Article summary
Over the past two decades, women in medicine have made their way to leadership positions, but disparities and challenges remain in qualifying as first authors and speakers and participating in clinical guidelines. . Independent experts discuss the reasons and offer recommendations for addressing the disparities.
The percentage of women in neurology is significantly different than it was decades ago. For example, in 2000, only 19.4% of AAN’s American Neurologist members were women. This will increase her to 37% in 2021, according to AAN membership data. Representation, especially in academic neurology, has also improved. Women made up 27% of her neurology faculty in 2000, according to the Association of American Medical Colleges, but in 2021 she made up 43%.
but, neurology, reflects the remaining challenges in achieving balanced male and female representation in neurological research in research and academic funding, authorship, speaking opportunities, and clinical guidelines. Her COVID-19 in particular has disproportionately impacted women seeking to pursue research careers and activities.
Burden on Female Researchers
In 2018, the AAN Clinical Research Subcommittee decided to investigate anecdotal reports from AAN members on challenges facing neurological researchers. The COVID-19 pandemic hit just as the subcommittee was about to conduct its research, so questions were incorporated about how lockdowns are affecting researchers’ careers. The results reflect the differential impact of the pandemic on researchers who identify as women.
The subcommittee sent a survey of 34 questions to more than 4,000 US-based AAN members who identified themselves as researchers and received 700 responses. Respondents who identified as female reported receiving similar numbers of grants and research support, formal research training and mentoring compared to respondents who identified as male.
However, women had fewer intermediate author publications and were less likely to present at grand rounds and conferences, but these differences almost disappeared when educational background was considered.
“Some of the problems we see in medicine, especially when it comes to women in neurology, are people relying on what they know. It is the same small group of colleagues who rely on each other when asking for help with clinical practice guidelines.In these networks, junior trainees have the opportunity to participate. You can’t, and guidance will open that door.”—DR. Suma Shah
“In a post hoc analysis, we found no difference in publications or public speaking activity at the national level between women and men with ranks below full professors, whereas women with ranks below full professors did not make the grand rounds. Except they are unlikely to attend,” said Deborah A. Hall, MD, PhD, FAAN, first author of the study. “Beyond these results, it is not clear from our results whether lower-ranking women experience more challenges in other areas than similarly-ranking men. may be required.
Women were also less likely than men to report that their chair or department did not discriminate against them and that they were willing to help them with the time they needed away from work. It has also been reported to be low.
Furthermore, the results show that during the COVID-19 pandemic, more women than men reported that family responsibilities hindered their ability to conduct research.
“These data show that women’s responsibilities outside the workplace are different than men’s,” said Hall, Ph.D., chair of the Movement Disorders Division in the Division of Neuroscience at Rush Medical School and co-chair of the study. said. “If you’re trying to get a grant or publish a paper in the same environment, and you’re starting with her 15 hours less hours a week than your competitors, it’s a lot harder.”
Female researchers probably need a different set of resources than men, Dr. Hall said. For example, a program that provides researchers with protected time to write and edit manuscripts could benefit women in particular, she said.
“These data show that women have different responsibilities outside the workplace than men. If you’re starting with 15 fewer hours a week, it’s a lot harder.” —DR. Deborah A. Hall
Lealani Mae Acosta, MD, MPH, an associate professor of neurology at Vanderbilt University School of Medicine, said the results suggest that employers should encourage women to take advantage of opportunities such as providing paid maternity leave, access to reliable and available childcare resources, and flexible parenting. Said it shows what more can be done to support. Consider your family’s needs.
“Women need support from all means to address these disparities,” said Dr. Acosta. “Women historically earn less than their male colleagues, so fair wages are necessary. Societal expectations of the roles of women and men in the home and workplace need to be changed and made fair and realistic. I have.”
Shortage of women in clinical practice guidelines
another neurology This study examined the number of women who produced AAN clinical practice guidelines published between January 2015 and December 2020. The researchers found that of the 68 clinical practice guidelines published during this period, 31% (233) of the physician authors were women. 68% (484) were male and 0.3% (2) could not be identified. According to the results published online on June 9, only 18% of her physician first authors were women. neurology
These differences are important because women may bring a different perspective to clinical care than men.
