Factors associated with endowed chair allocation in medical oncology divisions and departments in the United States.

Abstract

11044 Background: Despite an increasing number of female physicians in the workforce, a gender disparity remains in many leadership roles in medicine. Endowed chairs can provide a multitude of research and career opportunities; thus, they are coveted positions in academic medicine. We examined factors associated with holding endowed chairs in oncology across the US, with a focus on whether a gender difference existed, as has been demonstrated in top internal medicine departments more generally. Methods: In 2019, we identified 95 academic oncology divisions/departments in the US, using the Oncology Division Chiefs & Department Chairs listing in the American Society of Clinical Oncology (ASCO) myConnection forum to define the institutions included. We requested a list of full professors and endowed chairs in those divisions/departments, relying on public data on websites when an institution did not respond. Using public data (e.g., institutional websites, NIH reporter, Scopus, state licensing boards), we collected information on gender, degree, total NIH funding as PIs, H-indices, publication and citation numbers, and graduation year for these individuals. We then created a multivariable logistic regression model to examine if, after controlling for other variables, gender was independently associated with an increased likelihood of holding an endowed chair. Results: One thousand thirty-three oncology full professors were identified, 290 (25.6%) of whom held endowed chairs. Overall, and in an adjusted model, greater research productivity (as measured through publications, citations, and h-index) and greater levels of NIH funding were significantly associated with having an endowed chair. Gender was not significantly associated with endowed chair status (21.9% [95% CI:17.2-27.3] of females and 26.8% [23.8-29.9] for males held endowed chairs; p = 0.11) on bivariable analysis, nor was it significant in the adjusted multivariable model (p = 0.50). Power to detect the observed difference given the total number of professors and their gender distribution was found to be ̃53%, suggesting a 47% chance of failing to reject the null hypothesis of equal gender distributions in endowed chairs when the observed difference is as large as estimated. Conclusions: Among oncology full professors, gender was not significantly associated with endowed chair status, although the number of professors in this field is too small to definitively rule out a modest gender difference. This finding contrasts with prior work that revealed a more substantial difference by gender that remained significant after controlling for other factors in a study, including all divisions in the Departments of Internal Medicine at top medical institutions. Further work is necessary to understand what specialty-specific and institutional cultural factors may help mitigate challenges in the pursuit of equity, diversity, and inclusion.