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Figure.  Multivariable Logistic Regression Model Explaining Having an Endowed Chair for Full Professors
Multivariable Logistic Regression Model Explaining Having an Endowed Chair for Full Professors

The model includes 1598 individuals with complete data on covariates listed. NIH indicates National Institutes of Health; OR, odds ratio.

Table.  Characteristics of Male and Female Full Professors With and Without Endowed Chairs at Top 10 US Medical Schoolsa
Characteristics of Male and Female Full Professors With and Without Endowed Chairs at Top 10 US Medical Schoolsa
1.
Treviño  LJ, Gomez-Mejia  LR, Balkin  DB, Mixon  FG  Jr.  Meritocracies or masculinities? the differential allocation of named professorships by gender in the academy.   J Manage. 2018;44(3):972-1000. doi:10.1177/0149206315599216 Google Scholar
2.
Mangurian  C, Linos  E, Urmimala  S, Rodriguez  C, Jagsi  R. What’s holding women in medicine back from leadership. Accessed March 1, 2020. https://hbr.org/2018/06/whats-holding-women-in-medicine-back-from-leadership?utm_source=twitter&utm_medium=social&utm_campaign=hbr
3.
Jagsi  R, Means  O, Lautenberger  D,  et al.  Women’s representation among members and leaders of national medical specialty societies.   Acad Med. 2020;95(7):1043-1049. doi:10.1097/ACM.0000000000003038PubMedGoogle ScholarCrossref
4.
Mensah  M, Beeler  W, Rotenstein  L,  et al.  Sex differences in salaries of department chairs at public medical schools.   JAMA Intern Med. 2020;180(5):789-792. doi:10.1001/jamainternmed.2019.7540 PubMedGoogle ScholarCrossref
5.
Walter  JK, Griffith  KA, Jagsi  R.  Oncologists’ experiences and attitudes about their role in philanthropy and soliciting donations from grateful patients.   J Clin Oncol. 2015;33(32):3796-3801. doi:10.1200/JCO.2015.62.6804 PubMedGoogle ScholarCrossref
6.
Steinpreis  RE, Anders  KA, Ritzke  D.  The impact of gender on the review of the curricula vitae of job applicants and tenure candidates: a national empirical study.   Sex Roles. 1999;41(7-8):509-528. doi:10.1023/A:1018839203698 Google ScholarCrossref
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    Research Letter
    August 31, 2020

    Gender Differences in Endowed Chairs in Medicine at Top Schools

    Author Affiliations
    • 1Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
    • 2Department of Psychiatry, University of California, San Francisco, San Francisco
    • 3Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor
    • 4Department of Internal Medicine, University of Michigan, Ann Arbor
    • 5Department of Radiation Oncology, University of Michigan, Ann Arbor
    JAMA Intern Med. 2020;180(10):1391-1394. doi:10.1001/jamainternmed.2020.2677

    Although women are increasingly represented in academic medicine, gender inequities persist in senior positions. Endowed chairs are among the most distinguished roles in a university setting and typically provide funding that can support salary, novel research, or staff for the chair holder.1 Previous research has documented gender differences in compensation, funding, authorship, and leadership positions in medicine.2-4 To our knowledge, no prior studies have examined whether inequities exist in the allocation of endowed chairs within academic medicine. Thus, we examined the gender distribution of endowed chairs in departments of medicine and determined if gender is associated with holding an endowed chair after controlling for other relevant characteristics.

    Methods

    We considered departments of medicine from the top 10 schools of medicine based on National Institutes of Health (NIH) funding in 2018 (http://www.brimr.org/NIH_Awards/2018/NIH_Awards_2018.htm). Endowed chair and full professor lists were obtained directly from department chairs between November 2019 and January 2020 and subsequently coded using publicly available sources (eg, institutional websites, NIH Reporter, Scopus [Elsevier], and state licensing boards) for gender, graduate degree, years since completion of graduate degree, subspecialty, publication and citation number, H-index, and total NIH grant funding as a principal investigator. Because no identifiable private information was included about the individual members of the organizations who were the participants in the research, the research plan was filed with the University of Michigan institutional review board, which did not consider it to require regulation or informed consent.

    After describing full professors with and without endowed chairs by gender, we constructed a multivariable logistic regression model to determine whether gender was independently associated with holding an endowed chair after controlling for other measured characteristics. Given the collinearity of publication number, citations, and H-index, we retained citations as the sole measure of publication productivity in the model after considering the Akaike Information Criterion for model selection. Analyses were conducted using SAS, version 9.4 (SAS Institute), and statistical significance was set at P < .05.

    Results

    Of the 1654 full professors in the sample, 411 (25%) held endowed chairs (of whom 76 [18.5%] were women). On bivariable analysis, full professors with vs without endowed chairs differed significantly for all measured characteristics, as did men vs women full professors (Table).

    On multivariable analysis (Figure), factors independently associated with holding an endowed chair were specialty, having an MD, higher funding, higher citations, and male gender. Women full professors were significantly less likely to hold endowed chairs than men, even after adjustment for differences in specialty, degree, citations, funding, and graduation year (odds ratio [OR], 0.70; 95% CI, 0.51-0.97; P = .03). The magnitude of the gender difference was consistent when adding institution as a random effect (OR, 0.73; 95% CI, 0.56-0.97; P = .03) or fixed effect (OR, 0.74; 95% CI, 0.64-1.02; P = .07). We found no significant interactions between gender and the other model covariates.

