How Can We Narrow the Opportunity Gap?

How Can We Narrow the Opportunity Gap?

Women in Oncology

Nov 28, 2017

By Julia Close, MD

When I first introduced to the concept of sponsorship, it took me some time to really understand how this was different from mentorship. Looking back on my career, the distinction seems more obvious. Mentors provide consistent advice, while sponsors provide opportunity. A mentor may recommend that my career could be improved by writing a review article, while a sponsor will put their reputation on the line to use their influence to recommend me to an editor. I appreciated my mentors. I am indebted to my sponsors.

A few months ago, a long time friend from medical school sent me an article from JAMA Internal Medicine, “Differences in Mentor-Mentee Sponsorship in Male vs Female Recipients of National Institutes of Health Grants.”1 In her email to me, and a number of our other female former classmates, she acknowledged that not all of us are grant-funded researchers, but that the general themes applied to all of us as we entered mid-careers in academia. “How can we do better than this, for ourselves and the women that follow?” she asked.

The letter reviewed a subset of results from a postal survey of NIH K08 and K23 grants awarded from 2006 to 2009. The recipients were queried as to the impact of sponsorship in academic success. In this case, academic success included measures such as grant support, publications, and leadership positions. Sponsorship experiences included invitations to present at national meetings, write editorials, or serve on national committees. The results were striking (and statistically significant). When divided by gender, the percentage of sponsorship experiences by mentees consistently followed the same pattern in a number of sponsorship opportunities. The largest number of sponsorship opportunities came for men with male mentors, followed by men with female mentors. Next in line were the number of opportunities for women with male mentors, and the lowest number of experiences related from women with female mentors. In summary, the greatest number of opportunities originated from men, and women were less likely to be given opportunities.

I am not a grant-funded researcher, and have no plans to become one in the future. However, I find myself mentally referencing these findings often. While women are entering medicine in numbers equal to or outpacing men, they remain behind in leadership positions. Sponsorship is an important factor in career advancement.

In the series of emails that followed, we all pondered the results. Notably, we spent little time debating the merits of the data presented—it falls in line with a growing body of literature related to women across multiple professions. We agreed with the possibilities mentioned by authors to explain this gap (all are generalities, not absolute truths for all individuals):

  • Women may have less powerful mentors, unable to offer the same quality of opportunities.
  • Women mentors may lack the size or strength of network for opportunities compared to men.
  • Mentors in general may be less likely to think of a female mentee compared to a male mentee when an opportunity comes along.
  • Women mentees may be less likely to ask for opportunities.

The study was not designed to determine these nuances, nor can we say for sure. An alternative solution was offered—that men truly may, on average, possess greater talents in these arenas. This seems unlikely to be the case.

A few months ago, I asked my colleague who organizes the hematology/oncology portion of the resident lecture series when she needed me to sign up for my annual lecture. She gave me an awkward look, and a pause. “You realize you haven’t given that lecture for 2 years, right? I passed it on to someone else. You don’t really need it anymore.”

I was a little offended. After all, I have excellent teaching evaluations (I’ve won awards!). I realized I really wasn’t sure when I had last given it, in the blur of work and life, which included multiple other speaking engagements. I retorted, “So I was fired? And I didn’t even know about it?”

She replied, “No. You are really busy. The chief residents gave me someone else’s name, she works with the house staff more often, and I put her on the schedule. TWO YEARS AGO. She does a great job.”

My immediate reaction is telling, and I don’t think I am alone. I was offended that I was not asked, as I given this lecture for years. On the other hand, I had not even noticed its absence in the long list of commitments I have carried in the past 2 years. I felt some degree of guilt that someone else had to do my job. I also felt some relief, as it was one less task to complete. The lecture was an opportunity for someone else, and in this stage of my career was not likely to help me advance in any way. Why had I not given it up sooner?

In addition to the postulates above, do we carry some degree of guilt by asking others to work on projects with us? I have a few colleagues who have related to me how overwhelmed they are by work. I have asked them, “Why don’t you ask for help? Co-authoring that paper would be a great opportunity for a fellow.” Their response: “I feel bad asking someone to do my work. I’ll just finish it myself.”

What can we do moving forward? There’s a nice piece by Dr. Janet Bickel entitled “How Men Can Excel as Mentors of Women,”2 which can be applied to all of us. Reading this, and through other experiences, I am working on the following to help promote women around me:

  • Be sure to consider a women for every position and award. The final decision should go to the best applicant. Be sure a woman is considered.
  • Support and encourage the women around us. Women are more likely to wait to apply for something when they are ready, whereas men are more likely to assume they will learn on the job. You won’t know how to do something until you do it! Apply for the new position.
  • Build up our networks so we can offer better sponsorship opportunities.
  • Do not make assumptions about the impact of life on work, or vice versa—prioritizing children does not mean a woman is not interested in the next step in her career.

What are you doing to help turn the sponsorship stats around?


  1. Patton EW, Griffith KA, Jones RD, et al. Differences in mentor-mentee sponsorship in male vs female recipients of National Institutes of Health grants. JAMA Intern Med. 2017;177: 581-2.
  2. Bickel J. How men can excel as mentors of women. Acad Med 2014;89:1100-2.

Dr. Close is a clinical associate professor at the University of Florida, where she is the program director of the Hematology/Oncology Fellowship Program. In addition to education, she is focused on performance improvement as the assistant chief of medical service in the Gainesville VA Medical Center.


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Sonali M. Smith, MD

Nov, 28 2017 3:19 PM

Julia--this is a thoughtful, data-filled, and eye-opening piece! One part of your blog that is particularly insightful is that female mentors are often in a weaker position than male mentors to help their mentees. This has to change, and the only way is to move forward is for each of us to open the door for a female colleague whenever we can. So--better sponsorship will enable better mentorship. If each of us can do this right now, think of the ripple effect!

Julia Lee Close, MD

Nov, 29 2017 2:31 PM

Agreed! We need to expand our own networks to expand the opportunities we can offer-


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