#KeyLIMEPodcast 286: Time to Walk the Talk

Reference

Balmer et. al., Applying the Theory of Gendered Organizations to the Lived Experience of Women with Established Careers in Academic Medicine. Teaching and Learning in Medicine. 2020 May 27;1-10.

Reviewer

Lara Varpio (@LaraVarpio)

Background

• Gender inequality is a system level problem. We have many papers in the field that talk about how women are paid less, aren’t promoted at the same pace, are disadvantaged in regards to authorship, mentorship, harassment, and family responsibilities. The literature talks about the coping strategies that women develop to deal with that, but the problem remains a systems level problem.

Purpose

• In this paper, the research team examines gender inequity from perspective of organizations like academic medical centers.
• To do that the team uses the theory of gendered organizations.

Key Points on the Methods

• Inductive qualitative research study that explored the lived experiences of women who had established careers in academic medicine at one academic medical center (American, urban, private institution with over 2,600 full time faculty members, of which 40% were women).
• They recruited women who were at the later stages of their careers, who held MDs or PhDs.
• Interviews were semi-structured. In the first cycles, they asked questions about career experience but did not ask explicitly about gender inequity because they didn’t assume that it would necessarily reflect the participants’ experiences at the medical center.
• In the second cycle, because the participants consistently brought it up, they did ask about gender inequity explicitly
• In this paper, they do what is called theory-informing inductive data analysis:
  • Start: descriptive coding, and they wrote memos to describe different dimensions of the codes

Key Outcomes

• The participants described how the formal expectations set out in the academic medical center promoted gender equity, but the informal workplace interactions that participants had were FAR from equal
• The promotion criteria at the center were clearly laid out and scholarship was the primary factor for advancement—that was the formal expectation. BUT, informally, the system privileged men. To fight this, the women had to disrupt the inequity by building arguments for the need for equality and by acting as levers for change for other women when they had the seniority to do so
• Salary. Again the academic medical center had equal opportunity policies. So the formal policy was one of equality. But, informally, women were held back. Participants had to advocate for equitable salaries for themselves and others, and they are calling for transparency to know that policy of equality is actually in place.
• Becoming savvy to the inequities later in their careers. They were too busy when they were juniors to realize the inequity. As the women gained experience, they learned that the formal expectations were not being met in informal interactions with the organization.

Key Conclusions

• While academic medical centers need formal policies that promote equality across genders, those formal policies are NOT enough. The inequality gets pushed to informal interactions where people representing the organization create inequality. We need to focus on how formal policies are enacted. That’s what matters if we want to create change.

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