Promotion of women physicians in academic medicine. Glass ceiling or sticky floor?

Objective. —To assess possible explanations for the finding that the percentage of women medical school faculty members holding associate or full professor rank remains well below the percentage of men. Design. —Cross-sectional survey of physician faculty of US medical schools using the Association of American Medical Colleges (AAMC) database. Subjects. —Surveyed were 153 women and 263 men first appointed between 1979 and 1981, matched for institutions of original faculty appointment. Main Outcome Measures. —Academic rank achieved, career preparation, academic resources at first appointment, familial responsibilities, and academic productivity. Results. —After a mean of 11 years on a medical school faculty, 59% of women compared with 83% of men had achieved associate or full professor rank, and 5% of women compared with 23% of men had achieved full professor rank. Women and men reported similar preparation for an academic career, but women began their careers with fewer academic resources. The number of children was not associated with rank achieved. Women worked about 10% fewer hours per week and had authored fewer publications. After adjustment for productivity factors, women remained less likely to be associate or full professors (adjusted odds ratio OR=0.37; 95% confidence interval CI, 0.21 to 0.66) or to achieve full professor rank (adjusted OR=0.27; 95% CI, 0.12 to 0.63). Based on the AAMC database, 50% of both women and men originally appointed as faculty members between 1979 and 1981 had left academic medicine by 1991. Conclusion. —Women physician medical school faculty are promoted more slowly than men. Gender differences in rank achieved are not explained by productivity or by differential attrition from academic medicine. (JAMA. 1995;273:1022-1025)