Women in radiology

Women in RadiologyWomen in Radiology

K. Krizmanich-Conniff, M.D.Radiology Grand Rounds

February 3, 2010

Women in MedicineWomen in Medicine•

Now an equal number of men and women in medical schools

•

Women account for:– 74% of OB/GYN residents*– 67% of Pediatrics– 56% of Dermatology*– 51% of Psychiatry– 50% of Family medicine* Growth over the past 10 years

Applegate, KE. The Future Workforce in Academic Radiology: Gender, Generational and Cultural Influences J Am Coll Radiol 2005; 2:133-138.

Women in MedicineWomen in Medicine•

However, only 25% of radiology residents are women, stable for approximately 20 years

Why is this occurring?Why is this occurring?•

Women may choose specialties such as OB/GYN and Peds due to:– Exposure to female role models– Expected societal role to care for women

and children– Work environment (both as resident and

staff) that is flexible•

Stanford female faculty members surveyed: Need w/ significantly highest ranking was “flexible work environment without negative consequences for women with young children.”

McGuire LK et al. Career advancement for women faculty in a U.S.

school of medicine: perceived needs. Acad Med 2004; 79(4):319-22.

•

Family responsibilities often play a role in selecting specialties for women

•

So, given the possibility for a “better lifestyle” with radiology, why not more women?

Why Radiology?Why Radiology?•

Top 4 reasons:

(3000 Radiologists surveyed, randomly

selected from AMA data base)–

Interest in diagnostics

–

Potential quality of life–

Diversity of practice

–

Potential for defined hours

•

Significant gender differences:–

Men placed more emphasis on “Interest in procedures and technology”

and “Presence of

strong role model”–

Women placed more emphasis on “Potential for defined hours”

and “Potential for part-time work”

Chertoff JD at al. Career paths in diagnostic radiology: scope and effect of part-time work. Radiology 2001; 221(2):485-94.

Roubidoux et al. Female Medical StudentsRoubidoux et al. Female Medical Students’’

Interest in Radiology Interest in Radiology Careers. Careers. J Am Coll Radiol 2009J Am Coll Radiol 2009; 6:246; 6:246--253.253.

•

First year medical students, given a survey before and after a required 7 week course in Radiology

•

Asked to rate 10 factors that could affect residency choice as positive, neutral or negative

•

Also asked to rate their level of interest in Radiology in particular

ResultsResults•

Women with high levels of interest in radiology were more likely to rate “role models”

positively

•

3 differences between men and women:– Women more commonly rated “patient

contact”

positively– Less commonly rated “visual work”

positively– More commonly rated “technological work”

negatively

Results (cont.)Results (cont.)•

No significant differences in level of interest in radiology between genders

•

Fewer women rated “no interest”

after the course (1%) compared with before (10%)

Fielding J et al. Choosing a Specialty in Medicine: Female Medical Students and Radiology. AJR 2007; 188:897-900

•

Survey completed by 3rd

and 4th

year medical students completing their radiology clerkship at 5 institutions (n=288, 47% women)

•

Asked to rank 10 factors in order of importance to their residency choice

•

If they didn’t consider radiology a possible career, asked to rank the factors that dissuaded them most

ResultsResults•

Overall, both men and women ranked direct patient contact

and intellectual

stimulation

as the most important factors.

•

For those going into radiology, 22% of men considered a mentor

to be an

important factor, compared to 0% of women.

Results (cont.)Results (cont.)•

For those that did not consider radiology as a possible career, lack of direct patient contact

was the #1 factor (94%

in women, 97% in men). – Competitiveness: strong dissuading factor

for 33% women (vs. 20% for men)– Radiation exposure: strong dissuading

factor for 10% women (vs. 3% of men)

Lastly, yet another possible factorLastly, yet another possible factor……•

At RSNA in 2004, survey results were presented indicating fewer than half of all radiology residency programs had a written policy for pregnant residents and radiation safety

•

However, 2/3 reported resident concerns about the subject

Fielding J et al. Choosing a Specialty in Medicine: Female Medical Students and Radiology. AJR 2007; 188:897-900

What can be done to change What can be done to change this pattern?this pattern?

Based on the dataBased on the data……•

Importance of exposing 1st

and 2nd

year

medical students to radiology, and all of its possibilities

•

Importance of exposing females to subspecialties with patient contact including mammography, pediatrics, IR, GI/GU

•

Importance of establishing female role models

More important thoughtsMore important thoughts……•

Women are more likely to avoid competitive situations–

Given the competitiveness of Radiology, mentors counseling qualified women should help them overcome any reservations

•

Change the emphasis from patient contact to patient impact–

Nearly every patient will undergo an imaging examination, and we do impact patient care significantly, even when we are not directly caring for the patient

Fielding J et al. Choosing a Specialty in Medicine: Female Medical Students and Radiology. AJR 2007; 188:897-900

Sax L.. Why gender matters: what parents and teachers should know about the emerging science of sex differences. New York, NY: Doubleday, 2005:39-76.

