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This study assesses the midcareer outcomes of a highly select cohort of able and motivated physician–researchers. Many of its findings are heartening. A high proportion of respondents reported maintaining careers in academic medicine and continued to spend a meaningful proportion of their working time on research, as one would hope within such a highly select population who received considerable societal resources to support their career development as medical researchers. Even though only a minority of respondents had gone on to receive R01 funding from the NIH, the vast majority had achieved promotions in academic rank and had published numerous papers since their K award. The study did not allowed us to consider a more comprehensive measure of success. In this study, we considered a composite measure, for which particular success in any one area—grant funding, publications, or administrative leadership—sufficed. Unfortunately, we observed that male gender was an independent, significant predictor of greater success, even using this broader definition, within this highly select population.
A number of explanations are possible for this finding. Some studies have suggested that much of the sex difference observed in academic career outcomes is related to whether or not an individual is a parent, with mothers particularly less likely to succeed. In this study, we did observe that within this highly select group, women were less likely to have children than men, perhaps because some of these women perceived that motherhood is particularly challenging for women who wish to succeed in such careers, or perhaps because the conflict between the tenure clock and the biological clock is more pronounced for females than for males. However, in this study we did not observe an interaction between gender and being a parent; even women without children were less likely to succeed than men. This suggests that gender differences in academic medicine may not be related exclusively to motherhood.
Another possibility is that even within this highly select population, the men prioritized greater career success more than the women did. Although this seems unlikely to be the sole explanation within a population of individuals who sought competitive career development awards as fully mature adults, it is possible, for example, that these researchers internalized to some degree society’s gendered expectations of career success, and these expectations may contribute to some of the difference observed. Moreover, stereotype threat may play a role even in this highly accomplished group, and women may react to competitive situations or to the rejection of a paper or grant in systematically different ways than men.