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British Journal of Anaesthesia
BJA

A mentoring circle supports women anaesthesiologists at every career stage

Open ArchivePublished:January 22, 2020DOI:https://doi.org/10.1016/j.bja.2019.12.014

      Keywords

      Editor—In 1849, Elizabeth Blackwell became the first woman to have an American medical degree conferred upon her. Since the Second World War, the number of women in medicine has increased steadily.
      • Chandrabose R.V.
      • Pearson A.C.S.
      Organizing women in anesthesiology.
      Comprising only 9% of the total number of students in USA medical schools in 1969, women now account for more than half of medical students. Despite these growing numbers, gender inequity is still prevalent in today's medical workforce,
      • Chandrabose R.V.
      • Pearson A.C.S.
      Organizing women in anesthesiology.
      especially in positions of leadership. This disparity is prevalent across medical schools worldwide.
      • Mottiar M.
      • McVicar J.
      A call to action: gender equity in Canadian anesthesiology.
      Australian and New Zealand College of Anaesthetists. Gender equity metrics.
      • Dinner L.
      • McGlennan A.
      The gas ceiling.
      Men hold a disproportionate percentage of dean and department chair roles. An April 2019 report by the Association of American Medical Colleges shed light on the severity of the gender imbalance in academic medicine.
      Association of American Medical Colleges. Faculty Roster.
      In 2018, across all USA-based medical schools and specialties, 75% of full professors were men, and only 12.9% of women were full professors. Among all department chairs, 2656 (82%) were men and only 618 (18%) were women.
      Association of American Medical Colleges. Faculty Roster.
      Similar to other medical specialties, anaesthesiology has a disproportionate gender representation in leadership. Women represent 35% of the 8826 full-time anaesthesiology faculty across USA medical schools.
      Association of American Medical Colleges. Faculty Roster.
      Of these, 1217 (14%) are full professors but only 8% of women achieved this rank. The disparities in leadership extend to the highest levels. Of the 123 anaesthesiology department chairs in the United States, only 16 (13%) are women.
      Association of American Medical Colleges. Faculty Roster.
      Participation of women in medical education and in leadership mirrors that in other countries. More than 50% of Canadian medical students are women. Forty-two percent of Canadian anaesthesiologists are women, but only 18% are full professors.
      • Mottiar M.
      • McVicar J.
      A call to action: gender equity in Canadian anesthesiology.
      In Australia, New Zealand, and the UK, the leadership disparities among anaesthetists are similar; only 9% of academic women anaesthesiologists are full professors in the UK,
      • Dinner L.
      • McGlennan A.
      The gas ceiling.
      and 24% of department heads in New Zealand and Australia are women.
      Australian and New Zealand College of Anaesthetists. Gender equity metrics.
      Women face unique barriers to career advancement in academic medicine. They take on a majority of family responsibilities, thereby stretching their range of responsibility and cognitive load.
      • Gotian R.
      Why you need a support team.
      Implicit gender bias by those in supervisory roles may also contribute to the obstacles women face.
      • Carnes M.
      • Bartels C.
      • Kaatz A.
      • Kolehmainen C.
      Why is John more likely to become department chair than Jennifer?.
      Hiring practices tend to overestimate men's and underestimate women's performance.
      • Carnes M.
      • Bartels C.
      • Kaatz A.
      • Kolehmainen C.
      Why is John more likely to become department chair than Jennifer?.
      As a result, men are hired or promoted based on their perceived potential, whereas women are often hired and promoted based on their past track record. This may be particularly problematic for women at the start of their careers.
      • Johnson W.B.
      • Smith D.
      Athena rising: How and why men should mentor women.
      The time and urgency to cultivate our women faculty has never been more vital.
      Mentorship, when one person or a group of people help another person achieve their full potential, has been cited as one of the most influential factors in helping women achieve leadership roles within academic medicine.
      • Chandrabose R.V.
      • Pearson A.C.S.
      Organizing women in anesthesiology.
      However, women face more barriers than men in securing mentorship. With the increase of early career women in anaesthesiology, there is an opportunity to decrease gender disparities. This is a team effort that requires all faculty of all genders and ranks to work together to develop mentoring programmes and opportunities within their departments that are specific to their own needs and circumstances. We offer several mentoring possibilities that could be enacted by all genders.
      A community of practice, a group of people doing the same type of work, provides an excellent form of peer mentorship. In 2019, four women in leadership positions (two division chiefs, one vice chair, and one chief learning officer) at the Weill Cornell Medicine Department of Anesthesiology in New York City, created the Women's Mentoring Circle. The Circle, open to all genders, was established in order to discuss and offer solutions and support to the problems pervasive to women anaesthesiologists. Having a support team, people who understand one's unique stressors and opportunities, is critical for a feeling of belonging while reducing the feeling of isolation.
      • Gotian R.
      Why you need a support team.
      Women learn to amplify each other's voices, share opportunities, and discuss challenges, such as scheduling and work–life balance.
      The initiative was successful, and additional supportive avenues, such as other sessions and communication channels, were developed by additional faculty members. A risk of such an undertaking is the minority tax,
      • Kali D.C.
      Medical education and the minority tax.
      in which minority faculty members may be burdened with extra responsibilities in the name of diversity.
      • Kali D.C.
      Medical education and the minority tax.
      This problem is generations in the making and it is not up to today's women to solve it on their own. Doing so is an undue burden, and the feeling of support and elation will quickly disintegrate as one realises that time needed for one's own research and publishing is diminished.
      A paucity of women in senior roles means that junior women cannot always look to senior women for mentorship. Men in senior roles should mentor women, encouraging women to embrace opportunities, offering stretch assignments, using their social and political capital to introduce them to people of influence, and sponsoring them.
      One mentor offers only one perspective, so there is benefit to having a team of mentors who can offer guidance, perspective, skill, and an expanded network.
      • Carnes M.
      • Bartels C.
      • Kaatz A.
      • Kolehmainen C.
      Why is John more likely to become department chair than Jennifer?.
      Although it may be unreasonable to physically assemble a group of mentors, the mentee should actively reach out to each mentor, either in person or virtually, and formally or informally. A diverse group of mentors is critical in order to diversify perspectives. One's mentoring team should include all genders and non-anaesthesiologists.
      • Jarrett V.
      Finding my voice: my journey to the west wing and the path forward.
      Men and women alike can amplify the voices of women. They can reiterate that they appreciate an idea and thank the woman for first raising it. When women are given awards, are invited to give talks, or are awarded grants, leaders should publicly acknowledge their achievements in person and via social media. This will reduce women's feelings of imposter syndrome, encouraging them and others as well.
      The dearth of female academic anaesthesiologists in leadership roles and senior faculty positions will not be solved overnight, but the pipeline is expanding. Taking proactive strides is a step toward putting women in control of their careers and promotion opportunities. Mentoring of women should not be bound to any one gender or career stage. Between individual and group mentoring, there are opportunities for people of any gender and rank to support and promote the development of women anaesthesiologists.

