The grand rounds podium is a coveted perch in medicine, a place where clinical leaders showcase their expertise. It’s also a pedestal women don’t reach as often as men.
A new study published in JAMA Internal Medicine on Monday found that women are underrepresented as grand rounds lecturers in a wide range of clinical specialties. In a nationwide sample of medical schools and academic hospitals, a median of 26 percent of speakers were women. Meanwhile, women comprise 47 percent of medical students, 46 percent of residents, and 36 percent of faculty in the US.
“When you don’t see people who look like you, it can cause you to say, ‘This doesn’t look like a field I can thrive in,” said the study’s lead author, Dr. Julie Boiko, a pediatrics resident at the University of California, San Francisco.
These disparities in medicine are also not limited to gender or the lecture circuit: Another JAMA study published Monday found that black and Asian students are less likely than whites to be selected for membership in Alpha Omega Alpha, a prestigious medical honor society.
Boiko, who was a student at the University of Pittsburgh when she did the research on grand rounds, said the gender imbalance lowers the visibility of female leaders and may stifle the ambitions of women in academic medicine. Giving a grand rounds lecture is an opportunity to teach peers about new research and best practices. It’s not merely a boost to one’s ego, it is also an accomplishment to put on a resume and helps physician faculty members win promotions and tenure.
The study is the latest of several to highlight the gender gap in medicine. One recent paper found that women in academic medicine are paid an average of 8 percent less than their male colleagues, while others have found that they are also less likely to get promoted.
A group of researchers at Harvard further underscored the disparity by finding that female doctors achieved better outcomes than males in a large population of Medicare patients.
Dr. Ashish Jha, the author of the latter study, said the unequal treatment of women undermines the quality of care and the quality of medical education, especially in grand rounds lectures. “It’s problematic for the people in the audience because you’re getting a far less diverse set of views,” said Jha, a professor of health policy at Harvard T.H. Chan School of Public Health. “If you have a system that doesn’t encourage new voices, it makes the quality of the grand rounds meaningfully lower.”
He said fixing the imbalance is not difficult: “Organizations need to make a commitment to bringing in more diverse voices. It’s not hard to find totally qualified and competent women.”
In their review of grand rounds lectures, Boiko and her research team analyzed 2014 data on speakers in nine specialities from 79 medical schools and hospitals nationwide. Overall, the researchers analyzed more than 200 grand rounds websites and calendar listings for speaker series, as well as more than 7,000 individual sessions.
The study’s publication comes at a time when female enrollment in medical schools is increasing and many programs are working to create a more diverse and welcoming environment. But Boiko said the study’s findings underscore a simple truth for women in medicine: “We’re still in an uphill battle.”