Gender and Pathways to Leadership in Academic Anesthesiology: A Qualitative Content Analysis of US Chairpersons' Curricula Vitae.

BACKGROUND: Women are underrepresented in medicine and academic anesthesiology, and especially in leadership positions. We sought to characterize career achievement milestones of female versus male academic anesthesiology chairs to understand possible gender-related differences in pathways to leadership. METHODS: We conducted a retrospective observational cross-sectional analysis. In November 2019, curricula vitae (CVs) were requested from then-current members of the US Association of Academic Anesthesiology Chairs. Data reflecting accomplishments up to the time of chair appointment were systematically extracted from CVs and analyzed using a mixed methods approach with qualitative content analysis supplemented by descriptive statistics and bivariate statistical testing. Missing data were not imputed. RESULTS: Seventy-two CVs were received from eligible individuals (response rate 67.3%). The respondent sample was 12.5% women (n = 9), 87.5% men (n = 63), and no transgender or nonbinary people; this is similar to the known gender balance in anesthesiology chairs in the United States. No statistically significant differences in objective markers of academic achievement at the time of chair appointment were evident for female versus male chairs, including time elapsed between the first faculty appointment and assumption of the chair role (median 25 vs 18 years, P = .06), number of publications at the time the chair was assumed (101 vs 69, P = .28), or proportion who had ever held a National Institutes of Health (NIH) grant as principal investigator (44.4% vs 25.4%, 0.25). Four phenotypes of career paths were discernible in the data: the clinician-administrator, the educator, the investigator, and the well-rounded scholar; these did not differ by gender. CONCLUSIONS: Female chairpersons who were members of the Association of Academic Anesthesiology Chairs in the United States demonstrated similar patterns of academic achievement as compared to male chairpersons at the time the position of chair was assumed, suggesting that they were equally qualified for the role as compared to men. Four patterns of career achievements were evident in the chairperson group, suggesting multiple viable pathways to this leadership position.

Development and Implementation of a Clinician-Educator Track for Residents in Anesthesiology.

Background: Clinician-educators in academic settings have often had no formal training in teaching or in giving feedback to trainees. We implemented a Clinician-Educator Track within the Department of Anesthesiology with the initial goal of improving teaching skills through a didactic curriculum and experiential opportunities for a broad audience of faculty, fellows, and residents. We then assessed our program for feasibility and effectiveness. Methods: We developed a 1-year curriculum focusing on adult learning theory, evidence-based best teaching practices in different educational settings, and giving feedback. We recorded the number of participants and their attendance at monthly sessions. The year culminated in a voluntary observed teaching session using an objective assessment rubric to structure feedback. Participants in the Clinician-Educator Track then evaluated the program through anonymous online surveys. Qualitative content analysis of the survey comments was performed using inductive coding to generate relevant categories and identify the main themes. Results: There were 19 participants in the first year of the program and 16 in the second year. Attendance at most sessions remained high. Participants appreciated the flexibility and design of scheduled sessions. They very much enjoyed the voluntary observed teaching sessions to practice what they had learned throughout the year. All participants were satisfied with the Clinician-Educator Track, and many participants described changes and improvements in their teaching practices due to the course. Conclusions: The implementation of a novel, anesthesiology-specific Clinician-Educator Track has been feasible and successful, with participants reporting improved teaching skills and overall satisfaction with the program.

Misconceptions about women in leadership in academic medicine.

Despite progress made over the past decade, women are under-represented in positions of leadership in academic medicine. Women physicians face numerous challenges throughout their careers. Despite achieving leadership positions, women in leadership continue to experience the impact of those challenges. In this review, we describe four misconceptions about women in leadership, along with their impact and recommendations. First, we describe differences between mentorship and sponsorship, as well as their impact on attaining leadership positions. Second, the gender pay gap persists throughout women's careers, regardless of leadership positions. Third, we explore the role of self-efficacy in leadership in the context of stereotype threats. Fourth, gendered expectations of leadership characteristics place an undue burden on women, detracting from their leadership effectiveness. Organizations can address the challenges women face by creating robust mentorship and sponsorship networks, establishing transparent and equitable pay policies, promoting and normalizing a broader range of leadership styles, and improving work flexibility and support structure. Ultimately, such changes serve all members of the organization through increased retention and engagement.

RéSUMé: Malgré les progrès réalisés au cours de la dernière décennie, les femmes demeurent sous-représentées dans les postes de direction en médecine universitaire. Les femmes médecins font face à de nombreux défis tout au long de leur carrière. Malgré leur accession à des postes de direction, les femmes occupant ces postes continuent de subir l'impact de ces défis. Dans ce compte-rendu, nous décrivons quatre idées fausses sur les femmes en position de leadership, ainsi que leur impact et quelques recommandations. Tout d'abord, nous décrivons les différences entre le mentorat et le parrainage, ainsi que leur impact sur l'accession à des postes de leadership. Deuxièmement, l'écart de rémunération entre les sexes persiste tout au long de la carrière des femmes, quels que soient les postes de leadership. Troisièmement, nous explorons le rôle de l'auto-efficacité dans le leadership dans le contexte des menaces stéréotypées. Quatrièmement, les attentes genrées à l'égard des caractéristiques recherchées dans le leadership imposent un fardeau indu aux femmes, ce qui nuit à l'efficacité de leur leadership. Les organisations peuvent relever les défis auxquels les femmes sont confrontées en créant de solides réseaux de mentorat et de parrainage, en établissant des politiques salariales transparentes et équitables, en promouvant et en normalisant un éventail plus varié de styles de leadership et en améliorant la flexibilité du travail et les structures de soutien. En fin de compte, de tels changements servent tous les membres de l'organisation grâce à une rétention et une implication accrues.

Women in anaesthesia: a scoping review.

Despite an increase in the proportion of women anaesthesiologists over time, women remain under-represented in academic and leadership positions, honour awards, and academic promotion. Current literature has identified several reasons for the observed gender disparity in anaesthesiology leadership and faculty positions, including unsupportive work environments, lack of mentorship, personal choices, childcare responsibilities, and active discrimination against women. A scoping review design was selected to examine the nature and extent of available research. Our review provides an overview of the literature that explores gender issues in anaesthesiology, identifies gaps in the literature, and appraises effective strategies to improve gender equity in anaesthesiology. We searched PubMed, MEDLINE, and EMBASE up to July 2019, and included 30 studies for analysis. Most reports used retrospective or survey methodologies. The review shows that women anaesthesiologists face gender biases in the work environment, are under-represented in various positions of leadership or influence, and as authors. Work-life demands may impose a challenge. Motivation and interest in career advancement of women anaesthesiologists have not been well studied. Several strategies have been proposed, ranging from an individual to administrative level, which may help anaesthesiologists achieve equal representation of women in the field.