      Declarations of interest

      The authors declare that they have no conflicts of interest.

      Funding

      Weill Cornell Medicine Department of Anesthesiology (Mentoring Circle activities).

      References

        • Chandrabose R.V.
        • Pearson A.C.S.
        Organizing women in anesthesiology.
        Int Anesthesiol Clin. 2018; 56: 21-43
        • Mottiar M.
        • McVicar J.
        A call to action: gender equity in Canadian anesthesiology.
        J Can Anesth. 2019; 66: 755-756
      1. Australian and New Zealand College of Anaesthetists. Gender equity metrics.
        (Available from:)
        • Dinner L.
        • McGlennan A.
        The gas ceiling.
        R Coll Anaesth Bull. 2015; 98: 24
      2. Association of American Medical Colleges. Faculty Roster.
        (Available from:)
        http://aamc.org/data/facultyroster/
        Date accessed: January 6, 2020
        • Gotian R.
        Why you need a support team.
        Nature. 2019; 568: 425-426
        • Carnes M.
        • Bartels C.
        • Kaatz A.
        • Kolehmainen C.
        Why is John more likely to become department chair than Jennifer?.
        Trans Am Clin Climatol Assoc. 2015; 126: 197-214
        • Johnson W.B.
        • Smith D.
        Athena rising: How and why men should mentor women.
        Taylor and Francis Group, New York, NY2016
        • Kali D.C.
        Medical education and the minority tax.
        JAMA. 2017; 317: 1833-1834
        • Jarrett V.
        Finding my voice: my journey to the west wing and the path forward.
        Penguin Random House, New York2019