(1123) Roadblocks to Promotion: Barriers Facing Women Otolaryngologists

Introduction: Female doctors, particularly female otolaryngologists, make substantially less income than their male counterparts. Despite growing recognition of this disparity, there has been limited progress in bridging the gap. This qualitative study seeks to better understand why gender inequity exists, with a specific focus on timely promotion for women in academic otolaryngology.

Methods: From January 2023-January 2024, female associate professors in academic otolaryngology were asked to participate in telephone interviews. Semi-structured telephone interviews were utilized to glean individual experiences within ENT and with the promotion process. Participants were chosen via a purposeful criterion-based sampling to reach women from different regions of the country, sub-specialties, and training backgrounds. Interviews were transcribed, coded, and analyzed by independent reviewers for thematic content.

Results: Ten associate professors from all sub-specialties in otolaryngology were interviewed. Participants noted multi-tiered barriers to promotion, relative to their male colleagues. This included intrinsic factors such as imposter syndrome, lack of self-promotion, pregnancy, and child-raising activities. Extrinsic factors within otolaryngology departments included lack of mentorship, scarce female colleagues, and exclusion from the “boy’s club”. When integrated into departmental leadership, participants were often delegated to non-productive administrative tasks or roles. Finally, systemic implicit gender bias, micro-aggressions, non-standardized or unclear promotions processes, and lack of female leadership pose barriers at the college/hospital level.

Conclusions: On a granular level, female otolaryngologists face many challenges to timely promotion. Yet, identifying and addressing these factors can lead to mitigation to increase equity in promotion and pay across gender.