Johns Hopkins Women and Men Score Equal Numbers of Key NIH Grants

Young female and male Johns Hopkins University (JHU) Medical School M.D.’s and Ph.D.’s receive equal numbers of key National Institutes of Health (NIH) grants, says a recent Journal of Women’s Health study.

“A really interesting study,” American Society of Clinical Oncology ethics chair Reshma Jagsi, M.D., Ph.D., told Bioscience Technology. Jagsi, who published a 2009 paper finding similar groups of women nationwide score far fewer key NIH grants than men, was uninvolved in the new work.

“I think it shows what is possible within the context of a single institution where substantial efforts have been made to support gender equity and the success of all individuals pursuing careers as physician scientists,” Jagsi said. “This doesn't mean this is the case yet everywhere, as the authors very responsibly note in their conclusions. But it certainly shows what is possible.”

Meg Urry, director of the Yale Center for Astronomy & Astrophysics, and president of the American Astronomical Society, told Bioscience Technology: “This is a very interesting and encouraging experimental result, although the sample size is small. I think that the result found—that there is no gender imbalance in obtaining grants—was put in place two decades ago by conscious and determined efforts to improve mentoring in the workplace.” Urry was also uninvolved in the study.

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“Our numbers were surprising compared to national numbers,” said the paper’s lead author, Rita Kastogi Kalyani, M.D., M.H.S. “We are quite excited by the findings.”

"If I were a young physician scientist, I would ask to see the kind of data Hopkins just published from all the institutions where I was considering training," neurobiologist Jennifer Raymond, Ph.D., told Bioscience Technology. Raymond, associate dean of Stanford Medical School's Office of Faculty Development and Diversity, was uninvolved in the study.

The new study

In 2009, the above Jagsi et al. study found that, among nationwide grantees of elite, early career NIH K grants, women were 21 percent less likely than men to achieve prestigious NIH RO1 grants.

But no study had looked at the grant track record of universities making major diversity efforts.

So the Hopkins team of senior author, Susan McDonald, M.D., decided to take a look at grant-scoring abilities of its own staff, given that the school has launched many diversity efforts.

Young scientists and clinicians given K grants are considered elite. Their K grants offer them mentorship, extra money and time to build careers.

McDonald’s team found that, between 1999 and 2008, 92 faculty members in the JHU department of medicine (DOM) received K grants (49 men and 43 women). Of those, 34 would eventually receive prestigious NIH R01 grants (16 men and 18 women).

According to the American Association of Medical Colleges (AAMC), from 2013 to 2014, women made up 31 percent of full time US medical school faculty, but only 21 percent of full professors, 15 percent of department chairs, and 16 percent of deans. Nationwide, the most recent records (2013) indicate women make up only 1/3 of the physician workforce.

The new paper did not publish any JHU figures to compare with the national figures it cited in the above paragraph. The paper also did not indicate the size of the NIH grants scored by JHU women

But the JHU team did report that, “in 2012, 209 faculty members were in the DOM at the assistant professor level, including 95 females (45 percent) and 17 blacks or Hispanics (8 percent). Overall, there was a relatively similar representation of junior faculty men and women. The Task Force on Women’s Academic Careers in Medicine, formed in the DOM at our institution in 1990 to investigate gender-specific obstacles to advancement and implement solutions, was recognized by the AAMC with a 2013 Women in Medicine Leadership Development Award for an Organization.”

Yale’s Urry noted she was a graduate student in the JHU Physics Department, and worked in an affiliated institute on the Homewood campus for many years (the Space Telescope Science Institute). “I know a bit about the JHU med school’s diversity initiative in the 1990s,” she told Bioscience Technology. “At that time we were working to improve the climate for women at our astronomical observatory, and I came across a paper about the JHU School of Medicine, which had noticed that young women doctors were not nearly as successful in promotion and tenure as young men. There were striking differences. They determined that this was because of insufficient guidance and feedback; that the women didn't know `the rules.’ So they started a mentoring program, which greatly increased the success of women—and men, too. It was good for everyone. It helped good young scientists do their best work.”

