Recruitment and Retention of
Women to Leadership Positions
in Medicine
Texas Tech University Health Sciences Center
2nd Annual Cultural Competence Seminar
April 12, 2013
Elizabeth L. Travis, Ph.D., FASTRO
Associate Vice President, Women Faculty Programs
[email protected]
www.mdanderson.org/womenfacultyprograms
Women M.D. and Ph.D. graduates
1966-2010
100%
% of graduates
80%
60%
40%
20%
NSF http://www.nsf.gov/statistics/wmpd/tables.cfm and AAMC https://www.aamc.org/data/facts/enrollmentgraduate/
2010
2008
2006
2004
2002
2000
1998
1996
1994
1992
1990
1988
1986
1984
1982
1980
1978
1976
1974
1972
1970
1968
1966
0%
Women Faculty in Medical Schools &
Universities/4-Year Colleges, by Rank and Field: 2010
Women as a % of total faculty
Professor
Associate Professor
Assistant Professor
100%
80%
60%
40%
20%
0%
Medical
Schools
S&E
Biological
scientist
Computer Math scientist
scientist
Physicial
scientist
Psychologist
Engineer
Women, Minorities, and Persons with Disabilities in Science and Engineering: 2013, National Science Foundation (NSF) and
AAMC Women in U.S. Academic Medicine: Statistics and Benchmarking Report (2011-2012)
Women faculty leaders in science and medicine
In NCI-designated cancer centers1 (2012)
• 12% of directors
In medical schools2 (2011)
• 12% of medical school deans
• 14% of department chairs
• 22% of division/section chiefs
In science & engineering3 (2010)
• 29% of presidents, provosts, chancellors
• 30% of deans, department heads and chairs
(1) NCI: http://cancercenters.cancer.gov (2) AAMC: https://www.aamc.org/members/gwims/statistics/
(3) NSF: http://www.nsf.gov/statistics/wmpd/2013/tables.cfm
Other professions: Women represent:
• 18% of the U.S. Congress
- U.S. is 72nd of 189 countries for % of women legislators, behind France,
Germany, Afghanistan and Pakistan
• 20 of 193 (10%) world leaders
• <20% of top positions in business, law, journalism
• 3% of CEOs of Fortune 500 companies
• 5% founders or SAB members in 14 biotech companies
• <10% members of SABs of 500 biotech companies since 1976
- But 10-30% of academically active PhDs
Knowing Your Value: Women, Money, and Getting What You’re Worth, Mika Brzezinski, 2010
Does leadership gender matter?
Departments chaired by women
• 89% (8/9) - gender-balanced
• gender equity across ranks/tenure status
Departments chaired by men
• 30% (13/47) - gender-balanced
BUT
• > 50% are non-tenured and in junior rank
Significant relationship between chair gender and gender ratio
ranking of departments (p=0.004)
Gender-balanced (36% to 67%), Female Minority (18% to 35%) and Female Token (0% to 17%)
MDACC Faculty Academic Affairs (January 09)
Women leaders:
Better suited for the contemporary workplace that values:
• Empowering others
• Collaborations/ Teams
• Sharing information
• Rewarding employees
• Improves the bottom line1:
- Better financial performance for companies
- Diverse backgrounds for committees
- Patients prefer physicians who look like them
(1) The Bottom Line: Connecting Corporate Performance and Gender Diversity, Catalyst, 2004
(2) Cheung FM, Halpern DF, Women at the Top, American Psychologist, April 2010, Vol.65, No.3, 182-193
Why should women want to LEAD?
• Open doors for others (sponsors)
• Signals female friendly culture
• Role model for other women
• Bring unique qualities to the job
Where are the women leaders?
Sr. Associate Dean/
Vice Dean
143 (32%)
Associate Dean
352 (37%)
12% of deans
are women
(N=14)
Assistant Dean
239 (44%)
Why are they not advancing?
Why are they not in senior leadership positions?
How can we change this?
9
Navigating through the labyrinth
“It is not the glass ceiling, but
the sum of many obstacles along the way”
?
Eagly AH, Carli LL., Women and the Labyrinth of Leadership, Harvard Business Review, 2007
Unconscious bias
Implicit biases are:
pervasive
unknown
predict behavior
differ between individuals
People have stereotypic
associations linking
• males with science/careers
• females with liberal arts/family
Harvard Implicit Association Test (IAT)
https://implicit.harvard.edu/implicit/demo
11
Source: Project Implicit, https://implicit.harvard.edu
Unconscious bias and gender schemas
Schema:
Expectations or stereotypes associated
with members of a group that guide
perceptions and behavior.
