Which Meritocracy? An Exploration of Gender Differences in Meritocracy Belief and Experiences in Relation to Advancement in Academic Medicine

Abstract

This research contributes to the gender and medical sociology literature with two explorations: 1) a comparison of how men and women perceive the institution of academic medicine as a meritocracy and 2) linking these perceptions with a gendered comparison of academic physician’s experiences with opportunities and challenges toward full promotion. In-depth oral history interviews with 30 tenured full professors at a large mid western medical school were compared by gender. Both groups expressed a shared belief in meritocracy as the basis for advancement in academic medicine. Both groups described the culture of academic medicine as a male model. An informal internal social control mechanism used by physicians signaled the institution of academic medicine as a meritocracy by policing deviance regarding time spent at work as the notion of “hard work” as well as an ability to devote oneself solely to academic medicine. Using Reskins’s (2002) critique of previous sociological research’s inability to find mechanisms of how organizations reproduce inequality, this study establishes a mechanism of meritocracy belief coupled with vast gender differences in expectation for success, preferential treatment and sponsored access to advancement opportunities in academic medicine. This mechanism reproduces male dominance structurally and culturally in the institution of academic medicine. Male physicians claim academic medicine is a meritocracy but describe experiences in which they were given more advantages, such as easier access to mentors and sponsors, and put in positions of leadership in ad hoc ways. Male physicians reported few, if any, challenges in their experiences with promotion to Full Professor. Conversely, while female professors also made statements that academic medicine is a meritocracy, their experiences belied an institution in which they still struggle to persist against an assumption that they are culturally ill fit for success in academic medicine. They experienced far fewer advantages and many more challenges. Male physician perceptions and experiences in tandem with female physician perceptions and experiences work together to reinforce academic medicine as a male dominated organization. Importantly, each gender perceives that what is happening to them is equivalent to what is happening to the others. Neither men nor women expressed recognition of the gendered differences in allocation of resources and the unequal opportunities for advancement.