Using the Professional Curriculum Vitae to Tackle Pandemic-Related Inequities
Authors: Avital O’Glasser, MD; Shikha Jain, MD; Vineet Arora, MD
Keywords: curriculum vitae, CV, professional development, COVID-19 pandemic, gender equity, mommy tax, minority tax
Now past the one year mark, the COVID-19 pandemic had permanently altered the healthcare landscape and created unimaginable challenges. It has directly threatened the physical safety, as well as mental and emotional safety, of healthcare workers. It has dramatically reshaped how physicians work, utilize their time outside of work, educate their children, and care for their families while keeping them safe. And as the pandemic persists, so too do exhaustion, burnout, and ongoing disruptions to careers and personal lives.
Many physicians work in academic centers, with expectations for annual productivity in addition to direct patient-care responsibilities--frequently, though not exclusively, scholarly productivity including publications, research, and presentations at medical conferences and other academic institutions. Some institutions implement “promotion deadline decisions”, sometimes also known as “up or out” structures that require benchmarks to be met within a certain number of years of employment as a condition for retainment. Additionally, our colleagues outside of traditional academic medicine may strive for scholarly productivity or other professional development goals.
These criteria can be challenging to meet most years--and the COVID-19 pandemic added significant stress to these preexisting pressures. At the work environment level, physicians were deployed to inpatient services during surges, outpatient practices had to rapidly transition to telehealth, and new leadership and advocacy roles required time and attention. Outside of the immediate work environment, childcare challenges including rapid shifts to home-schooling diverted time and energy away from academic bandwidth.
The pandemic has disproportionately negatively affecting working mothers including women physicians, including (but not limited to) a decrease in publications, more at-home responsibilities, and home-schooling responsibilities. Women remain disproportionately affected by its economic impact and burden on personal responsibilities. The preexisting “mommy tax”, as well as the “minority tax” and the “second pandemic” of structural racism, have only been compounded.
In the early Spring months of the pandemic, our group (including two male allies) recognized that it was more critical than ever to ensure that pivots, novel work, and other academic disruptions be captured on the professional CV. We created the “COVID-19 Curriculum Vitae Matrix”. In articles published in the Journal of Hospital Medicine and Proceedings of the National Academy of Sciences, we expound on our rationale and motivation for this tool.
The matrix includes multiple categories of contributions, helping the user articulate both ADDED efforts in response to the COVID-19 pandemic and lost/modified professional opportunities:
Direct clinical contributions
Research
Education
Service and volunteerism
Advocacy
Social Media
Women in medicine are uniquely threatened by the COVID-19 pandemic, which promised to stall and even setback progress towards gender equity. A “she-cession” in academic medicine would lead to “a lost generation of women falling off the path”, reducing work hours, or leaving medicine altogether.
For decades, publication volume and subsequent number of citations have been the currency of promotion and tenure pathways in academia. Prior to the pandemic, there were signs that alternative and non-traditional promotion benchmarks were being considered and debated. We hope that this matrix spurs additional conversation about what defines meaningful and impactful contributions within medicine. While we developed the matrix to support gender equity in medicine, we hope that all colleagues will benefit from the open-minded conversations it generates. But the work will still require discussions and discussions--just last month, a new publication revealed women’s CVs were rated lower than men’s CVs, even when they were identical.
When the time comes, we cannot move past the COVID-19 pandemic and return to “prior state”. Amidst the suffering and struggles, we must harness the innovations, pivots, and lessons learned. We hope that a new recognition of the need to broaden the definition of what “counts” in academic and non-academic medicine, along with a means to articulate that, is a lasting outcome of academic medicine’s response to the pandemic.
About the Authors: Avital O’Glasser, MD, is a hospitalist at Oregon Health & Science University and the editor of the WIMS blog (Twitter: @aoglasser). Shikha Jain, MD, is an oncologist at the University of Illinois at Chicago and the founder of the Women in Medicine Summit (Twitter: @ShikhaJainMD; Vineet Arora, MD, is a hospitalist and the Dean of Medical Education at the University of Chicago (Twitter: @FutureDocs)