•
•
•
•
•
Blind auditions
Evaluation of CVs
Evaluation of resumes
Evaluation of job credentials
Evaluation of fellowship
applications
• Letters of recommendation
Critical mass reduces dependence
on schemas (30 - 40%)
STRIDE Program at the University of Michigan, Strategies and Tactics for Recruiting to Improve Diversity and Excellence
Leadership bias
Cultural stereotypes are stacked against women as leaders.
Why? It’s because of behavioral traits.
Women are construed as COMMUNAL,
seen as nice, friendly, socially skilled
and egalitarian.
Agentic
Communal
Men are considered AGENTIC.
They’re described as dominant,
assertive, tough-minded and
take-charge types.
AGENTIC traits are associated with LEADERSHIP
Santovec, Mary Lou. (2010, December). Women’s Metaphor: From ‘Glass Ceiling’ to ‘Labyrinth’. Women in Higher Education, 19(12), 1-2.
Double-bind penalizes women leaders
Women leaders find themselves in a double bind1. If they are:
highly communal → criticized for not being agentic enough
highly agentic → criticized for lacking communion
Do they have “the right stuff” for powerful jobs?
“Think-leader-think-male” mindset2:
Men → largely seen as leaders by default
Women → seen as going against norms of leadership/femininity
i.e. Women can’t win, with men or women!
(1) Eagly AH, Carli LL., Women and the Labyrinth of Leadership, Harvard Business Review, 2007
(2) The Double-Bind Dilemma for Women in Leadership: Damned if You Do, Doomed if You Don’t, Catalyst, 2007
Recruiting women leaders: Policy matters!
• Search committee must be inclusive (35% women/minorities)
• AVP reviews search committee members prior to approval
• AVP serves as voting member on all search committee
Women/minorities on short list sent to the President
WFP role in leadership searches
Be Proactive!
•Provide list of women/minority faculty to serve on search committee
•Identify potential women candidates
•Encourage women to be candidates
•Educate search committees
•Recruit everywhere all the time!
Outcome
Initially had to remind search committee chairs to suggest women
and minority members. No longer necessary!
Lack of women candidates now noted by all committee members,
close to double the number of women leaders in 4 years
RESULT: Number of women leaders more than doubled in 6 years
Increase from 15% (n=12) to 28% (n=27)
Preventing unconscious bias
• Inclusive search committee membership >30% women/minorities
• All key people in search process take IAT test
• Create an objective/structured interview process
• Use behavioral interviewing
• Be aware
-
unconscious bias in letters of recommendation
-
cultural differences affect first impressions of candidates
• Allow time to review candidates, gender bias creeps in when
hurried
Corrice, A. Unconscious Bias in Faculty and Leadership Recruitment: A Literature Review, Analysis in Brief, AAMC, 9(2), August 2009
Grow Your
Own!
Varsha Gandhi, Ph.D.
chair
Sharon Dent, Ph.D.
chair
• Identify them early and groom them
• Career development opportunities
• Mentors and sponsors
Diane Bodurka, M.D.
VP
Stephanie Watowich, Ph.D.
associate dean
Valerae Lewis, M.D.
Elizabeth Grimm, M.D.
section chief
scientific director, Moonshots
Karen Lu, M.D.
chair
Michelle Barton, Ph.D.
Dean, GSBS
Career development programs provide an introduction to the knowledge and
skills needed to succeed in academic medicine locally taught by MDACC
women faculty who attended national career development programs.
Modeled after GWIMS AAMC career development programs
Driver: Needs of women faculty are sufficiently unique to warrant targeted programs
Rationale for in-house program:
• “Pay it forward”/return on investment.
• Past attendees are showcased, practice leadership, hone presentation skills
• Demand is high for AAMC programs: Not all applicants are accepted
• Program costs minimal
Outcome/Impact:
• 50 women faculty attendees, all present at end of 5 hr. workshop
• Program rated very satisfied by attendees
• 100% would recommend to colleagues
Comments from attendees:
• Programming was highly relevant
• Programming allows junior women faculty to feel highly supported
• Participation of executive leaders signaled support of women faculty
Demands of family life
Decision makers often
assume that married
women/mothers have
domestic responsibilities that
make it inappropriate to
promote them to demanding
positions.
Eagly AH, Carli LL., Women and the Labyrinth of Leadership, Harvard Business Review, 2007
A baby or a lab coat?
