It’s Time for a Change

Young, professional women pursuing careers in psychiatric academic medicine continue to battle harsh gender bias and discrimination. 

The year was 1973. Bell bottoms topped the fashion charts, a gallon of gas rolled in around 39 cents, and Tie a Yellow Ribbon Round the Ole Oak Tree was the number 1 song. The year also gets credit for dismal challenges facing female medical students, residents, and physicians — particularly young female psychiatrists and psychologists in academic medicine. 

That’s according to a 1973 article published in the American Journal of Psychiatry1 about women in medicine. Almost half a century ago, the authors wrote, “Most of the students we have seen have noted that there is a lack of women in prominent faculty and administrative positions to serve as acceptable role models and figures for identification.”

Fast forward to the 2021 virtual American Psychiatric Association Annual Meeting and the presentation Triple Threat: Young, Female, Professional – the Experiences of Young Female Psychiatrists and Psychologists in Academic Medicine. Marcia Unger, MD, MPH, a child psychiatrist at the University of California, Davis, kicked off the session and led with an alarming update: “When I read the American Journal of Psychiatry article, I realized that not a ton has changed between 1973 and now.”

With that, Dr. Unger dove into some jarring stats. For example, in 2017,the majority of medical school matriculants, or 50.7%, were women and 49.3% were male. “How exciting that women are the majority of medical school matriculants,” Dr. Unger said.

However, she added, a 2019 survey found that about 42% of medical school faculty were women, and of those women in faculty positions, only 26% were full professors and only 32% were full professors in academic psychiatry specifically. A deeper analysis of the 2019 study reveals that 23% of psychiatry chairs are women.2

“Even though we have this majority of female medical school matriculants, we’re still very much lagging behind in academic faculty positions,” Dr. Unger said.

A 2015 study3 identifies the same lacking balance – but from the psychology graduate student’s perspective. Only seven years ago, 75% of graduate students in the United States were women, and about 35% were black, indigenous, and people of color. “In regard to academic psychology faculty, only 45% were full professors, which again, I think just shows that the vast majority of graduate students are women in psychology, but there’s this under representation in female professors,” Dr. Unger said.

While the statistics alone say so much, they’re “really just the tip of the iceberg for women in academic psychiatry,” Dr. Unger said. “There are a multitude of issues, including salary differences, harassment, parental leave policies, microaggressions, lack of mentorship. And these are just some of the challenges that young female faculty face.”

Taking a sidestep away from under representation, Dr. Unger turned to a 2019 study that “found that over 50% of female faculty have experienced gender-based discrimination perpetuated by faculty and patients. And almost 93% of female residents in one 2019 study endorsed gender-based discrimination, regardless of specialty.”

Women who participated in the 2019 study also noted that gender-biases were likely to result in diminished responsibility, diminished patient trust, and diminished provider trust.

In another 2019 study, conducted by AAMC and about the seat of women in academic medicine, about 70% of women surveyed reported experiencing an incident of disrespect based on their gender in the last year – as opposed to 12% of men.

“So again, there’s still so many women faculty members who experience disrespect as compared to men and about 35% of women do not agree that there are equal opportunities regardless of gender. So, there’s still quite a lot of improvement that needs to be done, Dr. Unger concluded. 

  1. Notman MT, Nadelson CC. Medicine: a career conflict for women. Am J Psychiatry. 1973 Oct;130(10):1123-7. doi: 10.1176/ajp.130.10.1123. PMID: 4728905.
  2. Borlik, M.F., Godoy, S.M., Wadell, P.M. et al. Women in Academic Psychiatry: Inequities, Barriers, and Promising Solutions. Acad Psychiatry 45, 110–119 (2021). https://doi.org/10.1007/s40596-020-01389-5
  3. American Psychological Association. (n.d.). The Academic Psychology Workforce. American Psychological Association. https://www.apa.org/workforce/publications/academic-psychology.