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Objective: To summarise quantitative evaluations of interventions designed to support the careers of women in academia of any discipline., Method: A systematic search of English entries in PubMed, CINAHL and Google Scholar was conducted in September 2017. Methodological quality of the studies was independently assessed by two authors using the Joanna Briggs Institute quality appraisal checklists. Meta-analysis was not possible due to heterogeneity in methods and outcomes; results were synthesised and displayed narratively., Results: Eighteen eligible studies were identified, mostly evaluating programmes in academic medicine departments. The most common interventions were mentoring, education, professional development and/or networking programmes. All programmes took a 'bottom-up' approach in that women were responsible for opting into and devoting time to participation. Study quality was low overall, but all studies reported positive outcomes on at least one indicator. Most often this included improvements in self-rated skills and capabilities, or satisfaction with the programme offered. Results regarding tangible outcomes were mixed; while some studies noted improvements in promotion, retention and remuneration, others did not., Conclusions: This review suggests that targeted programmes have the potential to improve some outcomes for women in academia. However, the studies provide limited high-quality evidence to provide information for academic institutions in terms of the best way to improve outcomes for women in academia. The success of an intervention appears to be undermined when it relies on the additional labour of those it is intending to support (ie, 'bottom-up' approaches). As such, academic institutions should consider and evaluate the efficacy of 'top-down' interventions that start with change in practice of higher management., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Women are under-represented in academic medicine. We reviewed the empirical evidence focusing on the reasons for women's choice or rejection of careers in academic medicine. Using a systematic search, we identified 52 studies published between 1985, and 2015. More than half had methodological limitations and most were from North America. Eight main themes were explored in these studies. There was consistent evidence for four of these themes: women are interested in teaching more than in research; participation in research can encourage women into academic medicine; women lack adequate mentors and role models; and women experience gender discrimination and bias. The evidence was conflicting on four themes: women are less interested in research than men; women lose commitment to research as their education and training progress; women are deterred from academic careers by financial considerations; and women are deterred by concerns about work-life balance. Inconsistency of findings across studies suggests significant opportunities to overcome barriers by providing a more enabling environment. We identified substantial gaps in the scientific literature that could form the focus of future research, including shifting the focus from individuals' career choices to the societal and organisational contexts and cultures within which those choices are made; extending the evidence base to include a wider range of countries and settings; and testing the efficacy of interventions., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

A shortage of surgeons has been a serious problem in recent years. There is an urgent need to utilize female surgeons who tend to resign because of bearing and raising of children. To examine possible measures to deal with the issue, we performed questionnaire survey about work-life balance and career planning on 20 female surgeons in the Department of Surgery and Oncology, Kyushu University. The response rate was 80.0%. In the 16 respondents, seven were unmarried and nine were married. A large fraction of the respondents recognized the importance of work-life-balance. Female surgeons have many difficulties to continue working with good work-life balance; therefore, understanding and cooperation of both their spouses and coworkers is considered to be necessary. Married female surgeons considered that improvement of the working environment and sufficient family support were more important for good work-life balance compared to those who were unmarried. Female surgeons should recognize the importance of improvement of their environment, including the workplace and the family to continue working with good work-life balance in youth and should have the prospects about their career plan of their own.

Purpose: Despite recent efforts to understand the complex process of physician career development, the medical education community has a poor understanding of why, how, and when women physicians embark on careers in academic medicine., Method: In 2010, the authors phone-interviewed women physicians in academic medicine regarding why, how, and when they chose academic medicine careers. Project investigators first individually and then collectively analyzed transcripts to identify themes in the data., Results: Through analyzing the transcripts of the 53 interviews, the investigators identified five themes related to why women choose careers in academic medicine: fit, aspects of the academic health center environment, people, exposure, and clinical medicine. They identified five themes related to how women make the decision to enter academic medicine: change in specialty, dissatisfaction with former career, emotionality, parental influence, and decision-making styles. The authors also identified four themes regarding when women decide to enter academic medicine: as a practicing physician, fellow, resident, or medical student., Conclusions: Choosing a career in academic medicine is greatly influenced by the environment in which one trains and by people-be they faculty, mentors, role models, or family. An interest in teaching is a primary reason women choose a career in academic medicine. Many women physicians entering academic medicine chose to do so after or during fellowship, which is when they became more aware of academic medicine as a possible career. For many women, choosing academic medicine was not necessarily an active, planned decision; rather, it was serendipitous or circumstantial.

Purpose: To determine the causes among underrepresented racial and ethnic minority groups (URM) of a decline in interest during the undergraduate years in pursuing a career in medicine., Method: From fall 2002 through 2007, the authors conducted a longitudinal study of 362 incoming Stanford freshmen (23% URM) who indicated on a freshman survey that they hoped to become physicians. Using a 10-point scale of interest, the authors measured the change in students' levels of interest in continuing premedical studies between the beginning of freshman year and the end of sophomore year. Follow-up interviews were conducted with 68 participants, approximately half of whom had experienced decreases in interest in continuing as premeds, and half of whom who had experienced increases in interest., Results: URM students showed a larger decline in interest than did non-URM students; women showed a larger decline than did men, independent of race or ethnicity. The authors found no association between scholastic ability as measured by SAT scores and changes in level of interest. The principal reason given by students for their loss of interest in continuing as premeds was a negative experience in one or more chemistry courses. Students also identified problems in the university's undergraduate advising system as a contributor., Conclusions: Largely because of negative experiences with chemistry classes, URM students and women show a disproportionate decline in interest in continuing in premedical studies, with the result that fewer apply to medical school.

Background: While medicine in general is becoming more female-dominated, women are still under-represented in surgery. Opinion is divided as to whether this is due to lifestyle considerations, disinterest or perceived discrimination. It is not clear at what stage these careers decisions are made., Methods: 300 first year medical students at Guy's King's and St Thomas' School of Medicine (GKT) were asked their view on possible career choices at this stage., Results: While men represented only 38% of the student population, they represented over two-thirds of the students wishing to pursue a career in surgery. Women still opt for general practice and paediatrics., Conclusion: Surgery is a disproportionately unpopular career choice of the female first-year medical students of GKT compared to the male students. It appears that the choice is freely made and, at this stage at least, does not represent concerns about compatibility with lifestyle.

Objectives: In the areas of psychosomatic medicine and psychotherapy, the relative proportion of female physicians is above average compared with other medical specialty areas. Is there a gender-specific affinity for the subject even among medical students and if so, how does it affect the students' choice of their subsequent specialty and their further professional career?, Methods: Gender proportions were studied in a) students of elective courses in psychosomatics and psychotherapy at the University of Goettingen, b) graduate students of German medical faculties between 1993 and 2004 and c) advanced ranks of medical career., Results: Female preponderance in psychosomatics and psychotherapy is already to be found among students and extends to the rank of specialists. However--as in other medical specialties--women are not adequately represented in managerial positions., Conclusions: The relatively high proportion of female physicians might be the result of women's special disposition for the field. While an adequate representation of both sexes among medical psychotherapists is desirable for clinical practice, an increase of female physicians in management and research positions would be expedient in order to direct more attention to gender-specific questions in psychosomatics and psychotherapy.

Throughout the past century rural health care has been dependent upon general practitioners (GPs) and their successors, family physicians (FPs). Only FPs and GPs have practiced in rural areas in proportion to the population, then and now. As specialization occurred, numbers of GPs declined and physician shortages developed in rural areas. The creation of family practice residencies in the 1970s halted this decline, but rural shortages persist today. During the 1990s the number of allopathic and osteopathic FP residency graduates rose 54 percent. At the same time, the percentage of women enrolled in these residencies increased to 46 percent, and women have been less likely than men to select rural practice. We project that if current numbers of graduates continue, the nonmetropolitan FP/GP-to-population ratio will increase 17 percent by the year 2020. However, today, medical students' interest in primary care residencies (including family practice) is declining precipitously. If numbers of FP graduates return to 1993 levels, the density of FPs in rural America and in the nation as a whole will decline after 2010.

Are differences in men's and women's career progression and satisfaction in academia related to their sex? This article discusses the variables that contribute to sex-based career differentials and the implications both for the individual and for society.

This article is based on a career history study of gender differences and similarities in recruitment to and transitions between specialities among Norwegian doctors. A questionnaire on career and family history was sent to all Norwegian doctors authorised in 1980-1983. Descriptive statistics and logistic regression were used to describe and analyse completion of specialisation in the specialty in which they started their career. Survival analysis was used to analyse transitions between medical specialities. The findings clearly contradict the idea that the low proportion of women in male dominated areas of medicine reflects women's lack of interest in specialities like surgery and internal medicine. Women were as likely as men to start their career in these fields. The problem is their not completing specialist training. A far higher proportion of men than women completed their specialist training in surgery. The reasons for this are complex. Heavy work loads with duties and "nights on call" make it difficult for women to combine childcare and work and make them change to other specialities. Also, female specialists in surgery and internal medicine postpone having their first child compared to women in other medical specialities. However, the fact that some women change from surgery to gynaecology and obstetrics, a specialty which to a considerable extent are comparable with surgery with regard to duty and work loads, indicate that structural barriers in combining childcare and a hospital career do not fully explain the flux of women. The possible existence of other closure mechanisms in surgery, as indicated by some doctors in this and in other studies, have to be further explored.

This paper provides an exploration of the gendered nature of the working experience of women within a high status and predominantly male dominated medical specialty, that of general practice or primary care physician. Women currently represent just over a third of all general practitioners in the U.K. and their numbers have been increasing. Women now account for 60% of new recruits into general practice. Despite this increase, consideration of the experience and role of women within medicine has largely focused on hospital medicine. The findings presented are derived from a three year project, that aimed to develop an understanding of the role women health workers play in the U.K. in the construction and provision of primary health care services for women. The methods employed consisted of a series of postal surveys and qualitative interviews conducted with GPs, female nurses and women service users. The first section of the discussion provides an exploration of the nature and impact of the sexual division of labour within general practice and the resulting occupational marginalisation of women GPs. Attention is given to identifying the key processes whereby the sexual division of labour is maintained and reproduced, particularly through the normative expectations of colleagues, patients and women GPs themselves. The final section presents a typology of the differing strategies the sampled women GPs adopted for managing their working roles in response to the existence of a sexual division of labour. The conclusion highlights the possible impact of the differing strategies upon the functioning of women within general practice and their relationship with women users of the service.

During the 1970s, partly as a response to U.S. public policy which promoted the objective of equal opportunity for women, there was a dramatic increase in the proportion of women entering careers in medicine. Some observers have expressed the expectation that these women physicians will promote progressive changes in health care and that they will be more likely to emphasize "humanistic" aspects of treating patients. This paper presents data from a national survey of U.S. medical students which provides a comparison of several relevant characteristics of these male and female students. There are several important areas where significant differences are apparent. Women students are more likely to place greater importance on the desire to help people as a career motivation, for example, and are less likely to express satisfaction with the status quo in American health care. There are also significant male-female differences in career plans with respect to areas such as specialty choice and preference for practice setting. These findings are used to consider the question of the probable impact of increased numbers of women physicians on the future of American health care. Projections for the future are made more difficult because of important changes within the medical profession and in the context of health care organization, but it is clear that women physicians do represent some potential for progressive change in American medicine.

This paper asserts that the selection of medical specialty by women physicians-in-training is a "choice by constraint." Comparative data on men and women interns and residents are provided in order to document parameters of constraint in three separate areas: 1) subjective reasons for selection of medical specialty and subspecialty; 2) the type of practice a physician intends to enter; and 3) the differential function served by high vs low interaction specialties. Findings suggest that severe constraints occur on the specific level of subspecialty, rather than on the more general level of specialty. Findings also show that high and low interaction specialties serve two distinctly separate socioeconomic functions for different types of women. Within the present medical system these functions are considerably restrictive.

Women comprised only 8.8 percent of active physicians in the United States in 1977. However, recent trends in the sex composition of medical school classes indicate that women will make up at least one-fourth of total physician supply in the future. Consequently, the effect of sex-composition changes on the supply of physicians' services is of importance, especially since much current federal policy is based upon assumptions about physician behavior drawn from observation of the current stock of physicians. This article explores the issue of differences by sex in lifetime earnings associated with alternative specialty choices. Economic incentives to specialize rather than enter general/family practice are examined initially. Then the incentives influencing the decision to specialize in either primary care or non-primary care fields are considered. Findings are reviewed and implications for future trends in specialty distribution of physicians, as well as implications for current and future federal policy affecting physicians' specialty decisions, are discussed.