SESSION II
Presentations and Panel Discussion



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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 SESSION II Presentations and Panel Discussion

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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 Opening Remarks Vivian Pinn, M.D. Director, Office of Research on Women’s Health Associate Director, Research on Women’s Health National Institutes of Health I am pleased to welcome you to “Achieving XXcellence 2002” to look at the role of professional societies in advancing women’s careers in science and clinical research. I will tell you briefly about how we got into this project. The Office of Research on Women’s Health was established at the National Institutes of Health [NIH] in September 1990, almost 12 years ago, with three major mandates: (1) to determine what we know and don’t know about women’s health research; (2) to establish a research agenda; to fund, encourage, increase, and stimulate research related to women’s health; and to ensure that women are included in clinical studies related to the health of women; and (3) to develop opportunities for the recruitment, retention, reentry, and advancement of girls and women in biomedical careers. Those are the mandates that led us to the topic of this meeting. Now let me address the third mandate—the recruitment, retention, reentry, and advancement of women in biomedical careers—and how it has gone over the years. As with most of our major efforts at the NIH, we design specific programs with input from the greater public and the scientific community. Some years ago we held a public hearing and a workshop entitled “Women in Biomedical Careers: Dynamics of Change, Strategies for the 21st Century.” As I pointed out in the opening session, an NIH task force led this effort and produced a full report of that effort. That task force was co-chaired by Dr. Carola Eisenberg and Dr. Shirley Malcom of the American Association for the Advancement of Science. At the time of that effort, some of the barriers that affect women and girls entering and succeeding in biomedical careers were identified. Even though these barriers were pointed out a few years ago, they have held over the years as we

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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 have continued to review the potential barriers to women entering or advancing in biomedical careers. In taking these barriers to heart, looking for recommendations from that workshop, and assessing all of our efforts since, including the update of our research agenda, we have begun to put in place career development programs to help our office provide support for girls and women in biomedical research careers and health care professions. In fact, I must compliment Joyce Rudick, who has overseen almost all of our programs related to career development. But the major one we are addressing today is related to “AXXS, Achieving XXcellence in Science.” This idea was first brought to us by Sue Shafer—then deputy director of the National Institute of General Medical Sciences at the NIH—and other intramural women scientists at the NIH. These women asked if we would support them in a joint activity with the American Society for Cell Biology. The initiative would help representatives of professional societies exchange information about strategies they could adopt to support women in their career development. Our first meeting was held in 1999 to bring together representatives of various organizations and professional societies. We were told not to expect much collaboration or much support from many societies because there would not be great interest. However, to our pleasure and to the amazement of others, our first meeting was extremely successful, with 93 participating organizations. We were exhilarated with the interest and the ambition of the participants, who took that meeting seriously and have continued to work on developing ideas related to AXXS. The wonderful report of the AXXS ’99 workshop summarizes its recommendations, and the report can be found on the workshop’s Web site [www4.od.nih,gov/axxs]. As we’ve moved from 1999 to AXXS 2002, there have been more efforts by various working groups to address mentoring and networking, career development, achieving senior and leadership levels, representation of women in scientific societies, and developing and identifying model systems that work. These groups have also been pursuing outreach and collaboration within and between societies and organizations. This brings us to AXXS 2002, which is where we are today, to look at the role of professional societies in advancing women’s careers in science and clinical research. We turned to the Committee on Women in Science and Engineering at the National Academy of Sciences to assist us and take over this effort and move it forward in 2002. We asked that the committee develop a workshop at which clinical societies could come together to discuss ways that societies can enhance the participation of women scientists in the clinical research workforce. And we requested that the workshop focus particularly on initiatives and action items that clinical societies can adopt within their organizations to enhance women’s advancement in the clinical research field; on ways that clinical societies can disseminate proven, successful strategies in order to advance women’s careers; and on ways that clinical societies can collaborate with each other to promote women’s contributions to their fields.

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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 Sally Shaywitz, M.D. Professor of Pediatrics, Yale University School of Medicine Chair, AXXS Steering Committee As chair of the steering committee, I’m delighted to add my welcome to the AXXS 2002 workshop, “Achieving XXcellence in Science: The Role of Professional Societies in Advancing Women’s Careers in Science and Clinical Research.” This workshop aims to expand the progress achieved at AXXS ’99, which gathered representatives of basic science societies to discuss ways to encourage women scientists. We are tremendously excited by the potential of this workshop to bring about change and to enhance the participation of women scientists in clinical research, and to do so through the efforts of our clinical societies. We strongly believe that professional societies can make a difference. They play a key role in career development. They can appoint women to editorial boards, to important committees—for example, to nominate candidates for awards—and to positions as committee chairs and speakers. In essence, professional societies often provide the currency that counts in advancement in academic medicine. Our goal today is to determine how the important role of societies can be leveraged to enhance women’s advancement in clinical research. We have defined an ambitious agenda—one that will allow us at the close of this workshop to identify specific initiatives and activities that can be adopted within our societies, to develop mechanisms to disseminate successful strategies to advance women’s careers, and to determine ways that clinical societies can collaborate to promote women’s contributions to their fields. At the onset, let’s also clear up some incorrect assumptions. It was once thought that the underrepresentation of women in leadership roles in clinical research was mainly a pipeline problem—that is, not enough women were entering medicine and so fewer women were available in the pool for selection to

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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 academic leadership positions. This is no longer a tenable explanation. As you will hear later, women are entering medical school in numbers almost equal to those of men. Furthermore, in the past proportionately more women medical school graduates than men chose academic medicine as a career pathway. This appears to be changing now that fewer women seem interested in choosing academic medicine. Instead, proportionately more women appear to be seeking careers in private practice or industry. Throughout all of this, what has not changed is the underrepresentation of women in the ranks of senior faculty. Women are obtaining faculty appointments and increasing their representation on medical school faculties. But these are junior, not senior, positions. The proportion of women faculty who are full professors has not changed in over 15 years. According to an editor’s note in the Journal of the American Medical Association, “Even if the rate of women attaining full professor rank continues to grow yearly, at least twenty-five years remain until the proportion of women at full professor rank is half that of men, despite near gender equity when entering medical school.” So as we examine the chain of academic leadership, we note that women are represented in fewer numbers as department chairs or as members of important committees—those that wield power rather than those that take care of the housekeeping items. At the top of the chain, according to the AAMC [Association of American Medical Colleges] database on medical school deans, only 4.1 percent of all deans of U.S. medical schools are women. But just as the problem is becoming increasingly evident, so are some of the solutions. For example, there is general agreement about the essential role of mentoring in advancing the careers of both men and women. Unanswered questions concern the fewer numbers of senior faculty women available to assume mentorship roles and the possibility that some approaches are more successful than others for women. Women often seek collaborative approaches and that brings with it the potential for exploitation. These issues are now on the table for clinical societies to address, and, optimally, to help resolve. As editor Cathy D’Angelis asked in an editorial in the New England Journal of Medicine, we now ask: What can societies do to promote effective mentorship? How can societies go about promoting seminars and sponsoring discussion groups that help women in negotiating research time, space, and institutional resources? How can societies help clinical researchers become cognizant of the importance of a sharp, circumscribed academic focus? Our focus today is not so much to convince you of the need, but to develop a workable action plan to bring about change. Our goal is to transform the advancement of women in clinical medicine into a central issue rather than a peripheral or side one. The data are convincing, but we want more than to just document the problem. We want—in fact, we must create—change. Such data are not endpoints. Rather, they serve to persuade us of how much must be done.

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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 This is not a symposium but a workshop, aptly named because we’re asking each of you here today to work with us to problem-solve and to take potential solutions back to your societies and act on them. We hope to be following the results of these actions through tracking programs over the next several months and, we hope, years. This work is important for each of you and for your societies, and for the community of clinical research scientists and for our patients and for society at large. The increased representation of women scientists as leaders in clinical research will be good for individual women, for their institutions, and for society. What will be good for women will be good for all. Indeed, the problems that clinical research addresses are too important, too complex, and too elusive to waste any talent that might provide new insights, new ideas, or new approaches. We must ensure that the makeup of the leadership of clinical research efforts resembles that of the society we are serving, nothing less. I urge you to be bold in your recommendations. There is an urgent need for not one token woman but at least several women to be appointed for each promotion and search committee, including those for deans and presidents. It can be done. In 2001 Shirley Tilghman became president of Princeton University. To quote a recent New York Times article, “When she became president, Dr. Tilghman said she knew how to close the lingering gap. At Princeton, women made up about 27 percent of the faculty but only 14 percent of full professors. The key, she said, was to appoint more women as administrators. And she did—as provost, as dean of the Woodrow Wilson School, as dean of the School of Engineering and Applied Science, and as dean of the undergraduate college—a total of five women among the nine top academic officers. Such bold actions do not sit well with everyone. Recalling that Princeton was once an all-male school, U. M. F. Lewis, a Princeton alumnus, class of ’41, wrote in the Princeton Alumni Weekly, “To save time, I recommend that the trustees promptly convert Princeton into a single-sex, female university, and be done with it.” In a subsequent issue, a 1993 graduate, Betsy Helman, wrote: “Based on your letter, Mr. Lewis, it is clear that you are no tiger. You are a dinosaur.” So Princeton demonstrated that change is possible and that it can come about quickly. According to Nancy Hopkins, professor of biology at the Massachusetts Institute of Technology and a leader in bringing issues of gender inequality in academia to the fore, “Having women in power sends a message to young women that, yes, of course, you can become president of a university, win the Nobel Prize, or do anything. Up to now we’ve been telling them that, but no one was showing them.” Our mission, then, is to figure out how to show women at all levels of clinical research that they too can be president, can win a Nobel Prize and certainly can be professor. As we begin our formal program for the workshop, I wish to point out that this is an auspicious occasion on several fronts. As far as I know, it marks the first time the Institute of Medicine [IOM] has formally addressed the issue of advancing women scientists’ careers in clinical research. We are delighted to acknowl-

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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 edge the participation of the IOM Clinical Research Roundtable. And we are especially pleased that the new president of the IOM has signified his interest and his support by joining us in welcoming you to what we believe will be a landmark event in the progress of women scientists engaged in clinical research.

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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 Harvey Fineberg, M.D., Ph.D. President, Institute of Medicine SPEAKER INTRODUCTION SALLY SHAYWITZ, M.D., CHAIR, AXXS STEERING COMMITTEE It is a great pleasure to introduce Harvey Fineberg, who on July 1, 2002, became the seventh president of the Institute of Medicine [IOM]. Dr. Fineberg earned his bachelor’s degree from Harvard University, his medical degree from Harvard Medical School, and his master’s and doctoral degrees in public health from Harvard University’s Kennedy School of Government and Graduate School of Arts and Sciences, respectively. He most recently served as provost of Harvard University and, before his appointment as provost, as dean of the Harvard School of Public Health. Dr. Fineberg was elected to the Institute of Medicine in 1982, but his work for the institution dates back 25 years. He has chaired various important committees of the National Academies, including those that produced the reports Understanding Risk: Informing Decisions in a Democratic Society and Society’s Choices: Social and Ethical Decision-Making in Biomedicine. His wide-ranging research interests encompass HIV/AIDS and other infectious diseases, the fields of risk assessment and decision making, the evaluation of diagnostic tests and vaccines, the ethical and social implications of new medical technologies, and medical education. In announcing his appointment, National Academy of Sciences President Bruce Alberts said, “Dr. Fineberg’s background and skills are ideal for this position. Public health has become recognized as an area of increased national importance, which will make IOM’s mission to advise the nation’s health policy even more critical.” Kenneth Shine, Dr. Fineberg’s predecessor as president,

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Achieving XXCellence in Science: Role of Professional Societies in Advancing Women in Science - Proceedings of a Workshop AXXS 2002 noted, “Harvey Fineberg combines a rich academic leadership experience with a continuing commitment to and involvement in the health of the public.” He is an outstanding choice, and I am so delighted to be able to welcome him and introduce him to you. DR. FINEBERG: It is a pleasure for me to be here with you at this workshop for many reasons. First, it’s just a delight for me to be established now here at the Institute of Medicine, within the National Academies. This is actually the first workshop or working program that I’ve been privileged to welcome since my appointment just a week ago. I could not imagine a more fitting way to begin as the president of the Institute of Medicine. When I saw the title of this enterprise, I actually thought the pronunciation was double-excellence. The reason that seemed especially meaningful to me is that it’s so obvious that society cannot afford to squander half of the scientific and clinical brainpower available to us. Aside from how important it is to individuals, the purpose of this activity to me from a social point of view is very simple: we need to take fullest advantage of every individual’s talent and ability to contribute. But we’re failing to do that. We’re failing to do it for women. We’re failing to do it for disadvantaged minorities. We’re failing to do it for reasons that have nothing to do with that individual’s ability to contribute. I hope that in the course of your deliberations each of you representing a professional and clinical society can carry back two or three really good ideas that you had not previously thought of. If each society can introduce just a few initiatives that can make a difference, I believe the effect will be cumulative and significant. This is a field for long-distance runners; it is not a place for sprinters who run out of breath. This is a field that requires perseverance. At the same time, I don’t think we have to content ourselves only with distant and remote solutions. I believe there can be positive tipping points. I think Princeton is a good example. Believe me, in academia if women can take over at Princeton, they can take over anywhere. I hope we will find a way to put those initiatives, those new activities, and those commitments into place, so they can bring more of our organizations, institutions, and societies to that positive tipping point where the place of women is no longer a matter for future solution but a matter of current reality for scientists, clinicians, and leadership at every level. I commend each of you for being here, and I wish you every success today and in the months and years to follow.