1. ChairDavid S Pisetsky MD PhD Professor of Medicine and Immunology Duke University Medical Center Durham, NC GuestsEllen M Ginzler MD MPH Professor of Medicine Chief of Rheumatology SUNY Downstate Medical Center Brooklyn, NY Ingrid E Lundberg MD PhD Rheumatology Unit Department of Medicine Karolinska University Hospital Stockholm, Sweden Women in rheumatology

2. Increasing number of women in medicine Great advance but creates a set of challenges What are the challenges and obstacles that remain in encouraging women to enter this field? What can be done to ensure that women are well represented? David Pisetsky MD PhD

3. Women in rheumatology 50% of medical students are women Not reflected among higher ranks: academic or research positions Mentoring is the key — eg, ACR women’s committee made women more visible in rheumatology Became so successful ACR women’s committee no longer needed to exist Ellen M Ginzler MD MPH

4. Importance of mentoring Fellows are initially undecided about the the kind of career they want Quality of the mentoring will be the determining factor Male mentors should encourage and guide men and women fellows equally Ellen M Ginzler MD MPH

5. Why are so few women senior scientists? Is this unique for rheumatology? Ingrid E Lundberg MD PhD

6. Women professors among faculty in academia overall (www.cordis.lu/improving/women/documents.htm)www.cordis.lu/improving/women/documents.htm CountryYearFull professorsAssociate professorsAssistant professors Turkey1996/721.530.728.0 Finland199818.4n.a. Portugal199717.036.044.0 Australia199714.023.040.7 France1997/813.834.2n.a. Spain1995/613.234.930.9 US20021324n.a. Norway199711.727.737.6 Canada199812.0n.a. Sweden1997/811.022.045.0 Italy199711.027.040.0 New Zealand199810.410.2/23.545.5 Greece1997/89.520.330.6 UK1996/78.518.433.3 Iceland19968.022.045.0 Israel19967.816.030.8 Belgium (Fr)19977.0 18.0 Denmark19977.019.032.0 Ireland1997/86.87.516.3 Austria19996.07.012.0 Germany19985.911.323.8 Switzerland19965.719.225.6 Belgium (Fl)19985.110.013.1 The Netherlands19985.07.020.0 Ingrid E Lundberg MD PhD

7. Why are so few women senior scientists? Is it just of question of time? Is it because of childbearing? Is it due to lack of childcare? Ingrid E Lundberg MD PhD  These explanations cannot account for the discrepancies between the genders

8. Other explanations Informal barriers (less access to strategic resources and social networks) Sonnert G et al. Rutgers Univ Press 1995. Lack of role models Cultural norms or social attitudes and expectations on men and women Bellini L et al. Acad Med 2001. Accumulation of advantages and disadvantages during the scientific career Sonnert G et al. Rutgers Univ Press 1995. Ingrid E Lundberg MD PhD

9. What can we do to change the situation? Turkey Affirmative actions and national policies to promote women Support for women as role models Johns Hopkins University Specific interventions, a 5-year program (problem identification, leadership, education of faculty) Encourage, inspire confidence and commitment Balancing family and work Handelsman J. Science 2005;309(5738):1190. Ingrid E Lundberg MD PhD

10. Differences within rheumatology Women are less present in RA Women have more prominent positions in lupus Chronic disease Intellectual challenge Women’s issues History David Pisetsky MD PhD Ellen M Ginzler MD MPH

11. Can men be role models for women? Takes a man who is comfortable with his identity Need the will to pass on knowledge and encourage fellows and residents, male or female Male mentors have larger networks in science Ingrid E Lundberg MD PhD

12. Advice for young physicians 50% of women fellows have a child during their fellowship Encourage young women to use their time wisely Pregnancies should be planned An academic career with independent investigation is difficult to make happen on a part-time basis — careful planning Ellen M Ginzler MD MPH

13. Programs to support mothers Sharing childcare: maternity as well as paternity leave Equate women’s salaries to those of men so that the father is able to care for the child Re-entry programs Programs to keep stay-at-home parents up-to-date in their field Clinical schedules adapted for parents Ellen M Ginzler MD MPH Ingrid E Lundberg MD PhD