Date Published: November 6, 2017
Publisher: Springer International Publishing
Author(s): Jeffrey A. Lieberman, Anke A. Ehrhardt, H. Blair Simpson, Melissa R. Arbuckle, Abby J. Fyer, Susan M. Essock.
In academic medicine, as in many employment settings, women frequently earn less than men and hold fewer senior positions [1–5]. While the magnitude of this disparity varies across professions and employment sectors, it is virtually ubiquitous, and academic medicine is no exception. Among physicians with academic appointments at public medical schools in the USA, women are paid about 80% of what men are paid ($207,000 versus $258,000; data from 2011 to 2013) . Gender disparities should be a concern for all medical specialties, but they are of greatest importance to those that attract the highest proportion of women trainees. Given the number of women pursuing training and careers in psychiatry, departments need to consider whether a gender gap exists among their faculty to improve the mental health workforce, quality of care, and financial and ethical reasons.
Columbia University’s Department of Psychiatry (hereafter, Columbia Psychiatry) is comprised of Columbia University College of Physicians and Surgeons Department of Psychiatry, the Psychiatric Services of New York-Presbyterian Hospital-Columbia University Medical Center, and the New York State Psychiatric Institute. Columbia Psychiatry is one of the nation’s largest and leading academic psychiatry programs, with nearly 500 salaried faculty with primary appointments in psychiatry (215 men and 259 women). As such, our numbers are large enough to look at temporal trends with respect to gender parity. Thousands of clinicians, researchers, and educators have passed through Columbia Psychiatry’s ranks, with many more to come. Thus, we felt that it was essential to examine our practices to identify any apparent gender disparities and act to ensure that we practice the principles we espouse.
Nationally, 38% of physicians at academic medical institutions are women. Women are well-represented in the lower academic ranks but under-represented at higher ranks, with roughly equal numbers of men and women Assistant Professors, a 3-to-2 men-to-women ratio at the Associate Professor level and 3-to-1 ratio for Full Professors .
We surveyed gender equity in career development opportunities for our faculty. The leadership structure of our department consists of the chair, 6 vice chairs, and 20 division directors. Like many departments of psychiatry, Columbia has never had a woman chair. Currently, 4 of the 6 vice chairs are women, and 9 of the 20 division directors are women. Women faculty also head 3 of the department’s 5 inpatient units.
Department funds support our academic mission; hence, how these resources are distributed is an indicator of how we value and invest in our faculty. Therefore, we examined total compensation for all Columbia Psychiatry doctoral level faculty (MD and equivalent and PhD and equivalent), grouped by rank and gender. We found that the median salaries for men and women were roughly comparable (Fig. 2). At the Assistant and Associate Professor levels, median salary for women exceeded that for men by $1999 and $2557, respectively (Fig. 2). At the Full Professor level, median salary for men exceeded that for women by $11,507, a gap of about 5%. The largest difference in salary ($15,093) was at the instructor rank (Fig. 2). At Columbia, the instructor rank is used much less often than the other ranks, and the people holding this rank often fill specialty niches within the department, as reflected in the overall-higher salaries for instructors than assistant professors.Fig. 2Median Salary by Rank 2015–2016 academic year, AAMC Northeast compared with men and women at Columbia Psychiatry. For individuals at Columbia working less than full time, salary used was the full-time equivalent. Includes psychiatrists and doctoral-level research scientists salaried at least 50% time in Psychiatry at any time during the academic year; excludes the department veterinarian and department Chair
The two major sources of revenue generation in academic departments are through sponsored research (research productivity is the gold standard by which faculty are evaluated in academic medicine) and clinical services. Sponsored research, particularly awards funded by the NIH, is prestigious and important source of revenue for faculty, the department, and university, because of the indirect costs associated with them. In 2016, there were 222 Columbia Psychiatry faculty with active sponsored research that generated indirect cost revenues of $24 million. These funds are critical to the university and department’s functioning. Forty-seven percent of these 222 individuals were women, and, in the aggregate, women faculty generated 51% of the total annual indirect cost revenue (Fig. 4).Fig. 4Gender distribution of Columbia Psychiatry Principal Investigators on grants and contracts awarded in Fiscal Year 2016
Columbia Psychiatry has made significant progress with respect to gender equity. At the same time, we also see the need to sustain and improve our efforts. Like other academic departments and scientific organizations that have engaged in such self-examination, we have found that it is possible to make substantive improvements in supporting the career development of women faculty and that, at least for the present, ongoing monitoring and intervention appears essential [11–13]. We were unable to obtain comparable data from other departments within or outside of our university to use as benchmarks. The AAMC’s annual survey of member institution collects data on salary and gender ; reporting salary data by gender as part of the widely circulated annual AAMC Faculty Salary Report would make such benchmarking readily available.