GENDER INEQUALITIES IN MEDICAL CAREERS

Women have made a significant progress in the medical profession. In 2013, they accounted for 46.8% of total physicians in OECD countries, a 10% increase from 2003. In Italy, women account for almost 40% of the medical work-force in 2013 and their increase has been very strong in years, up to +34% in the decade 2001-2011 and up to +3% from 2012 to 2013. Notwithstanding the strong feminization of the medical workforce, gender inequalities still persist. Empirical research has shed light on gender inequalities in pay, leadership and specialty fields. It is widely acknowledged that women physicians earn less than men, cluster in less remunerative specialties and progress more slowly through ranks. Most of these studies have taken place in the United States, where cross-sectional and longitudinal dataset are available. This research is part of the wider European project S.T.A.G.E.S. (Structural Transformation to Achieve Gender Equality in Science) at the University of Milan and it aims to fill the gap in the literature \u2013 with respect to the European context \u2013 on gender inequalities in medical careers. Data on more than one thousand physicians working in five hospitals in the Lombardy Region have been collected through an online survey with a rate of response of 48.7%. Data have been analysed through descriptive statistics and through regression analysis. The results point out that women earn 15% less than men, controlling for human capital, work and family characteristics, while they are 44.4% less likely to be promoted to the intermediate levels of the career ladder. Female physicians tend to cluster in medical specialties, while surgery still remains a male-dominated specialty area. Moreover, they do less private practice than their male colleagues, which is highly remunerative. Compared to private institutions, public hospitals seem to guarantee a stronger equality in earnings. The division of paid and unpaid work appears strongly unbalanced, with women as the main responsible for the care of children and the elderly. As a consequence, they tend to solve their work-life conflict by outsourcing care activities while reducing the number of children or renouncing to motherhood (39% of women in the dataset are childless). Regression analysis show that mechanisms of gender discrimination take place both in pay and promotions. Moreover, the same attributes are differently \u201crewarded\u201d whether they refer to women or men. Hence, being father significantly increase men\u2019s income and their likelihood to promotion. The pay penalty for motherhood is significant at 90% level from the third child, while it negatively affects promotion from the second child. Overall, the fatherhood premium appears stronger than the motherhood penalty. Being married positively increases male\u2019s income but it doesn\u2019t have any effect on female colleagues. Educational credential \u201cpays\u201d more for men than for women in terms of pay, as well as being a surgeon and a head of a unit. Doing private practice is more rewarding, controlling for work hours, for men than for women. The amount of time spent at work and the years of work experience are also differently rewarded in terms of career outcomes, suggesting that gender inequalities are not only a matter of \u201cbeing like men are\u201d. Overall, these results fill a gap in knowledge and argue that structural constraints \u2013 preventing female physicians to earn as much as men do and to have the same chances of career than men have \u2013 are taking place

Gender-Dependent Specificities in Cutaneous Melanoma Predisposition, Risk Factors, Somatic Mutations, Prognostic and Predictive Factors: A Systematic Review.

Over the last decades, the incidence of melanoma has been steadily growing, with 4.2% of the population worldwide affected by cutaneous melanoma (CM) in 2020 and with a higher incidence and mortality in men than in women. We investigated both the risk factors for CM development and the prognostic and predictive factors for survival, stratifying for both sex and gender. We conducted a systematic review of studies indexed in PUB-MED, EMBASE, and Scopus until 4 February 2021. We included reviews, meta-analyses, and pooled analyses investigating differences between women and men in CM risk factors and in prognostic and predictive factors for CM survival. Twenty-four studies were included, and relevant data extracted. Of these, 13 studies concerned potential risk factors, six concerned predictive factors, and five addressed prognostic factors of melanoma. The systematic review revealed no significant differences in genetic predisposition to CM between males and females, while there appear to be several gender disparities regarding CM risk factors, partly attributable to different lifestyles and behavioral habits between men and women. There is currently no clear evidence of whether the mutational landscapes of CM differ by sex/gender. Prognosis is justified by a complex combination of phenotypes and immune functions, while reported differences between genders in predicting the effectiveness of new treatments are inconsistent. Overall, the results emerging from the literature reveal the importance of considering the sex/gender variable in all studies and pave the way for including it towards precision medicine. Men and women differ genetically, biologically, and by social construct. Our systematic review shows that, although fundamental, the variable sex/gender is not among the ones collected and analyzed

Premiums and Penalties Among Physicians in Italy: How Gender Affects the Combined Impact of Marital and Parental Status on Pay

This paper focuses on the penalties and premiums associated with marriage and parenthood among physicians. The research is based on a dataset of more than one thousand doctors working in five hospitals in the Lombardy region of northern Italy. The results show that, all else being equal, married fathers report a 15% premium compared to childless single men while married mothers report a 15% penalty compared to single childless women. Marriage and parenthood significantly affect wages only when they are combined together. Moreover, both males' premiums and women' s penalties grow as the number of children increases, but if married fathers' premium occurs from the first child, married mothers' penalty appears only from the second child on

Effetti e ostacoli delle pratiche di conciliazione vita-lavoro: dalla valutazione delle politiche allo studio delle organizzazioni.

