On Getting Promoted as a Woman in Medicine
Author: Jane Zhu, MD
In July, after a nearly year-long process, I was promoted to Associate Professor at my institution. Since joining faculty 5 years ago, and in the midst of a global pandemic, I became a working mom of two young kids, so this honor came at a time when I was reeling from constant demands on my time, mental load, and effort. Because of the structure of my federally funded grant dollars, I only took 4 weeks of maternity leave with my first child, and less than two years later, I took two weeks of leave after my second. Many nights, after my kids have gone to bed, I turn on my laptop to get a few more hours of work done. These are the realities that many early career faculty in academic medicine, particularly women, expect the journey to promotion and tenure will look like.
As a primary care physician and health services researcher, I am naturally drawn to empirical evidence. The evidence reveals persistent uphill battles when it comes to promotion and attrition. One in 5 faculty consider leaving academic medicine altogether, with women physicians leaving academic medicine at higher rates than men at every career stage. Women in medicine are also less likely to hold senior faculty ranks or attain leadership positions than men, earning an estimated $2 million less than male colleagues over a 40-year career.
Studies also show that female physicians lack the same career-building opportunities, sponsorships, collaborators, and role models as their male counterparts. These individuals - mentors, sponsors, and collaborators - serve as a key protective factor against later career attrition when introduced in early-career stages. And these same individuals are also key promoting factors for academic productivity, self-reliance, job satisfaction, and career advancement.
Reflecting on my own experience, I’m lucky to have been, and to continue to be, the beneficiary of a large, diverse, and interdisciplinary network of mentors and collaborators who have helped me onto the career highway when there are sometimes more off-ramps than on-ramps.. One major off-ramp for many early career physicians is family; my new role as a parent to young kids has come with evolving daily challenges, responsibilities, and time demands. In this context, I have had to rely on many people in my network so that my career goals, particularly at this formative early stage, don’t incessantly compete against and conflict with my priorities around family and parenting, though they sometimes still do. My network at work has been critical in sharing not only knowledge and advice, but also sharing in the work load when needed. My network at home - a rolodex of family, friends, and babysitters – has done the same. I would not be able to do this alone.
In many ways, those of us in academic medicine are unique in the multiplicity of our missions – we are purveyors of knowledge, we are researchers and educators, and we deliver clinical care. We are also people with families, hobbies, and passions outside of medicine. For these reasons, mentors, sponsors, and collaborators become even more important for early-career women physicians, because they help to cushion shocks, introduce opportunities, and optimize efficiencies when navigating the inherent tensions between professional success and family commitment. I am lucky to have a research career that gives the gift of time – that is forgiving of life interruptions and offers day to day flexibility. But this is not true for everyone, and because of that, we need people and institutional policies that support early career physicians, particularly those who historically have been left behind in the promotion and tenure process.
About the Author: Jane M. Zhu, MD, MPP, MSHP, is a primary care physician and newly minted Associate Professor of Medicine in the Division of General Internal Medicine at Oregon Health & Science University. A health policy researcher, Dr. Zhu's work centers on health care access and quality, as well as the effects of provider incentives and organization on health care delivery.
