BACKGROUND AND OBJECTIVES

The Women’s Wellness through Equity and Leadership (WEL) program was developed as a collaboration between 6 major medical associations in the United States. The goal was to contribute to the creation of equitable work environments for women physicians. The purpose of the current study was to evaluate the pilot implementation of WEL.

METHODS

Participants included a diverse group of 18 early career to midcareer women physicians from across medical specialties, 3 from each partner organization. WEL was developed as an 18-month program with 3 series focused on wellness, equity, and leadership and included monthly virtual and in-person meetings. After institutional board review approval, a mixed-methods evaluation design was incorporated, which included postseries and postprogram surveys and in-depth telephone interviews.

RESULTS

Participants delineated several drivers of program success, including peer support and/or networks; interconnectedness between the topics of wellness, equity, and leadership; and diversity of participants and faculty. Areas for improvement included more opportunities to connect with peers and share progress and more structured mentorship. Regarding program impact, participants reported increased knowledge and behavior change because of their participation.

CONCLUSIONS

This longitudinal, cohort initiative resulted from a successful collaboration between 6 medical associations. Evaluation findings suggest that providing opportunities for women physicians to connect with and support each other while building knowledge and skills can be an effective way to advance wellness, equity, and leadership for women in medicine.

What’s Known on This Subject:

Women physicians are growing in numbers yet continue to face discrimination and a lack of opportunities for advancement. Although their challenges are well-documented, little is known regarding how to effectively provide women physicians with support.

What This Study Adds:

In this study, we highlight a successful collaboration between 6 US medical associations to promote equitable work environments for women physicians. Built around the critical concepts of wellness, equity, and leadership, the program described offers a model for fostering needed change.

The majority of medical school applicants and matriculants are women,1  and women comprise more than one-third of the active physician workforce.2  Women have made significant progress in terms of entering the physician workforce; however, disparities remain in leadership positions, career advancement,3  compensation,46  and wellness.7,8  Women in medicine face many additional challenges, including discrimination, gender-based harassment, gender bias, gendered expectations, and cultural environments not conducive to success.911  The challenges faced by women of color are even greater.1215  Discrimination remains despite studies showing that patient satisfaction is higher with women physicians and that, in some settings, women physicians have better clinical outcomes.1620  In addition, numerous studies have shown that patients receive higher quality care when they have the same race, ethnicity, and/or language as their providers.21,22  It is therefore imperative to foster diversity among physicians; supporting women in medicine is a critical part of this imperative.

Many of the challenges faced by women physicians are directly linked to work environment, organizational culture, social support, and community-level factors.23  To improve health care, environments that are conducive to the success of diverse groups of women must be created. To address these pervasive issues, the Women’s Wellness through Equity and Leadership (WEL) program was conceived as a collaborative effort between 6 partner organizations: the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), American College of Physicians (ACP), American Hospital Association (AHA), and American Psychiatric Association (APA). Across these groups, there was potential to impact >400 000 physicians.

Funded by the Physicians Foundation, WEL aimed to contribute to the creation of healthier, more equitable work experiences for women physicians. WEL sought to make change at both individual and organizational levels, by fostering the development of women leaders and building an enduring infrastructure among the 6 partner organizations to advance work in these areas. Training and supporting the next generation of women leaders constitutes a crucial investment that will shape and enhance the delivery of care for years to come. An 18-month curriculum was developed, which included 3 educational series: wellness, equity, and leadership (Table 1). The curriculum was delivered via monthly webinars and 4 in-person meetings. Eighteen women physicians were enrolled in the pilot implementation of WEL, 3 from each partner organization (the cohort). At the start of the program, participants drafted a statement of purpose and impact (impact statement). Most participants used their statement as a guide for action throughout their involvement in WEL. At the program’s conclusion, cohort members presented their progress toward achieving their goals.

TABLE 1

Topics Addressed in the WEL Program Curriculum

WEL Topics
Wellness 
 Gender-based differences in burnout and wellness 
 The business case for organizational wellness 
 Organizational factors related to physician wellness 
 Burnout: How do you change the culture around you? 
 Building your own wellness plan 
 Organizational wellness 
Equity 
 Common workplace inequities 
 Organizational strategies to address inequities 
 Finding your voice 
 Using advocacy to increase representation of women in leadership roles 
 Identifying and practicing personal-equity principles 
 Negotiation as a strategy to advocate for women 
 Identifying the role of bias in decision-making 
 How to build inclusive environments 
Leadership 
 Understanding leadership disparities for women in medicine 
 Organizational change and transition management 
 Organizational strategic planning 
 Organizational financial planning 
 Management versus leadership 
 Leadership styles and critical skills 
 Collaborative negotiations 
 Difficult conversations 
 Providing effective feedback 
 Advocacy: finding your voice 
 Media training 
 Building your social media presence 
WEL Topics
Wellness 
 Gender-based differences in burnout and wellness 
 The business case for organizational wellness 
 Organizational factors related to physician wellness 
 Burnout: How do you change the culture around you? 
 Building your own wellness plan 
 Organizational wellness 
Equity 
 Common workplace inequities 
 Organizational strategies to address inequities 
 Finding your voice 
 Using advocacy to increase representation of women in leadership roles 
 Identifying and practicing personal-equity principles 
 Negotiation as a strategy to advocate for women 
 Identifying the role of bias in decision-making 
 How to build inclusive environments 
Leadership 
 Understanding leadership disparities for women in medicine 
 Organizational change and transition management 
 Organizational strategic planning 
 Organizational financial planning 
 Management versus leadership 
 Leadership styles and critical skills 
 Collaborative negotiations 
 Difficult conversations 
 Providing effective feedback 
 Advocacy: finding your voice 
 Media training 
 Building your social media presence 

The purpose of this study was to conduct an evaluation of the pilot implementation of WEL, including delineating program strengths, identifying areas for program improvement, and assessing program impact on participant knowledge and behavior. This study was undertaken to inform future iterations of WEL and contribute to the general body of work around supporting women physicians.

Approved by the AAP Institutional Review Board and conducted by 2 independent consultants, this evaluation incorporated a mixed-methods design with both qualitative and quantitative data.24,25  The dominant–less dominant framework was used for combining these methodologies, with the qualitative data taking a more prominent role.25 

The recruitment strategy for the 18-member cohort varied across partner organizations; several used a competitive review process, and others invited leadership-selected candidates to participate. Organizations were asked to (1) identify women physicians with demonstrated leadership or leadership potential and (2) intentionally attend to diversity across key characteristics, including age, race and/or ethnicity, year in practice (early career and midcareer26  women were recruited), geographic location, and type of position (eg, practitioner versus academic).

