From a study published on JAMA Network Open, July 5, 2019, by Arghavan Salles, MD, PhD; Michael Awad, MD, PhD; Laurel Goldin, MAet al
Enrollment of women in medical school has been nearly equivalent to that of men in the United States since 1999 and has recently surpassed that of men for the first time.
Despite this apparent equality, as of 2017 only 41% of all faculty and approximately 24% of full professors were women. These gaps are even larger when looking at department chairs: only 14% are women.
Many factors likely contribute to women’s lack of equal representation in medical careers beyond medical school. Perhaps academic medical careers are less interesting or attractive to women than they are to men, or maybe pressures within medical training and academics favor men over women.
Implicit biases, or mental associations outside of conscious awareness or control that influence one’s interactions with others, may hinder the advancement of women in medicine. Sometimes, implicit biases lead people to act in ways that are not in line with their explicit beliefs or values. For example, one may explicitly believe that men and women are equally good at math. However, implicitly or unconsciously, one might be more likely to associate math with men than with women. These biases are shaped by the environment in which we live and are only weakly related to one’s conscious attitudes or beliefs. Importantly, implicit biases are associated with behaviors in socially sensitive contexts, such as interracial interactions.
Question: Do surgeons and health care professionals hold implicit or explicit biases regarding gender and career roles?
Findings: A review of 42 991 Implicit Association Test records and a cross-sectional study of 131 surgeons provided evidence of implicit and explicit gender bias. Data suggest that health care professionals and surgeons hold implicit and explicit biases associating men with careers and surgery and women with family and family medicine.
Meaning: This work contributes an estimate of the extent of implicit gender bias within medicine; awareness of bias, such as through an Implicit Association Test, is an important first step toward minimizing its potential effect.
Conclusion: The main contribution of this work is an initial estimate of the extent of implicit gender bias within health care. Future research could examine implications of implicit gender biases on gender inequality and discrimination. Other research already provides some interventions for addressing gender bias regardless of whether it comes from implicit bias or other sources. For example, increasing transparency of hiring and promotion policies, considering diversity as a performance metric for organizations, and promoting flexible leave all serve to increase the success of female physicians and trainees. Further documentation of implicit associations and other potential psychological obstacles to women’s success will be important for determining the most effective interventions to reduce gender inequality. It is important to also intentionally study the effects of bias on individuals who hold more than one minority identity, such as black or Hispanic women. Such research will benefit current medical students who will become our physicians tomorrow.
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Salles A, Awad M, Goldin L, et al. Estimating Implicit and Explicit Gender Bias Among Health Care Professionals and Surgeons. JAMA Netw Open. Published online July 05, 20192(7):e196545. doi:10.1001/jamanetworkopen.2019.6545