Evaluating the Role of Self-Esteem on Differential Career Outcomes by Gender in Academic Medicine

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Abstract

Gender differences in faculty advancement persist in academic medicine. Understanding of what drives these differences remains limited. The relationship among self-esteem, gender, and career outcomes has not previously been explored. The authors evaluated the association between gender and 2012–2013 career outcomes, specifically, the number of publications, academic rank, leadership positions, and retention, and whether self-esteem as measured in the 1995 National Faculty Survey mediates this relationship. They measured self-esteem using the modified Rosenberg Self-Esteem Scale. The authors used multivariable logistic regression analysis to understand the association among gender, self-esteem, and the outcomes of rank, leadership, and retention, and negative binomial models for number of publications. Models were adjusted for race, specialty, effort distribution, and years since first faculty appointment. The authors performed a mediation analysis to understand whether self-esteem mediates the relationship between gender and these career outcomes. Overall, self-esteem scores were high. Women had lower self-esteem in 1995 than their male colleagues. In adjusted models, female gender was associated with lower performance on all four career outcome metrics. While self-esteem scores were positively associated with all four outcomes, the authors’ mediation analysis suggested that self-esteem did not mediate the relationship between gender and these 4 career metrics. Female medical faculty members lag behind men on traditional metrics of faculty achievement. While higher self-esteem is positively associated with faculty achievement, it did not mediate the relationship between gender and career advancement over the 17 years of follow-up and, thus, may not be an ideal target for programs and policies to increase gender parity in academic medicine.

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Gender differences in self-esteem: a meta-analysis.

K. C. Kling, J S Hyde, C J Showers … (1999)

Two analyses were conducted to examine gender differences in global self-esteem. In analysis I, a computerized literature search yielded 216 effect sizes, representing the testing of 97,121 respondents. The overall effect size was 0.21, a small difference favoring males. A significant quadratic effect of age indicated that the largest effect emerged in late adolescence (d = 0.33). In Analysis II, gender differences were examined using 3 large, nationally representative data sets from the National Center for Education Statistics (NCES). All of the NCES effect sizes, which collectively summarize the responses of approximately 48,000 young Americans, indicated higher male self-esteem (ds ranged from 0.04 to 0.24). Taken together, the 2 analyses provide evidence that males score higher on standard measures of global self-esteem than females, but the difference is small. Potential reasons for the small yet consistent effect size are discussed.

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The "gender gap" in authorship of academic medical literature--a 35-year perspective.

Reshma Jagsi, Elizabeth A Guancial, Cynthia Worobey … (2006)

Participation of women in the medical profession has increased during the past four decades, but issues of concern persist regarding disparities between the sexes in academic medicine. Advancement is largely driven by peer-reviewed original research, so we sought to determine the representation of female physician-investigators among the authors of selected publications during the past 35 years. Original articles from six prominent medical journals--the New England Journal of Medicine (NEJM), the Journal of the American Medical Association (JAMA), the Annals of Internal Medicine (Ann Intern Med), the Annals of Surgery (Ann Surg), Obstetrics & Gynecology (Obstet Gynecol), and the Journal of Pediatrics (J Pediatr)--were categorized according to the sex of both the first and the senior (last listed) author. Sex was also determined for the authors of guest editorials in NEJM and JAMA. Data were collected for the years 1970, 1980, 1990, 2000, and 2004. The analysis was restricted to authors from U.S. institutions holding M.D. degrees. The sex was determined for 98.5 percent of the 7249 U.S. authors of original research with M.D. degrees. The proportion of first authors who were women increased from 5.9 percent in 1970 to 29.3 percent in 2004 (P<0.001), and the proportion of senior authors who were women increased from 3.7 percent to 19.3 percent (P<0.001) during the same period. The proportion of authors who were women increased most sharply in Obstet Gynecol (from 6.7 percent of first authors and 6.8 percent of senior authors in 1970 to 40.7 percent of first authors and 28.0 percent of senior authors in 2004) and J Pediatr (from 15.0 percent of first authors and 4.3 percent of senior authors in 1970 to 38.9 percent of first authors and 38.0 percent of senior authors in 2004) and remained low in Ann Surg (from 2.3 percent of first authors and 0.7 percent of senior authors in 1970 to 16.7 percent of first authors and 6.7 percent of senior authors in 2004). In 2004, 11.4 percent of the authors of guest editorials in NEJM and 18.8 percent of the authors of guest editorials in JAMA were women. Over the past four decades, the proportion of women among both first and senior physician-authors of original research in the United States has significantly increased. Nevertheless, women still compose a minority of the authors of original research and guest editorials in the journals studied. Copyright 2006 Massachusetts Medical Society.

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Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers.

Shruti Jolly, Kent Griffith, Rochelle DeCastro … (2014)

Female physician-researchers do not achieve career success at the same rate as men. Differences in nonprofessional responsibilities may partially explain this gap.