AWNings

The newsletter of the Academic Women's Network at Washington University

Vol. 5 No. 4 October 1996

AWN Board Holds Retreat

The AWN Board of Directors held a two-hour planning meeting on August 24. Newly-elected AWN President Sherida Tollefsen reviewed the accomplishments of the AWN over the last 5 years and our major challenges. The Board discussed its major policy objectives for the 1996-1997 academic year, which include (1) tracking recruitment, promotion, and salaries of women faculty; (2) developing guidelines for promotion on the clinical track; (3) identifying and providing strategies to advance the careers of women faculty: (4) maintaining/increasing pressure for quality child care facilities; (5) enhancing interactions with trainees, and (6) networking with AWF, the newly-formed women’s faculty organization on the Hilltop campus. To address these objectives, the ad hoc committees have been reorganized slightly this year, and AWN members will be invited to join these (see from the President’s Desk section of this issue).

Plans for the major AWN functions were then discussed. Two dinner meetings will be held, on November 21 and in the Spring. A reception for new women faculty members was scheduled for October 8. Brown bag lunches will be organized by the ad hoc committees, and the first of these--Strategies and Support for Women in Science and Medicine with Helen Kornblum and Lynne Kipnis--were scheduled for October 2 and 9. Other topics for this popular seminar series were considered. The AWN directory will be compiled and printed by the Membership and Faculty Development committee, and the third edition of the Family Resource Handbook will be published by the Child Care/Family Resources committee. AWNings will continue to be published quarterly by the Publications committee.

AWN Fall Dinner

The AWN will host a dinner for members on Wednesday, November 21, at Whittemore House. After dinner, Professor Cynthia Weese, Dean of the School of Architecture at Washington University, will speak and a short general business meeting will be held. Watch your mailboxes for your invitation.

Irene Karl Receives Second Century Award

Irene Karl, Ph.D was awarded Washington University’s Second Century Award on October 4 Also receiving awards were Michael M. Karl, M.D., William H. Danforth, M.D. and David M. Kipnis, M.D. The Second Century Award celebrates the advent of the second hundred years of excellence in research, teaching and patient care at the Washington University School of Medicine.

Irene Karl, research professor of medicine, has been a member of the faculty since 1959. She holds a doctorate in biochemistry from the University of Wisconsin and is known as an authority on muscle metabolism. She has published more than 100 papers in prestigious peer-reviewed journals and is currently doing research in the area of sepsis.

In Karl’s acceptance speech, she recounted the years of struggle that she endured to become a woman scientist, to rejoin the science community after years of raising her family, and to achieve success in the face of gender bias. She was honored especially for her commitment to enhancing the research environment and the mentoring of young scientists.

She has also received the Barnes Hospital Distinguished Service Award and the Albert Einstein Award from Technion University in Israel for distinguished service in her field. The Irene E. and Michael M. Karl Professorship in Endocrinology and Metabolism and the Michael and Irene Karl Lectureship, part of the Masters of Medicine Series, are named in honor of the Karls.

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Kudos

Ellen Li, M.D. has been named Chief of the Division of Gastroenterology. She succeeds Dr. David Alpers who has been appointed to a new vice chairmanship in the Department of Internal Medicine. Li joined the faculty as an assistant professor of medicine in 1986 and was made an associate professor in 1992. Her research focuses on the structure, function and regulation of vitamin A-binding proteins in the intestine. In addition, she is interested in studying host-microbial interactions, focusing on the human intestinal parasite, Entamoeba histolytica, which causes amebic dysentery and amebic liver abscesses.

Susan Mackinnon, M.D. has been appointed Chief of the Division of Plastic and Reconstructive Surgery. Mackinnon joined the School of Medicine in 1991 as a professor of surgery. She is known for her groundbreaking work in the area of peripheral nerve transplantation. She also has done research on cumulative trauma disorder--carpal tunnel syndrome in the wrist, cubital tunnel syndrome in the elbow and thoracic outlet syndrome in the chest and shoulder.

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from the President's

(cluttered) Desk

Our year is off to a great start! As discussed earlier in this newsletter, the Board of Directors met on August 24 to define our policy objectives, to plan activities, and to coordinate major functions for the 1996-1997 academic year. I have decided to write an open letter to members in each AWNings, addressing some of the accomplishments of and challenges for our organization.

One of our greatest challenges this year is to involve more members in our work. When the AWN was organized 5+ years ago, informal groups of members who shared an interest in a particular issue were formed. Some of these groups have remained very active whereas others dissolved. The work of our organization is currently done by our officers and by two standing and five ad hoc committees, which I reorganized slightly this year. Let me describe each of these committees briefly.

Program (Susan Wente and Sherida Tollefsen, co-chairs) - This committee secures dates/times and locations, makes dinner/refreshment arrangements, and provides announcements (to the Secretary) for all AWN meetings and other functions. In addition, this committee arranges speakers for the Fall and Spring meetings, if such are to be included in the program.

