Department of Obstetrics and Gynecology, Institute for Innovations in Medical Education, New York University Grossman School of Medicine, New York, NY, USA.
Pomona College, Claremont, CA, USA.
J Gen Intern Med. 2021 Aug;36(8):2392-2399. doi: 10.1007/s11606-021-06836-z. Epub 2021 May 4.
Gender disparities exist in the careers of women in medicine. This review explores the qualitative literature to understand how gender influences professional trajectories, and identify opportunities for intervention.
A systematic review and thematic synthesis included articles obtained from PubMed, Cochrane Central Register of Controlled Trials (Ovid), EMBASE (Ovid), APA PsycInfo (Ovid), and GenderWatch (ProQuest) on June 26 2020, updated on September 10, 2020. Included studies explored specialty choice, leadership roles, practice setting, burnout, promotion, stigma, mentoring, and organizational culture. Studies taking place outside of the USA, using only quantitative data, conducted prior to 2000, or focused on other health professions were excluded. Data were extracted using a standardized extraction tool and assessed for rigor and quality using a 9-item appraisal tool. A three-step process for thematic synthesis was used to generate analytic themes and construct a conceptual model. The study is registered with PROSPERO (CRD42020199999).
Among 1524 studies identified, 64 were eligible for analysis. Five themes contributed to a conceptual model for the influence of gender on women's careers in medicine that resembles a developmental socio-ecological model. Gender influences career development externally through culture which valorizes masculine stereotypes and internally shapes women's integration of personal and professional values.
Medical culture and structures are implicitly biased against women. Equitable environments in education, mentoring, hiring, promotion, compensation, and support for work-life integration are needed to address gender disparities in medicine. Explicit efforts to create inclusive institutional cultures and policies are essential to support a diverse workforce.
女性在医学职业中的发展存在性别差异。本综述探讨了定性文献，以了解性别如何影响职业轨迹，并确定干预机会。
系统综述和主题综合分析包括 2020 年 6 月 26 日从 PubMed、Cochrane 中央对照试验注册库（Ovid）、EMBASE（Ovid）、APA PsycInfo（Ovid）和 GenderWatch（ProQuest）获得的文章，并于 2020 年 9 月 10 日更新。纳入的研究探讨了专业选择、领导角色、实践环境、倦怠、晋升、耻辱感、指导和组织文化。研究地点在美国以外、仅使用定量数据、在 2000 年之前进行或专注于其他卫生专业的研究被排除在外。使用标准化提取工具提取数据，并使用 9 项评估工具评估严谨性和质量。使用三步主题综合法生成分析主题并构建概念模型。该研究已在 PROSPERO（CRD42020199999）注册。
在确定的 1524 项研究中，有 64 项符合分析条件。五个主题为性别对女性医学职业发展的影响提供了一个概念模型，该模型类似于发展的社会生态模型。性别通过重视男性刻板印象的文化从外部影响职业发展，而从内部塑造女性对个人和职业价值观的整合。
医学文化和结构对女性存在隐性偏见。需要在教育、指导、招聘、晋升、薪酬以及支持工作与生活的融合方面创造公平的环境，以解决医学领域的性别差异。创造包容的机构文化和政策的明确努力对于支持多元化的劳动力至关重要。
