Abstract
Objective. To evaluate the status of gender equity in US pharmacy education since the two previous publications on the topic in 2004 and 2014.
Methods. Data were gathered from existing national databases, internal American Association of Colleges of Pharmacy (AACP) databases, AACP meeting minutes, published reports, scholarly articles, pharmacy association websites, individual school websites, and LinkedIn profiles. Differences between men and women were evaluated on degree completion, discipline, rank, tenure status, research, leadership development, leadership positions, salaries, and professional awards. Comparisons were also made to academic medicine and dentistry.
Results. Fifty-one percent of full-time faculty members across all academic pharmacy disciplines are women. The percentage of women at the rank of professor was 36.6%, compared to 25% in 2014. Of the 2992 tenured or tenure track pharmacy faculty, 39.2% were women. Out of 388 department chairs, 146 were women. Throughout 2014-2021, there were 121 chief executive officer (CEO) dean permanent appointments, with men holding 91 (75.2%) and women holding 30 (24.8%). Women received 29.7% of the National Institutes of Health grants awarded to pharmacy schools compared to men (70.3%), although women’s funding amount was higher. In both the pharmacy practice discipline and all sciences disciplines, the total salary across all ranks and years in rank was significantly higher for men than women, even for department chairs, but there were no differences for CEO deans. To date, women have received 13% of four national pharmacy organizations’ top 13 awards.
Conclusion. Since 2014, some achievement gaps have narrowed, but areas of concern still exist and need continued attention and resources so inequities can be eliminated. Women in academic pharmacy need mentoring and support to extend throughout the trajectory of their careers in areas such as academic advancement, grant applications, salary negotiation, leadership pursuit, and award applications.
INTRODUCTION
By 1985, women made up the majority of first professional pharmacy degree recipients (54%) in the United States. That percentage increased to 63% by 2020.1 However, despite this pipeline of qualified candidates, women are still underrepresented in leadership positions, professional achievement awards, tenure status, academic advancement, and salaries in academic pharmacy. This discrepancy is not unique to academic pharmacy, as recent reports have detailed similar gender gaps in academic medicine and dentistry.2-9 The goal of this paper was to evaluate changes in gender equity in US pharmacy education that have taken place since the two previous inquiries into the topic in 2004 and 2014.10-11 A second goal was to compare data on academic pharmacy to that for academic medicine and dentistry.
METHODS
Data for this paper were obtained from a variety of sources, including existing national databases, internal American Association of Colleges of Pharmacy (AACP) databases, AACP meeting minutes, published reports, scholarly articles, pharmacy association websites, individual school websites, and LinkedIn profiles (LinkedIn Corp). Differences between men and women were calculated for degree completion, faculty member rank, tenure status, teaching discipline, leadership positions, national achievement awards, career advancement, and salaries using descriptive statistics, such as frequencies, means, and standard deviations. Differences in mean salary were calculated using the Mann-Whitney test because the distribution of monetary data required nonparametric statistical techniques.
RESULTS
Results related to degree completion revealed that the number of pharmacy degrees conferred for women had increased since 1965, when women received 14.1% of first professional degrees, 14.8% of Master of Science (MS) degrees, and 2.8% of Doctor of Philosophy (PhD) degrees.1 In 1985, women received 54% of first professional degrees, 41% of MS degrees, and 25% of PhDs.1 In 2020, women made up 63.0% of Doctor of Pharmacy (PharmD) graduates, 65.1% of MS graduates, and 45.9% of PhD graduates.1
In comparison, in 2018-2019, less than half (48%) of US medical school graduates were women, which was unchanged from 2011-2012.12 In 2020, 51% of dental school graduates were women, representing an increase from 2009 when 46.1% dental school graduates were women.10,13
Data related to the number of women faculty working in different disciplines or departments were assessed. In academic pharmacy in 2012-2013, the percentage of women who were full-time faculty in any department was 48%.10 In 2020-2021, the percentage of women who were full-time faculty in any department was 51%, as noted in the AACP 2020-2021 Roster and Faculty Salary Survey (RFSS).
