Closing the Gender Gap

Kate Hacker and Audrey Verde, seventh-year students in the MD-PhD program at Carolina, were aware of gender disparities in science. It wasn’t until they became more familiar with the research, however, that the inequalities pushed them to act.

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Kate Hacker, PhD and Audrey Verde/Photo by Max Englund, UNC Health Care

by Zach Read - zachary.read@unchealth.unc.edu

When Kate Hacker, PhD, and Audrey Verde wanted to become physician-scientists, they understood the challenges they would face. Historically, fewer women reach top leadership positions in medical schools, grant distributions between male and female researchers aren’t equal, and women are often overlooked as panelists or speakers at conferences and as grant reviewers.

Some of the differences, they assumed at the time, could be attributed to attrition. Perhaps the career demands presented too many obstacles for women who wanted families. Or maybe there weren’t enough role models available for younger women interested in becoming physician-scientists. These sounded like plausible reasons for the differences. But two years ago, when they started paying closer attention to the research on gender disparities in science, they knew there had to be more to the story.

According to the NIH, in 2002 it awarded research grants to 31,801 men at an average of $403,047 per grant; in the same year, 10,199 women received grants averaging $330,169. Women simply choosing other fields or electing to leave medical research couldn’t be the sole reason for the differences.

Fast-forward a decade to 2012: 30,768 men received grants averaging $507,279 compared to 13,025 grants to women for $421,385. Slight improvements, but not what Hacker and Verde would expect to see based on their experiences four years into their medical and graduate education.

Then they came across a study published in PNAS showing that both male and female science faculty display biases favoring male students when presented with identical application materials from a lab manager candidate, except for one simple change: the name was changed from a male’s to a female’s. Faculty members consistently reported they would hire the male student, provide him with more mentoring, and thought he was higher qualified even though the female applicant had an identical CV.

“I had no idea that the differences were so large,” says Verde, whose work utilizes several neuroimaging modalities to understand structural alterations in cigarettes smokers compared to nonsmokers. “Learning about the existing research became the final straw for me. You can be outraged by disparities, but nothing will change without action.”

Taking Action

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Attendees of the first Southeast Symposium for MD-PhD Women in Science. Photo courtesy of Jerome Carpenter.
Last year, eager to do their part to build greater gender parity in science, Hacker and Verde launched UNC Advocates for MD-PhD Women in Science, a student group committed to creating a level playing field for women physician-scientists.

To achieve their goals, the group works to educate members about the inequalities women face in academic medicine and research; increase mentoring between MD-PhD students at UNC and women physician-scientists in the Triangle community; facilitate career-development workshops and lectures; recruit more women into the MD-PhD program; and perform outreach to encourage more young women to pursue dual-degree careers.

“Many people think that there’s no difference in treatment between men and women, that discrimination doesn’t happen, and that these issues aren’t a concern today,” says Hacker, whose kidney cancer research focuses on the functional consequences of mutations in chromatin-remodeling enzymes – proteins that affect how DNA is packaged in cells. “We want to educate our peers about the facts and share the research with them. If we can stimulate thought and discussion, then we can hopefully discover solutions.”

The group holds monthly meetings to discuss up-to-date research on gender disparities, share personal experiences, and brainstorm ideas for educating their peers and for encouraging young women to consider the MD-PhD. One idea recently resulted in the Southeast Symposium for MD-PhD Women in Science on May 3, 2014, which Hacker and Verde organized. They invited women MD-PhD program students from six universities in N.C., S.C., and Virginia for networking and career-development workshops. Dr. Etta Pisano, physician-scientist, dean of the Medical University of South Carolina, and former Vice Dean here at UNC, gave the keynote address.

“The workshop leaders provided tools for successful negotiation and strategies for improving work-life harmony that we can immediately implement and the keynote address from Dr. Pisano was inspirational,” Hacker says. “She encouraged all of us to pursue our goals, while offering tips on how to achieve successful careers in academic research. We hope to make this event a yearly tradition.”

Susan Henning, PhD, is professor of medicine and cell biology and physiology at UNC. She has been an important faculty supporter of the group since its inception. At one of the events, held at Henning’s home, Dr. Nancy Andrews, dean of Duke University School of Medicine and an MD-PhD herself, answered students’ questions about her own career path.

“If you said to the average graduate student, male or female, that you’re going to meet the dean and we want you to ask questions, most would cringe,” Henning says. “But it was as lively as you could have dreamed, and I think it helped students understand that it’s possible to be successful at the highest level.”