Impact of Fewer Female RadiologistsImpact of Fewer Female Radiologists•

18% of all professionally active radiologists are women

•

The 2003 ACR Survey revealed that generally women are:– Younger than male counterparts– Work fewer hours– Perform more breast imaging work– Tend to accept salaried positions in

academia over private practiceFielding J et al. Choosing a Specialty in Medicine: Female Medical Students and Radiology. AJR 2007;

188:897-900

Impact of Fewer Female RadiologistsImpact of Fewer Female Radiologists•

Has a negative impact on academic radiology as a whole(↑

# of vacancies/academic

department since 2003)

•

Especially in Breast Imaging:–

82% of breast fellows are women (and many spots unfilled each year)

–

75% of radiologists who consider breast imaging their 1°

or 2°

subspecialty are women

Update on the Diagnostic Radiology Employment Market: Findings Through 2007-

2008. JH Sunshine; J Am Coll Radiol 2008; 5:827-833.

Impact on Breast ImagingImpact on Breast Imaging•

From 2004-2007, BI had highest proportion of unfilled positions among all subspecialties w/ vacancies in almost 30% of practices

•

Although, overall 3% surplus in 2007•

With ↑

patient population over 40 years,

means longer waiting time •

More BI centers closing than opening in 2006-07 w/ recruiting and retaining mammographers playing a significant role

Update on the Diagnostic Radiology Employment Market: Findings Through 2007-2008. JH Sunshine; J Am Coll Radiol 2008; 5:827-833.

Roubidoux et al. Female Medical Students’

Interest in Radiology Careers. J Am Coll Radiol 2009; 6:246-253.

The U of M ExperienceThe U of M Experience

Staff Radiologists at U of MStaff Radiologists at U of M

•

39 women out of 105 total (37%)

•

13 women in Breast Imaging (33%)•

10 women in Cardiothoracic (26%)

•

4 women in Abdominal (10%)

•

2 female division directors (Chest & ER)

•

Female Residency Program Director

20082008--2009 RESIDENT SELECTION 2009 RESIDENT SELECTION COMMITTEE REPORTCOMMITTEE REPORT

•

“Women make up 25% of the candidate pool, year in and year out

•

Women who matched at Michigan: 2006-

3, 2007-

2, 2008-

4 (but 1 withdrew to do

emergency medicine), 2009-

1 (20% total)•

We plan to survey women who could have come here, but went elsewhere, to see if there are gender issues affecting our recruitment”

(Excerpt from a power point sent by Dr. Barry Gross)

12 Women Emailed, 10 Responses12 Women Emailed, 10 Responses•

5 noted that they are single and/or would like to live in a larger city

•

2 based their decisions on being closer to family

•

No gender issues were noted•

1 suggestion: During interview day have a “separate session for women talking about quality of life issues in the city, maternity leave policy, child care, etc.”

Survey of our current residentsSurvey of our current residents•

28/43 responded (65%)– 8/12 females (67%)– 20/32 males (63%)

– By class:•

1st

years: 6/11 (54%)

•

2nd

years: 8/11 (73%)

•

3rd

years: 7/10 (70%)

•

4th

years: 7/11 (64%)

During the interview day, do you think it would be useful to have a session specifically dedicated to family issues such as maternity/paternity leave, local

child care options, part-time possibilities?

0102030405060708090

100

Yes No

MenWomen

%%

Did you have a mentor in Radiology when you Did you have a mentor in Radiology when you were in medical school?were in medical school?

0

10

20

30

40

50

60

Yes No

MenWomen

%%

What year in medical school did you decide on What year in medical school did you decide on Radiology?Radiology?

•

Average for women: 3.1 years

•

Average for men: 3.3 years

How happy are you with your choice to go into How happy are you with your choice to go into

Radiology?Radiology?

0

10

20

30

40

50

60

70

VeryHappy

Happy Indiff. NotHappy

Men Women

%%

How much did future How much did future ““lifestylelifestyle””

play into your residency play into your residency

decision?decision?

0

10

20

30

40

50

60

70

A lot Somewhat Not at all

Men Women

%%

How much did future earning potential play into your How much did future earning potential play into your residency decision?residency decision?

01020304050607080

A lot Somewhat Not at all

Men Women

%%

Have you had or do you plan on having children during Have you had or do you plan on having children during residency?residency?

0

10

20

30

40

50

60

70

Yes No Unsure

Men Women

%%

Do you think having children during residency puts you at a Do you think having children during residency puts you at a disadvantage in comparison to residents without children (as fardisadvantage in comparison to residents without children (as far

as learning is concerned)?as learning is concerned)?

0

10

20

30

40

50

60

70

Yes No

Men Women

%%

Upon Graduation from residency/fellowship, how much Upon Graduation from residency/fellowship, how much do you plan on working?do you plan on working?

0102030405060708090

100

Full time Part time

Men Women

%%

Will you be (or are you already) the primary wageWill you be (or are you already) the primary wage--earner earner

in your household?in your household?

0102030405060708090

Yes No Shared

Men Women

%%

Which type of environment would you prefer to work in?Which type of environment would you prefer to work in?

0

10

20

30

40

50

60

70

Academic Private Unsure

Men Women

%%

Given the choice, do you prefer a workGiven the choice, do you prefer a work--day that includes day that includes patient contact?patient contact?

0102030405060708090

Yes No

Men Women

%%

ConclusionConclusion--

U of MU of M•

All women like the idea of the added session on interview day

•

Roughly equal % ♂

and ♀

with mentors•

Lifestyle more of a driving force for women in residency selection

•

Men more likely to have children during residency, be the 1°

wage earner and work

full-time•

Women more likely to work part-time in academics

Overall ConclusionOverall Conclusion•

Equal # of ♂

and ♀

in medical school, but only 25%

of radiology residents are ♀•

Important factors:–

Lack of role models

–

Lack of exposure to subspecialties with patient contact•

Impact on academic radiology and especially breast imaging

•

Things to consider:–

Female mentoring program

–

Elective catered to patient-care subspecialties–

? Required exposure to radiology earlier in med school

Thank you!Thank you!

Special thanks to Dr. Bailey and Dr. Roubidoux Special thanks to Dr. Bailey and Dr. Roubidoux for their help and insight.for their help and insight.