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Women in academic medicine - challenges and issues

• Awareness of gender issues within the organisational structure needs to be raised in all faculties. A greater commitment is needed towards a long-term view of the situation, with greater emphasis on long-term solutions. Many of the issues raised by women working in a medical academic environment require a gradual shift in culture and perception, not short-term quick fixes.
• A flexible career structure is vital to improving the recruitment and retention of doctors in academic medicine. Central to this is retraining for those who wish to take a career break at some point, particularly women who take time out to have a family. As such the Flexible Careers Scheme should be encouraged and promoted. The BMA published a paper on flexible training in 2003 'Flexible Training' report of the BMA led working party on flexible training”, BMA, July 2003.; the recommendations from this report should be considered by the university sector and the Modernising Medical Careers academic working party.
• Forms of assessment and accountability, such as the RAE, must be made more flexible in order to take into account part-time and flexible working arrangements and career breaks and measure output in terms of achievement, not hours worked. A RAE target of 60% for part-time academics is suggested as a measure of addressing this issue. The teaching aspect of an academic career must also be taken into account and valued more explicitly.
• Accessibility to appropriate, objective mentors should be available to all medical academics. This mentoring system should be integrated into established structures and given value and credibility. Mentoring schemes such as those set up by the Academy of Medical Sciences for clinician-scientists, should be made available to all medical academics at all levels, from trainee to senior posts. Accessibility is crucial and one suggested method of ensuring this, is to establish a database of appropriate mentors from which medical academics can choose or be allocated a suitable mentor.
• Medical schools and university departments must be made more accountable, particularly in relation to senior appointments. The recruitment process itself needs to be more transparent to avoid the possibility of discrimination of any form.
• A well defined career structure must be established, which includes realistic and appropriate objectives and achievable outcome measures. This career structure must be flexible and progressive. In addition, systems of support should be established and promoted including objective career advice.
• Greater co-ordination between the relevant agencies: the NHS, the Universities and the funding agencies needs to take place if recruitment and retention of medical academics is to be improved.
• Further research is needed if the current recruitment and retention crisis in academic medicine is to be addressed. In particular, the under-representation of women in academic medicine requires further research, specifically in relation to career progression and the recruitment of women to senior positions. Quantitative data disaggregated by gender is urgently needed to provide supportive evidence for the key issues identified by qualitative research.