Break the Bias: A Conversation with Anne Taylor, MD

March 8 is International Women’s Day, and this year’s theme is “Break the Bias.” We spoke with Anne Taylor, MD, senior vice president for faculty affairs and career development at Columbia University Irving Medical Center, about her role as a leader in the arena of gender equity in academic medicine.

In addition to heading faculty affairs for CUIMC,  Taylor is vice dean for academic affairs and the John Lindenbaum Professor of Medicine at the Vagelos College of Physicians and Surgeons. As SVP, she stewards the career growth, satisfaction, and recognition for all faculty across the medical center. We discussed the challenges facing women in academic medicine, the value of mentorship, and the opportunities that lie ahead for achieving a more equitable medical professoriate.  

This interview has been edited for length and clarity.

CUIMC News: To start us off, could you tell us about your own experiences as a Black woman in medicine and how those experiences influenced your path to being an advocate for racial and gender equity? 

Anne Taylor, MD: Thank you for having me! It’s an interesting question, because you're asking about the intersection of two identity groups, both of which have had substantial issues achieving equity in medicine. As a Black woman in medicine, I’ve seen a huge number of opportunities to advocate for change over the last 35 years, especially in advocating for more equitable treatment and representation. 

As a patient, I could see firsthand how treatments and patient interactions differed by group. As a medical student and young physician, I then began to understand the ways that medicine doesn't serve all populations equally. It became very clear, very early on, that my personal practice in medicine would be devoted to quality care for everyone—for all groups—irrespective of their position in society. So from that perspective, it was great to be a Black woman in medicine. I could see the problem firsthand, and I could make a commitment to never allowing those factors to enter into my care.

As my career evolved in academic medicine, there was the opportunity to pursue changes on a larger scale, for the diversification of both our faculty and our student body. There was the opportunity to advocate for equality of care as a principle, not just something that I did in my own practice. I was able to support the development of a professoriate that represented those principles, to increase not only the numbers of women and underrepresented groups in medicine, but their positions within the academic structure.

So, being a Black woman in medicine gave me purpose. It afforded me a view of what medicine should be and a clear view of how that ideal differed from the way medicine really was when I began my career. My experiences were, for me, the impetus for change. 

In a recent article about CUIMC’s advancements in gender equity, your peers and mentees had so much to say about you as a mentor and role model. Who were some of your most important mentors, and how did they impact your approach to mentorship?

I was very fortunate in that my first mentors were my parents. They grew up in the South and only had their high school education, but their self-education extended so far beyond that. My mother was my first reading teacher and piano instructor. Piano, I think, was meant to offer her a reprieve—if one kid was playing the piano, she could have her eyes firmly set on the other two—and she just rotated the cast of who was doing what.

My father was the first feminist in my life. He was the kind of man who would laugh out loud at being called a feminist, but he was, whether he knew it or not. His daughters were treated the same as his son: no difference in our education, no difference in our responsibilities at home, no limitations in the horizons that we chose for our lives. That was really a gift. It encouraged us to be adventurous, to go out into the world, and to do something with our lives without ever thinking, “Girls don't do this.”

I found other early mentors in the New York City school system; I'm a public school child through and through. I also had a wonderful cello teacher, who taught life lessons in addition to cello. Once, I was learning a very difficult piece and I was absolutely terrified of it. Each time I played it, you could hear the fear. He finally stopped me and said, “You can't be a great cellist, or anything else, unless you play with courage.” As a woman, the idea that I would need to be courageous to succeed was a wonderful lesson, and it’s proven to be true throughout my career. I try to pass on the same advice. 

What other advice would you give to younger people seeking quality mentors?

Students, junior faculty, and trainees can find mentors by being adventurous. You have to be willing to be proactive and ask for people's advice. You also have to be able to put up with those who aren't willing to support you and just move on without allowing that to be a statement about your worth. Learning how to extricate yourself from negative or demeaning mentoring relationships is an important lesson, too.

One of the things that I've enjoyed doing is developing our mentorship programs for faculty. We tell our faculty that you are the CEO of your life. Think about your direction, be strong in asking for advice and in taking risks, and don’t be deterred by negative views from others. 

