When Deborah Powell, M.D., arrived at the University of Minnesota as dean of the Medical School in 2002 — a post she held for seven years — she knew that she’d be in the minority as a woman in a top leadership role. The numbers of women in high-ranking positions were small at all medical schools, and the University of Minnesota was no exception.
What she didn’t fully understand at the time was how difficult it would be to nudge those numbers upward. “[Unequal representation] has been on my radar screen for a long time,” says Powell, now dean emerita and a professor in the Department of Laboratory Medicine and Pathology. “But at the time, I didn’t realize how difficult it was to recruit women into leadership, even though I tried hard to bring women into the pool, include them in our search committees, and personally make phone calls.”
Her push for greater equality was about more than evening up the numbers: study after study has shown that organizations with greater diversity, including women, in their leadership roles are significantly more innovative and successful than those with a more homogeneous mix. And in a wide-ranging survey of more than 7,000 leaders published in Harvard Business Review in 2012, women were rated more highly than men in overall leadership effectiveness at supervisor, manager, and executive levels.
But despite the obvious benefits of having a more equal balance of men and women in leadership roles, creating that parity remains a vexing problem, both at the University’s Medical School and across the nation. Even in 2016, the number of women in top positions at the U’s Medical School continues to be modest. Just a quarter of all department chairs, deans, and vice deans are women, and less than 15 percent of faculty holding endowed chairs are women.
Currently, the Medical School is taking steps to improve those statistics. A just-completed internal report has helped to shine a spotlight on the problem, and commitment from Brooks Jackson, M.D., M.B.A., Medical School dean and the U’s vice president for health sciences, will help turn the report’s recommendations into a seven-year action plan that, among other things, seeks to double the number of women in academic and medical leadership positions.
“Equity is a high priority because it’s critical to our success,” says Jackson. “To be truly world class, we need faculty and leaders who reflect the population. We need to have an environment that supports promotion and leadership opportunities for all faculty with the skills and interest. Leadership needs to be focused and insistent on this issue in order to catch up with, and surpass, our peer institutions.”
The scope of the problem
In early 2015, more than a dozen people with a wide breadth of experience at the Medical School convened on a dean’s committee to begin work on a report that would help pinpoint the problems and offer suggestions for improvements.
What they discovered was far more nuanced than a simple statistical breakdown could suggest. Indeed, the Medical School does quite well at some levels. For example, women make up a full 51 percent of the Medical School’s 556 assistant professors (and 55 percent of the first-year Medical School class).
Beyond the assistant professor rank, however, the drop-off is steep. For example, in recent years, only 25 percent of faculty members promoted to associate professor at the Medical School were women (compared with 41 percent nationally). Just 21 percent of those promoted to full professor were women (compared with 34 percent nationally). “The problem is complex,” says committee cochair Carol Lange, Ph.D., a professor of medicine and pharmacology, “but that’s where we’re really hurting compared to national averages.”
Other areas also could benefit from significant improvements. For example, although the Medical School is in line with national averages for the percentage of women who are department heads and deans (25 percent), its leaders want to aim higher than the status quo.
Multiple factors contribute to these disparities. In some cases, there are few or no women who make the short list for job interviews. In others, women who would be exceptional leaders opt out because they see that their predecessors worked 80-hour weeks, and they don’t want that life for themselves. (The study’s committee cochair, Anne Joseph, M.D., M.P.H., an internist, points out that many women reconsider leadership roles when they realize that the job could be restructured in ways that would allow them to maintain a reasonable schedule and still succeed in the role.)
Ensuring that there’s one woman in the pool for a leadership position is not enough, says dean emerita Deborah Powell, M.D. (Photo: Scott Streble)
Lange and Joseph point to an array of subtle but real problems that, when added together, can create a frustrating atmosphere for women faculty. For example, women who shoulder many of the child care responsibilities in their families often struggle to make the not-uncommon 7 a.m. academic meetings because they have to get their kids up, ready, and out the door to school. And while many organizations offer last-minute backup to support working parents who need someone to care for a sick child, the University is not yet among them. Women at the highest levels are willing to work hard, but they often choose the job with more flexible options.
Other times, women may not pursue a promotion because they haven’t seen other women do the same. “Most of us need role models to look at and say, ‘That looks like a good job,’” says Joseph. “It can be hard to think of yourself [in a high-level job] unless you see people who look like you in those roles.”