In 2021, across all disciplines, 52.3% of all faculty were in the pharmacy practice discipline, per the AACP 2020-2021 RFSS. Within each discipline, women accounted for the majority of faculty in pharmacy practice (65.8%) and pharmacotherapeutics/translational research (54.6%). Medicinal/pharmaceutical chemistry/pharmacognosy had the least representation of women (19.3%), followed by pharmaceutics/pharmacy (30.8%), pharmacology/toxicology (33.1%), biological/biomedical sciences (37.9%), pharmacokinetics/dynamics/genetics (41.2%), and social/administrative sciences (47.5%). See Table 1 for faculty gender distributions across disciplines.
Percentagea of All Full-Time Pharmacy Faculty Positions Held by Women by Discipline and Year
Changes were also found in the faculty rank of women. According to the AACP 2020-2021 RFSS, out of 5426 full-time faculty in academic pharmacy, the number of women professors (36.6%) and associate professors (53.0%) had increased from 25% and 46%, respectively, in 2014 (Appendix 1).10 However, the percentage of female assistant professors (59.4%) remained essentially unchanged from 2014, when 60% of assistant professors were women.14 In comparison, in medical schools, women represented 43% of full-time faculty. These women comprised 27% of professors, 40% of associate professors, and 48% of assistant professors in academic medicine.15 In dental schools, 37% of full-time and part-time faculty were women.2
As for tenure status, 13.2% of all full-time pharmacy faculty worked at a nontenure granting institution, and 38.9% of full-time faculty worked in nontenure track positions. The remaining 47.8% were tenured or in a tenure track position. Of the 2992 tenured or tenure-track pharmacy faculty, 39.2% were women. In 2012-2013, 45.8% of men and 29% of women were tenured or tenure eligible.
Data related to faculty research outcomes and grants were assessed. As indicated by the AACP 2020-2021 Funded Faculty Research Grant Survey (and the Federal Grants Search tool), 1076 National Institutes of Health (NIH) grants were awarded to individuals with pharmacy academic or administrative rank, and 1052 reported gender. From this total, 312 (29.7%) of the 2020-2021 NIH grants were awarded to women. As a comparison, in 2012-2013, there were 710 NIH grants awarded to pharmacy faculty, and 196 (28.39%) of those were women.10 It is unknown whether the rejection rates for grant applications differed between men and women because it is unknown how many total NIH grant submissions were from pharmacy faculty. The average 2020-2021 funding amount for grants awarded to women was $425,586, with a median of $340,152, which was higher than the average funding amount awarded to men, which was $407,089, with a median amount of $344,250.
Leadership development data were also assessed. According to AACP internal data, there were 80 (54.8%) women out of the 148 pharmacy faculty participants in the Academic Leadership Fellows Program from 2014-2015 through 2018-2019 (five years of cohorts, cohort numbers 11-15). Of note, data from cohorts 16 and 17 are in progress. Another AACP career advancement program, AACP Catalyst, formerly known as the Academic Research Fellows Program, was a professional development program for midcareer faculty to accelerate their development into research leaders. While the program has since been suspended, out of the 59 participants, 16 (27.1%) were women.
Results related to academic leadership positions pertaining to dean and faculty positions are in Appendix 1, which provides the breakdown of male and female academic administrators. Table 2 highlights the status of women department chairs from 2002 to 2021. Findings showed that out of 388 department chairs, 146 were women (37.6%). When examining department chairs by discipline over time, the number of women continued to grow, especially in the social and administrative sciences and pharmacy practice. Social and administrative sciences is the only discipline where the percentage of women in the discipline equaled the number/percentage of department chairs who were women.
Total Number of Women and Men and Total Percentage of Women Serving as Department Chairs and Deans in Pharmacy Colleges and Schools by Discipline and Year
Throughout 2014-2021, there were 121 CEO permanent dean appointments, including 91 men (75.2%) and 30 women (24.8%). Of the 30 female deans appointed, 14 were hired at newly established programs, 14 were internal candidates, and two were external candidates. Of the 91 male deans appointed, four were at newly established programs, 53 were internal candidates, and 34 were external candidates.
In comparison, according to the 2020 American Association of Medical Colleges (AAMC) Faculty Roster Snapshots, in medical schools women made up 18% of the 136 permanent deans and 20% of the 2959 permanent chairs.15 Of the 66 US dental schools, 15 (23%) had female deans, according to data from 2017-2018.2
The results related to salary differences between male and female pharmacy faculty are presented in Appendix 2 and Appendix 3. Analyses were conducted for rank, years in rank, and totals for full-time calendar year appointments in pharmacy practice and in all sciences combined. Overall, in both the pharmacy practice and all science disciplines, results showed that the total salary across all ranks is significantly higher for men than women, with a mean difference of $7,961 and $13,148, respectively, both p<.001.