Nominating (Barbara Monsees, chair) - This committee nominates from the active membership at least one candidate for each of the organization’s offices, including the councilors at large, and compiles biographical sketches of each candidate for the ballot.

Faculty Recruitment and Promotion (Diane Merritt, chair) - This committee supports and monitors the recruitment and promotion of women faculty at WUMS.

Membership and Faculty Development (Barbara Cole and Barbara Zehnbauer, co-chairs) - This committee welcomes new women faculty to WUSM and provides ongoing strategies and support for career advancement to AWN members.

Child Care/Family Resources (Joan Downey, chair) - This committee works to assure quality on-site child care facilities at WUMS and prepares the Family Resource Handbook.

Social Interactions and Mentoring (Karen O’Malley and Diana Gray, co-chairs) - This committee provides opportunities for AWN members and trainees to interact in order to assist trainees in the pursuit of their goals and selects the AWN Leadership Award recipients.

Publications (Linda Pike, chair) - this committee publishes the quarterly newsletter, AWNings.

I am interested in joining the following AWN Committee:

_______ Recruitment and Promotion

_______Membership & Faculty Development

_______Child Care and Family Resources

_______Social Interactions and Mentoring

_______Publications

_______Nominating

_______Program

Dept. _____________________________

Phone _____________________________

E-mail _____________________________

Mail to Sherida Tollefsen, Box 8116

by Helen Kornblum

Women’s Policy, Inc. reported this month that the 104th Congress had a "bitter-sweet record on women’s issues." Congressional Caucus for Women’s Issues Co-Chair Constance Morella (R-MD) said, "While I am disappointed in the unprecedented number of attacks on a woman’s right to choose, the 104th Congress was able to achieve some solid gains for women: the National Domestic Violence Hotline: a new law prohibiting health insurers from discriminating based on genetic information or a history of domestic violence; increased funding for NIH research on women’s health and more reasonable hospital stays for women with newborns."

And Co-Chair Nita Lowey (D-NY) said "Those of us in the House spent a great deal of time fighting a large number of anti-women legislative items . . . It is also hard to focus on gains for women in a Congress that will go down in the record books as the most anti-choice Congress in history." "While conducting a historic number of 53 votes to restrict access to abortion, the 104th Congress also approved an 86 percent reduction in funding for international family planning programs in FY1996, which is expected to increase the need for abortions world-wide.

Women’s votes are being aggressively sought after this election. Perhaps, all elected officials will know from this point forward that women’s issues must be taken seriously. Women are watching and we vote!!

Congress outlawed the rite of female genital mutilation just before it recessed. Public outrage, thanks to several front page articles in the New York Times, no doubt played a role in getting Congressional attention. Now, the Times has taken up the cause of women in Thailand. In a recent article, the paper reported that the Padaung women wear several pounds of brass around their necks to create an appearance of long necks. So called "Burmese Giraffe Women" have become a new Thai tourist sight. Girls start as young as 4 years with over 2 pounds of brass coiled around their necks. X-rays of the Padaung women have shown that the neck is not actually lengthened but that the weight of the rings pushes down on the rib cage, causing the shoulders to slope dramatically. A 42 year old woman reported that "If the rings are removed for medical treatment, the neck will have become too weak to support the head without a brace, and it will be difficult to eat." The article also noted that "The men swing in hammocks while women earn money." Yet, one more major women’s health inequity!

The idea was proposed and a bill will be re-introduced in both the House and Senate to create a new 33-cent stamp and earmark the extra penny for breast cancer research. The potential revenue could be substantial. The money earned under the proposed act would be funneled to the National Cancer Institute and the U.S. Department of Defense for breast cancer research.

In early October, two brown bag lunches were held on gender bias and career navigation in a male dominated system. The response was positive and several women who attended the meetings were interested in an ongoing discussion group. Anyone interested in being kept informed of more discussions, please contact Helen Kornblum at 721-8778 or HKornblum@aol.com or Lynne Kipnis at 725-1556 so your name can be added to our mailing list.

Discrimination related to gender continues to be a fact of life for all too many women physicians and students. A large study of hospital-affiliated general internists found that 67% of women internists reported gender-related discrimination from patients, 56% from peer physicians and 48% from senior physicians. In 1994, 25% of women and 3% of men medical students responding to AAMC’s Graduation Questionnaire reported "offensive sexist remarks or names directed at them personally."

While purposeful discrimination against women is decreasing, unintended slights remain common. Though they pay the same tuition as men medical students, women must sometimes share lockers when men have private ones or may be told there is "no place for women" in a surgical subspecialty". Some medical school functions are still held in clubs which exclude women as members.