    Discussion

    Within top-tier US medicine departments, women full professors are less likely to hold endowed chairs than their male counterparts. Although endowed chairs are allocated, at least in part, on the basis of objective scholarly performance, this study observed persistent gender differences even after adjustment for such relevant factors. Other factors may affect the selection of endowed chairs. For example, women may be less likely to receive sponsorship from predominantly male faculty who interface with philanthropists, and women may feel less comfortable with philanthropic solicitation,5 potentially decreasing their chances of securing an endowed chair. Women faculty may also face gender-biased evaluations6 that require them to have greater professional achievements to be awarded an endowed chair.2

    Study limitations include the inability to control for faculty track (eg, clinical vs tenure) or quality of medical/graduate school where professors received their degree. We did not have access to information on endowment amounts or include quasiendowments provided through state lines. Finally, we lacked information on race, ethnicity, sexuality, or other characteristics that may affect selection.

    Nevertheless, the results of this study suggest the under-representation of women among endowed chairs compared with their male peers is unlikely to be because of differences in merit alone. Given the considerable prestige and resources that accompany endowed chairs, greater transparency in the allocation of these positions is necessary to understand and reduce gender inequities.

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    Article Information

    Accepted for Publication: May 19, 2020.

    Corresponding Author: Reshma Jagsi, MD, DPhil, Department of Radiation Oncology, University of Michigan, 1500 E Medical Center Dr, UHB2C490, SPC 5010, Ann Arbor, MI 48109 (rjagsi@med.umich.edu).

    Published Online: August 31, 2020. doi:10.1001/jamainternmed.2020.2677

    Author Contributions: Mr Griffith had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Gold and Roubinov contributed equally as co–first authors. Drs Mangurian and Jagsi contributed equally as co–senior authors.

    Concept and design: Gold, Roubinov, Mangurian, Jagsi.

    Acquisition, analysis, or interpretation of data: All authors.

    Drafting of the manuscript: Gold, Roubinov, Jia, Griffith, Mangurian, Jagsi.

    Critical revision of the manuscript for important intellectual content: All authors.

    Statistical analysis: Griffith.

    Administrative, technical, or material support: Carethers, Mangurian, Jagsi.

    Supervision: Mangurian, Jagsi.

    Conflict of Interest Disclosures: Dr Gold reported nonfinancial support from TIME'S UP Healthcare and personal fees from Women in Medicine Summit outside the submitted work. Dr Mangurian reported grants from the National Institute of Mental Health, Doris Duke Charitable Foundation, Genentech, and California Health Care Foundation and personal fees from Uncommon Bold outside the submitted work. She is a founding member of TIME'S UP Healthcare but receives no financial compensation from that organization. Dr Roubinov reported grants from the National Institute of Mental Health and Canadian Institute for Advanced Research outside of the submitted work. Dr Jagsi reported grants from the National Cancer Institute/National Institutes of Health, Doris Duke Charitable Foundation, Komen Foundation, Blue Cross Blue Shield of Michigan, and Genentech, grants and personal fees from Greenwall Foundation, personal fees from Amgen, Vizient, Sherinian & Hasso, and Dressman, Benziger, Lavelle outside the submitted work, serving as an advisory board member from Equity Quotient, and is an uncompensated founding member of TIME'S UP Healthcare. No other disclosures were reported.

    References
    1.
    Treviño  LJ, Gomez-Mejia  LR, Balkin  DB, Mixon  FG  Jr.  Meritocracies or masculinities? the differential allocation of named professorships by gender in the academy.   J Manage. 2018;44(3):972-1000. doi:10.1177/0149206315599216 Google Scholar
    2.
    Mangurian  C, Linos  E, Urmimala  S, Rodriguez  C, Jagsi  R. What’s holding women in medicine back from leadership. Accessed March 1, 2020. https://hbr.org/2018/06/whats-holding-women-in-medicine-back-from-leadership?utm_source=twitter&utm_medium=social&utm_campaign=hbr
    3.
    Jagsi  R, Means  O, Lautenberger  D,  et al.  Women’s representation among members and leaders of national medical specialty societies.   Acad Med. 2020;95(7):1043-1049. doi:10.1097/ACM.0000000000003038PubMedGoogle ScholarCrossref
    4.
    Mensah  M, Beeler  W, Rotenstein  L,  et al.  Sex differences in salaries of department chairs at public medical schools.   JAMA Intern Med. 2020;180(5):789-792. doi:10.1001/jamainternmed.2019.7540 PubMedGoogle ScholarCrossref
    5.
    Walter  JK, Griffith  KA, Jagsi  R.  Oncologists’ experiences and attitudes about their role in philanthropy and soliciting donations from grateful patients.   J Clin Oncol. 2015;33(32):3796-3801. doi:10.1200/JCO.2015.62.6804 PubMedGoogle ScholarCrossref
    6.
    Steinpreis  RE, Anders  KA, Ritzke  D.  The impact of gender on the review of the curricula vitae of job applicants and tenure candidates: a national empirical study.   Sex Roles. 1999;41(7-8):509-528. doi:10.1023/A:1018839203698 Google ScholarCrossref
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