News for Women in Psychiatry

By HAROLD PINCUS, MD AND SANDY FERRIS

The recent Robert Wood Johnson Clinical Scholars Annual Meeting reinforced two observations and concerns that we share. The first was how few psychiatrists were participating in a program that has produced many of the major physician leaders both in health generally and in health services research specifically (more on this in a future column). The second, and more to the point of this column, was of those participating, significant proportions were female clinical scholars, and it appeared that almost half of these women were pregnant.

Speaking with several of these future mother-researchers to discuss career options and opportunities and to get a sense from their perspectives of their future in research only solidified our concerns. Their own apprehension about their future, coupled with our own observations, lead us to believe that efforts to assist pregnant women or those seeking to have children to link with research training programs or other early career opportunities have continued to progress at an exceedingly slow pace.

The bottom line is that we-and we are speaking of everybody (society, the NIH, and academic medicine-have been aware of the problems of research careers crashing headfirst into the biological, financial, and other practicalities involved in starting a family. Yet, it appears that many potential young investigators wishing to start a family do not really have an opportunity for a "pregnant pause" in their career Instead, the lack of part-time opportunities and other career accommodations may drive them into "permanent exile."

While we don’t wish to ignore the impact of both a demanding research career and raising a family on men, women have traditionally taken the hardest "hit" and are an increasingly important source of future talent. The proportion of women in the U.S. medical school applicant pool is 43.3 percent. Women now comprise 36 percent of all residents, and for psychiatry, this figure jumps to 45.4 percent. Yet, women completing fellowships around the age of 30 today face essentially the same set of hurdles and difficulties that women did 10, 20, even 100 years ago. Yes, we have made some progress and have developed allowances for part-time work, special programs for reentry, and opportunities for mentorship. However, access to information about and entry into these programs is not easy or transparent. Success in these endeavors requires a high degree of initiative, motivation, and a precisely timed set of circumstances along with help from institutions, mentors, and others-something that is still rare in our field. It should not take an excessive amount of exploration to learn about potentially helpful investigator development programs and part-time eligibility for those raising a family. Nor should part-time research training be essentially prohibited (unless one goes through a complicated approval process with a far from certain outcome) under the National Research Service Award program. On the contrary, NIH and the field should do everything in its power to bring these opportunities to the attention of young investigators -- even advertising on billboards on Rockville Pike-not to mention its Web site.

While the billboard comment may be somewhat facetious, it is time to dust off the reports and recommendations of federal agencies, professional societies, and the academic community to see if we have really accommodated the female research fellow. Can they actually see real opportunities in a career pathway that integrates having a family and a successful research career? If not, why not? Have we really changed policies and reward systems? Most importantly, have we changed attitudes about flexibility and part-time work? With less than 500 American medical graduates going into psychiatry each year and half of them being women, to ignore this issue places future research progress in psychiatry in great peril.

Reprinted from Psychiatric Research Report, Winter 1999