L\u2019esistenza di una politica di welfare da sola non basta per garantirne l\u2019efficacia. Questo \ue8 vero anche per tutte quelle politiche che intendono favorire la conciliazione dei tempi di vita con i tempi di lavoro. Il presente working paper intende rendere conto di quella letteratura, per lo pi\uf9 internazionale, che rispetto alle misure di conciliazione vita-lavoro si \ue8 spinta al di l\ue0 della loro descrizione per entrare nell\u2019ambito della valutazione della loro efficacia, e pi\uf9 in particolare dell\u2019analisi dei fattori che ne favoriscono o ne impediscono l\u2019utilizzo e dell\u2019individuazione degli effetti sui potenziali beneficiari. L\u2019obiettivo del presente contributo \ue8 triplice: rendere visibile in Italia un filone di ricerca pressoch\ue9 sconosciuto; riflettere sui limiti e sulle sfide metodologiche che la valutazione delle pratiche di work-life balance comporta; fare luce sulla \uabcultura organizzativa\ubb, intesa come quel set di norme e valori condiviso all\u2019interno di un\u2019azienda che funge da facilitatore o da ostacolo al successo delle politiche e che pertanto non pu\uf2 non essere preso in considerazione nell\u2019ambito di un processo di valutazione. Sulla base dei risultati finora raggiunti dalla letteratura, verranno suggerite alcune possibili prospettive di ricerca

Gender inequalities in medical careers: findings from five hospitals in the Lombardy region

Le donne hanno fatto progressi significativi nella professione medica, ma nonostante questa tendenza persistono disparit\ue0 di genere nella retribuzione e nell\u2019avanzamento di carriera. Questo studio indaga i determinanti dei salari e dei differenziali di promozione tra i medici sulla base di un dataset di oltre 1000 medici che lavorano in cinque ospedali nella Regione Lombardia, Italia. I dati sono stati raccolti attraverso un sondaggio online con un tasso di risposta del 48,7%. Controllando le differenze nelle caratteristiche osservate, le donne guadagnano il 18% in meno rispetto ai loro colleghi maschi e hanno meno probabilit\ue0 di essere promosse. Lo svantaggio di genere nella promozione sussiste al passaggio tra il primo e il secondo livello, ma non nel passaggio dal secondo al terzo livello. Questo risultato suggerisce che la sottorappresentazione femminile nelle posizioni apicali \ue8 dovuta pi\uf9 a un meccanismo di \u2018sticky floors\u2019 (pavimenti che incollano) che a un effetto di \u2018glass ceiling\u2019 (soffitti di vetro).Women have made a significant progress in the medical profession, but despite this trend gender inequalities in pay and career advancement persist. This study investigates the determinants of wage and promotion differentials among physicians based on a dataset of more than 1000 doctors working in five hospitals in the Lombardy Region, Italy. Data were collected through an online survey with a response rate of 48.7%. Controlling for differences in observed characteristics, women earn 18% less than their male colleagues while they are less likely to be promoted from the early to the mid-level of the career ladder, while no adjusted penalty in promotion persists from the mid-level to the final step of the ladder. This result suggests that female underrepresentation in senior positions is due more to a sticky floor mechanism than to a glass ceiling effect

Welfare contrattuale e politiche di conciliazione tra uguaglianza di genere e tempo per la cura

Le politiche di conciliazione vita-lavoro hanno effetti non solo sull\u2019occupazione femminile ma anche sulla distribuzione dei carichi di cura tra uomini e donne e, di conseguenza, sull\u2019uguaglianza di genere. Analogamente, anche le iniziative di welfare aziendale in ambito di work-life balance possono avere implicazioni differenti sulle opportunit\ue0 di conciliazione vita-lavoro e di carriera dei lavoratori a cui si rivolgono, e in particolare della componente femminile all\u2019interno delle organizzazioni. Il presente contributo analizza le politiche implementate dalle aziende attraverso lo studio dei contenuti di 148 accordi aziendali siglati nel periodo 2004-2014, nel tentativo di individuare le implicazioni di diverse \uabstrategie\ubb aziendali in ottica di genere