Commentary Commentary: A Call for Culture Change in Academic Medicine

Disappointed by the lack of progress in the advancement of women and underrepresented minority faculty to senior positions and leadership roles in academic medicine and concerned by the prospect that these valuable faculty resources were being lost, a group of five medical school deans agreed to embark on a multiyear project to change the culture of their medical schools for these underrepresented faculty. This commentary outlines the rationale and motivation for the project and sets the stage for future reports from and wider participation in this initiative. Acad Med. 2010; 85:586–587. Culture eats strategy for lunch every day. —Old truism A recent survey of medical school deans conducted by the Association of American Medical Colleges (AAMC) on leadership recruiting practices in U.S. medical schools revealed that the deans responding were highly dissatisfied with the numbers of women and racial and ethnic minority finalists in all department chair searches, particularly in those for clinical chairs.1 This survey and the deans ’ responses illustrate the reality for academic medicine today. Even though we now have a large female cohort of highly trained potential leaders, senior physicians, and research scientists, women are still markedly underrepresented in senior academic and leadership positions in our medical schools and teaching hospitals. In 1980, women constituted 29 % of students admitted to medical schools, and this proportion has increased steadily. Since 2003, medical school admissions for men and women have been virtually equal.2 As of 2008, women constituted 35 % of clinical science faculty and 31 % of basic science faculty at U.S. medical schools. However, female full professors as a proportion of all female faculty at medical schools only rose from 9 % in 1980 to 12 % in 2008 (compared with 30 % male full professors of all male faculty). In clinical science departments, less than one-fifth (17%) of all professors are women. Currently, only 17 % of tenured faculty at U.S. medical schools are women. In medical schools, where half our trainees are women, there is an average of 35 female and 188 male professors per school. In 2008, female full professors constituted 4 % of all faculty in the basic and clinical sciences