Here at sheMD, we believe in the importance of practicing Evidence-Based Medicine. We believe the same principles apply to discussing Gender and Medical Education. Therefore, we are bringing you an entire Journal Club series! Our series will focus on foundational and new literature within the gender and medicine space.
Today, we will be discussing the article entitled, Here to chair: Gender differences in the path to leadership.
Why is this article important?
Though women make up almost half of all United States medical school classes, they are significantly less likely to have leadership positions in medicine.
80% of department chair roles in academic medicine are held by men. Though female faculty member numbers are increasing, female leadership numbers are not increasing at the same rate.
There are other challenges which contribute to the lack of female advancement to leadership roles, including fewer federally funded grants, first or last authorships on manuscripts, journal editorial positions, and national awards.
What they looked at:
This article aimed to look at career trajectory differences between genders in faculty who have attained academic chair roles in emergency medicine.
How they measured things:
The study was a cross-sectional observation utilizing CVs of department chairs in United States ACGME-accredited academic emergency departments to collect data such as residency type and length; board certification; fellowship training; time from training to first leadership position and to chair position; and number of publications, presentations, and grants. Number of years spent in different types of leadership roles were used to create tracks of academic activity.
Categorical analyses were conducted to compare demographics, qualifications, and achievements by gender. Quantitative achievements by gender were also compared while adjusting for years in practice.
What were their outcomes:
The median number of years to first appointment to a chair position was 7 years after graduation.
Female chairs obtained more advanced degrees (47.4% vs 24.6%, p=0.02) and had a greater number who served as chief resident (50.7% vs 31.6%, p=0.12). There were no gender differences in residency type, board certification, or fellowship position.
Women were more likely to be first appointed to educational rather than operational roles (52.6% vs 61.2%, p=0.02) as well as to be in those roles immediately prior to first chair appointment (p=0.01).
Female chairs attained more nonfederal grant awards (p=0.04) and national leadership positions (p=0.02) prior to chair appointment.
Why do we care about this article?
What does this mean?
The most common pathway to a departmental chair role was through an operations track, and male physicians were more likely to have an initial role in operations, while females were more likely to have an initial role in education.
Female chairs had significantly different characteristics prior to becoming chair with greater additional degrees, grants, and national leadership positions, which may suggest greater efforts and achievements needed for women to be granted chair positions.
How does this apply to us?
Women remain significantly underrepresented in leadership positions in academic medicine and continue to face systemic obstacles on the pathway to career advancement. Institutions desiring female leadership should focus on supporting women to assume operational and administrative roles early on in the career path and commit to the overall recruitment, retention, and promotion of women into leadership positions.
Take Home Point
Improving diversity in academic medical leadership has been shown to have a great impact on training physicians, as highlighted by this data, and continued efforts are necessary to improve leadership opportunities for women in medicine.
For further reading on the topic, check out these articles!
Alwazzan L, Al-Angari SSWomen’s leadership in academic medicine: a systematic review of extent, condition and interventionsBMJ Open 2020;10:e032232. doi: 10.1136/bmjopen-2019-032232
Farrugia G, Zorn CK, Williams AW, Ledger KK. A Qualitative Analysis of Career Advice Given to Women Leaders in an Academic Medical Center. JAMA Netw Open.2020;3(7):e2011292. doi:10.1001/jamanetworkopen.2020.11292
Flaherty, S.M., Moran, C.J. & Scott-Vernaglia, S.E. Looking in the Mirror: Expanding Female Leadership in Academic Medicine. Dig Dis Sci67, 364–366 (2022). https://doi.org/10.1007/s10620-021-07115-x