title: A "ton of feathers": gender discrimination in academic medical careers and how to manage it.
abstract: OBJECTIVE
  To evaluate the experience of gender discrimination among a limited sample of women in academic medicine, specifically, the role of discrimination in hindering careers, coping mechanisms, and perceptions of what institutions and leaders of academic medicine can do to improve the professional workplace climate for women.
  
  
  METHODS
  In-depth, semistructured telephonic individual interviews of 18 women faculty who experienced or may have experienced discrimination in the course of their professional academic medical careers from 13 of the 24 institutions of the National Faculty Survey. A consensus taxonomy for classifying content evolved from comparisons of coding. Themes expressed by multiple faculty were studied for patterns of connection and grouped into broader categories.
  
  
  RESULTS
  Forty percent of respondents ranked gender discrimination first out of 11 possible choices for hindering their career in academic medicine. Thirty-five percent ranked gender discrimination second to either "limited time for professional work" or "lack of mentoring." Respondents rated themselves as poorly prepared to deal with gender discrimination and noted effects on professional self-confidence, self-esteem, collegiality, isolation, and career satisfaction. The hierarchical structure in academe is perceived to work against women, as there are few women at the top. Women faculty who have experienced gender discrimination perceive that little can be done to directly address this issue. Institutions need to be proactive and recurrently evaluate the gender climate, as well as provide transparent information and fair scrutiny of promotion and salary decisions.
  
  
  CONCLUSIONS
  According to this subset of women who perceive that they have been discriminated against based on gender, sexual bias and discrimination are subtly pervasive and powerful. Such environments may have consequences for both women faculty and academic medicine, affecting morale and dissuading younger trainees from entering academic careers. Medical schools need to evaluate and may need to improve the environment for women in academe.
authors.affiliation: Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusett, USA. plcarr@bu.edu
authors.forename: Phyllis L
authors.initials: PL
authors.lastname: Carr
authors.forename: Laura
authors.initials: L
authors.lastname: Szalacha
authors.forename: Rosalind
authors.initials: R
authors.lastname: Barnett
authors.forename: Cheryl
authors.initials: C
authors.lastname: Caswell
authors.forename: Thomas
authors.initials: T
authors.lastname: Inui
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000739:Anecdotes as Topic; D001291:Attitude of Health Personnel; D002321:Career Choice; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008875:Middle Aged; D010822:Physicians, Women / Q000523:psychology; D011287:Prejudice; D012737:Sex Factors; D012938:Social Perception; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce