CAses for ASE WIE Webinar 2023 11 13

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School

University of Pittsburgh *

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3513

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Medicine

Date

Dec 6, 2023

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docx

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6

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Sarah Hull Case 1: Advancement of a Female Clinical Cardiologist Background: A 34-year-old female clinical cardiologist joined an academic medical center in 2010 as an instructor in medicine. She was a part of a dual physician household and had a 2-year-old daughter. Over the next three years, she made significant contributions to her field, including 15 publications and 4 original manuscripts. She also took on leadership roles within the department, directing CME courses. During an annual meeting, her Division Chief advised her to publish two more papers before considering promotion to assistant professor. She worked diligently and met this requirement. In a subsequent meeting, she was advised to publish one additional original manuscript before being promoted, even though she was already very close. Promotion and Challenges: Her CV was externally reviewed in the faculty development office, and she was recommended for promotion to Assistant Professor in 2015, after five years on faculty at the age of 39. She also took on leadership roles in the Department of Medicine and the division, and actively participated in national CME activities. With institutional funding and the assistance of a medical writer, she published an additional 20 papers. However, after the birth of her third child in 2018, she noticed a decline in invitations to national meetings and speaking engagements. Her primary mentor retired during this time, and she began to face challenges that might be attributed to biases or gender-related factors, such as fewer opportunities for advancement and increased administrative duties compared to her male counterparts. Addressing the Challenges: 1. Equity in Evaluation: Implement blind reviews for promotions and publications to mitigate gender bias. This ensures that the evaluation is solely based on the quality and impact of the work, rather than the gender of the researcher. 2. Supporting Work-Life Balance: Encourage a supportive work environment that values work-life balance. Highlight the benefits of career advancement, including financial incentives, leadership opportunities, awards, and flexible positions such as chairs, which allow individuals to prioritize their family responsibilities without hindering their professional growth. 3. Mentorship and Sponsorship: Establish formal mentorship and sponsorship programs to provide female physicians with guidance, support, and advocacy throughout their careers. Promote equitable distribution of mentorship opportunities and sponsorships to ensure women receive the necessary support to advance professionally.
4. Addressing Administrative Burdens: Recognize that women in mid-career often face increased administrative duties while receiving less mentorship and sponsorship. Allocate resources to alleviate the administrative burden and ensure fair distribution of workload among faculty members. By implementing these strategies, the medical center can create an inclusive environment that supports the career advancement of female physicians and helps address the unique challenges they may face. Purvi Parwani Case 2: Addressing a Hostile Work Environment in the Operating Room Background: During a valvular surgery, an early career cardiologist was conducting a postoperative transesophageal echocardiogram (TEE) in the operating room. The surgery was led by the Chief of Surgery. While the patient was on bypass, the TEE results appeared normal, and the chief surgeon left the room, instructing the rest of the surgical team to close the chest and complete the procedure. However, after the patient was taken off bypass, a postoperative complication arose. The Chief surgeon was called back to the OR, and the cardiologist who performed the TEE reported the complication observed on the study. Incident and Consequences: In response to the complication being reported, the chief surgeon became visibly angry and shouted at the cardiologist and the rest of the OR team. He expressed frustration at being called back to the OR for revision of the surgery due to a postoperative complication that he was not made aware of while the patient was still on bypass. This outburst caused the cardiologist to feel embarrassed and belittled in front of the entire OR staff. It is worth noting that the Chief surgeon has a history of similar outbursts and interactions with junior staff members, creating a hostile work environment and fear among the staff. Addressing the Hostile Work Environment: 1. Promote Respectful Communication: Establish a culture of respectful and open communication in the operating room. Encourage surgeons and staff to express concerns and report findings without fear of reprisal or belittlement. 2. Leadership Training: Provide leadership training and education to all surgeons and medical staff, emphasizing the importance of fostering a positive work environment and effective communication. This training should address conflict resolution, emotional intelligence, and maintaining professionalism under stressful situations. 3. Supportive Policies: Implement policies and procedures that explicitly prohibit harassment, bullying, and intimidating behavior in the workplace. Create a
safe reporting mechanism for incidents of hostile behavior, ensuring confidentiality and protection for those who come forward. 4. Investigation and Accountability: Conduct a thorough investigation into reported incidents, including interviewing witnesses and collecting relevant evidence. Hold individuals accountable for their actions, regardless of their position or authority within the hospital system. 5. Support for Affected Staff: Provide support and resources for individuals who have experienced or witnessed hostile behavior. Offer counseling services, mentoring, and opportunities for professional development to help them recover from the emotional impact and foster career growth. By implementing these strategies, the medical center can foster a culture of respect, open communication, and professionalism in the operating room, ensuring the well-being and professional growth of all staff members. Renee Bullock Palmer Case 3: Addressing Workplace Bullying and Building Resilience Background: A highly accomplished and respected female faculty member in her field is facing persistent bullying by a male senior leader at her institution. The senior leader has made false statements about her, engaged in gaslighting, and directed offensive remarks towards her. This pattern of behavior is not new, as he had a reputation for similar actions at his prior institution. Despite his history, he has managed to advance professionally. He specifically targets this female faculty member, blocking her advancement opportunities within the institution. When she sought help from a senior colleague to address the bullying, it backfired, leading to further retaliation and the removal of her leadership roles. As a result, she experiences extreme fear and avoidance of the bully, even developing post-traumatic stress disorder (PTSD) symptoms upon encountering him. The bully holds a senior leadership position and has influential allies who protect him, while others who could potentially help her have chosen to turn a blind eye. Due to personal and professional constraints, she feels unable to leave the institution, and she worries that the bully may impede her chances of securing a job elsewhere. In this challenging situation, she wonders if there are strategies she can employ to survive or if leaving is her only option. Strategies for Addressing Workplace Bullying and Building Resilience: 1. Document Instances of Bullying: Maintain a detailed record of incidents, including dates, times, descriptions, and any witnesses. This documentation will serve as evidence and support your case should you need to escalate the situation. 2. Seek Supportive Allies: Identify individuals within the institution who are sympathetic to your situation and willing to offer support. Collaborate with
