A. Raj is Tata Chancellor Professor of Society and Health, professor of education studies, and director, Center on Gender Equity and Health, University of California, San Diego School of Medicine, San Diego, California. T. Kumra is assistant professor of pediatrics, codirector, Longitudinal Ambulatory Clerkship, and medical director, Remington Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. G.L. Darmstadt is associate dean for maternal and child health and professor of neonatal and developmental medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California. K.M. Freund is professor of medicine and vice chair for faculty affairs and quality improvement, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts.
Acad Med. 2019 Nov;94(11):1658-1664. doi: 10.1097/ACM.0000000000002877.
In this Perspective, the authors review Association of American Medical Colleges data on gender parity and intersectionality, consider the literature on gender parity in academic medicine and the underlying gender norms that explain these statistics, and offer recommendations for moving past indicators of parity to achieve gender and social equality.Improvements in gender parity among medical school graduates have not translated to gender parity among practicing physicians or medical school faculty, particularly for racial/ethnic minorities. Further, gender parity does not correspond to gender equality, such that gender-based disparities in salaries and advancement persist. In addition, social norms related to traditional gender role expectations reinforce existing biases and lead to sexual harassment and discrimination against women in the workplace.Building on their analysis of existing data and the literature, the authors offer concrete recommendations to achieve gender equality in academic medicine that not only improve parity but also support policies and practices to address the norms that further bias and discrimination. These recommendations include the collection, monitoring, and open reporting of data on salaries as well as on sex and race/ethnicity; stronger policies related to family leave and sexual discrimination and harassment; and accountability structures to ensure that policies are enforced. While these efforts alone cannot eliminate gender inequalities, academic medicine should be at the forefront of creating a climate in medicine that is supportive of gender equality as part of their larger goal of promoting social equality.
在这篇观点文章中,作者回顾了美国医学院协会关于性别均等和交叉性的数据,考虑了学术医学中性别均等的文献以及解释这些统计数据的潜在性别规范,并提出了超越均等指标以实现性别和社会平等的建议。医学院毕业生中的性别均等状况的改善并没有转化为执业医生或医学院教师中的性别均等,特别是对于少数族裔。此外,性别均等并不等同于性别平等,因此工资和晋升方面的基于性别的差距仍然存在。此外,与传统性别角色期望相关的社会规范强化了现有的偏见,并导致工作场所对女性的性骚扰和歧视。基于对现有数据和文献的分析,作者提出了在学术医学中实现性别平等的具体建议,这些建议不仅可以提高均等性,还可以支持解决进一步产生偏见和歧视的规范的政策和实践。这些建议包括收集、监测和公开报告薪酬以及性别和种族/族裔的数据;与家庭休假、性别歧视和性骚扰有关的更强有力的政策;以及问责制结构,以确保政策得到执行。虽然这些努力本身并不能消除性别不平等,但学术医学应该处于创造支持性别平等的医学氛围的前沿,这是其促进社会平等的更大目标的一部分。