In the evaluation, we used data from 3 sources developed by the evaluation consultants with input from the WEL staff and leadership team.

Three postseries evaluation surveys assessed cohort members’ self-reported change in knowledge and confidence after the leadership, equity, and wellness series. These surveys were administered electronically and by paper. Thirteen (72%), 17 (94%), and 10 (56%) cohort members completed the wellness, equity, and leadership postseries evaluation surveys, respectively.

A postprogram evaluation survey containing questions about WEL overall was administered after the last in-person cohort meeting, on paper for those who attended in-person and electronically for those who attended virtually. Thirteen cohort members (72%) completed a postprogram survey.

Ninety-minute telephone interviews were conducted with cohort members by using a semistructured discussion guide; when feasible, cohort members of partner organizations were interviewed together. Questions were focused on 2 themes: program experience and outcomes and impacts. Interviews were recorded with participant permission. All 18 cohort members completed an in-depth interview.

Descriptive statistics were generated for postprogram survey responses. Interview responses were transcribed verbatim and reviewed for accuracy. An iterative consensus-based process was used by the 2 evaluators to identify key content and themes.

Eighteen women physicians were enrolled in the pilot implementation of WEL; 13 (72%) completed a demographics questionnaire (Table 2). Their median age was 42 years (range = 34–48); 6 identified as white (46%), 4 as Black (31%), and 1 each as Asian American (8%), Native Hawaiian and/or other Pacific Islander (8%), and white and Asian American (8%). At the time WEL began, 7 were early career (1–10 years posttraining; 54%) and 6 midcareer (11–20 years posttraining26 ; 46%), and 11 worked full-time (≥40 hours per week; 85%) and 2 part-time (<40 hours per week; 15%). Regarding (sub)specialty, participants practiced family medicine (3: 23%), obstetrics and/or gynecology (3: 23%), internal medicine (2: 15%), pediatrics (2: 15%), allergy and/or asthma and/or immunology (1: 8%), psychiatry (1: 8%), and pulmonary and/or critical care (1: 8%). Six were employed at an academic and/or medical school or parent university (46%), 2 within nongovernment hospitals and/or clinics (15%), 1 within a US government hospital or clinic (8%), and 1 within a multispecialty practice (8%);1 was self-employed in solo practice (8%), and 2 reported some other type of employment setting (15%).

TABLE 2

WEL Participant Demographics (n = 13)

CharacteristicParticipants in Each Category
Gender, n (%)  
 Female 13 (100) 
Transgender, n (%) 0 (0) 
Age, median (range), y 42 (34–48) 
Race, n (%)  
 White 6 (46) 
 Black 4 (31) 
 Asian American 1 (8) 
 Native Hawaiian/other Pacific Islander 1 (8) 
 White and Asian American 1 (8) 
Sexual orientation, n (%)  
 Heterosexual 12 (92) 
 Prefer not to answer 1 (8) 
Career stage at start of WEL, n (%)  
 Early career: 1–10 y posttraining 7 (54) 
 Midcareer: 11–20 y posttraining 6 (46) 
Work schedule at start of WEL, n (%)  
 Full-time (≥40 h/wk) 11 (85) 
 Part-time (<40 h/wk) 2 (15) 
Medical specialty, n (%)  
 Family medicine 3 (23) 
 Obstetrics and gynecology 3 (23) 
 Internal medicine 2 (15) 
 Pediatrics 2 (15) 
 Allergy, asthma, andimmunology 1 (8) 
 Psychiatry 1 (8) 
 Pulmonary/critical care medicine 1 (8) 
Primary employment setting, n (%)  
 Academic/medical school or parent university 6 (46) 
 Nongovernment hospital/clinic 2 (15) 
 US government hospital or clinic 1 (8) 
 Multispecialty practice 1 (8) 
 Self-employed solo practice 1 (8) 
 Other 2 (15) 
CharacteristicParticipants in Each Category
Gender, n (%)  
 Female 13 (100) 
Transgender, n (%) 0 (0) 
Age, median (range), y 42 (34–48) 
Race, n (%)  
 White 6 (46) 
 Black 4 (31) 
 Asian American 1 (8) 
 Native Hawaiian/other Pacific Islander 1 (8) 
 White and Asian American 1 (8) 
Sexual orientation, n (%)  
 Heterosexual 12 (92) 
 Prefer not to answer 1 (8) 
Career stage at start of WEL, n (%)  
 Early career: 1–10 y posttraining 7 (54) 
 Midcareer: 11–20 y posttraining 6 (46) 
Work schedule at start of WEL, n (%)  
 Full-time (≥40 h/wk) 11 (85) 
 Part-time (<40 h/wk) 2 (15) 
Medical specialty, n (%)  
 Family medicine 3 (23) 
 Obstetrics and gynecology 3 (23) 
 Internal medicine 2 (15) 
 Pediatrics 2 (15) 
 Allergy, asthma, andimmunology 1 (8) 
 Psychiatry 1 (8) 
 Pulmonary/critical care medicine 1 (8) 
Primary employment setting, n (%)  
 Academic/medical school or parent university 6 (46) 
 Nongovernment hospital/clinic 2 (15) 
 US government hospital or clinic 1 (8) 
 Multispecialty practice 1 (8) 
 Self-employed solo practice 1 (8) 
 Other 2 (15) 

Evaluation findings are presented according to the following questions: (1) What themes emerged as important to project success? (2) What considerations emerged regarding project improvement? (3) What was the project impact in terms of knowledge and behavior? Within each question, themes are presented, and representative quotes from cohort participants are provided in corresponding tables.

What Themes Emerged as Important to Project Success?

Throughout interviews and survey comments, cohort members identified several factors that fostered project success (see representative participant quotes in Table 3).

TABLE 3

Program Strengths as Reported by Cohort Members

ThemeExample Quotes
Trust and meaningful relationships “I won't lie. I felt intimidated and nervous because, do I belong in this room?...But I think the amazing thing is that, the way the program was set up, that the barriers were all brought down at the very beginning.” 
 “…everyone was so positive, and you were comfortable showing your full self to everybody from the beginning, which is really unique too. You didn't feel like you had to pretend or hide because everybody kind of ripped off those band aids the first day we were there, and we kind of let all the laundry out from the beginning, and then the vulnerability was welcomed every single time.” 
Importance of impact statements “And so, for me, that was the most important content because I still use that today when I'm trying to determine what direction I want my career to go into and how different opportunities may fit into my career.“ 
 “I also found the [impact statement] exercise to be really valuable. I was initially a bit skeptical that it would be a useful exercise. But it allowed me to focus on and clarify my own goals, and I've sort of been working on lots of different projects that are quite diverse, and it gave me the opportunity to identify one project specifically that I wanted to focus on.” 
Accountability “I think with us having set dates for meetings… it… kept me on task. So I did set goals for myself, aligned to meetings or aligned to teleconferences…” 
 “…I think the accountability in terms of having to report back and our phone calls where we would hear about other people's [impact statement], and their process. That was helpful because that not only gave me ideas but also was really motivating…the accountability I think was crucial because I knew that I was responsible to the leaders of WEL, but also to my peers.” 
Peer support “So, 100% that was what it was, for me, was making those connections. We bonded really well. We leaned on each other. It was…like a peer support group, really, where you're empowered by bringing each other up.” 
 “I would say that the peer-to-peer support was instrumental and to solidify that, we had to have the in-person meetings. We had to have these social breaks where we were sharing stories, getting to know each other as people. On the webinar, that just doesn't occur. Webinars [were for] information giving.” 
Interdisciplinary approach “…the peer relationships. I think I've developed great friendships, a great professional relationship and met with people that I otherwise would have never had interactions with because we don't normally cross paths, given that often there's not a lot of communication between fields, especially in community health or in private practice.” 
Integration of leadership, equity and wellness “It solidified or brought together some things that I think are floating around in my head typically related to how equity and wellness intersect. And I think for me, [it] crystallized this idea that really, conversations about physician wellness cannot exclude conversations about equity experiences of different people and so that has really informed how I move forward and my research and what I do from a leadership standpoint.” 
 “For me was a really novel way to think about it in that all those things are aligned. So, to achieve wellness among physicians, you have to think about equity and that equity is a part of achieving wellness for everyone. And that leadership is necessary. So, for us to address the systemic problems that lead to inequity and lead to lack of wellness among physicians, we have to be leaders in that and there has to be leadership at the table, that's aware of those of equity and wellness. And so, for me, just understanding how all of those things intersect [and you] really can’t address one effectively without addressing another.” 
Diversity of cohort and faculty “…we need to be sure that we're highlighting so much diversity, equity, and inclusion in all stages. And I think that the WEL cohort did a great job of that. All of our teachers, they displayed a wide variety and every way. And so it wasn't just talking the talk, you could see that they were very deliberate in who they put in front of us. And that is empowering in and of itself.” 
 “I will applaud WEL, and I have sung their praises in a lot of different venues to say that they picked the cohort from geographic practice area to practice types to racial diversity. Clearly just very impressive.” 
 “It was also the diversity of the group, too. I mean, we see certain groups and even just being put in these leadership groups that are not diverse in most cases. Then you start to believe things about yourself because you don't look like everybody else. And that was one of the really unique things about this is that you look around the room, and we all had these shared experiences that were so unique, and yet we had still been successful.” 
 “As a Black and African American woman who entered this cohort with five other Black women, we were all leaders in our own section of the country. But it was nice to come together as part of WEL, to recognize one another as leaders and recognize who we are ethnically and racially.” 
ThemeExample Quotes
Trust and meaningful relationships “I won't lie. I felt intimidated and nervous because, do I belong in this room?...But I think the amazing thing is that, the way the program was set up, that the barriers were all brought down at the very beginning.” 
 “…everyone was so positive, and you were comfortable showing your full self to everybody from the beginning, which is really unique too. You didn't feel like you had to pretend or hide because everybody kind of ripped off those band aids the first day we were there, and we kind of let all the laundry out from the beginning, and then the vulnerability was welcomed every single time.” 
Importance of impact statements “And so, for me, that was the most important content because I still use that today when I'm trying to determine what direction I want my career to go into and how different opportunities may fit into my career.“ 
 “I also found the [impact statement] exercise to be really valuable. I was initially a bit skeptical that it would be a useful exercise. But it allowed me to focus on and clarify my own goals, and I've sort of been working on lots of different projects that are quite diverse, and it gave me the opportunity to identify one project specifically that I wanted to focus on.” 
Accountability “I think with us having set dates for meetings… it… kept me on task. So I did set goals for myself, aligned to meetings or aligned to teleconferences…” 
 “…I think the accountability in terms of having to report back and our phone calls where we would hear about other people's [impact statement], and their process. That was helpful because that not only gave me ideas but also was really motivating…the accountability I think was crucial because I knew that I was responsible to the leaders of WEL, but also to my peers.” 
Peer support “So, 100% that was what it was, for me, was making those connections. We bonded really well. We leaned on each other. It was…like a peer support group, really, where you're empowered by bringing each other up.” 
 “I would say that the peer-to-peer support was instrumental and to solidify that, we had to have the in-person meetings. We had to have these social breaks where we were sharing stories, getting to know each other as people. On the webinar, that just doesn't occur. Webinars [were for] information giving.” 
Interdisciplinary approach “…the peer relationships. I think I've developed great friendships, a great professional relationship and met with people that I otherwise would have never had interactions with because we don't normally cross paths, given that often there's not a lot of communication between fields, especially in community health or in private practice.” 
Integration of leadership, equity and wellness “It solidified or brought together some things that I think are floating around in my head typically related to how equity and wellness intersect. And I think for me, [it] crystallized this idea that really, conversations about physician wellness cannot exclude conversations about equity experiences of different people and so that has really informed how I move forward and my research and what I do from a leadership standpoint.” 
 “For me was a really novel way to think about it in that all those things are aligned. So, to achieve wellness among physicians, you have to think about equity and that equity is a part of achieving wellness for everyone. And that leadership is necessary. So, for us to address the systemic problems that lead to inequity and lead to lack of wellness among physicians, we have to be leaders in that and there has to be leadership at the table, that's aware of those of equity and wellness. And so, for me, just understanding how all of those things intersect [and you] really can’t address one effectively without addressing another.” 
Diversity of cohort and faculty “…we need to be sure that we're highlighting so much diversity, equity, and inclusion in all stages. And I think that the WEL cohort did a great job of that. All of our teachers, they displayed a wide variety and every way. And so it wasn't just talking the talk, you could see that they were very deliberate in who they put in front of us. And that is empowering in and of itself.” 
 “I will applaud WEL, and I have sung their praises in a lot of different venues to say that they picked the cohort from geographic practice area to practice types to racial diversity. Clearly just very impressive.” 
 “It was also the diversity of the group, too. I mean, we see certain groups and even just being put in these leadership groups that are not diverse in most cases. Then you start to believe things about yourself because you don't look like everybody else. And that was one of the really unique things about this is that you look around the room, and we all had these shared experiences that were so unique, and yet we had still been successful.” 
 “As a Black and African American woman who entered this cohort with five other Black women, we were all leaders in our own section of the country. But it was nice to come together as part of WEL, to recognize one another as leaders and recognize who we are ethnically and racially.” 

