Title:Persistence and Progress for Women in Academic Medicine

Georgetown organization fosters a collegial, supportive community of female faculty in pursuit of equity.

Above: Georgetown Women in Medicine (GWIM) President Kristi Graves hopes to bring more visibility to female leaders through the organization’s new “Women on the Walls” campaign.

What spurred one professor to travel around the globe to provide medical care in Cameroon? Her life-changing experience as one of the first presidents of Georgetown Women in Medicine (GWIM). The organization offers a supportive community of women colleagues at Georgetown University Medical Center who inspire each other to reach their goals.

After she became involved with the group, Professor of Medicine Marilee Cole, MD, had an awakening. “I felt empowered to take a closer look at myself and ask: Are you where you want to be professionally?” she recalls. “The answer was absolutely no. I was part-time and on the lowest rung as an instructor. So the next year, encouraged by the support of my stellar female colleagues, I decided to fulfill my professional dream— to work in Africa.”

In 1998, she traveled throughout Zimbabwe and Tanzania, and finally settled in Cameroon. There she worked with an organization to improve medical care in the region, and wrote an HIV/AIDS protocol that impacted one third of all Cameroonians.

In 2004, she created the Georgetown Global Health Elective, bringing three residents with her each year to Cameroon. Developing the elective “was and remains the highlight of my professional career,” Cole says. The inspiration and drive to pursue the opportunity came directly through her involvement with GWIM.

“Just name all the GWIM presidents—they’re my best friends at Georgetown,” she adds. “They’re my support and I’m their support.”

An all-volunteer organization dedicated to the professional advancement of women faculty at Georgetown University Medical Center (GUMC), GWIM aims to establish policies and a working environment that promote equality and diversity in hiring, promotion, and compensation throughout the Medical Center. The organization offers engagement opportunities for faculty across the GUMC sectors: School of Medicine, School of Nursing & Health Studies, and Biomedical Graduate Research. Cole and a group of colleagues, including GWIM’s first president, Terry Taylor, MD, founded the organization in 1994 and called it the Society of Medical Women Faculty. In 2005 the group became GWIM (pronounced to rhyme with “swim”).

Because GWIM’s support and encouragement was life-changing for Cole, she now returns the favor by mentoring others: she consults faculty at other universities to develop similar elective programs and is advising Kacie Saulters, MD, assistant professor of medicine and director of the school of medicine’s Global Health Track, to further expand the elective to include physicians from multiple disciplines.

“It all comes from GWIM’s efforts,” Cole says. “By helping others, it turns out I was really helping myself.”

Gender inequities in academic medicine

This isn’t to say that her path in medicine has been easy. Like many women in academic medicine, Cole faced obstacles to her career advancement.

A nationwide study published earlier this year in the Journal of the American Medical Association reports that women physicians in academic medicine are less likely than men to become full professors—11.9 percent versus 28.6 percent. Another study found that start-up funding packages, which help to launch academic careers, on average are more than two-thirds higher for men ($980,000) than for women ($585,000). A third study showed that women physicians in academic medicine are paid 8 percent less than men.

National disparities manifest in various forms at different institutions, ranging from differences in career progress and pay, to work cultures that exhibit gender biases.

Initiatives such as GWIM have driven significant progress at Georgetown in recent years. At the dean level today, a full two-thirds—16 of the School of Medicine’s 24 deans—are women. Nationally, only 16 percent of medical school deans are women, according to the Association of American Medical Colleges (AAMC). Of the full-time faculty at Georgetown University Medical Center, which includes the School of Nursing & Health Studies, 37 percent are women (688 of 1846)—close to the national average of 38 percent. Twelve percent of the Medical Center’s department chairs are women, tracking similarly to AAMC’s national rate of 15 percent.

GWIM has also focused on creating a more inclusive work culture at Georgetown, seeking to develop an environment that supports women’s careers and proactively addresses issues of bias. Susan Cheng, senior associate dean for the Office of Diversity and Inclusion, says GWIM “thoughtfully cultivates the role of mentorship,” noting professional development efforts, such as a regularly occurring speaker series, that bring attention to women’s advancement in medicine.

