学术性医院医学中的性别问题：对医院医生领导者的全国性调查。
Gender Issues in Academic Hospital Medicine: a National Survey of Hospitalist Leaders.
作者信息
Herzke Carrie, Bonsall Joanna, Bertram Amanda, Yeh Hsin-Chieh, Apfel Ariella, Cofrancesco Joseph
机构信息
Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 8-134, Baltimore, USA, MD, 21287.
Emory University School of Medicine, Atlanta, GA, USA.
出版信息
J Gen Intern Med. 2020 Jun;35(6):1641-1646. doi: 10.1007/s11606-019-05527-0. Epub 2020 Mar 3.
BACKGROUND
Gender inequities are documented in academic medicine. Within General Internal Medicine (GIM), there are fewer female division directors and first and last authors on publications. With gender parity in US medical school graduates and with Academic Hospital (AH) medicine being a relatively newer discipline, one might postulate that AH would have less gender inequity.
DESIGN
A national survey of AH programs was developed via literature review and expert recommendations. Domains included program and faculty information. Gender of the leader was determined via website or telephone call.
PARTICIPANTS
Leaders of AH programs associated with the American Association of Medical Colleges (AAMC). Programs without a primary teaching hospital or hospitalist program and those not staffed by university-affiliated physicians were excluded.
MAIN MEASURES
Description and characteristics of leaders and programs including a multivariable analysis of gender of hospitalist leaders and the portion of female faculty.
KEY RESULTS
59% response rate (80 of 135); there were no differences between responders/non-responders in NIH funding (p = 0.12), type of institution (p = 0.09), geographic region (p = 0.15), or year established (p = 0.86). Reported number of female and male faculty were approximately equal. 80% of hospitalist leaders were male; 37% of male hospitalist leaders were professors, no female leaders were professors. In univariate and multivariate analysis only the number of hospitals staffed was a significant predictor of having a female hospitalist leader. There were no significant predictors of having fewer female faculty.
CONCLUSION
This study demonstrated gender inequality in academic hospital medicine regarding leadership and rank. Though there was equal gender distribution of faculty, among leaders most were men and all "full professors" were men. As diversity benefits the tripartite mission research on methods, initiatives and programs that achieve gender equity in leadership are needed.
背景
学术医学领域存在性别不平等现象。在普通内科（GIM）中，女性科室主任以及出版物的第一作者和最后作者较少。鉴于美国医学院毕业生的性别比例均等，且学术医院（AH）医学是一门相对较新的学科，有人可能会推测AH的性别不平等现象会较少。
设计
通过文献综述和专家建议开展了一项针对AH项目的全国性调查。调查领域包括项目和教员信息。通过网站或电话确定负责人的性别。
参与者
与美国医学院协会（AAMC）相关的AH项目负责人。没有主要教学医院或住院医师项目的项目以及没有大学附属医生任职的项目被排除在外。
主要指标
负责人和项目的描述及特征，包括对住院医师负责人性别和女性教员比例的多变量分析。
关键结果
回复率为59%（135个中的80个）；在国立卫生研究院（NIH）资金（p = 0.12）、机构类型（p = 0.09）、地理区域（p = 0.15）或成立年份（p = 0.86）方面，回复者与未回复者之间没有差异。报告的男女教员数量大致相等。80%的住院医师负责人为男性；37%的男性住院医师负责人为教授，没有女性负责人是教授。在单变量和多变量分析中，只有配备人员的医院数量是有女性住院医师负责人的显著预测因素。女性教员较少没有显著的预测因素。
结论
本研究表明，在学术医院医学的领导地位和职级方面存在性别不平等。尽管教员的性别分布均等，但在负责人中大多数是男性，所有“正教授”都是男性。由于多元化有利于三方使命，因此需要开展关于实现领导地位性别平等的方法、举措和项目的研究。
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