“Previous literature has shown differences in communication styles between female and male physicians,” says Dr. Ross. “There are even studies showing different results between women and men, such as lower mortality rates associated with female surgeons.”
The study found a lower proportion of women as physician authors when both men and women were first authors (31% vs. 43%). Dr. Ross said the results aren’t surprising because women tend to publish with other women more often. Some of them may be successful,” she said.
To improve representativeness, Dr. Ross incorporates advice for achieving author inclusiveness in publications from federal agencies and medical societies intended to guide the development of rigorous clinical practice guidelines. said it should.
“We hope that those organizations that develop the criteria for rigorous production of guidelines will explicitly encourage inclusion as a goal in the development of their team of guideline authors,” said Dr. Ross. I’m here. “Several strategies for which there is evidence in the current literature are to standardize recruitment practices, promote diversity among team leadership, and incorporate input into recruitment strategies from groups that have traditionally been underrepresented in the medical community. It’s a collection.”
How to support female neurologists
Female neurologists say that the active support of women by institutions and individual colleagues makes all the difference. It may help women who take time away from volunteering for
“Many female neurologists struggle with pregnancy (delaying infertility for a career), parenting, caring for parents and other family members. very helpful if you have [developing guidelines]”—Dr.Mia T. Minnen
“Many female neurologists struggle with pregnancy (we delay infertility for careers), parenting, and caring for parents and other family members,” Mia T. Minen, MD, MPH, FAAN, Associate Professor of Neurology NYU Grossman School of Medicine. “If there is some kind of reward or dedication for this kind of work, it would be very helpful.” [developing guidelines]”
Dr. Minen, author of the American Headache Society guidelines and a member of two AAN guideline development committees, said the AAN has made great efforts to achieve gender parity in guideline development.
“Looking at the gender composition of the AAN Guidelines subcommittee, it’s pretty much gender equal in terms of committee members,” she said.
Dr. Minnen says research published by her and colleagues suggests that other ways to support women in academic neurology include providing flexible schedules and managed time to return patient calls and messages. receiving support from appropriate care providers and arranging meetings during more standard working hours. early in the morning or in the evening.
Neurology has historically been a male-dominated field, so women need mentors to introduce them to opportunities, says assistant professor of neurology at Duke University School of Medicine and co-founder of the Mentorship Group, Duke Women in Neurology. Director Sumah Shah, M.D., said.
“Some of the problems we see in medicine, especially when it comes to women in neurology, are people relying on what they know,” Dr. Shah said. , it is the same small group of colleagues who rely on each other when asking for speakers, asking someone to cooperate with clinical practice guidelines, etc. In these networks, junior trainees participate. Mentorship opens that door for them.”
Dr. Shah said this could be a bigger problem for women, as historically the field has been male-dominated. “Leaders in our field are now training together, getting to know each other and asking each other to join committees and publish research,” she said.
According to Molly McDermott, M.D., clinical associate professor in the University of Michigan Department of Neurology, mentorship relationships involve regular meetings about every two months, with time reserved for both mentors and mentees. and department approval should be given. Medical school.
Emmanuelle Waubant, MD, PhD, FAAN, founder of the International Women in Multiple Sclerosis network, said her group has established partnerships with scientific institutions around the world, increased speaker diversity in scientific programs and review sections, He said he created an international mentoring program. .
“This creates momentum to improve diversity in our field, ultimately benefiting research and patient care,” said Dr. Worbant.
Dr. Hall said there is no better time for university leaders to think about how to improve the pipeline for women, and the survey encourages university doctors to reduce their work hours or quit medicine altogether. He pointed out that this indicates a growing interest in
“There are neurologists who have experienced burnout and are leaving academic neurology,” she said. “I see this as an opportunity for our academic institution to think deeply about clinician scientists and how we can support their careers.”
Disclosure
Dr. Hall is Associate Editor-in-Chief of Neurology Today. Doctor. McDermott and Minen had no disclosures. Dr. Shah received honoraria from Novartis and his EMD Serono. Dr. Waubant received compensation for his Emerald Pharmaceuticals consulting.
