Staff nurse perception of job empowerment and organizational commitment. A test of Kanter's theory of structural power in organizations. J Nurs Adm. Apr 1994;24(4 Suppl):39-47. Kluska KM, Laschinger HK, Kerr MS. Staff nurse empowerment and effort-reward imbalance. Nurs Leadersh (Tor Ont). Mar 2004;17(1):112-128. Laschinger HKF, J; Shamian, J. Promoting Nurses' Health: Effect of Empowerment on Job Strain and Work Satisfaction. Nursing Economics. 2001;19(2):42-58. Laschinger HKF, J; Shamian, J. The Impact of Wokplace Empowerment, Organizational Trust on Staff Nurses' Work Satisfaction and Organizational Commitment. Health Care Management Review. 2001;26(3):7-23. Laschinger HKF, J; Shamian, J.; Wilk, P. Workplace Empowerment as a Predictor of Nurse Burnout in Restructured Healthcare Settings. Longwoods Review. 2003;1(3):2-11.
Solution Average CEO Tenure < 7 years Kaplan SNM, B. How Has CEO Turnover Changed? Increasingly Performance Sensitive Boards and Increasingly Uneasy CEOs: National Bureau of Economic Research; August, 2006. Average Department Chair Tenure 9.6 + 7.8 years 37.5% in position > 10 years Kurichi JE, Sonnad SS. Authorship patterns of surgical chairs. Surgery. Feb 2007;141(2):267-271. What if there were term limits?
“We are using imperfect data to perfect perfect-imperfection.” -Mitchell Goldman Resident Work Hours and Improved Safety Tight Glycemic Control Peri-operative Beta Blockade