Program Structure and Content

Participant responses were nearly unanimous that WEL in-person meetings and webinars were key to program success. This included comments about the high-quality curriculum and the importance of having time away from normal life and routines to focus on learning. As described below, in-person meetings were particularly critical to providing participants time to connect with each other.

Multiple cohort members identified the first in-person meeting as the setting in which they developed sufficient comfort to trust and begin to build meaningful relationships with other participants. Several cohort members reported initial feelings that they were not worthy to participate in WEL but felt more comfortable after that first meeting because of the vulnerability they all shared. Key to the first meeting was the process of each participant drafting her impact statement. Statements varied by participant and included intentions to improve medical training and/or education, foster physician diversity by focusing on pipeline initiatives, foster patient outcomes and health and gender equity, improve physician wellness, and address racism. Participants also discussed the program structure as fostering accountability as participants made progress on their impact statements.

Peer Support and/or Networks

Another helpful aspect of the program discussed by participants was peer support and networking. Participants talked about the validating nature of these relationships, and how they found camaraderie in their similar experiences. Participants also mentioned appreciating the multidisciplinary nature of the project and being exposed to women from other areas of medicine. Providing dedicated time and space to participants to develop and grow their relationships throughout the 18-month program was critical to project success.

Interconnectedness Between Components

Cohort members repeatedly stressed the synergy, or interconnectedness, between the 3 WEL topics: wellness, equity, and leadership. Participants discussed both the novelty and utility in considering these concepts together.

Diversity of Participants and Faculty

WEL leadership intentionally attended to diversity across a variety of personal and workplace characteristics when recruiting WEL cohort members. Similarly, program leaders sought out a diverse group of program faculty, and 39% of the faculty were Black, Indigenous, and/or people of color (BIPOC). Reflecting on their WEL experience, numerous cohort members spoke about the value and importance of this diversity. Some participants specifically talked about the value of the cohort’s racial and/or ethnic diversity, and the validating nature of the diverse composition of the group.

What Considerations Emerged Regarding Project Improvement?

Cohort members also identified several opportunities to improve the WEL experience. Many of the areas mentioned mirrored those discussed in terms of program strengths (see representative participant quotes in Table 4).

Table 4

Opportunities for Program Improvement as Reported by Cohort Members

ThemeExample Quotes
Program structure and content “…we had some very impressive speakers. I think really making a better effort to connect the participants to those speakers would be helpful.” 
Expansion of peer support and network development Cohort members suggested development of some form of check-in groups or teams or affinity groups (eg, regional, topic-specific, leadership level) as an informal way to stay connected outside of structured WEL Program touchpoints. 
Enhanced mentoring “…it would have been nice to have someone sort of paired with you to kind of check in and help see if you're moving things along and what the challenges might be in that. I had a lot of challenges with time and an opportunity to do the things I was trying to do, and I think I really could have used somebody to bounce things off of with that mentorship, that senior mentorship to help me along.” 
 “I was really hoping to get from this some sort of a formal mentor in this space. I know that was one of the intentions to have in the program, and I’m not sure what the limitations were in having that happen. But I think I would have really appreciated, and it would have been a really tangible something that I would have continued to benefit from after the 18 mo are over.” 
 “…directly linking people would be helpful. Like [partner organization] is a very big organization and…trying to approach people felt very closed…” 
ThemeExample Quotes
Program structure and content “…we had some very impressive speakers. I think really making a better effort to connect the participants to those speakers would be helpful.” 
Expansion of peer support and network development Cohort members suggested development of some form of check-in groups or teams or affinity groups (eg, regional, topic-specific, leadership level) as an informal way to stay connected outside of structured WEL Program touchpoints. 
Enhanced mentoring “…it would have been nice to have someone sort of paired with you to kind of check in and help see if you're moving things along and what the challenges might be in that. I had a lot of challenges with time and an opportunity to do the things I was trying to do, and I think I really could have used somebody to bounce things off of with that mentorship, that senior mentorship to help me along.” 
 “I was really hoping to get from this some sort of a formal mentor in this space. I know that was one of the intentions to have in the program, and I’m not sure what the limitations were in having that happen. But I think I would have really appreciated, and it would have been a really tangible something that I would have continued to benefit from after the 18 mo are over.” 
 “…directly linking people would be helpful. Like [partner organization] is a very big organization and…trying to approach people felt very closed…” 

Project Structure and Content

Suggestions to improve the impact statement experience included creating more frequent opportunities to share progress updates. Cohort members also recommended encouraging updates that not only celebrate successes and accomplishments but also explore, with appropriate peer support and coaching, barriers and challenges.

Opportunities to improve webinars were focused largely on scheduling. Cohort members recognized the difficult logistics of planning across time zones but recommended establishing a standing webinar time to allow participants to protect time on their calendars. Additionally, some participants requested greater access to the impressive WEL webinar faculty.

Cohort members made recommendations to enhance specific aspects of the curriculum; these were largely individualized and included adding content addressing the finances of health care, socioeconomic and racial equity, and supporting other women. Importantly, it was noted that content around balancing professional and personal life should include women who do not have children.

Peer Support and/or Networks

On the basis of the value ascribed to the cohort network, members unequivocally advocated for additional opportunities to facilitate peer support and relationship building within their partner organization subcohort and across the WEL cohort. Several cohort members suggested the development of check-in groups, teams, or affinity groups (eg, regional, topic-specific, or leadership level) as an informal way to stay connected outside of structured WEL touchpoints.

Mentoring

Consistent across the cohort, a lack of mentorship was identified as a program shortcoming. Most cohort members anticipated mentorship as part of their WEL experience but reported informal to nonexistent opportunities. As a result, cohort members advocated for a more structured mentorship program in future iterations of WEL. Some participants talked specifically about the benefits mentorship would have had when trying to navigate opportunities for participation in their sponsoring medical associations.

What Was the Project Impact in Terms of Knowledge and Behavior?

Overall, cohort members were uniformly positive about having participated in WEL. In response to a postprogram survey question asking whether cohort members would recommend WEL to another early career or midcareer woman physician, all 13 cohort members who responded indicated yes.

In addition, several descriptors, illustrated here in exemplar comments, were used repeatedly throughout interviews:

“This is life and career changing.”

“Participating in this series has been a fantastic experience and a game changer for me. I was at a point in my career and life where there wasn't a clear path laid out. The dedicated time to developing an [impact statement] in addition to the strong focus on leadership development, removal of internal/external barriers, and the networking opportunities have not only opened doors, but they opened my mind to the possibility that the next part of my story was only waiting for me to fully author and inhabit it… Having access to mentorship, sponsorship, role models, peers, resources, a structured program, and knowing that an investment was made so that my story could be written differently have been the key difference makers.”

Although enthusiasm was broad for the program overall, cohort member assessment of the individual program components varied. In the end-of-program survey, in-person meetings, webinars, peer support, and developing cross-specialty relationships were rated as the most useful program components (Table 5); impact statements were also rated highly.

TABLE 5

Utility of WEL Program Components

WEL Program ComponentNo. Cohort Members Reporting Useful or Very Useful (n = 13)
In-person meetings 13 
Monthly webinars 13 
Peer support network 13 
Opportunity to develop cross-specialty relationships 13 
Impact statement 12 
WEL curriculum resources (eg, readings, Web sites, and presentations) 
Mentor relationships (2 participants responded not applicable) 
WEL Program ComponentNo. Cohort Members Reporting Useful or Very Useful (n = 13)
In-person meetings 13 
Monthly webinars 13 
Peer support network 13 
Opportunity to develop cross-specialty relationships 13 
Impact statement 12 
WEL curriculum resources (eg, readings, Web sites, and presentations) 
Mentor relationships (2 participants responded not applicable) 

Scale: 1 = very useful, 2 = useful, 3 = somewhat useful, 4 = not very useful, and 5 = not at all useful.

Evaluation of program impact assessed the degree to which cohort participants acquired the intended knowledge, skills, attitude, confidence, and commitment on the basis of their participation in WEL. This assessment was based on cohort member self-reports (interviews and surveys); the evaluators did not, for example, administer pretests and posttests to directly assess changes in knowledge or attitudes.

Across postseries surveys, participants reported improved knowledge and confidence in WEL topics after program participation. In addition, participants reported that each of the 3 series (wellness, equity, and leadership) contributed to the development of their leadership skills and that the curriculum content was pertinent to helping them move forward with achieving their goals (Table 6).

TABLE 6

Impact of the 3 WEL Program Series

Question About Series ImpactNo. Cohort Members Who Indicated Agree or Strongly Agree
Wellness Series, n = 13Equity Series, n = 17Leadership Series, n = 10
The series contributed to the development of my leadership skills. 13 17 
I have been/will be able to use the information I learned during the series to move forward on my impact statement. 13 17 
Question About Series ImpactNo. Cohort Members Who Indicated Agree or Strongly Agree
Wellness Series, n = 13Equity Series, n = 17Leadership Series, n = 10
The series contributed to the development of my leadership skills. 13 17 
I have been/will be able to use the information I learned during the series to move forward on my impact statement. 13 17 

In interviews with cohort members, specific content or topics in each series were highlighted as having the most value or contributing significantly to achieving new skills, knowledge, and attitudes (see Table 7 for representative participant quotes). Specific to wellness, participants highlighted WEL’s focus on the business case for wellness and presentation of burnout as an organizational rather than strictly personal issue. Being offered concrete examples and strategies increased confidence in participants’ ability to make change in their workplace or personal life. In addition, some cohort members reflected that WEL had helped them identify their own burnout.