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colleagues, mentors, or other influential figures who can advocate on your behalf and help address the bullying. 3. Confidential Reporting Mechanism: Investigate whether your institution has a confidential reporting system for workplace harassment and bullying. Utilize this mechanism to report the incidents and provide evidence, ensuring your safety and privacy. 4. Legal Advice: Consult with an employment attorney who specializes in workplace harassment and discrimination. They can provide guidance on your rights, legal options, and potential avenues for recourse. 5. Self-Care and Well-being: Prioritize your mental and emotional well-being. Engage in activities that reduce stress, such as exercise, therapy, meditation, or hobbies. Seek support from friends, family, or support groups to help navigate the emotional toll of the situation. 6. Build External Networks: Strengthen your professional network outside of your institution. Attend conferences, seminars, or workshops in your field to connect with colleagues and potential collaborators. These connections can provide alternative career opportunities if needed. 7. Maintain a Positive Work Record: Continue producing high-quality work and building a strong reputation in your field. Focus on achieving professional milestones and seek recognition through awards, publications, or presentations. This can help counteract any attempts by the bully to undermine your accomplishments. 8. Explore Internal Resources: Research the policies and resources available within your institution to address workplace bullying. Reach out to human resources or your institution's ombudsman office for guidance on potential intervention or support measures. 9. Empowerment through Education: Stay informed about workplace rights, diversity, and inclusion initiatives. Attend workshops or seminars on assertiveness, conflict resolution, and building resilience. Equipping yourself with knowledge can strengthen your confidence and help navigate difficult situations. 10. Networking Beyond Your Institution: Cultivate connections with professionals outside your current workplace. Attend industry events, join professional organizations, and participate in online communities related to your field. Expanding your network can create opportunities for career growth and provide an alternative support system. While these strategies can help you navigate the difficult situation, it's essential to consult with professionals, including legal advisors and therapists, who can provide personalized guidance.
Sharon Mulvagh Case 4: Inequitable Treatment of Female Faculty in Directorship Role Background: A female faculty member holds the position of director for a highly regarded clinical program and is a well-funded clinical investigator. The newly appointed division chief insists that the female faculty increase her clinical responsibilities to maintain her directorship, claiming that a clinical director should dedicate more time to clinical duties. However, complying with this demand would require the female faculty member to relinquish her grant funding to accommodate the increased clinical workload. In response, she chooses to prioritize her grant projects, leading to the removal of her directorship title by the division chief and a subsequent salary reduction. Interestingly, within the same division, a male faculty member also serves as a director for a clinical program and is a well-funded clinical investigator. However, he faces no request to surrender his grants or increase his clinical commitments, and his directorship title remains intact. Notably, both the male and female faculty members have identical clinical effort levels and grant funding, yet only the female faculty member is compelled to make the choice between her grants and directorship title. Furthermore, the female faculty member is the sole individual who experiences the loss of her directorship title. No explanation is provided for this disparate treatment, aside from a vague assertion that the clinical programs are "different" without further clarification on the nature of these differences and why they warrant distinct rules for directorship between the male and female faculty members. Addressing Inequitable Treatment and Seeking Resolution: 1. Document the Discrepancy: Maintain detailed records of all communications, requests, and decisions related to the directorship position and the treatment received. Collect any evidence that demonstrates the similarities in clinical effort and grant funding between yourself and the male faculty member. 2. Seek Internal Guidance: Consult with a trusted mentor, a senior faculty member, or an ombudsman within your institution to discuss the situation. Request their advice on how to address the inequitable treatment and explore potential avenues for resolution. 3. Address the Division Chief: Arrange a meeting with the division chief to discuss the disparities in treatment and seek clarification regarding the decision- making process. Request a specific explanation for the differential treatment and present your evidence of the comparable clinical effort and grant funding. 4. Document the Conversation: Take detailed notes during the meeting with the division chief, including any explanations provided or lack thereof. Retain this documentation for future reference and potential escalation.
5. Engage with Faculty Leadership: If the initial meeting with the division chief does not yield satisfactory results, escalate the matter to higher levels of faculty leadership within your institution. Present your case, highlighting the inequitable treatment and the lack of justification provided. 6. Seek Allies and Support: Connect with other faculty members, particularly those who have experienced or witnessed similar inequities. Collaborate with them to collectively address the issue, garner support, and advocate for change. 7. Consult Human Resources or Equal Opportunity Office: If your institution has a human resources department or an equal opportunity office, seek their guidance on how to address the inequitable treatment and potential violations of policies or regulations. 8. Pursue Mediation or Arbitration: If internal resolution attempts fail, explore options for mediation or arbitration to address the disparities in treatment. These processes can provide an unbiased and neutral platform to seek a fair resolution. 9. Legal Advice: Consult with an employment attorney experienced in gender discrimination and workplace inequality. They can evaluate your case, provide legal guidance, and determine if there are grounds for legal action. 10. Raise Awareness and Advocate for Change: Share your experiences and concerns with relevant professional organizations, academic societies, or advocacy groups that focus on gender equity in academia. By raising awareness, you contribute to a broader conversation and work towards systemic changes to prevent similar situations in the future.
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