Far from being specific to medicine, such slights are part of a much larger pattern reinforcing outdated gender stereotypes. Authoritative and aggressive women are much more likely than men to be censured and labeled "angry" or "harsh". In many professional arenas men’s competence is more likely to be presupposed and women’s questioned." More often than men, women are assigned tasks not relevant to their career interests. Women’s cumulative experience of the effects of such micro-inequities may be described as a "ton of feathers" that, especially on top of family commitments, can rob enough energy to derail a career.

Issues of child- and elder-care are not gender-specific, but women tend to shoulder these responsibilities. Now that over 46% of the labor force are women, however, unnecessary barriers between work and family deserve close inspection. In academic medicine, the round-the-clock nature of patient care presents special challenges during and after training. But the paucity of less-than-full-time options during residency, fellowship and research training and structural inflexibilities in faculty promotion and tenure policies contribute to women’s "brain drain" by forcing them to choose between family and career with little hope of regaining the "academic track".

Family-related issues take a greater toll on women than men in many other ways, beginning with interviews to medical school and residency. Some interviewers continue to grill women applicants on their family plans with questions that make it clear that there are no "right" answers. Difficulties arranging maternity leave and child care during medical school, residency and faculty appointments are well-documented. But perhaps most concerning with regard to increasing the number of women leaders is that moving "up" usually involves moving away. And women are often exceedingly reluctant or unable to take on the responsibilities and guilt associated with re-locating their families, even if their partners are willing and able to find new jobs.

One disadvantage that accumulates in power over time is women’s additional difficulty identifying and making the best use of mentors, given the extra challenges of mixed-sex mentoring relationships. A study in one internal medicine department found that mentors more actively promoted their men than their women mentees’ participation in professional activities outside the institution. In this study, women were also three times more likely than men to report that their mentor utilized their work to advance the mentor’s career rather than the protege’s.

In general, women tend to make less targeted use of work relationships, for instance, assuming that hard work and loyal service will be appropriately rewarded instead of strategizing with a close advisor about how to engineer a higher salary. In this regard, many studies have found that women tend to be more modest than men about their achievements and less apt to see themselves as qualified for top positions even when their credentials are equivalent or superior. In addition, women’s informal networks are less extensive than men’s and less likely to include faculty of higher rank, contributing to their isolation and thereby to political and negotiating ineffectiveness.

Finally to be mentioned are subtleties of the selection process. Research on selecting candidates for senior positions has found that "comfort level" is an important factor. If a culture’s leadership is dominantly male, even highly qualified women will be viewed as "risky" because they do not look or sound like the traditional executive.

The traditional gold standard for advancement into academic medicine’s upper echelon has been first-rate research training followed by many years of preferably NIH-funded grants combined with ever-increasing renown as a clinician and teacher. While this high standard has resulted in dramatic accomplishments by our nation’s academic health centers, this combination of credentials no longer assures effective leadership given the increasing complexity of these centers’ missions. Moreover, this combination of research, teaching and clinical excellence is harder and harder for faculty to achieve. Most junior clinical faculty are now caught between conflicting demands--with university promotion criteria requiring traditional scholarly achievements, the dean’s office asking for more energy devoted to small-group teaching, and the department head calling for increased clinical productivity. Another increasingly obvious conflict is between the work ethic modeled early on to students and the likelihood that physicians with a reasonable balance in their lives will be more likely to maintain enthusiasm for their work and inspire patients toward good self-care.

Credentials for leadership positions also deserve reconsideration and expansion in light of medical centers’ needs to make optimal use of resources and to forge unprecedented linkages within and outside their communities. It is of interest here that the most distinguishing characteristic of medical schools successful at achieving an integrated approach to care is the strong presence of a service-oriented institutional mission. Clearly, academic medicine needs leaders able to inspire commitment to service to build successful teams and to facilitate systemic change. Many current department heads, however, are less skilled in these areas than they are at commanding authority--though it is increasingly understood that the tough-talking, control-oriented executive is less likely to contribute lasting improvements than one committed to understanding and motivating people. Changes in academic medicine are demanding a new model of faculty development. As Arana and McCurdy recently recommended, "chairs should be chosen, trained, and evaluated by deans based on administrative and management skills as well as professional stature."

Few generalizations are possible about how to improve executive searches with regard to attracting more qualified women. Deans report that women candidates for top jobs are scarce, not surprising given that men still outnumber women professors by ten to one. But many search committees may also give up too easily, rather than working to tap into the networks developed by women or to convince women to interview (some qualified women report that they have been brought in too often simply to satisfy EEOC requirements and will no longer interview unless convinced that the job is "real"). Certainly, spouse placement is a particular challenge in recruiting women as well.

Increasingly deans and CEO’s are requiring that each search committee include at least one woman and that a woman appear on the "short list." Adding diversity to committees can increase the time required for the group to develop trust and to address conflicts, i.e., move from "polite" to "skillful" discussion. Nonetheless, the products of diverse teams skilled at examining their methods and addressing disagreements are likely to be of much greater value than the products of teams that do not reflect their constituencies and have not challenged their own assumptions.