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ADVANCEMENT First Findings Reported in Survey on Faculty Careers Clinical duties, family responsibilities, and time away from work may be bigger obstacles than gender to getting ahead at HMS, according to preliminary findings from the School's faculty career advancement and satisfaction survey conducted last spring. The results were presented for the first time at the half-day Women's Health Research Conference on Oct. 15 at the Inn at Longwood Medical. Maureen Connelly presented preliminary findings from the HMS faculty career advancement and satisfaction survey conducted last spring. They focused on mentorship, work-family balance, productivity, and pace of advancement. (Photo by Steve Gilbert) Similar surveys from Johns Hopkins University and MIT have made headline news, but this first pass at the HMS data probably raises more questions than it answers. "We are only at the very beginning of analyzing those findings," said principal investigator Maureen Connelly, HMS instructor in ambulatory care and prevention at Harvard Pilgrim Health Care. Male, Female Work Patterns Less than half the faculty report having mentors, Connelly said. Mentorship is concentrated in the lower ranks, where women are more likely to have mentors than men. Both genders ranked their experience with mentors similarly (about 3.5 on a scale from 1, very negative, to 5, very positive). Of those who do not have mentors, women want them more than men. "The truth is, it's hard to get promoted," said co-investigator Nancy Tarbell, HMS professor of radiation oncology and director of the Partners Office of Women's Careers at MGH. "A mentor is someone who recommends you for national talks, makes sure you know your department's promotion criteria, helps keep you focused on the right work to get promoted, and generally watches out for you." One Department's Family-friendly Mission Near the end of her training nine years ago, Alessandra Peccei found her perfect job: director of the new obstetrics/gynecology service for the three Massachusetts General Hospital neighborhood health centers in Charlestown, Chelsea, and Revere, many of whose clients are poor or recent immigrants. It promised to be time-consuming but meaningful work. Then, the evening she and her fellow doctors were celebrating their last day of residency, Peccei met her future husband. Now, with two children, four and six years old, and a job that demands more than 60-hour weeks and regular all-night shifts, Peccei, HMS instructor in obstetrics, gynecology and reproductive biology, feels the familiar work-family tension of many HMS parents, particularly women. Fortunately, her husband shoulders a lot of the parenting responsibilities. And her department head has helped lead several family-friendly policy changes for all MGH faculty. When he arrived as chief of the Vincent Memorial Obstetrics and Gynecology Service at MGH 15 years ago, Isaac Schiff, the Joe Vincent Meigs professor of gynecology at HMS, focused on hiring young, enthusiastic doctors who knew the latest techniques. Most of them were women. The service has grown from six faculty positions to 40, about 60 percent women. "There was no policy for maternity leave at the hospital," Schiff said. "Instead of celebrating pregnancy, women felt guilty. One of the things we did was to help make people feel it was a happy event." Schiff lobbied for paid faculty maternity leave, which Peccei called crucial support for her new family. To fund that, the MGH physicians organization raised the salary overhead for each department from 23 percent to 23.5 percent. Faculty meetings have been changed from 6:45 a.m., too early for most child care providers. Last spring, Schiff won the 2003 Dean's Award for the Support and Advancement of Women Faculty from the HMS Joint Committee on the Status of Women for his efforts. Most notable was his instrumental role in creating the back-up child care service at MGH, where Peccei and other parents can bring children when a baby sitter or nanny is sick. A newer service, Parents in a Pinch, provides dependable on-call home care when a child is sick. Full-time malpractice insurance rates for his part-time faculty continue to frustrate Schiff. The department subsidizes salaries to allow faculty working at, say, 80 percent time to take home 80 percent of their pay. Recently, Schiff's department piloted a mentorship project developed by the MGH Partners Office of Women's Careers. A similar effort to start back-up child care in the Longwood Medical Area has been stymied for lack of space. In other findings, women work fewer hours (about 55 per week compared with 63 for men, and both do about one fifth of that at home). Male faculty are more likely than their female colleagues to have a spouse without paid employment (31 percent versus 7 percent), while women have spouses who typically work more hours than they do. Women report a disproportionate level of responsibility for management of the home. Women take longer to advance from instructor to assistant professor (six years compared with about five years for men). From there, they keep about the same pace to associate professor (six to seven years) and then to full professor (almost nine years). Marking time in the lower ranks may reflect women's choices to take their careers more slowly or to do work less likely to contribute to promotion, such as putting in more clinical hours, Connelly said. Further analysis will incorporate the faculty perception of their career pace and satisfaction. As at many universities, HMS basic science departments have an "up or out" rule, allowing 11 years for faculty members to transition from assistant to full professor. However, Harvard allows faculty members in clinical sciences to hover at any given rank as long as their academic contributions continue and their tenacity holds out, said moderator Eleanor Shore, HMS dean for faculty affairs. Importance of Gender "I don't think the conclusion yet can be that gender isn't important," said co-investigator JoAnn Manson, the Elizabeth F. Brigham professor of women's health at HMS. "We will need to get at that in a more detailed analysis, controlling for factors highly correlated with gender." In a 1996 survey of Partners HealthCare System, Manson and her colleagues found that parental responsibilities predict slower academic advancement and less satisfaction, even stronger than gender. Nearly half of HMS's 6,000 full-time faculty responded to the 16-page anonymous questionnaire. The demographics of respondents roughly matched the HMS faculty, including about 34 percent women, 40 percent instructors, 25 percent assistant professors, and 18 percent associate professors. Only about 12 percent of full professors are women, which helped motivate this effort "to understand what it is that keeps vexing us about the advance of women in academic medicine," Shore said. The questionnaire was developed by the HMS Joint Committee on the Status of Women. The survey and preliminary analysis were funded by a grant from the HMS Center of Excellence in Women's Health. Pending further funding, Connelly and coprincipal investigator Susan Parsons, director of the Center on Child and Family Outcomes at Tufts-New England Medical Center, will report a more comprehensive analysis and recommendations to the HMS deans and Faculty Council in the spring. --Carol Cruzan Morton