TABLE 7

Project Impact as Reported by Cohort Members

ThemeExample Quotes
Business case for wellness “[WEL] made a very strong case for organizational wellness and that if we don't have an organization that is well from the top down, then we can't expect to have the employees to be well… that idea and understanding of the economics of wellness, an organizational standpoint, a macrostandpoint, was very helpful for me.” 
 “I appreciated hearing some strategies that different individuals or organizations or people are actually doing about wellness because we spend a lot of time establishing this is important, the thing, how it works. But once you get that, and you have the buy-in and have the understanding of that, then you're like, okay, well what do I do about it?” 
Identified opportunities for personal wellness “I think wellness was a big piece to me coming into this program, which I didn't actually recognize until I got to the first session and I think recognized much more burnout in myself than I thought that I had.” 
 “…coming into the program I was really burnt out…And this program helped me recognize that I can have success and I can do the work that I would like to do without necessarily having to have that the burnout that goes with it.” 
Enhanced knowledge and application of equity principles “And the equity talks were just mind blowing. I have realized how much I don't know.” 
 “Being able to apply that to rural health equity, that has allowed me to look at the rural space in a different way as well. So that I didn't even expect or I wasn't really even looking for that.” 
 “And that experience allowed me to really put myself in their shoes and feel what they were feeling in a way I'm not sure I would have ever experienced, and so I can bring that back and use that at my own institution and really try to move the cause for all of us and know how I can be most helpful in fighting that for those injustices.” 
Normalizing experiences “[I learned] my presence is a sign of an uncomfortable conversation. And that can sometimes be what I represent to some people, even though that's not all of me. And that's okay. And I don't have to internalize that… So that an immense amount of freedom that came from that because I no longer had to bear the burden of other people’s privilege. And I didn't have to take that on. That's a choice that I can make, and I don't always have to be that person to educate or to do whatever.” 
Improved confidence and commitment to lead “WEL showed me the need for leadership, the need for women in leadership, the need for women of color in leadership and what can be accomplished with that and almost my duty to lead in certain aspects. So, I don't think I probably would have pursued the type of career that I'm now pursuing if I hadn't done WEL.” 
 “In theory, we're already all leaders. We all have these titles and…just being physicians, we’re already leaders. But it seems as though every single one of us felt a little bit of imposter syndrome…or a lot of imposter syndrome. And I think through the leadership aspect of WEL, we, I mean, I know I felt more empowered. I felt ready to kind of present myself as a leader versus in the past like, ‘Oh, I hope people see me as a leader.’ And I know, as a result of this, I have kind of put myself out there more.” 
Growth in specific leadership skills “…And the whole negotiations talk. It was not only how we can negotiate what we deserve but negotiate for the women after us.” 
 “A change module that we had… was really invaluable. Organizational planning I also thought was invaluable.” 
Change in perception of leadership “My view of leadership evolved…I saw the opportunities to lead and with a much broader scope and realize that it's not a zero-sum game in terms of not everybody has to be the CEO or make it to the C-suite or become a Dean. There are plenty of opportunities to lead where you are and come from it with a diverse perspective and background. And you can take any of the skillsets or tools that are important in leadership and apply them in a number of settings.” 
 “I think the issues for me personally that I have faced were really feeling like I'd never get there…[that] people had already been picked out for these positions so I might as well not try... And they taught us the skill of graceful self-promotion. And that it's very intentional. So, I think they taught me a lot about the intentionality of being a leader. And that if that is something that you want, and you have every right to want it and you deserve it, then be intentional about it and be thoughtful about that there are ways to get there and not to be afraid of that. That people who are successful leaders also go on those paths, and they're not off limits. We also can go down those paths, and we can use those resources. And sometimes we need to bring ourselves to other people's attentions to get into the leadership positions that we want and deserve.” 
Growth in awareness and intentionality “I am much more aware of how I limit my own capabilities by minimizing my needs/desires. I make a concerted effort now to speak up, lean into the fear of hearing my own voice, and stop apologizing for who I am.” 
 “…we talked about negotiation and how women oftentimes will negotiate with themselves before they ever have the conversation with somebody else and talk themselves out of even bringing up the negotiation, which I found to be really true. I don't even want to have the conversation; I just go ahead and talk to myself and decide that it's not worth it. And so during WEL, I was really struggling…I would say both the leadership and the equity piece teaching me that I have more than every right to be at the table and at all these conferences. Even though I look different, I am there and to be there and be present and be proud and use my title and use my name and just show up and after a while, it’ll get easier, because somebody has to start it. If I'm the only woman there, and [a] minority woman at that, then at least there's one of us starting the process and I start that trend, and I bring other women up by doing that.” 
Shift from awareness to action “I will also do a better job of addressing microaggressions especially by and toward my trainees (calling them out, using them as teachable moments).” 
 “… I'm a Caucasian woman. And I think I kind of always thought that I had an idea of the struggles that people who are not white may experience, but I don't think I ever really appreciated, I don't know how deep that was or how pervasive it was or how things that you think don't hurt someone's feelings might actually hurt someone's feelings because it's not even in your worldview, so you don't even realize it. So, I thought that was that was very useful…I have a lot of people who work for me. As I watch interpersonal relationships and I watch the friction, I perceive it differently than I did when I started. Now, I'm always asking myself ‘Is this really because you don't like the way this person did this, or is this because you have a different expectation of this person because of the way they look?’ So, I try to be a little bit more thoughtful about how I approach things before jumping in from my white female perspective…” 
 “Especially being in [geographic location], in a white male dominated area, has made me more aware and a stronger voice of amplification for those who have wanted it or needed it. And right now, with the talks that I do on women leadership and sexual harassment, I'm getting phone calls every week, especially from underrepresented minority women that are reaching out to me as a resource of ‘How do I go against these strong white men who have put me in compromising positions?’ So, an unintended issue of me being a voice is I'm now a sounding board and a place for safety and a safe place for information and knowledge.” 
 “I think I've definitely been able to empower women in my own department to rise to leadership positions, to not be fearful to use every situation as a learning experience. I've also, I think, been able to empower women in other departments. I think I'm also able to empower my female patients from some of the things that I've learned at WEL.” 
 “…it's definitely helped me prioritize my own wellness and recognizing the importance of having more balance.” 
 “I kind of moved away from things that didn't serve me and that I wasn't enjoying and, as such, wasn't excelling [in] and I… shifted toward things that involved more leadership and managerial. And I think the WEL cohort really kind of helped develop that, helped me redefine my professional goals and also mentor women.” 
ThemeExample Quotes
Business case for wellness “[WEL] made a very strong case for organizational wellness and that if we don't have an organization that is well from the top down, then we can't expect to have the employees to be well… that idea and understanding of the economics of wellness, an organizational standpoint, a macrostandpoint, was very helpful for me.” 
 “I appreciated hearing some strategies that different individuals or organizations or people are actually doing about wellness because we spend a lot of time establishing this is important, the thing, how it works. But once you get that, and you have the buy-in and have the understanding of that, then you're like, okay, well what do I do about it?” 
Identified opportunities for personal wellness “I think wellness was a big piece to me coming into this program, which I didn't actually recognize until I got to the first session and I think recognized much more burnout in myself than I thought that I had.” 
 “…coming into the program I was really burnt out…And this program helped me recognize that I can have success and I can do the work that I would like to do without necessarily having to have that the burnout that goes with it.” 
Enhanced knowledge and application of equity principles “And the equity talks were just mind blowing. I have realized how much I don't know.” 
 “Being able to apply that to rural health equity, that has allowed me to look at the rural space in a different way as well. So that I didn't even expect or I wasn't really even looking for that.” 
 “And that experience allowed me to really put myself in their shoes and feel what they were feeling in a way I'm not sure I would have ever experienced, and so I can bring that back and use that at my own institution and really try to move the cause for all of us and know how I can be most helpful in fighting that for those injustices.” 
Normalizing experiences “[I learned] my presence is a sign of an uncomfortable conversation. And that can sometimes be what I represent to some people, even though that's not all of me. And that's okay. And I don't have to internalize that… So that an immense amount of freedom that came from that because I no longer had to bear the burden of other people’s privilege. And I didn't have to take that on. That's a choice that I can make, and I don't always have to be that person to educate or to do whatever.” 
Improved confidence and commitment to lead “WEL showed me the need for leadership, the need for women in leadership, the need for women of color in leadership and what can be accomplished with that and almost my duty to lead in certain aspects. So, I don't think I probably would have pursued the type of career that I'm now pursuing if I hadn't done WEL.” 
 “In theory, we're already all leaders. We all have these titles and…just being physicians, we’re already leaders. But it seems as though every single one of us felt a little bit of imposter syndrome…or a lot of imposter syndrome. And I think through the leadership aspect of WEL, we, I mean, I know I felt more empowered. I felt ready to kind of present myself as a leader versus in the past like, ‘Oh, I hope people see me as a leader.’ And I know, as a result of this, I have kind of put myself out there more.” 
Growth in specific leadership skills “…And the whole negotiations talk. It was not only how we can negotiate what we deserve but negotiate for the women after us.” 
 “A change module that we had… was really invaluable. Organizational planning I also thought was invaluable.” 
Change in perception of leadership “My view of leadership evolved…I saw the opportunities to lead and with a much broader scope and realize that it's not a zero-sum game in terms of not everybody has to be the CEO or make it to the C-suite or become a Dean. There are plenty of opportunities to lead where you are and come from it with a diverse perspective and background. And you can take any of the skillsets or tools that are important in leadership and apply them in a number of settings.” 
 “I think the issues for me personally that I have faced were really feeling like I'd never get there…[that] people had already been picked out for these positions so I might as well not try... And they taught us the skill of graceful self-promotion. And that it's very intentional. So, I think they taught me a lot about the intentionality of being a leader. And that if that is something that you want, and you have every right to want it and you deserve it, then be intentional about it and be thoughtful about that there are ways to get there and not to be afraid of that. That people who are successful leaders also go on those paths, and they're not off limits. We also can go down those paths, and we can use those resources. And sometimes we need to bring ourselves to other people's attentions to get into the leadership positions that we want and deserve.” 
Growth in awareness and intentionality “I am much more aware of how I limit my own capabilities by minimizing my needs/desires. I make a concerted effort now to speak up, lean into the fear of hearing my own voice, and stop apologizing for who I am.” 
 “…we talked about negotiation and how women oftentimes will negotiate with themselves before they ever have the conversation with somebody else and talk themselves out of even bringing up the negotiation, which I found to be really true. I don't even want to have the conversation; I just go ahead and talk to myself and decide that it's not worth it. And so during WEL, I was really struggling…I would say both the leadership and the equity piece teaching me that I have more than every right to be at the table and at all these conferences. Even though I look different, I am there and to be there and be present and be proud and use my title and use my name and just show up and after a while, it’ll get easier, because somebody has to start it. If I'm the only woman there, and [a] minority woman at that, then at least there's one of us starting the process and I start that trend, and I bring other women up by doing that.” 
Shift from awareness to action “I will also do a better job of addressing microaggressions especially by and toward my trainees (calling them out, using them as teachable moments).” 
 “… I'm a Caucasian woman. And I think I kind of always thought that I had an idea of the struggles that people who are not white may experience, but I don't think I ever really appreciated, I don't know how deep that was or how pervasive it was or how things that you think don't hurt someone's feelings might actually hurt someone's feelings because it's not even in your worldview, so you don't even realize it. So, I thought that was that was very useful…I have a lot of people who work for me. As I watch interpersonal relationships and I watch the friction, I perceive it differently than I did when I started. Now, I'm always asking myself ‘Is this really because you don't like the way this person did this, or is this because you have a different expectation of this person because of the way they look?’ So, I try to be a little bit more thoughtful about how I approach things before jumping in from my white female perspective…” 
 “Especially being in [geographic location], in a white male dominated area, has made me more aware and a stronger voice of amplification for those who have wanted it or needed it. And right now, with the talks that I do on women leadership and sexual harassment, I'm getting phone calls every week, especially from underrepresented minority women that are reaching out to me as a resource of ‘How do I go against these strong white men who have put me in compromising positions?’ So, an unintended issue of me being a voice is I'm now a sounding board and a place for safety and a safe place for information and knowledge.” 
 “I think I've definitely been able to empower women in my own department to rise to leadership positions, to not be fearful to use every situation as a learning experience. I've also, I think, been able to empower women in other departments. I think I'm also able to empower my female patients from some of the things that I've learned at WEL.” 
 “…it's definitely helped me prioritize my own wellness and recognizing the importance of having more balance.” 
 “I kind of moved away from things that didn't serve me and that I wasn't enjoying and, as such, wasn't excelling [in] and I… shifted toward things that involved more leadership and managerial. And I think the WEL cohort really kind of helped develop that, helped me redefine my professional goals and also mentor women.” 

