key: cord-0836734-54royb7o
authors: Bass, Barbara Lee
title: Amplified Awareness of Gendered Barriers to Academic Achievement in Surgery: Another Silver Lining of the SARS-COVID 19 Pandemic?
date: 2021-12-14
journal: Ann Surg
DOI: 10.1097/sla.0000000000005341
sha: 1ca4920c5ef15bb07211577f1024f9180930e94c
doc_id: 836734
cord_uid: 54royb7o

nan

T here is little to be thankful for from a global pandemic that has killed over 5 million people globally and almost 800,000 in the United States and harmed millions more. 1 However, as we have learned in the past, it often takes a terrible catastrophe to amplify the presence of smoldering, unsolved issues, and in so doing to launch a new focus and committed energy to create a better way for our future. Clearly, the COVID pandemic has laid bare the racial inequities in our nation that have long been recognized but poorly and inadequately addressed. With hope, I say our heightened awareness of these tragic disparities in health and other burdens for people of color in our nation, shown in brutal clarity during the pandemic, has fueled a new national energy to remedy the many structural gaps that have long contributed to those inequities. Let's hope.

Similarly, gender inequity in academic achievement in medicine and surgery and other STEMM fields has long been recognized: women are less likely to achieve academic promotion or to hold leadership roles, women faculty secure less research funding, publish fewer manuscripts, and are more likely to find themselves responsible for education and service. The specific exacerbation of these achievement disparities for women during the COVID-19 pandemic was reflected in decreased article submissions, panel participations, and other academic assignments by women but not for men during the pandemic, with the greatest impact on women with children aged 0 to 5 years. 2 The reasons for these disparities are both obvious and subtle, and many have proposed explanations, while few have offered effective strategies to remedy these gaps. In fact, a working group of the National Academies have recently articulated these exacerbated gaps and possible causes during the COVID-era for women in STEMM in a consensus study report and proposed a portfolio of research to decipher the causes and possible remedies. 3 Overcoming COVID-19: Strategies to Mitigate the Perpetuated Gender Achievement Gap from the accomplished faculty of the Michigan Women's Surgical Collaborative bluntly notes the leaden impact of the pandemic on women faculty; responsibilities of family and home borne disproportionately by women in most family households went into overdrive as carefully constructed home care infrastructure collapsed-schools, daycare, even nannies-became unstable essential assets. 4 Women in surgery and academic surgery have long crafted a myriad of home support structures to allow their professional lives to flow smoothly, so smoothly in fact that this extraordinary systematic juggling is invisible to colleagues (except to each other where wisdom is routinely shared.) Burnout, already disproportionally experienced by women surgeons, accelerated disproportionality as well. These factors, still not fully settled even these 20 months after the first wave of COVID in our nation, continue to ebb and swell with each COVID wave placing new negative impact on professional activities and certainly on the brain time available for academic scholarship, and access to the professional and scientific network that is essential to academic success.

In this article, the authors propose multiple strategies to try to address these longstanding challenges, which have been exacerbated during the pandemic. They focus on systemic changes-delaying nonessential exercises such as annual reviews, extension of contracts without review, faculty-driven reallocation of effort to allow focus on areas of priority, recognition, and reward of all aspects of shifted service and contributions for all faculty in a standardized fashion, flexibility in schedules to allow for family and self-care, and ''meaningful'' expansion of caregiver support, including supplemental compensation. In fact, while proof of efficacy or even implementation steps are not clear, it seems self-evident that any of these steps may help offset the disproportionate burdens faced by women faculty during this terrible pandemic. I am quite certain the authors would agree that these same strategies would also be highly applicable to other high ''life'' demand periods of one's career.

This must be high priority work. The myriad of paper cuts over the course of an early career disproportionally placed on women in high-demand professions like ours, can no doubt derail not only scholarship, academic achievement, and leadership advancement, but also personal resilience, ambition, and indeed career satisfaction. These are the harsh realities for many valuable women faculty in surgery, inequities that we as a professional community have long quietly tolerated; we acknowledge the inequity but rarely have crafted durable, deliverable pathways for resolution of the gaps. Further, we have failed to recognized the great challenges exacerbated by intersectionality-race, ethnicity, or other features that may distinguish us from others.

There was a time, I recall it clearly, when women in professions had to make a choice-work or a life that included family and parenthood-life fully lived as many women wish, I suppose. Women could not do both and expect to reach the highest levels of the profession. Regrettably, in that time, that dual privilege was reserved for men, with a societal structure standing in support. No one's fault-just the way it was. But, even as women have now marched forward in those high value professions with aspirations for leadership and success, we have not reset the structures needed to ensure their goals can be achieved; we still rely on women to craft that invisible network of personal and life support. We have not yet reset many elements in our institutions to recognize the high value of life events for all of our faculty, in articulating and valuing those life roles not as limiters, but as elements of enrichment for our community as wise leaders, role models and mentors, and collaborators-all along that extended timeline of their professional and personal lives, recognizing that those professional and personal life roles may simply be different by gender or by other unique human feature.

So, I am going to say yes, the pandemic has given us another thin silver lining-revealing more brightly a long tolerated inequity for faculty by gender; it has amplified the extra burdens of home, of service, and of missing sustained support of many types, that have contributed to the well-recognized gaps in academic achievement for women in surgery. Let's use this moment to recognize that fact-again-to avoid placement of blame, to study our own implicit biases, and to put our collective energy and will together to seriously create a future to enable the success and durable career satisfaction, with full accolades for accomplishments, for all of our members who have worked so hard to become our valued colleagues. Let's keep this light shining brightly on this additional inequity, even as the pandemic hopefully soon will leave us.

Academic productivity differences by gender, child age in science, technology, engineering, mathematics, and medicine faculty during the COVID-19 pandemic

The Impact of COVID-19 on the careers of women in academic sciences, engineering and medicine

The National Academies Press

behalf of the Michigan Women's Surgical Collaborative. Overcoming COVID-19: strategies to mitigate the perpetuated gender achievement gap