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CommentaryCreating a Culture of Micro-Affirmations to Overcome Gender-Based Micro-Inequities in Academic Medicine

Creating a Culture of Micro-Affirmations to Overcome Gender-Based Micro-Inequities in Academic Medicine

A woman physician meets with the department chairperson and colleagues to discuss her project ideas. The group agrees that they have transformative potential. The chairperson says to her in front of the group, “With your looks and my brain, we’ll be a great team.” Unable to muster a response to him, she laughs uncomfortably and changes the subject. Several weeks later, the physician presents a patient case at medical rounds. A new colleague mistakes her for a medical student and after realizing the mistake comments, “As a woman, you should be grateful to look so young!” As the physician’s career progresses, she finds herself questioning her ability to lead projects and defers applying for career opportunities because she feels underqualified.

This case vignette highlights an example of gender bias. While versions of these encounters have played out across the globe with growing attention to overt gender bias in the workplace, the more subtle forms of bias—the micro-inequities—are equally important to identify and correct to support women’s advancement in medicine.

Unconscious, or implicit, biases are stereotypes or associations outside of conscious awareness that may lead to a negative evaluation of a person on the basis of irrelevant characteristics, such as gender or race.1 Research demonstrates that health care professionals exhibit similar levels of unconscious associations—both positive and negative—as the wider population, and that these biases may influence the quality of care administered.1, 2 Unconscious bias becomes entrenched in hierarchies of training and clinical practice, insidiously takes root in the workplace, and creates a culture of disadvantage for women in academic medicine. Evidence suggests that unconscious bias regarding gender and race impacts both medical school admissions and workforce recruitment and retention.3 Gender bias is particularly salient when women apply for positions historically occupied by men, and they experience negative stereotypes in the hiring process;4 such biases may contribute to gender-discordant leadership and hinder women’s success.

To read this article in its entirety please visit our website.

-Rose L. Molina, MD, MPHa,b,c, Hope Ricciotti, MDa,b, Lucy Chie, MD, MPHa,b, Rebecca Luckett, MD, MPHa,b,d, Blair J. Wylie, MD, MPHa,b, Ebonie Woolcock, MD, MPHe, Jennifer Scott, MD, MPHa,b,c

This article originally appeared in the July 2019 issue of The American Journal of Medicine.

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