Why Women Leave Academic Medicine

Phoebe S. Leboy was, she acknowledges, one of the lucky ones. It's not that things were easy for female scientists when she came of age as an academic in the 1960s and 1970s; women earned a small fraction of the Ph.D.'s in biology and chemistry at the time, and they were an even rarer presence on medical or dental school faculties (Leboy was the first woman promoted to a tenured faculty position at Penn's dental school).

Things may well be tougher for female basic scientists now, though, Leboy told a gathering of researchers and others Wednesday at a Washington area meeting of the Association for Women in Science, of which she is the president-elect. The picture is better in some key ways: In stark contrast to the physical sciences, where women remain severely underrepresented in degree programs and as doctoral candidates, women have largely gained parity in the early parts of the biological sciences pipeline. They earn nearly half of all Ph.D.'s awarded in fields such as cell and molecular biology, and they are getting jobs as postdocs and as entry-level non-clinical professors at respectable if not nearly equitable rates.

But the positives fade at later points in the process, where women are increasingly leaving academe in droves, Leboy said at the gathering of the association's Bethesda chapter, held at the National Institutes of Health's National Library of Medicine. "You've got postdocs who don't end up in tenure track positions, tenure track professors who don't get tenure, and tenured professors who don't end up to be department chairs, deans, and the like.

"It's not that they don't come into the field," she said. "It's that they're dropping out because the pipeline gets so clogged with crud that you can't get through it if you're a woman."

Is "crud" just another term for the sex discrimination that Larry Summers got into trouble for saying didn't exist for female professors? No, Leboy said. While overt bias does exist, she said, she seemed to lay the later-stage leaks in the academic biomedicine pipeline much more at the feet other sorts of obstacles, most notably a raising of the expectations bar that affects both genders but hurts women disproportionately.

Like any good scientist, she started with the data to reveal the perceived problem. Citing statistics she had collected on the composition of faculties at 24 medical schools in 2006, she found that in fields such as cell biology, biochemistry and and neuroscience, the proportion of female assistant professors lagged the Ph.D. pool in the disciplines from a decade earlier by anywhere from 10 to 15 percentage points.

Focusing on seven of the most elite medical schools -- those at Harvard, Johns Hopkins, Penn, Stanford, the University of Washington, Washington University in St. Louis, and Yale -- she found that "they are not doing a whole lot of hiring of junior [female] faculty at all," and those that they are hiring aren't staying. Five of the seven biochemistry departments, and four of the six cell biology programs, at those schools have no junior women, Leboy's study found. At Penn's own medical school, the number of female assistant professors in the basic sciences had dropped from 14 a decade ago to four now (representing a net loss in women, since the number of tenured female professors had risen to 23 from 18).

Why are women appearing to drop out of the pipeline early in their medical school faculty careers? Leboy attributed the problem largely to a set of obstacles that make the life "unattractive." She ascribed some of it to the traditional explanation of family-unfriendly policies such as tenure clocks that coincide with child-bearing years, a culture of early and late meetings that are difficult for parents to make, and leave policies that are improving but still insufficient.

But perhaps more interestingly, Leboy explained how the rising "expectations and criteria for success" for non-clinical researchers in the biomedical science are having a disproportionate effect on women.

The average male researcher, according to NIH data Leboy cited, has 1.4 basic research project grants, compared to slightly less than 1.3 for women. While men and women earn new NIH grants at roughly the same rate, women get "consistently fewer" competing renewals grants than men do. And for every dollar a male primary investigator receives, women get 80 cents.

Female researchers earn 42 percent of the NIH's lower-level "career development" awards, which is about the rate one would expect given the rate at which they earn doctorates. But they get 25 percent of regular research grants and less than 20 percent of the bigger "center" and small business innovation research grants that the NIH is increasingly emphasizing. And only 17 percent of NIH-funded research centers at medical schools have women as their primary investigator, Leboy's research shows.

Most of the other criteria used in assessing performance -- number of publications, numbers of collaborators and of graduate students and postdocs, invitations to speak and to present at national and international conferences -- are tied in one way or another to the grant levels, said Leboy, who noted that she earned tenure with seven publications. As the bar for all of them keeps rising -- Leboy recounted one female assistant professor being told by her department chairman, 'You know, quality is no substitute for quantity,' drawing a pained chuckle from the audience -- "women are very sensibly avoiding tenure track positions in academic health centers," she said. "If they get there, they are abandoning them, either because they're told they can't succeed, or they perceive that they can't succeed."

Leboy said she had been unable to do enough solid research to conclude whether women are leaving the scientific enterprise altogether, or just ditching academe. One "sloppy" experiment she did suggested the latter: a look at the speakers invited to the major cell biology and neuroscience scholarly meetings found that women were appearing at roughly the rate in which one would expect based on their representation in the field, even as other numbers suggest that they have already dropped off of medical school faculties. "That suggests they're still in research, out there working and publishing." Exactly where isn't clear, although industry, research positions at academic institutions, and the NIH are possibilities.

Those are perfectly acceptable places for female scientists to work, Leboy said. But ensuring that women work in academic medicine is crucial, she said, because it "really impacts the next generation" of potential biologists and faculty members, who are likelier to stay in the field if they see role models in their classrooms."

"That's one reason why it's important to focus excessively on keeping women in academia," she said.