A new report commissioned by Imperial explores the experiences of women in clinical academia at the university and how to support them better.
The report, Exploring the experiences and progression of women in clinical academia, gives recommendations about how to improve the career progression, retention and job satisfaction of women in clinical academia. The Faculty of Medicine at Imperial College London has convened a working group to deliver an action plan based on these recommendations. The report's authors hope that their findings and recommendations can also be used to help address the issues facing women in clinical academia across the sector.
The work was funded by The Parasol Foundation, supported by Imperial Health Charity, and carried out by Research Coach on behalf of Imperial College London.
The 'leaky pipeline' of clinical academia in the UK
Previous research by the Medical Schools Council has showed evidence of a gender-related 'leaky pipeline' in the UK's clinical academic sector, demonstrated by a relative lack of women in academic medicine compared with medicine generally, and an apparent lack of comparable career progression.
Disparities between the disciplines are also clear, with low proportions of clinical academic women in surgery, emergency medicine and anaesthetics, and higher representations in fields such as public health, obstetrics and gynaecology.
Imperial is not alone in recognising and addressing such issues and the British Medical Association has established a Women in Academic Medicine group in response.
The report's aims
Imperial commissioned the new report in view of this broader context to explore the experiences and progression of women in clinical academia at the university, from a dual perspective. Its aims were firstly, to identify factors that can positively support career progression and workplace experiences of women in clinical academia, and secondly to shed light on the factors that may be obstacles to the recruitment, retention and progression of women in clinical academic careers.
The findings are based on interviews and survey responses from 113 women at different stages of the clinical academic career path who were based at the university and its partner NHS Trusts. This included qualified healthcare professionals also working in academia, typically in research, teaching or both, as well as women who had left a clinical academic career.
The report's findings
The report found that 70% of participants said they were either 'completely' or 'mostly satisfied' in their careers. The reasons for this included the variety of work, the freedom to pursue areas of interest, and the direct patient and clinical impact of their work.
"The recommendations from this report are a useful blueprint to help us understand what actions and changes will have the biggest impact." Professor Deborah Ashby Dean of the Faculty of Medicine
However, many participants reported that they felt their dual role was not understood and/or valued by both their respective clinical and academic colleagues. More than a third of interviewees described feeling invisible and not valued within the academic system.
The findings also showed that balancing the demands of their career is a key issue, with less than half of the women surveyed saying they felt that they could effectively balance their clinical and academic responsibilities.
The report also explored how participants were affected by 'womanload' - a complex amalgamation of societal, organisational, cultural, interpersonal and individual constructs and expectations about what it is to be a woman in the workplace, and society more broadly. Some participants shared challenges around being the default person required to respond to child- or elder-care emergencies; being expected to lead on EDI issues and Public and Patient Involvement; and being consistently asked to be 'the female representative' on interview panels or committees.
A full overview of the report's findings and recommendations is available in the Summary report, which can be downloaded here.
The report's recommendations
The report's recommendations are focused on nine key themes that include 'Visibility and value', 'Proactive Equity' and 'Coaching and mentoring'. The result is a holistic suite of practical actions that will be explored by the university and partner NHS trusts.
The report also highlights examples of best practice that are already underway in Imperial. For example, linked to the 'Funding' theme, the report recognised the challenges for clinical researchers at the end of their PhD and the danger of losing talent at this critical point of the clinical academic pipeline. It highlighted a case study from Imperial's Department of Surgery and Cancer Care which has instigated a bridging scheme to provide funded time for clinical academics to develop a fellowship proposal after their PhD.
Many participants, particularly those in the early career stages, said they valued the support offered by Imperial's Clinical Academic Training Office (CATO). This offers a wide range of free activities, support and opportunities to enable clinicians to complete their training, or carry out their roles, whilst learning and undertaking research alongside internationally renowned clinicians and researchers.
Support for women in clinical academia
Professor Deborah Ashby, Dean of the Faculty of Medicine at Imperial College London, said: "I am very grateful to the women who have shared their professional and personal experiences of pursuing a clinical academic career at Imperial in such depth.
"We commissioned this report to give us a greater insight into the complex challenges women may come up against whilst balancing their combined university and NHS roles. Clinical academics play a vital role in translating research into benefits for patients, as well as in training the next generation of medics and scientists, and it is essential we support all of them to reach their full potential and have impactful, rewarding careers.
"I am pleased that we are already making progress to support Imperial women in a wide variety of ways, but we know there is more to do to tailor our actions to the unique needs of women clinical academics. The recommendations from this report are a useful blueprint to help us understand what actions and changes will have the biggest impact.
"I hope our Imperial case study will be of benefit to other universities and NHS Trusts who want to join us in highlighting and tackling this important issue of gender equality."
Professor Clare Lloyd, Vice Dean (People and Culture) of the Faculty of Medicine, said: "We are pleased that the report demonstrated high levels of job satisfaction across our women clinical academics. They are deservedly proud to see that the evidence of their research is a driving force behind clinical improvements and is having a direct positive impact on patient care.
"But we cannot shy away from the fact that the lived experiences of the women highlighted in this report show that the barriers to achieving a fulfilling career in clinical academia are deeply complex and go beyond the practicalities of juggling two roles. It highlights that issues of gender discrimination and intimidation persist and often these negative workplace interactions and experiences are further exacerbated by challenges that relate to protected characteristics such a woman's race, disability, health condition, age or a pregnancy or maternity related factor.
"It's clear that supportive relationships both in the workplace, such as with colleagues, managers and mentors, as well as with friends and family outside of the workplace, are essential to sustaining a career in clinical academia. We want to explore different ways to strengthen these networks and help women clinical academics feel more connected to and supported in their two workplaces."
Ruth Monicka Parasol, Principal Benefactress, said: "We were pleased to fund this report to help identify practical ways to improve the working lives of female clinical academics. We know from other projects the crucial role they play and the example they set to those early on in their careers. Tackling the barriers to progress will benefit women now and all those who come after them."
Imperial's commitment to equality, diversity and inclusion
As recommended under the report's 'Cross-system working' theme, Imperial has now convened a working group with Imperial College Healthcare NHS Trust and Chelsea and Westminster Hospital NHS Foundation Trust to deliver an action plan based on the report's recommendations. While the group's primary focus will be on how to support women clinical academics, its impact has the potential to benefit all staff working in hybrid university-NHS roles. Such actions will add further momentum to Imperial's longstanding commitment to promoting diversity in the workplace.
Imperial has embedded gender equality work at the highest level of governance and leadership. The university was one of the original signatories of the Athena Swan Charter in 2005, which recognises and celebrates good employment practices for women in science, technology, engineering, maths and medicine. Imperial has successfully held an institutional Athena Swan Silver Award since 2012 and every department within the Faculty of Medicine holds its own Athena Swan award.
The report Exploring the experiences and progression of women in clinical academia was carried out by independent consultancy firm Research Coach. It was overseen by Imperial's Faculty of Medicine and Postdoc and Fellows Development Centre. The work was funded by The Parasol Foundation and supported by Imperial Health Charity.