The equity series brought new content to some of the participants and helped others apply equity principles in new ways. The intentional diversity of the cohort seemed to heighten their experiences. Other participants reported the equity section was liberating because it helped normalize their experiences.

Specific to leadership, participants consistently cited improved confidence, commitment, and skill across the topics presented. Several participants indicated that this was the most impactful of the series. Among individual leadership topics, negotiation and organizational change were most frequently cited as useful. Some cohort members described these as “hard skill sessions;” one noted “those are things not typically taught in a formal way in medicine.” Participants indicated the program’s particular emphasis on applying these skills as a woman was key. In addition, perceptions of what a leader is or what the role entails shifted over time for several cohort members.

In addition to changes in knowledge, cohort members’ interview and survey responses spoke to how participants had begun applying WEL learnings. A sense of greater awareness and intentionality underpinned much of the behavior change described by the cohort. Participants reflected on the WEL experience as a catalyst for recognizing the power of their own voice to advocate and negotiate for themselves and on behalf of others. Cohort members also reported increased understanding of the intersections between leadership, inequality, and wellness but acknowledged, as leaders, the insufficiency of awareness alone. The WEL experience provided tools to support cohort members in moving from awareness to action. For several participants, the WEL experience empowered change or intent to change to foster professional and personal wellness and satisfaction.

Cohort members also reported early changes they made because of WEL. At the time the cohort experience formally concluded in January 2020, cohort members had already begun to use their experience to promote WEL learnings and principles and detailed a broad range of activities and accomplishments they ascribed to their WEL participation, both in the context of their workplace and sponsoring medical association.

Workplace Results

Several women reported acting in their workplaces to advance equity principles, such as one participant who proposed a new position within her organization that “embraces the need for community collaboration to advance equitable care to our population.” WEL participation led 3 cohort members to examine their institutions’ residency and fellowship programs regarding gender balance among faculty and trainees and to advocate for changes, such as blinding applicant-identifying information and step scores. One cohort member reported that the WEL experience reenergized a recently developed business. Another is serving as coinvestigator on a grant focused on early career to midcareer women physicians. Yet another implemented an idea introduced by WEL webinar faculty to “boost morale and mitigate burnout” among her departmental colleagues. Two other cohort members described their emerging roles as advocates and resources for other women dealing with issues of inequality.

Partner Organization Results

Most cohort members were eager for greater involvement in their respective partner organization and sought out opportunities for engagement. Several recounted recently completed and upcoming activities with their partner organization at local, state, and national levels, in which they infused WEL learnings and concepts. These included serving on their partner organization’s national review panel and national committees, subcommittees, and task forces relevant to WEL topics; securing leadership roles with local partner organization affiliates; submitting an invited commentary on gender equality; starting a podcast devoted to issues of gender, diversity, and inclusion; leading activities relevant to WEL topics at professional conferences and meetings, including hosting a session, moderating a forum, and presenting a workshop, presentation, or poster; and developing a wellness reference guide and/or workbook.

