Department of Sociology, Brandeis University, Waltham, Massachusetts 02454, USA.
J Womens Health (Larchmt). 2010 Apr;19(4):799-805. doi: 10.1089/jwh.2009.1591.
Research on barriers to professional advancement for women in academic medicine has not adequately considered the role of environmental factors and how the structure of organizations affects professional advancement and work experiences. This article examines the impact of the hierarchy, including both the organization's hierarchical structure and professionals' perceptions of this structure, in medical school organization on faculty members' experience and advancement in academic medicine.
As part of an inductive qualitative study of faculty in five disparate U.S. medical schools, we interviewed 96 medical faculty at different career stages and in diverse specialties, using in-depth semistructured interviews, about their perceptions about and experiences in academic medicine. Data were coded and analysis was conducted in the grounded theory tradition.
Our respondents saw the hierarchy of chairs, based on the indeterminate tenure of department chairs, as a central characteristic of the structure of academic medicine. Many faculty saw this hierarchy as affecting inclusion, reducing transparency in decision making, and impeding advancement. Indeterminate chair terms lessen turnover and may create a bottleneck for advancement. Both men and women faculty perceived this hierarchy, but women saw it as more consequential.
The hierarchical structure of academic medicine has a significant impact on faculty work experiences, including advancement, especially for women. We suggest that medical schools consider alternative models of leadership and managerial styles, including fixed terms for chairs with a greater emphasis on inclusion. This is a structural reform that could increase opportunities for advancement especially for women in academic medicine.
针对学术医学领域女性职业发展障碍的研究尚未充分考虑环境因素的作用，以及组织的结构如何影响职业发展和工作经历。本文探讨了等级制度（包括组织的等级结构和专业人员对该结构的看法）对医学院校组织中教师成员在学术医学领域的经历和晋升的影响。
作为对美国五所不同医学院校教师进行的一项归纳定性研究的一部分，我们对处于不同职业阶段和不同专业的 96 名医学教师进行了深入的半结构化访谈，了解他们对学术医学的看法和经历。对数据进行编码，并按照扎根理论的传统进行分析。
我们的受访者认为，基于系主任任期不确定的主席等级制度是学术医学结构的一个核心特征。许多教师认为这种等级制度会影响包容度，降低决策的透明度，并阻碍晋升。系主任任期的不确定性减少了人员流动，可能会成为晋升的瓶颈。男性和女性教师都能感受到这种等级制度，但女性认为它的影响更大。
学术医学的等级结构对教师的工作经历，包括晋升，有重大影响，尤其是对女性。我们建议医学院考虑替代的领导模式和管理风格，包括主席任期固定，并更加注重包容度。这是一项结构性改革，可以为学术医学领域的女性，特别是为女性提供更多晋升机会。