Jagsi agreed the JHU medical school “absolutely” has a reputation for gender equity. “They wrote a landmark paper in the 1990s, published in JAMA (Journal of the American Medical Association), on the efforts of their DOM Task Force on Women. I was recently there as their Mary Elizabeth Garrett lecturer, named after the donor who helped establish the school, and insisted it admit women over a century ago when it was founded. I was very impressed by their efforts in this area.”

Urry did say she wished “they had said something about the relative sizes of the grants. I wonder if there might still be some disparities there.”

Urry added that the JHU’s Space Telescope Science Institute published a study last year showing that “women were slightly less likely to succeed in proposing for data and grants, a difference too small to see in any one of the annual proposal reviews, but adding up over 25 years to a very statistically significant difference. So disparities in grant success are seen in multiple places.”

All hiring criteria biased

This, Urry said, is “very worrying. If you look at the criteria we use to hire and promote and tenure scientists, every single one of them is biased by gender: grants, number of papers (depends directly on funding), numbers of citations (men prefer to cite other men), teaching (evaluations for women are more negative), university citizenship (women do more of it, and then get penalized for having done it), outreach (ditto), letters of recommendation. So why are we surprised when women are less likely to succeed in academic settings? Until we consciously recognize the extra obstacles to the progress of women, nothing will change.”

Happily, she noted, the new study may indicate that “concentrated, conscious attention to the issue can make an important difference.”

Raymond concurred, telling Bioscience Technology the new study is so "encouraging" it would be "wonderful" if more institutions released such data to establish a clear link between diversity training and success. JHU's DOM "deserves kudos for its innovation and leadership in the area of diversity and workplace culture. Their level of commitment to diversity is, unfortunately, still not at all common, particularly in the way they have embraced diversity goals, not just in terms of percentages of women and under-represented minorities, but also in terms of creating a culture of inclusion. (But) their results provide evidence that this kind of cultural transformation can have tangible, long-term impact on the overall excellence of an institution and the success of everyone in it."

Nancy Hopkins, an MIT emeritus biologist who launched a nationally recognized gender equity initiative at MIT, told Bioscience Technology the new Hopkins paper is “good news.”

However, she said, it is “limited…Even if men and women who have K awards obtain equal numbers of R grants from NIH after that, how does one know this has anything at all to do with the diversity/equity efforts of that institution? If the real goal here is to understand why there are fewer women at the top in academic medicine, one has to look at the whole funding picture. It used to be that most funding for biomedical research at MIT, for example, came from NIH. That ceased to be true long ago. It now comes from NIH, Howard Hughes, companies, private foundations, individual donors. And then of course there is the [disparity in] start up package sizes: see the recent JAMA article on this topic.”

What matters, Hopkins said, is “the total amount of money, not the source—though that may be interesting for other reasons. Also mattering is how much time one has to spend to get money; how steady the flow is; how all of that looks over time for women versus men. The places where institutional efforts matter are not in number of NIH grants obtained, but in start-up packages, inclusion on group grants, money given to scientists over their careers by the institution, access to private donors, etc. That is what diversity committees have to be able to track—which is not easy to do.”

Full professors

Harvard Medical School Associate Professor of Health Care Policy Anupam Jena, M.D., Ph.D., published a JAMA study in September finding that women nationwide are “substantially” less likely to hold the faculty rank of full professor even when differences in age, years of experience, specialty, number of scientific publications, NIH grants, and clinical trial leadership between men and women faculty are accounted for. See Drug Discovery & Development story.)

Noting the small size of the new JHU study, Jena told Bioscience Technology: “My guess is that looking at an underpowered study from one institution is a tough sell. I’m sure Hopkins has done a lot to promote diversity. But my sense is that many universities see this is a big deal as well, but just haven’t perfected things—obviously.” Jena was also uninvolved in the new study.

Kalyani responded that “the focus of the study was to see if there were differences in numbers of grants.” As there weren’t, she told Bioscience Technology, “the next step is to look at the reasons.”