For more specific salary comparisons, findings showed that in pharmacy practice, men with >20 years in rank were paid more than women at the professor rank (p=.003). Also in pharmacy practice, across all years in rank, men were paid more than women at the professor (p≤.001) and assistant professor ranks (p=.027). While there is an average salary difference of $3,295 in favor of male assistant professors in the pharmacy practice departments across all years in rank, this gap was found to widen to $12,051 in favor of male professors of pharmacy practice across all years in rank, with the most marked contrast occurring in male professors of pharmacy practice with >20 years of experience making an average of $41,401 more a year than their female colleagues. The total salary across all ranks and years in rank favored men by $7,961.
When evaluating the differences in salary between men and women in all other science disciplines (excluding pharmacy practice) data favoring men were seen. Two instances were noted where salary differences favored women professors in the category of all science disciplines. Women at the professor rank were paid $24,150 more than men in the 11-15 years category (p=.029) and $57,774 more than men in the >20 years rank (p=.008). However, the >20 years group was composed of 80 men and only nine women. Yet, this average difference across all years in rank was reversed for women professors, where, on average, men made $4,777 more than women, and across all years and ranks, men in all science disciplines at all ranks made $13,148 more than women.
At the administrative level, overall, female department chairs were paid less (mean=$169,105, SD=$47,249) than their male counterparts (mean=$188,539, SD=$52,905) p<.001. No difference in compensation was found for CEO deans on the basis of gender.
While overall faculty salaries at medical schools went up by 2.3% in fiscal year 2019, there were significant differences in compensation between men and women at equal levels of educational and professional achievement.16 After controlling for potential confounding variables of age, years in rank, and specialty, the largest salary gaps were at the higher levels of leadership.16 According to the latest 2018 AAMC Faculty Salary Survey, women in the basic science disciplines made 90 cents on the dollar compared to men, and women across the clinical sciences disciplines made 77 cents on the dollar compared to men, again with greater disparities at higher levels of leadership.17 The 2018-2019 American Dental Education Association Survey of Dental School Faculty showed that women earned less than men at all professional ranks and as department chair.18
Results related to awards and recognition are in Table 3, which shows the number of achievement award recipients by association, award name, gender, and first year awarded through 2021. For AACP awards, comparing 2013 to 2021, an increased number of women have received the Chalmers Distinguished Pharmacy Educator Award (27.3% to 29.3%), the Dawson Excellence in Patient Care Research Award (21% to 26%), and the Volwiler Research Achievement Award (5.4% to 11.1%). The AACP introduced the Lifetime Achievement Award in 2017, and it has been bestowed four times, including twice to a woman.
Number of Achievement Award Recipients by Association, Award Name, and Gender Through 2021, N=513 Awards
As of 2013, no woman had ever won any of the top three awards conferred by the American Association of Pharmaceutical Scientists (AAPS). That changed in 2014, when a woman received the Outstanding Educator Award, followed by a second woman recipient in 2015. The award was retired in 2016. The Dale E. Wurster Research Award in Pharmaceutics has now been awarded to two women (2018 and 2020). The Distinguished Pharmaceutical Scientist Award has yet to be awarded to a woman since its inception in 1989. In 2020, AAPS Past President Alice Till initiated the Alice E. Till Advancement of Women in Pharmaceutical Sciences Recognition Award.19 It was bestowed on two women based on their contributions in promoting the professional development, success, and recognition of women in the pharmaceutical sciences.
The Remington Honor Medal was established in 1918 to recognize distinguished service on behalf of American pharmacy during the preceding year, culminating in the post year, or during a long period of outstanding activity in the field of pharmacy. In 1979, the American Pharmacists Association (APhA) received ownership and stewardship of the award. It is the profession’s highest honor. Since 1919, it has been awarded 93 times to 86 men (92.5%) and seven women (7.5%).