Henning asserts that such open lines of communication could help produce the sort of outcomes the students are seeking.

“For whatever reason, women are often less willing to speak out, whether about treatment within a lab or other issues,” she continues. “If the group improves communication among students and between students and faculty, then they can make a difference. If, by meeting, they help each other speak out, either by sharing their fears and finding someone they can talk to or by sharing the successes they’ve had on campus, then they can help empower the next person. It’s a very simple concept.”

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Audrey Verde, UNC Chancellor Carol Folt and Kate Hacker, PhD
The group has received additional support from female and male leadership and faculty within the MD-PhD program and across the School of Medicine, as well as from leaders at the university level. Hacker and Verde recently attended the ceremony for the University Awards for the Advancement of Women, at which Verde  was presented the student recipient award.

In addition to educating people about the disparities that exist and offering venues for frank discussion, the students have set goals to improve relationship building between students and mentors and to develop self-advocacy skills among their peers.

Kim Rathmell, MD, PhD, is associate professor of medicine, urology, and genetics, translational research director of the MD-PhD program, and faculty advisor for the Advocates.

“Among the important issues they’ve helped identify and shed light on are the challenges of self-advocacy,” says Rathmell. “It’s easy to be overlooked in this field, and sometimes women have a more difficult time promoting themselves, so Kate and Audrey have been working not only with women, but also with men to help students overcome the issue….The truth is that self-advocacy and networking aren’t strictly women’s issues. Anyone may, by nature, be more introverted or hesitant, and those traits don’t often get rewarded.”

Hacker and Verde stress that removing disparities within science requires broad participation, and they have welcomed male students and faculty at their meetings.

“They bring a completely different perspective,” Verde says. “They ask great questions at our meetings and give us the opportunity to share what we’ve been going through and what the literature shows.”

A challenge for the MD-PhD program is overcoming the perception that it’s too difficult. Many undergraduates and interested applicants worry that the rigors of the dual-degree track won’t allow them to enjoy the rich social lives they expect to have as they develop as adults.

“You wouldn’t expect men and women coming up through college to be worried about how they’re going to fit a family and a life into this career, but they are,” says Rathmell. “I often get questions from students I interview about how to make a program like this fit into their personal lives, or when they’ll have a job, or how to handle the stresses when the hours get long.”

As they talk to young women, Hacker and Verde explain that not only are MD-PhD programs doable, they’re also a lot of fun.

“We have so much fun at UNC,” laughs Verde. “Applicants and other students are always amazed that our MD-PhD group is so happy, that we enjoy what we do, that we get along so well, and that we have lives.”

The current breakdown within the MD-PhD program at Carolina is 28 female students to 46 male students. Hacker and Verde believe that a key influence for young women interested in careers in science seeing MD-PhD students at UNC successfully navigating the educational aspects of the program while also enjoying life outside of it, making the possibility of a career as a physician-scientist become real for them.

“I think Kate and Audrey have done a fantastic job helping students understand that this work is fun and rewarding,” says Rathmell. “You get to take care of patients and work on cutting-edge research that you can take back into the clinic. I think MD-PhD work is sometimes viewed as beyond people’s reach, so what they’re doing is incredibly valuable.”

Read Audrey and Kate's 5 Tips for Young Women Building Careers in Medical Research.

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Dr. Eugene Orringer
"The UNC MD-PhD Program benefits greatly from its close association with NC TraCS and its Education, Training, and Career Development (ETCD) component, “said Eugene P. Orringer, MD.  “Because I direct both the MD-PhD Program and this ETCD Component of NC TraCS, I am ideally positioned to facilitate this interaction.  Among the major goals of ETCD is to train the next generation of clinical researchers and ensure that budding young physician-scientists like Audrey, Kate, and their peers in the MD-PhD Program have ideal role models and mentors available to them.  For example, the junior faculty members training in the ETCD Component (whom we refer to as KL2 Scholars) are particularly well-suited for this role.  Our students also benefit from teaching and advice provided by our biostatisticians and epidemiologists, and they have the support of many members of the senior ETCD Faculty. A good example is the relationship that has developed between Audrey and Kate and Dr. Henning (see above).  All of these interactions have proven to be absolutely invaluable to our MD-PhD students." --Dr. Eugene Orringer, Director of the MD-PhD Program

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