In light of International Women’s Day and this year’s theme, “Break the Bias,” tell us your thoughts on the biases facing young women in the profession today. What do the data and your mentees tell you about the challenges facing women in academic medicine?

For women, one of the biggest challenges is the integration of family caregiving and careers. In academic medicine, there is so much data illustrating that women and men spend the same number of hours at work. But women then spend an additional 10 to 20 hours on family caregiving outside of work.

That data is not new. Historically, institutions have felt that it’s a personal problem. But now, there is a growing collective realization that caregiving is one of the things that makes a woman’s career path much, much more difficult. That’s not to say that this issue doesn’t affect men; only that there is growing support for the idea that we should be thinking about ways that institutions can advance both women and men equally, recognizing that there may be some differences between them. A recent grant from the Doris Duke Foundation is an exciting development in this space, as it aims to address disparities in caregiving responsibilities. 

There are some other subtle challenges for women, too. There's growing awareness in both the business world and in academic medicine that mentorship is equally important for men and women, but the type of mentorship they receive differs. Men are much more likely to receive direct advice on strategies to advance, while women are much more likely to receive psychosocial support. Ideally, mentorship should include both of those components.

Men are also more likely to enjoy sponsorship, like being invited to speak in an important forum or to take on leadership roles. Women and faculty from underrepresented groups are less likely to be provided the same opportunities. So we need to increase awareness about the importance of sponsorship and make sure that those in a position to offer those opportunities are approaching it with equity in mind. 

Another interesting finding concerns feedback. We surveyed faculty and asked whether they were receiving feedback in their careers, and, importantly, we asked from whom they receive that feedback. 46% of men said that they received direct feedback from their department chairs. Only 26% of women could say the same. So what does that mean?

First of all, it means that men have more access to those who are empowered to help them advance their careers. If the person who is in a position to provide growth opportunities is not speaking to 75% of their women faculty, and is preferentially speaking to almost half of their male faculty, what's the impact of that? There's a lot of work to be done to parse out the effects of that kind of culture, but the bottom line is to make sure that those in a position to provide opportunities provide them with equity in mind.

In your opinion, what does a gender equal world look like, and how are we trying to achieve that?

We've made a lot of progress in gender equity over the last 10 years. Columbia has always had more women on their faculty than the national average and currently, 49% of our faculty are women. So it’s important to understand that this isn't a numbers problem. It is an inclusion problem.

Are women in positions of leadership? Do they receive awards and honors equivalently with men? Are they  proportionately included in key decision-making processes? These are the kinds of questions we now need to address. Over the last 10 years, we've tracked those numbers, and the good news is that they really have changed dramatically.

For example, we have increased the number of women chairing departments. We now have five women chairs, with even more active searches in the works. About 30% of our departmental vice chairs and our division directors are women, which also represents a significant change. The number of women receiving new endowed professorships went from 13% a decade ago to 44% by our most recent count.

The numbers of women in the tenure track have also increased, so that 45% of our tenure track are women, although women are still underrepresented in tenured positions. But with our tenure pipeline now almost proportionate to the numbers of women in medicine, we will see the number of tenured women accelerate over time, too, since the success rate for women who undergo tenure evaluation is equal to that of men. I’ve said it before, and it bears repeating: It is now a lag in time, not in opportunity, so it is key to continue to fill the tenure track pipeline with women.

Much of the same work remains to be done with faculty from underrepresented groups. With those groups, we also have the challenge of increasing the numbers, but I think that our successes with women have given us strategies to achieve our equity goals across the board. We are in a very unique and wonderful place, in that we have a broad coalition of people who support real diversification and equity, and so it's really the moment to move ahead in that respect. 

What advice do you have for those who will continue this work into the future?

Be courageous. Step up on your own behalf and on the behalf of others. The best thing about striving for and achieving equity across all of these groups is that it really allows us to have the most powerful intellectual capital possible. This work ensures that we are getting the best and the brightest from every group, and their inclusion can only make us better.