The APhA Research Achievement Award was established in 1961 as six separate awards, recognizing achievement in six disciplines of pharmaceutical sciences, although in most years not all disciplines have been recognized. From 1962 to 1994, the award was presented to 90 men and only one woman (in 1988). Between 1995 and 2021, the award has been presented to 20 men and four women. The APhA Tyler Prize for Stimulation of Research was established in 1962 and has been awarded 25 times. In 1996, the award took on a three-year rotation among the disciplines represented by the APhA Academy of Pharmaceutical Research and Science sections. The Tyler Prize has never been awarded to a woman.
The American Society of Health-System Pharmacists (ASHP) bestows three lecture awards annually. The John W. Webb Award recognizes a pharmacy practitioner who has fostered excellence in pharmacy administration. Women have accounted for 16.2% of Webb lecturers since 1985. The Harvey A.K. Whitney award has been given since 1950. It recognizes individuals who have made outstanding contributions to health-system pharmacy. It is recognized as health-system pharmacy’s highest honor. Women have accounted for 19.7% of recipients. The William Zellmer Award was established in 2010 to invite a distinguished speaker to address practice leaders of ASHP during ASHP policy week. Of the 11 Zellmer lectures, seven (63.6%) have been men and four (36.49%) have been women.
DISCUSSION
Since 1985, women have continually increased their majority status as the first professional degree recipients in pharmacy.1 This is in contrast to medical schools, where women remain in the minority of graduates, and in dental schools, where women recently became the majority.12,13 This majority extends into full-time pharmacy practice faculty positions, where a majority are women at the rank of assistant and associate professors. While these statistics may be reassuring to the Academy, especially when compared to data from medicine and dentistry, it is unclear why more gender equity in pharmacy has not occurred over this 37-year time frame. Progress still needs to be made to increase equity in areas such as the number of women who graduate from pharmaceutical sciences programs as well as the number of women faculty members and department chairs in pharmaceutical sciences.1,12
Concerns also remain over the continued lack of equity in the number of full-time women faculty at the rank of professor and in senior leadership positions, including associate deans and CEO deans. Even though the number of pharmacy programs led by a woman dean has continued to increase over approximately the last 20 years, the last seven years have only produced a 1.6% increase in the number of women CEO deans.10,11 This translates to the hiring of one additional female dean from 2014 to 2021, because in 2014 there were 30 women out of 107 deans, and in 2021 there were 31 women out of 119 deans. Questions remain as to why more gains have not been made.
Data outcomes related to gender equity in research are mixed. In 2020-2021, the average NIH grant funding amount awarded to pharmacy schools was higher for women compared to men. Because women only make up 34.5% of all positions in science disciplines, this funding amount is encouraging. However, last year, women in pharmacy were awarded fewer NIH grants (29.7%) than men, and over the past nine years the percentage of NIH grants awarded to women has only increased 1.4%; yet, pharmacy submission statistics are unknown. Publications are another variable related to research in academia. Although gender differences in publication rates were not evaluated in this study, a study by Ni and colleagues revealed that women’s contributions to research papers were devalued by both men and women, women were more likely to have disagreements over authorship than men, and women were more likely to be in the middle author position, indicative of a technical work role.20 The implications of these findings suggest that if women are deserving of a first author position but their efforts are not recognized, a woman’s research status could be negatively affected because authorship order is evaluated during promotion and tenure decisions.21 Excellence in research is also demonstrated in academia by serving on journal editorial boards. A study by Awad of 20 pharmacy journals’ editorial boards found that of the 813 board members, 326 (40%) were women, ranging from 8% to 63% per journal. Eighty percent had a male editor in chief.22 Similar underrepresentation has been reported in 44 medicine journals affiliated with the AAMC Council of Faculty and Academic Societies and in 69 dentistry journals.23,24 The pharmacy Academy needs to further investigate what barriers in research exist for women and why they remain, because research is a predominant aspect of the tripartite mission by which all faculty are judged.