Recently, in partnership with Cheng, GWIM has worked to increase awareness of unconscious bias, including its effect on hiring, promotion, and talent retention. Through speakers, on-campus trainings, and off-site trainings run by the AAMC, GWIM has been at the forefront of efforts to raise awareness of the issue within Georgetown’s medical community.

Judy Huei-Yu Wang, PhD, associate professor of oncology, and immediate past vice president of basic science for GWIM, notes the impact of these efforts but signals that more work remains. “How do we continue to put that training into action?” she asks. “How can clinicians translate bias training into their practices?”

Local children join Marilee Cole and two members of the visiting medical team from Georgetown. The residents begin their month-long Global Health Elective by shadowing a Cameroonian physician.

GWIM’s founding and progress

This spirit of persistence and the commitment to equity have characterized GWIM since its founding.

It all began in 1992 in the department of medicine. Its new chair, John Eisenberg, MD, formed multiple task forces to look at how the department functioned. Two members of the department (who would later become GWIM’s first two presidents), Taylor and Cole, joined the task force on tenure and promotion. Over the course of the committee’s yearlong effort, Cole recalls, they were struck by the inequities they identified.

Noting that Eisenberg’s goal was “to uncover and address inequities,” she says that she received a salary adjustment as a result of the task force’s work. As a busy physician and educator, it was the first time she had stopped to consider the possibility that she was making less than her male counterparts. “I wasn’t thinking about it; I was thinking about taking good care of my patients.”

At around the same time, a guest lecturer from the AAMC addressed a group at the Medical Center about similar inequities nationwide. When considering the progress of her own career, Cole found the national statistics eye-opening. “That was a wakeup—an epiphany—for me,” she recalls. “I always thought my lack of progress had to do with me and nothing else. But I came to see it wasn’t my issue in particular but a gender issue nationwide.”

Taylor approached Cole about forming an ongoing committee to further study and address this issue, and with Eisenberg’s support, they did.

Word spread across the medical school and colleagues from other departments expressed interest in joining their efforts. Taylor and Cole expanded the focus from their department to the entire medical school, forming the organization that would later become GWIM, in 1994.

“It was an exciting time,” says Bonnie Green, PhD, professor emeritus of psychiatry. “We felt empowered to accomplish things together, but it was also a time when we felt that women were at a disadvantage in the medical environment. It could feel like an uphill battle.” Still, she notes, the camaraderie among her colleagues created a powerful momentum.

On the national stage

In 2003, in recognition of the progress of GWIM’s first decade, the AAMC awarded the organization its annual Women in Medicine and Science Leadership Development Award.

“It put us on the national stage,” recalls Cole. “But we could see so much that we hadn’t yet done.”

One sign of progress was the university and school administration’s official support of and commitment to GWIM and its priorities. According to Cole, “everyone recognized that if women weren’t fostered and promoted to the limits of our abilities, then everyone was losing out. We were a resource that was just not being utilized.”

GWIM received the prestigious award again in 2014, making it the first and only entity in the nation to be twice recognized by the AAMC for work fostering the advancement of women in medicine.

Strategic focus

Even as GWIM achieves progress, its list of issues to address remains long. GWIM’s immediate past president, Stacey Kaltman, PhD, professor of psychiatry, instituted the practice of setting three strategic priorities for the organization each year. This helps organize its efforts and benchmark progress.

Under current president Kristi Graves, PhD, associate professor of oncology, last year’s strategic priorities were mentorship, leadership equity, and procedural justice—for example, having clear and transparent institutional processes regarding how decisions are made, and how resources are distributed.

This academic year, the group’s priorities are visibility, outreach, and policy. The emphasis on visibility will take the form of showcasing women in leadership positions within the Medical Center, and highlighting the importance of having women in visible roles. GWIM hopes to expand outreach to let more women faculty know about the organization, particularly those with faculty appointments who may work at offsite clinics or hospitals. For policy, the group plans to work with faculty governance to create official guidelines that promote gender equity in search, hiring, and promotion.

Wall-worthy women

To support its priorities in recent years, GWIM sponsors programming, speakers, and awareness campaigns—including the “100 Current Women Professors” campaign, to encourage the School of Medicine to reach the milestone of having 100 women full professors active on the faculty. To support this goal, GWIM helped institute formal one-toone coaching and encouraged women to apply for promotion to professor. The medical school reached and celebrated the 100-women-professor milestone in 2016.