Half of women with salaries ≥$100K & top executives → NO children
Only 1/3 of women who began research careers w/o children
become mothers
Tenured women are twice as likely as male counterparts to be single
12 yrs after obtaining their doctorates.
Presence of children
Marriage Premium for men
- stability and responsibility
- economic advantage in workplace
Motherhood Wage Penalty for women
- opposite effect
- less $ than comparable women w/o
children and men in general
Cheung FM, Halpern DF (2010) Women at the Top: Powerful Leaders Define Success as Work and Family in a Culture of Gender,
American Psychologist, 65:182-193
A baby or lab coat?
•
•
Women twice as likely as men to not pursue tenure-track
careers if they are have or PLANNING! to have children
No other factor accounts for as much leakage of women from
the research-professor pipeline.
(1) Inequality Quantified: Mind the Gender Gap, Helen Shen, Nature, March 7, 2013
(2) Williams WM and Ceci SJ, When Scientists Choose Motherhood, American Scientist, 100(2), 138, 2012
(3) Goulden, M., K. Frasch and M. A. Mason. 2009. Staying competitive: Patching America’s leaky pipeline in the sciences. Center for
American Progress
Is it a system-level problem?
• Women who have made it and the men who work for
them think that all they need to do is:
— urge young women to be more like them
— think differently
— negotiate more effectively
rather than make major changes
in the way their companies work
• Young women might be much more willing
to lean in if they saw better models and
possibilities of fitting work and life together.
Anne-Marie Slaughter
Balancing the scale:
NSF initiative
• Women comprise a significant
fraction of the STEM talent pool
• They have difficulties in balancing demands of career and life
without adequate institutional support.
• Utilizing women’s talent and potential in STEM fields is critical
to the national’s future success.
NSF’s Career-Life Balance Initiative aims to:
• enhance – and implement new – gender-neutral, family-friendly policies
• eliminate some of the barriers to achieving career-life balance
• engage the academic community in additional actions to integrate the
family and professional responsibilities of scientists and engineers.
Workplace flexibility isn’t just a women’s issue.
It’s an issue that affect the well-being of our families
and the success of our businesses.
-- President Obama
White House Forum on Workplace Flexibility
March 31, 2010
Work-life Balance and the Economics of Workplace Flexibility, Executive Office of the President of the United States, 03/2010
Work life balance!
THEN
NOW
Carol Greider and her children,
Gwendolyn and Charles
Marie Curie and her children,
Iréne and Eve
Nobel Laureate in Physics (1903) and Chemistry (1911)
Nobel Laureate in Physiology or Medicine (2009)
www.nobelprize.org
Two Body Recruits
PROBLEM Couples comprise 32% of medical school faculty
Women more than men consider partners’ careers as primary (21% vs. 5% )
But 50% men vs. 20% of women consider their career primary
Difficulty of finding 2 competitive academic jobs
-
Refuse offers if partners not accommodated
-
Women are less likely than men to seek out new leadership positions
-
Fewer women enter a dual hire as the 1st hire in a couple
RESULT → More difficult to move women
(1) Dual-Career Academic Couples: What Universities Need to Know, Stanford University, Michelle R. Clayman Institute for Gender Research, 2008
(2) Girod et al. Academic Couples: Implications for Medical School Faculty Recruitment and Retention, J Am Coll Surg, 212(3); 310-319, 2010
Recruiting & retaining dual-career couples
Academic couples are more productive and potentially
mobile component of the medical workforce
How do institutions achieve a hiring advantage?
•
Establish guidelines, clear practices/policies
increase transparency, fairness,speed of hiring process
Ask question early in search process regarding dual careers
Are there any challenges we need to be aware of?
How to increase diversity and capitalize on a broader range of
talent in the medical pipeline?
Recruit women and URM as 1st (rather than 2nd) hires
Sponsorship
Levels the Playing Field
“As you move up within an organization,
it’s important to have the sponsorship of someone
who has enough leverage in the organization
to make things happen, otherwise it won’t be effective.
In most senior level jobs,
you need SPONSORSHIP to make it to the very top.”
Elizabeth J. Smith
General Manager
IBM Corporation
30
Source: Hewlett SA, Marshall M and Sherbin L, The Relationship You Need to Get Right, Harvard Business Review. 10/2011
Famous women: Who were their sponsors?
Sarah Palin
(John McCain)
Elena Kagan
(President Obama)
Sponsorship is
Focused on advancement!
Predicated on power!
