Gender diversity in academic medicine
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4076 (Published 26 October 2020) Cite this as: BMJ 2020;371:m4076Linked Analysis
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Dear Editor
Thank you for publishing this editorial which highlights the ongoing gender imbalance among medical academics. The author's final paragraphs on the differences between male and female responses to competitive stress have really hit home. I am somewhat late to the academic game, having my first formal academic post in my final year of GP training. I am often reminded about the competitive nature of securing NIHR fellowships and sometimes I feel myself 'freezing' and 'folding,' wondering if I should just walk away now because I am unlikely to be good enough compared to my peers who might have come through academic Foundation Programme or ACF posts. This editorial (and some subsequent correspondence with the author) has motivated me to acknowledge these feelings for what they are: a stress response and not a reflection of my capabilities as a researcher.
Competing interests: No competing interests
Dear Editor
Many publishers, including BMJ, have given Open Access to Covid-19 articles as part of a global initiative. The pandemic has thrown a specific focus on racism and gender diversity, yet BMJ does not offer Open Access on articles such as these. Is there a reason for this?
Competing interests: No competing interests
The Law of Unintended Consequences: diversity in clinical-academia after removal of academic achievements from foundation programme applications
Stewart-Brown [1] highlights numerous barriers continuing to limit gender diversity in clinical-academia. Although there have been positive changes in recent years, we are far off achieving true equity in those engaging in research and pursuing clinical-academic careers [2]. Initiatives to engage and support those from a broader range of backgrounds must continue to be strongly encouraged.
In December 2020, the UK Foundation Programme Office (UKFPO) announced proposals to remove points for additional degrees and publications from foundation programme applications [3]. The stated rationale is to reduce potential inequality experienced by individuals from lower socioeconomic backgrounds - an underrepresented group in medicine [4], and undoubtedly in clinical-academia. However, this remains poorly studied, with minimal evidence published.
Medical students do experience significant barriers to gaining academic competencies [5], and financial burden is an important potential source of inequity. Yet the personal and professional benefits outweigh this for many students, even those from lower socioeconomic backgrounds. Furthermore, intercalation represents one of the few intracurricular opportunities for students to gain exposure and mentorship in clinical-academia, and can be a major factor in the decision to pursue a clinical speciality or the clinical-academic pathway [6]. Efforts should be geared towards motivating and supporting students to pursue research opportunities, rather than removing existing incentives.
So far, the unilateral decision to proceed with this course of action has been met with concern [3], and it remains unclear why educational achievements will be removed rather than promoting inclusivity through widening the scope considered. We call on the UKFPO to perform and publish an urgent impact assessment of this decision, prior to any implementation. Steps to address structural barriers to equity in clinical-academia are paramount, however these must not have unintended consequences of widening the inequities observed in clinical-academia further.
References:
1) Stewart-Brown S. Gender diversity in academic medicine. BMJ. 2020; 371: m4076
2) Medical Schools Council. Clinical academic survey. Medical Schools Council. [Internet]. Medical Schools Council. 2019 [cited 2020 Dec 12]. Available from: https://www.medschools.ac.uk.
3) Medical Schools Council. MSC Statement on the UKFPO decision to remove Educational Achievements from the Foundation ranking process. [Internet]. 2020 [cited 2020 Dec 12]. Available from: https://www.medschools.ac.uk/news/msc-statement-on-the-ukfpo-decision-to....
4) White C. Just 4% of UK doctors come from working class backgrounds. BMJ. 2016;355:i6330.
5) STARSurg Collaborative. Medical research and audit skills training for undergraduates: an international analysis and student-focused needs assessment. Postgrad Med J. 2018. 94(1107):37–42.
6) Morrison J. Academic medicine and intercalated degrees. Med Educ. 2004;38(11):1128–9.
Competing interests: No competing interests