This year, GWIM is launching the “Women on the Walls” campaign, which aims to install more portraits of women along the halls of the Medical Center. Graves says she sees this campaign “as a complement to last year’s theme of leadership equity, where we highlighted the fact that not enough women are in leadership positions. But this year, we are highlighting the need to recognize women who have been successful in leadership positions.”

Seeing more women on the walls offers a tangible way to inspire future female leaders, says Graves. “Having a role model helps others see opportunities for themselves in leadership.” Further underscoring its efforts to provide visibility and recognition for women’s career development, GWIM also hosts an annual event to present three main awards.

The John Eisenberg Career Development Award is given to four women faculty who demonstrate leadership potential and are selected to attend the AAMC’s Women Faculty Professional Development Seminar.

The Estelle Ramey Mentorship Award honors both women and men faculty who have provided outstanding encouragement, support, and mentorship for women faculty. It is named for the legendary endocrinologist and physiologist who called Georgetown home for decades (see page 25).

The Karen Gale GWIM Outstanding Achievement Award is given to a woman faculty member who has demonstrated outstanding achievement through her research, education or service, who is recognized at a national or international level, and who has contributed to the Georgetown community—three qualifications exemplified by the award’s namesake.

GWIM held a reception in September to recognize two recently appointed women chairs at the Medical Center: Michelle A. Roett, MD, MPH (M’03), in the department of family medicine, and Edilma L. Yearwood, PhD, in the department of professional nursing practice in the School of Nursing & Health Studies.

Community and camaraderie

In addition to the more formal achievements, many GWIM members express gratitude for the community and friendships it has brought them.

Years ago, colleagues from the early GWIM leadership started meeting monthly to discuss the group’s progress and direction. More than a decade later, that monthly meeting has become a monthly dinner amongst friends who share common passions, interests, and goals. The dinners emphasize the spirit of collegiality fostered by GWIM—the personal friendships it has facilitated and the professional collaborations it has enabled.

“We push each other,” says former GWIM president Miriam Toporowicz, MD, MPH, professor of pediatrics. “We push women to get promoted, to gain leadership skills, to get into positions of power, regardless of who they are—and they bring that experience with them whether they stay at or leave Georgetown.” Rhonda Friedman, PhD, professor of neurology, and another former president of GWIM agrees, pointing out the importance of women supporting women across departments, and fostering connections among the faculty employed by both the university and MedStar Health.

Mentorship and support thrive in the GWIM community, and differences are embraced, says Alfiee Breland-Noble, PhD, associate professor of psychiatry. She points to her friendship with her mentor, the late Karen Gale, PhD, professor of pharmacology. Gale was a previous co-president of GWIM, and to this day is remembered as a force who encouraged many to join the organization.

Breland-Noble recalls how Gale approached their relationship from the very start. “Right away, Karen shared with me her passion for social justice. It was the guiding force behind her passion for GWIM.” She says they spoke frankly about their different perspectives: Gale as a white woman, and Breland- Noble as a woman of color. They acknowledged their different experiences and perspectives, and worked to support each other as women in medicine.

Current president Graves values the sense of community GWIM offers. “Some of the things I appreciate most about GWIM include the camaraderie, knowing there’s someone else you can speak to about career development concerns, and recognizing the fantastic diversity of women and their accomplish – ments. GWIM has a ‘family feeling’ of sorts—a sense of culture, connection, and community,” says Graves.

“GWIM has helped define my career at Georgetown. I love the science and education I do, but I’m equally passionate about raising awareness around equity for women in academic medicine. GWIM is the true home for this work,” Graves says. “I really value and appreciate that—and the work that has come before me. It’s an honor that the leadership of the Medical Center now looks to GWIM as a partner for input and recommendations.”

Nady Golestaneh, PhD, MS, GWIM president-elect and assistant professor of ophthalmology, neurology, biochemistry, and cellular and molecular biology, echoes Graves: “Due to the efforts of the GWIM founders, presidents, and officers, today GWIM is recognized as a part of the Medical Center. We’ve seen progress but we still have a long way to go. We’re acknowledging the shortcomings, which is the first step.”

Taking a long view, she adds: “I’m happy to believe that this work can help the next generation of women at Georgetown—and anywhere else.”