Sex Differences in Faculty Rank Among Academic Cardiologists in the United States

Abstract

Background: Studies demonstrate that women physicians are less likely than men to be full professors. Comprehensive evidence examining whether sex differences in faculty rank exist in academic cardiology, adjusting for experience and research productivity, is lacking. Therefore, we evaluated for sex differences in faculty rank among a comprehensive, contemporary cohort of US cardiologists after adjustment for several factors that impact academic advancement, including measures of clinical experience and research productivity.

Methods: We identified all US cardiologists with medical school faculty appointments in 2014 by using the American Association of Medical Colleges faculty roster and linked this list to a comprehensive physician database from Doximity, a professional networking website for doctors. Data on physician age, sex, years since residency, cardiology subspecialty, publications, National Institutes of Health grants, and registered clinical trials were available for all academic cardiologists. We estimated sex differences in full professorship, adjusting for these factors and medical school-specific fixed effects in a multivariable regression model.

Results: Among 3810 cardiologists with faculty appointments in 2014 (13.3% of all US cardiologists), 630 (16.5%) were women. Women faculty were younger than men (mean age, 48.3 years versus 53.5 years, P<0.001), had fewer total publications (mean number: 16.5 publications versus 25.2 publications; P<0.001), were similarly likely to have National Institutes of Health funding (proportion with at least 1 National Institutes of Health award, 10.8% versus 10.4%; P=0.77), and were less likely to have a registered clinical trial (percentage with at least 1 clinical trial, 8.9% versus 11.1%; P=0.10). Among 3180 men, 973 (30.6%) were full professors in comparison with 100 (15.9%) of 630 women. In adjusted analyses, women were less likely to be full professors than men (adjusted odds ratio, 0.63; 95% confidence interval, 0.43-0.94; P=0.02; adjusted proportions, 22.7% versus 26.7%; absolute difference, -4.0%; 95% confidence interval, -7.5% to -0.7%).

Conclusions: Among cardiology faculty at US medical schools, women were less likely than men to be full professors after accounting for several factors known to influence faculty rank.

Keywords: academic cardiology; policy making; professional development; women; workforce.

Figure 1

Medical School Level Variation in Actual Versus Expected Sex Differences in Full Professorship This figure presents the results of an analysis of adjusted sex differences in full professorship across 109 US medical schools in this analysis. Each bar corresponds to a single US medical school and represents the adjusted difference in proportion of full professors among women versus men. Adjusted sex differences in proportion for each medical school were calculated in the following way: Using the multivariable regression model from the primary analysis, the difference in adjusted proportions of full professorship between women and men for each medical school were estimated as if all cardiologists in the study were affiliated with that medical school. Then, the difference between the observed and predicted sex differences in full professorship for each school was calculated. More negative differences representing greater sex disparities in full professorship.