Advancing the “Ethical Workplace” APWIMS AND WISDOM Joint Fall Meeting Anne Drapkin Lyerly, MD, MA Associate Professor, Social Medicine Associate Director, Center for Bioethics

The Problem Women under-represented in positions of leadership across the professions, including academic medicine, where they represent: 15% of department chairs and 16% of deans 22% of tenured faculty and 21% of full professors AAMC 2013-14 5 of 25 Directors of NIH institutes <20% of editorial boards of 3 leading medical journals PIs for 3 of 25 initial CTSAs 5/31/2018

UNC SOM – Tenure and Rank (Clinical) Tenure Status Academic Rank COSOW - 2013

UNC SOM – Clinical Department Chairs COSOW 2013

Medicine’s “Leaky Pipeline” Near parity among medical students – Women have constituted ≥ 40% of accepted medical students since 1992 (47.4% in 2013; 48% at UNC) Parity diminishes over time 15% of women vs. <1% of men plan to leave academic medicine (UNC Faculty Forward Survey, 2011) 5/31/2018

Faculty Diversity – UNC 42.3% 615 women ~85%ile 5/31/2018

Explanations Women have “opted-out” and headed for home Pamela Stone, Opting Out? There is an “ambition gap” between men and women Sheryl Sandberg, Lean In Women have been “pushed out” by a workplace culture which “values competition and devalues care.” Anne Marie Slaughter, Unfinished Business and “Why Women Can’t Have it All” AAMC – Women have constituted ≥ 40% of accepted applicants since 1991, the year I went to medical school (almost 25 years ago)

Faculty Forward Survey - UNC 2011 Male Female My job 85 Focus on Medical School Mission 66 Workplace Culture 74 73 Department Governance 64 62 Medical School Governance 44 36 Relationship with Supervisor 76 Growth Opportunities 59 55 Promotion Equality 77 61 Collegiality and Collaboration 75 Compensation and Benefits 58 Faculty Recruitment/Retention 71 68 Clinical Practice 57 51 N=777 (49.5% response rate) 5/31/2018

What would be an “ethical workplace”? Sincere commitment to meritocracy Attention to the ways gender shapes how faculty are assessed, supported and promoted, including factors relevant to career decisions [e.g., formal institutional policies, departmental structure, tacit expectations, perceived opportunities, interpersonal dynamics] Efforts to promote formal equality as well as substantive equality 5/31/2018

5/31/2018

Project – The Ethical Workplace DESCRIPTION Qualitative study to explore how faculty experience work life at UNC; factors relevant to career/leadership decisions ASPIRATION Ethical analysis – drawing on ethics, feminist theory, literature and public debate about women in leadership INTERVENTION Develop, pilot test, and implement concrete intervention CHANGE!?

Thank you! alyerly@email.unc.edu 5/31/2018