Background: Hospitalists’ engagement in scholarship (e.g., research, education) mitigates burnout, yet academic advancement and productivity among hospitalists lags behind other specialties. Gender inequities are well-documented across academic medicine, as evidenced by delayed career progression, lower scholarly productivity, and pay gaps. We aimed to characterize hospitalist interest, barriers, and facilitators to engage in academic activities. Results are intended to prioritize efforts among a growing and diverse academic hospital medicine division.
Methods: We distributed a survey to our hospital medicine division via Qualtrics in June 2024. The survey took approximately 5 minutes to complete and included questions on participant demographics and interest in becoming more involved in academic activities. Participants who reported satisfaction with their involvement were asked to select up to 3 of the most important perceived facilitators among a list of 5 options (see Figure). Conversely, participants who reported dissatisfaction were asked to select up to 3 of the most important perceived barriers among a list of 7 options. Both questions included an “other” option with free text responses. Responses were anonymous. A group ice cream social incentive was offered for achieving a set response rate.
Results: Seventy participants (61 physicians, 9 APPs) completed a survey (73% response rate). Forty (57%) identified as male. Thirty (43%) had >5 years of independent practice. The median clinical FTE was 88% and was similar between male and female respondents. Over half (53%) of participants wanted to increase their involvement in academic activities. Among those satisfied with their level of involvement (n=54), the most common facilitators were manageable clinical duties (56%), protected time (48%), and mentorship (33%). For those less involved than desired (n=53), the most common barriers were lack of protected time (57%), clinical burnout (47%), decreased compensation with non-clinical work (45%), and competing personal priorities (42%). Fifteen men (38%) were satisfied with their level of involvement compared to 2 (7%) women. Eight women (27%) identified lack of adequate mentorship as a barrier, while no men reported this. More women (57%) reported a lack of protected time compared to men (33%) as a barrier. Most men (63%) identified manageable clinical duties as a facilitator to academic engagement, while few women (17%) reported this. A higher percentage of junior faculty identified lack of protected time (53%) as a barrier compared to those with >5 years of experience (35%).
Conclusions: Hospitalists identified protected time and manageable clinical responsibilities as critical to engagement in academic activities. We additionally identified important gender disparities surrounding perceptions of clinical workload and mentorship that build upon earlier work on gender gaps in hospital medicine. Notably, women perceived clinical duties as a barrier to increasing involvement, while men found clinical workload facilitated their involvement. A hypothesis for this disparity may be due in part to the increased communication burden experienced by women. The gap in the perceived lack of mentors highlights the need to increase promotion activities and build mentorship programming. Women hospitalists may benefit from support beyond existing mentorship structures. Further qualitative data is needed to better understand these findings and identify opportunities for improvement.