More troublingly — and perhaps contributing to these other problems — both men and women are highly susceptible to unconscious bias. Such bias can lead them to value the same skills differently (more favorably or negatively) in a man as compared with a woman.
A 2014 study by social psychologists at Skidmore College, for example, found that academic scientists — both men and women — who were provided CVs of fictitious job applicants that differed only in the gender of the applicant were more likely to view the man’s resume more favorably. Even those who were open to hiring the woman recommended a salary 13 percent lower than that of her fictitious male counterpart. “We all have these biases,” says Powell. “But we need to understand and overcome these deep-seated stereotypes that favor men for jobs in science and medicine.”
Big goals, big solutions
The goals that the committee developed are ambitious. Among the most prominent: increase the percentage of women in academic and medical leadership positions (deans, regional deans, clinical and basic science department heads, and vice deans) to 40 percent by 2023, and recruit 50 new female faculty members at the associate professor and professor level in clinical and basic sciences in the same time frame.
Such numbers would put Minnesota well above average nationally, and there are strong models to follow. When the committee looked for other schools that were excelling at attracting and retaining women at the highest levels, they found success stories at several universities, including Johns Hopkins, the University of Utah, and the University of Wisconsin–Madison. They closely studied these schools’ best practices.
The report’s wide-ranging recommendations fall into five categories: leadership and education; faculty recruitment, mentorship, and retention; salary equity; metrics and evaluation; and infrastructure recommendations.
To get at the root of the problem, the report recommends training for all men and women on the faculty to help them spot and correct some of their own prejudices. Indeed, Jackson has already begun instituting training to combat unconscious bias for Medical School leaders.
Regional campus dean Paula Termuhlen, M.D., considers herself a product of women's leadership development programs. (Photo: Jeff Frey)
At the same time, the report recommends providing more resources and opportunities for women to develop their leadership skills. Such options might include bringing in female role models and speakers and providing the time and training for current women leaders to nurture female colleagues who are a few steps behind them. There are already some programs in place to support women faculty, including the AHC Duluth Women’s Mentoring Program on the Medical School’s Duluth campus. (See sidebar.)
Paula Termuhlen, M.D., who was hired as regional campus dean for the Medical School’s Duluth campus from the Medical College of Wisconsin last spring, knows that these approaches work. “I am personally a product of them,” she says. “I’ve done leadership development and women-in-medicine programming.”
To be sure, some leaders have long been focused on this issue and are already making an impact in their own spheres. Bobbi Daniels, M.D., CEO of University of Minnesota Physicians, copresident of University of Minnesota Health, and vice dean for clinical affairs at the Medical School, says that she often uses her position to help bring more women to the table.
“The University of Minnesota Physicians management team has a greater number of women in the highest level of leadership roles than many other health care organizations,” she says. “We’ve reached beyond traditional female roles in health care and had a woman as CFO, which is a relatively rare occurrence regardless of the industry.”
The report recommends developing stronger processes to ensure that women have every opportunity to land top roles at the Medical School during the search and hiring process. Guidelines include having equal representation of women and men on search committees, proactively reaching out to promising female candidates, and spending extra time to ensure that women are well represented on top-candidate lists. “It’s not enough to make sure you’ve got one woman in the pool,” says Powell. “You have to make sure there are several. And we have to make sure that, if we need to, we’re prepared to recruit a family.”
The report also advocates for annual salary equity studies and corrections for disparities. Carrying out this kind of financial evening up can help make it clear that the Medical School values women leaders as much as their male peers, and it can help prevent high-achieving women from jumping to a new job for a higher salary at another school.
To ensure that the Medical School makes steady progress on each of these goals, a standing committee focused on women in leadership has already been created with the help of Clifford Steer, M.D., the Medical School’s new associate dean for faculty affairs. The committee has been charged with monitoring progress, disseminating findings annually, and developing plans to address areas where improvements lag, says Joseph. “We also want to have outside experts review our progress, because we know that external accountability makes a difference [in driving improvement],” she says.
There may be no one who knows better that the climb ahead is steep, but Powell says she’s optimistic that the Medical School is both ready and able to make the big changes that are required. “A report like this can galvanize people to action,” she says. “The recommendations are practical and lay the groundwork for a more supportive environment for women. And when that happens, it feeds on itself. More women see that they have a place here at Minnesota.”