In regards to salary, equal pay is regarded as the primary indicator of gender equality, according to the Pew Research Center.25 Over the past 15 years, the gender gap in pay in the United States has remained stable; most recently, women were found to earn 84% of what men earn, which translates to women needing to work an extra 42 days per year to earn what men do.25 This wage gap is seen in academic pharmacy, where salary differences between men and women still remain. The gender inequities in pay are essential to address because these inequities compound over time. The pharmacy data show salary gaps for women in their first faculty appointment, and the gaps do not disappear as women progress through rank and promotion, most likely because a person’s starting salary influences their future raises and retirement funds. This persistent gap reveals how important salary equity is at the start of one’s career. Therefore, it is vital the universities and departments closely monitor salary differences in order to close existing gaps, prevent new gaps from forming, and, ultimately, create sustainable salary equity.
Women remain clearly disadvantaged in award recognition, because out of the 513 highest awards from four national pharmacy organizations, women received 12.9% of the national awards compiled and men received 87.1%. In the research realm, the two AACP research achievement awards have been predominantly awarded to men. Of the AAPS research awards, the Distinguished Pharmaceutical Scientist Award has been awarded to 18 men and no women, and the Wurster Research Award has been awarded to men 87.5% of the time. For APhA research awards, it is surprising that from 1962 to 1994 only one woman received the award out of the 91 times it was offered. Since the award was converted to a single recipient award in 1995, only four women have received the award compared to 20 men. The Tyler Prize for Stimulation of Research has been awarded 25 times to 25 men. It is unknown how many women have applied for or been nominated for these awards, but the question still remains as to why women are not receiving more awards across pharmacy professional organizations. Is it because they are not being nominated or their award dossiers are not as competitive? Or are there problems with selection criteria or committee composition? The solution is not merely to award more women because of these statistics, but, instead, programs should evaluate nomination rates and practices and committee compositions and procedures. Colleges and national organizations should encourage deserving candidates to apply and should also offer mentoring about how to create a competitive dossier.
Leadership development programs have been shown to make a difference in women faculty’s career advancement.10,26 There has been momentum to develop women’s leadership skills, as evidenced by their participation in the AACP Academic Leadership Fellows Program, where just over half of the 148 participants were women. However, consistent with the inequities for women in the basic sciences described earlier, only 27.1% of women participated in the AACP Academic Research Fellows Program (now AACP Catalyst) prior to the suspension of the program. Future efforts should be aimed at facilitating women pharmacy faculty members’ participation in leadership development programs, opportunities, and mentoring, which can be within their discipline or outside in programs such as the Bryn Mawr Leadership Institute and the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) program.26,27
Some limitations to the study exist. The data were predominantly gathered from the 2020-2021 AACP Profile of Pharmacy Faculty, which is the most complete national database. While there was a ∼95% response rate to the national survey, it is possible some data were not captured, which may result in slight variation to the results. Another limitation is that the number of women applying to or being nominated for leadership programs, positions, or awards is unknown, and the number of women not receiving the award, position, or program acceptance is unknown. Therefore, it is unclear whether there is an even distribution among male and female applicants and subsequent outcomes.
CONCLUSION
While some achievement gaps have narrowed since 2013-2014, areas of concern still exist and need continued attention. Academic pharmacy needs to acknowledge and rectify gender inequity in leadership positions and examine criteria and award requirements to ensure that women are on a level playing field to receive national honors, leadership positions, invitations for speaking engagements, and grant awards.28 Barriers to participating in organizational leadership roles need to be addressed, such as conscious and unconscious biases, leadership self-efficacy, and work-life integration challenges.29 Salary discrepancies need to be eliminated because they have cumulative effects over one’s entire career. Women faculty need support throughout the trajectory of their careers. This support can be gained through more intentional and accessible career and leadership mentoring, which should include a national network of mentors across the health sciences disciplines that allow women to gain diverse role models and comprehensive guidance.
ACKNOWLEDGEMENTS
Special thanks to AACP staff including Lynette Bradley-Baker, Dorothy Farrell, and Terry Ryan for their assistance in gathering and describing the data.
Appendix
2020-2021 Full-Time Pharmacy Faculty by Rank, Years in Rank, and Gender
Appendix
Full-Time Faculty Salaries in 2020-2021 by Rank, Years in Rank, and Gender for Calendar Year Appointments in Pharmacy Practicea
Appendix
Full-Time Faculty Salaries in 2020-2021 by Rank, Years in Rank, and Gender for Calendar Year Appointments in All Science Disciplinesa,b
- Received November 16, 2021.
- Accepted April 26, 2022.
- © 2022 American Association of Colleges of Pharmacy
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