Janet Bickel Studies comparing the advancement of men and women in academic medicine continue to find that, even when credentials and time commitment are equal, a lower percentage of women progress to the top ranks. The two contributing factors that seem to come up most often are that women receive less adequate institutional support for their research and a poorer quality of mentorship.

The "glass ceiling" metaphor is not helpful in enlarging our understanding of these complex phenomena. "Cumulative career disadvantages" is better, and many of these disadvantages are quite subtle. For instance, men have company as they enjoy career success, whereas women become greater rarities, living in "glass houses" where there is no room for error and no place to practice. This kind of "surplus visibility" is a stress for minorities of any kind. Another downside of isolation is a lack of "social capital," frequently resulting in politically naïve assumptions and...

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