WEL was designed to foster more equitable work experiences for diverse groups of early career and midcareer women physicians. In this program evaluation, findings indicated the 18 cohort members experienced improved confidence, commitment, and skills in wellness, equity, and leadership. Findings suggested several factors that facilitated program success and several areas for improvement in future work.

The current study makes several significant contributions to the existing literature. First, WEL involved a collaboration between 6 major US medical associations. Independently, each of these organizations is contributing significant work to foster wellness, equity, and leadership for its members. However, this work can at times be siloed and duplicative as a result. For example, several studies have been published in which researchers explore the challenges faced by women physicians; although critically important, these accounts are often specific to one area of medicine and repetitive across fields. Bringing these 6 organizations together to work toward a shared, common, solutions-focused goal was a significant step in breaking down these silos. The supplement in which this article appears, including the call to action, which appears at the end of the issue, is a concrete example of the power that these 6 organizations can have when speaking in one unified voice.

Second, WEL offered a longitudinal cohort design intended to provide participants with peer support. With few notable exceptions,27  this type of program is rare; yet, as seen throughout evaluation findings, peer support was critically important to fostering the success of the current group of women. Particularly in medicine, in which physicians are held up as infallible heroes, there is a tremendous culture of silence when it comes to discussing challenges.28  Genuine peer networks and support can help change this culture of silence and provide needed support to women.28  The value of peer relationships was repeatedly mentioned throughout evaluation findings because participants discussed the importance of the vulnerability they were able to share with their peers, as well as the importance of their ongoing peer networks and support. In addition, participants repeatedly commented on the value and importance of convening a cohort and faculty members who were diverse in terms of medical specialty and demographic and workplace characteristics and how they were able to connect with others who they would not usually be exposed to in their normal professional circles. The value stemming from expanding participants networks in this way validated the cross-specialty nature and intentional diversity of WEL.

Third, WEL adopted both an individual and organizational lens. As shown in Table 1, several sessions throughout the curriculum highlighted the importance of organizational influences in terms of wellness, equity, and leadership and offered strategies for impacting organizational change. Throughout evaluation findings, several participants commented on the utility of moving beyond the individual to focus on organizational approaches.

Finally, equity and explicit conversations about intersectionality29  were intentionally woven throughout discussions of all WEL topics. Several participants commented on the novelty and utility of the interconnectedness between the program components of wellness, equity, and leadership. To truly forge more equitable work environments for women physicians, equity must be engrained in all conversations.

Several limitations are important to consider when interpreting the results. First, the sample size of this pilot was small, because only 18 women were enrolled in this inaugural WEL cohort. Response rates for some of the evaluation surveys were also relatively low. Although there were several programmatic advantages to having such a small and cohesive group, the small sample size limited the type of analyses conducted and conclusions that can be drawn. Second, in this study, we relied on self-report methodology because evaluation findings that were included were assessed after the program’s completion, and no additional, more objective measures of participants’ professional growth were assessed. Future research should examine participant growth incorporating a variety of measures, including preassessments and postassessments and/or analyses of curriculum vitae and participants’ professional networks. Third, involvement in WEL required participants to take time away from their jobs and families. Therefore, it is likely that the women who were able to participate already had a certain level of support, professionally and personally, and therefore may not be representative of all women physicians. Finally, nearly half of the WEL participants were currently working in academic medicine, yet most women physicians are not in academic settings. Findings should therefore be interpreted in light of this context.

Research should continue to investigate how to effectively and efficiently provide women in medicine with the support they need to advance in their careers. The current study involved an 18-month program that included 4 in-person meetings and monthly webinars. In future work, researchers should investigate whether the same professional networks can be developed in virtual environments. At the time of this writing, the coronavirus pandemic is in its eighth month; in cases in which travel and in-person meetings are not possible, can virtual initiatives foster the same kind of meaningful relationships? In addition, programs like WEL are incredibly resource-intensive, both in terms of labor and travel costs. In future work, researchers should investigate how models like WEL can be sustained after, for example, grant funds end; and how leadership programs like WEL can be tailored for larger groups of women. In future efforts, researchers should also seek to involve women from other medical specialties in which they are particularly underrepresented, such as surgery. In addition, initiatives should be developed for, tailored to, and promoted among women who are not in academic settings. Meeting women where they are and providing supports to help them succeed in their current environments will help magnify the impact of WEL.

Findings from the current study indicate the importance of providing women physicians with training around wellness, equity, and leadership and time and space to develop networks with other women. As mentioned above, it is likely that women who had support at work and/or home were more likely to be able to participate in WEL. All organizations employing physicians should provide support and opportunities for their women leaders to connect with other women physicians. This may include offering opportunities to attend programs like WEL, with protected time for their growth and development as professional leaders. Medical associations can also provide support to their women members by providing grants or sponsorships for individuals to participate in these types of activities.

This longitudinal cohort initiative resulted from a successful collaboration between 6 medical associations. Evaluation findings suggest that providing opportunities for women physicians to connect with and support each other while building knowledge and skills can be an effective way to advance wellness, equity, and leadership for women in medicine.

We thank the Physicians Foundation for their support of WEL, including program evaluation activities; the WEL Program Director, V. Fan Tait, MD, FAAP; the WEL Steering Committee members, Heather Farley, MD, FACEP, Laurie Gregg, MD, Clif Knight, MD, FAAFP, CPE, and Nancy Spector, MD, FAAP (in addition to Drs Miskimen and Hingle); the WEL cohort members; and Linda Radecki, MS, who, along with Laura Peterson, conducted the WEL program evaluation.

Dr Kelly and Ms Rivera conceptualized and designed the study, designed the data collection instruments, drafted the initial manuscript, and reviewed and revised the manuscript; Drs Miskimen and Hingle conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript; Ms Peterson designed the data collection instruments, collected data, conducted the initial analyses, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

FUNDING: Supported by a grant from the Physicians Foundation, #3255197. The Physicians Foundation had no role in the design and conduct of the study.

AAFP

American Academy of Family Physicians

AAP

American Academy of Pediatrics

ACOG

American College of Obstetricians and Gynecologists

ACP

American College of Physicians

AHA

American Hospital Association

APA

American Psychiatric Associations

BIPOC

Black, Indigenous, and/or people of color

WEL

Women’s Wellness through Equity and Leadership

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Competing Interests

POTENTIAL CONFLICT OF INTEREST: The authors have no potential conflicts of interest to disclose.

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