Female Nephrologists Find Barriers to Achieving Goals in Academic Medicine

Inequities persisted among female nephrologists at U.S. academic institutions, with barriers to advancement and burnout among the reasons many felt a lack of satisfaction, an interim analysis of survey data showed.

Among 32 women included in the online study, gender bias, lack of mentorship, and family responsibilities were identified as dominant barriers to advancing in academic nephrology, reported Amir Abdi Pour, MD, of Loma Linda University Medical Center in California, at the National Kidney Foundation’s Spring Clinical Meeting.

Strategies for improvement suggested by respondents included salary transparency, formal mentorship programs, and equitable leadership opportunities. Most respondents (68%) reported they had “adequate” mentorship, but more than half admitted difficulty finding mentors who aligned with their specific career goals.

“Over the years, as a chief of the nephrology division, I’ve had the privilege of working closely with many talented women in nephrology, including faculty, fellows, and postdoctoral scholars, and it has become increasingly clear that, despite strong representation and leadership potential, there are persistent barriers in the nephrology workforce for women that require more efforts for career progression,” said Abdi Pour.

Roughly two-thirds of respondents reported feeling burned out, largely driven by heavy workloads and competing responsibilities. Having seniority did little to improve things, as 23 respondents held leadership roles at their institutions. Though leaders reported marginally higher support than non-leaders, the difference was not statistically significant (P=0.76).

“The interim results confirmed what many of us have sensed anecdotally,” Abdi Pour told MedPage Today. “Seeing that over 60% reported burnout, regardless of leadership role, really stood out. We often assume that leadership brings more control or support, but the data suggest that the pressures are widespread and persistent across different career stages.”

While most female nephrologists felt burned out, about half said they were either satisfied (40.6%) or very satisfied (12.5%) with their work-life balance, while a quarter felt neutral, 15.6% were dissatisfied, and 6.2% were very dissatisfied. Satisfaction with work-life balance was positively correlated with perceived institutional support (ρ=0.53, P=0.002), suggesting that supportive workplace policies enhance well-being and retention.

The study builds on years of data highlighting gender disparities in the field. A 2016 report found that only 25% of all active nephrologists were female, including just 13.5% of nephrologists over age 60. While women made up 44% of all residents, only 36% of nephrology fellows were female.

Authors of a 2019 perspective further noted that since 1966, there have only been three female versus 49 male presidents of the American Society of Nephrology. In line with Abdi Pour’s group, they, too, advocated for mentorship programs as a way to boost career mobility, satisfaction, and leadership capacity for female nephrologists.

“These are issues we’ve discussed for years, but seeing them remain so prominent, even among a group where many hold leadership positions, was a powerful reminder that progress has been made, but not evenly,” said Abdi Pour.

Addressing these issues is vital for the specialty’s survival, he noted. “Nephrology as a field is facing broader challenges, particularly with recruitment and retention. We are seeing fewer trainees choosing nephrology, and maintaining a strong, diverse, and motivated workforce has become a priority,” he said.

“If we do not address these structural barriers, we risk losing talented female individuals,” Abdi Pour added. “The goal is not to point out gaps, but to create a more supportive, sustainable environment where all female nephrologists can thrive. If we invest in this, we will strengthen the future of nephrology as a whole.”

The cross-sectional survey primarily captured mid-career faculty, 56% of whom had achieved academic promotion. Academic rank included full professors (34.4%), assistant professors (31.3%), and associate professors (28.1%).

Most survey respondents were between ages 40-49 (43.8%) or 50-59 (31.3%). The majority were married or partnered (84.4%) and had children (81.3%).