Eyeworld

Dr. Chang: Nearly half of U.S. med- ical students and ophthalmology residents are women. Why do you believe that most women are not en- tering academic ophthalmology? Dr. O'Brien: I believe that compared with pediatrics or obstetrics for ex- ample, the history of women achiev- ing senior academic rank is more recent in ophthalmology. This lack of success breeds more of the same. Dr. Day: We all respond to mentors around us. There are few women to serve as examples, but there are some men who recognize the need to support women as well as others who have not been given leadership opportunities. I was fortunate in having people such as Bruce Spivey encourage me to get involved in ac- tivities that could evolve into leader- ship positions. Academic ophthalmology is within a broader world of academia, where, just as in our specialty, there are few women deans or chancel- lors. People tend to be promoted in such environments who have achieved in research, scholarly activ- ity, and even fundraising activities. I believe the more feminine traits that (at the risk of stereotyping) favor lis- tening over speaking, seeking com- promise over control, regarding a "W" as a team effort rather than an individual accomplishment will have their day to shine; we just aren't there yet. I would encourage any person EW Ophthalmology Business 51 The shortage of women in academic ophthalmology August 2011 I n my July Corner of the world column, we explored the issue of gender bias with the three female chairs of our ASCRS cataract, refractive, and retina committees. The question was whether this is a significant contributing impediment to the ascent of women leaders in business and medicine. A recent paper from the University of Pennsylvania and Scheie Eye Insti- tute examined the shortage of academic women leaders specifically in ophthalmology. 1 By con- ducting a survey of chairs and program direc- tors, the authors examined potential factors behind the disproportionately low representation of women in academic chair and faculty posi- tions. They reported that the number of female ophthalmology chairs (<3%) is remarkably low compared to the national average across all other specialties (11%) and compared to the number of female ophthalmology full professors (14%). This low representation occurred despite the rise in the percentage of female ophthalmol- ogy residents from 28% in 1996 to 39% in 2007. In other words, this is not simply for lack of a "pipeline." I asked Joan M. O'Brien, M.D., chair of ophthalmology at Scheie Eye Institute, and Deepika N. Shah, M.D., the principal paper au- thor, to summarize the study and its implica- tions. Along with Dr. O'Brien, who was previously vice-chair at UCSF, I asked three other promi- nent department chairs—Joan W. Miller, M.D., Susan H. Day, M.D., and Eve J. Higginbotham, M.D.—for their thoughts. Dr. Miller has been chair of ophthalmology at the Massachusetts Eye and Ear Infirmary and Harvard Medical School since 2003. She received the 2010 Harvard Medical School Leadership Award for the Advancement of Women Faculty and the 2010 Suzanne Veronneau-Troutman Award from Women In Ophthalmology. Dr. Day has been chair of ophthalmology at the California Pacific Medical Center since 2000. She became the first female president of the American Academy of Ophthalmology in 2005 and is the immediate past president of the Association of University Professors of Ophthalmology. Dr. Higginbotham became the nation's first female ophthalmology chair when she was named to this position at the University of Maryland in 1994. She is now dean of Health Sciences, including the medical school, at Howard University. Reference 1. Shah DN, Volpe NJ, Abbuhl SB, Pietrobon R, Shah A. Gender characteristics among academic ophthalmology leadership, faculty, and resi- dents: results from a cross-sectional survey. Ophthalmic Epidemiol. 2010 Jan-Feb;17(1):1-6. David F. Chang, M.D., chief medical editor who chairs a program committee, has a departmental leadership role, or who is otherwise involved in select- ing participants to proactively seek out those who traditionally have been less well represented. Once se- lected, it is the participant's job to re- spond to the task at hand, to do a superlative job, and to make it obvi- ous to all that talents are coupled with willingness. Though perhaps not fair, we all know that breaking glass ceilings carries with it a greater responsibility. If in doubt, listen to Jackie Robinson's story. Dr. Higginbotham: The same issues impact women in ophthalmology that others face in other disciplines as they consider a career in acade- mia. Listed in the paper were issues such as lack of role models, the societal bias against women in lead- ership positions in academic medi- cine, and loss of women to the workforce due to the pull toward the traditional roles related to caregiving and raising of families that women retain. I would add the lack of op- portunities for women to develop the necessary skills to become quali- fied to excel in administrative roles. For example, women are often asked to serve on committees focused on education or mentoring. I suggest that we recommend that women serve on committees related to fi- nance and institutional policy, where the power resides. Women are not encouraged to stay in academia to the same extent as men, and the barriers for advanc- ing are often greater. In general, based on AAMC data, there is about 50% faculty turnover in 10 years, with women, particularly those who are junior faculty, among those leav- ing at the fastest pace. Dr. Miller: It is not clear from the ar- ticle that fewer women than men are currently entering academic ophthal- mology, although it is true that the overall percentage of women faculty is lower than their male counterparts. One would need to compare rates of entry to junior faculty positions rather than overall percentages of fac- ulty. However, it is true that women shoulder more of the caregiver role than men, whether that is elder care or child care, and this may impact their view of an academic career. Both men and women may be reluc- tant to pursue academic careers as they consider debt related to under- graduate and medical school educa- tion, the vagaries of research funding, and the demands of an aca- demic career. They must balance these concerns against the rewards of an academic career, including clinical and research innovation, and educat- ing the next generation. Department chairs need to consider the support provided to junior faculty, including financial support, family leave, men- toring, and faculty development, elements that are crucial to both women and men. Dr. Chang: This survey of ophthal- mology programs found that 34% of residency program directors, 28% of faculty, and 45% of residents are women. How important is it to have female mentors and role models within academic medicine? Dr. O'Brien: I think it is very impor- tant. Women's lives are different from men's lives. Successful women negotiating these differences can teach a new generation to do the same. Dr. Day: Mentors (or perhaps better yet, women-tors) are critical. No one is better to tell it like it is than some- one who has been there, done that. Whether it is solving the bal- ance between vocation and personal life, guiding a person to know when continued on page 52 Susan H. Day, M.D. Eve J. Higginbotham, M.D. Joan W. Miller, M.D. View Ophthalmology Business online at www.OphthalmologyBusiness.org

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