Active support by someone who
• is highly placed in the organization
• has significant influence on decision-making
processes or structures
• advocates for, protects and fights for the career
advancement of an individual
Foust-Cummings H, Dinolfo S, Kohler J. Sponsoring Women to Success, Catalyst, 2011
Sponsor… Different breed of cat
Mentors
Sponsors
Can sit at any level in the hierarchy
Senior executive with influence
Behind the scenes
Public, sticks neck out
Help envision next move
Opens doors for next move
Passive relationship driven by mentee
Directs/fuels the relationship
Do a better job, solve sticky situation
Focuses on future
Sponsors open doors…
Ibarra H, Carter NM, Silva C. Why Men Still Get More Promotions Than Women. Harvard Business Review. September 1, 2010
Mentor? Coach? Sponsor?
“A coach tells you what to do,
a mentor will listen to you and speak with you,
but
a sponsor will talk about you.”
Kathy Hopinkah Hannan
National Managing Partner
Diversity and Corporate Responsibility
KPMG LLP US
Source: Fostering Sponsorship Success Among High Performers and Leaders, Catalyst, 8/2011
Women are over-mentored and under-sponsored
13% of women have sponsors compared to 19% of men1
Without sponsorship, women are less likely
than men to be appointed to top roles and
more reluctant to go for them2
Men are 46% more likely than women to
have a sponsor1
Although women may be getting support and guidance,
mentoring relationships aren’t leading to
nearly as many promotions for them as for men.
(1) Hewlett, SA et al.Sponsor Effect: Breaking Through the Last Glass Ceiling, Harvard Business Review, 12/2010
(2) Ibarra H, Carter NM, Silva C. Why Men Still Get More Promotions Than Women. Harvard Business Review. 9/1/2010
Measurable Impact of Sponsorship
Women
Unsponsored
Men
Sponsored Unsponsored Sponsored
Asking for a stretch
assignment
36%
44%
43%
56%
Asking for a raise
30%
38%
33%
50%
Overall sponsor benefit on career:
22% to 30%
Hewlett, SA. The Real Benefit of Finding a Sponsor, Harvard Business Review, January 26, 2011
Why do women lack sponsorship?
Individual
fail to build relationship capital
Systemic
would be backers do not come forward
Under-invest in SOCIAL CAPITAL
• Work/life balancing act leaves little time for socializing
with colleagues and building professional networks
• Critical to promotions, particularly to leadership
These influential networks are mostly men----
Social capital may be more important
than other leadership skills/achievements
Eagly AH, Carli LL., Women and the Labyrinth of Leadership, Harvard Business Review, 2007
LEAN IN
• Think big: men are more ambitious
• Women underestimate their performance
• Don’t leave before you leave
• Nobody has it all
• Excuses and justifications won’t get you anywhere
• Success and likeability positively correlated for
men, negatively for women
• Men compromise less than women to “balance”
success and personal fulfillment
Why do women need sponsors?
• Provide women the self-confidence to apply for
challenging assignments
• Help women to truly value their accomplishments and
realize their full potential
• Advocate for and assist women to be proactive in
their pursuit of hot jobs in organization
• Help women to overcome their reluctance to selfpromotion and to assert their competence
• Encourage women to raise a hand for "stretch”
assignments rather than wait to be asked
Needed: More than a few good men!
Leaders matter…
• Encourage top executives to sponsor 2-3 future leaders,
including women.
• Instill a mind-set of “paying it forward,” every woman
sponsored will sponsor others.
• Embed effective sponsorship of women into the profile
of successful leaders at your company
• Show your wider commitment by talking with top
female talent
Source: Barsh J, Devillard S & Wang J. The Global Gender Agenda. McKinsey Quarterly. 11/2012
Sponsorship- A viable option in academic medicine
and science?
• Corporate sponsorship programs producing results
• AHCs can adapt aspects of the corporate model
-
Groom women faculty to compete for “hot jobs” highly visible projects, mission-critical roles,
international experiences
-
Appoint high potential women to key committees
-
Train them to serve as chairs
-
Appoint women to editorial boards of professional
organizations
A Renaissance Man Harold Shapiro, Ph.D.
President Princeton University (1988-2011)
• Identified talented women
• Gave them high-visibility assignments
that broadened their skills and
positioned them to advance
• Encouraged women to ask for what
they deserved
“Giving women chances isn’t just fair, it’s smart
management… You’re overlooking half of the
available talent, and you don’t get the best people
to help you do your job.”
Source: Hymowitz C. Ivy Leaders Thank One Man For Inspiring Women Presidents. Bloomberg Businessweek. 10/12/2012