By Nancy Spector, MD
The phenomenon of women experiencing invisibility is not new. History has often erased the contributions of women.
We are told the story of the world within a framework that highlights the achievements of men and that ignores the contributions – and sometimes even the existence – of women. For women with intersectionality, including Black women, Asian and Pacific Islander women and Latina women, the phenomenon can be even more pronounced. So, it should come as no surprise that we find in medicine the risk of invisibility for women (Lewiss, et al, 2020).
When a woman in medicine is not recognized for her accomplishments, she falls behind not only in her career trajectory but also in the building of wealth through increased compensation..
When women in medicine are invisible, they do not rise to leadership positions, which means that the institutional culture – and the ensuing priorities and funding – remains dominated by men and the lens through which they view the world.
Women become invisible because of barriers and inequities as well as micro-and macroaggressions. Black women in medicine experience this invalidation in heightened ways, as Onyinyechi Eke and the co-authors of “Black Women in Medicine – Rising Above Invisibility” write in the Lancet: “Despite exceptional merits and accolades, today there still exists a cognitive dissonance when a Black woman physician is in a leadership position. In medical institutions, evidence of this can be subtle; the consulting team might request to speak to the attending physician and then communicate through verbal and non-verbal behaviours [sic] their surprise at discovering that the attending physician is a Black woman” (2021).
But these roadblocks can be addressed. Leaders can intervene with a top-down approach designed to improve the status of women in their respective organizations, as Reesa E. Lewiss and her co-authors noted in “Is Academic Medicine Making Mid-Career Women Physicians Invisible?” Leaders – not the women who are impacted by the structural inequities – are charged with this work. Interventions can include gender bias training, mentorship and sponsorship and leadership trainings as well as speaker, author and editorial board invitations.
In “A Targeted Intervention for the Career Development of Women in Academic Medicine,” the authors report that institutional financial support for the research efforts of women junior faculty during the child-rearing years resulted in positive outcomes among grant recipients. Gains included increased rates of retention and promotion, optimistic career outlook and success in using the awards as seed funding for later grants.
Other institutional strategies, as outlined in Julie K. Silver’s “Her Time is Now Report,” include changing the criteria for faculty promotions to place a high value on scholarly and community work in diversity, equity and inclusion (DEI). The goal is to ensure that promotions committees are not only diverse but are also financially prioritizing DEI and focusing on DEI as a core component of professionalism.
Making women in medicine visible will take commitment and transparency from leaders of our institutions, professional societies, journals and organizations. We need policies and accountability, and we need them now..
- Eke, O., Otugo, O., Isom, J. (2021 February 13) Black Women in Medicine – Rising Above Invisibility. https://doi.org/10.1016/S0140-6736(21)00302-0
- Lewiss, R.E. Silver, J.K., Bernstein, C.A., Mills, A.M., Overholser. B., Spector, N.D. (2020 February 7) Is Academic Medicine Making Mid-Career Women Physicians Invisible? Journal of Women’s Health. https://DOI.org/10.1089/jwh.2019.7732
- Jagsi, R., Butterton, J.R., Starr, R., Tarbell, N.J. (2007 February 26) A Targeted Intervention for the Career Development of Women in Academic Medicine. Archives of Internal Medicine. https://dx.doi.org/10.1001/archinte.167.4.343
- Her Time Is Now Report. Version 2. (2020 September 1) https://sheleadshealthcare.com/wp-content/uploads/2020/09/HerTimeIsNow_Report.pdf
Nancy D. Spector, MD
A Professor of Pediatrics and serves in dual roles at the Drexel University College of Medicine (DUCOM): as Executive Director of the Hedwig van Ameringen Executive Leadership in Academic Medicine® (ELAM®) program, a part-time, year long, national leadership fellowship program for women in academic medicine, dentistry, public health, and pharmacy; and as Vice Dean for Faculty. Known for her leadership abilities and her facilitation skills, Dr. Spector is sought after as a speaker and a visiting professor. Her contributions to graduate medical education and academic medicine are in leadership skills development, professional development, gender equity and mentoring and sponsorship as well as curriculum development and implementation. She is a member of PROWD (Promoting and Respecting Our Women Doctors). She has been the educational leader of the I-PASS Handoff Study Group and serves as the Chair of the I-PASS Executive Council and is a co-founder of the I-PASS Safety Institute.
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