Gender Differences in Experiences of Leadership Emergence Among Emergency Medicine Department Chairs

Abstract

IMPORTANCEThe number of women entering medicine continues to increase, but women remain underrepresented at all tiers of academic rank and chair leadership in EM. The proportion of female chairs in EM has not exceeded 12% in 2 decades. OBJECTIVETo compare how male and female EM chairs experience leadership emergence, with attention to factors associated with support of the emergence of female chairs. DESIGN, SETTING, AND PARTICIPANTS This qualitative descriptive study was conducted between April 2020 and February 2021 at 36 US academic EM departments. Eligible participants were all current and emeritus female EM academic department chairs (with a possible cohort of 20 individuals) and an equal number of randomly selected male chairs. INTERVENTIONS Semistructured interviews were conducted via teleconferencing with an 11-item interview guide. MAIN OUTCOMES AND MEASURES Qualitative findings identifying similarities and gender differences in leadership emergence were collected. RESULTS Among 20 female chairs in EM, 19 women (mean [SD] age, 56.2 [7.1] years) participated inthe study (95.0% response rate). There were 13 active chairs, and 6 women were within 5 years of chair leadership. Among 77 male chairs in EM identified and randomized, 37 men were invited to participate, among whom 19 individuals (51.4%) agreed to participate; 18 men (mean [SD] age, 52.2 [7.5] years) completed their interviews. Reflecting upon their experiences of leadership emergence, male chairs saw leadership as their destiny, were motivated to be chairs to gain influence, were dismissive of risks associated with chairing a department, and were sponsored by senior male leaders to advance in leadership. Female chairs saw leadership as something they had long prepared for, were motivated to be chairs to make a difference, were cautious of risks associated with chairing a department that could derail their careers, and relied on their own efforts to advance in leadership. CONCLUSIONS AND RELEVANCEThis study found that experiences of leadership emergence differed by gender. These results suggest that leadership development strategies tailored to women should promote early internalization of leadership identity, tightly link leadership to purpose, cultivate active sponsorship, and encourage women's risk tolerance through leadership validation to support women's development as leaders and demonstrate a commitment to gender equity in EM leadership.

Physician Men Leaders in Emergency Medicine Bearing Witness to Gender-Based Discrimination

“…This secondary qualitative study was conducted on data drawn from a larger study (primary study). 15,16 This study was approved by the institutional review boards of Indiana University and the University of North Carolina Schools of Medicine. All participants provided verbal consent.…”

“…Participant checks were performed by sharing themes and representative quotes with participants for feedback and verification. Previously published methods and results from this analysis include a description of leadership challenges experienced by women academic department chairs in EM and gender differences in leadership emergence . The research team noted that all the men, and rarely any of the women, participants discussed their experiences with observing or learning of GBD, often in a powerful manner, identifying an opportunity to conduct a secondary analysis exploring how an advantaged group (men leaders) respond to GBD toward a less advantaged group (women colleagues).…”

“…The primary study was a qualitative descriptive study of gender and leadership in academic medicine. 15,16 The qualitative descriptive approach used purposive sampling, semistructured interviews, and content analysis to obtain a descriptive summary of the phenomenon of interest.…”

“…The primary study 15,16 used purposive criterion-based sampling to identify 19 women and 18 men EM academic department chairs. Preliminary lists of chairs were compiled from national organizations, 6 and university websites verified eligibility.…”

“…In particular, the most salient experience with GBD among women leaders in the primary study was experiencing GBD themselves. 15 As such, we could not probe if women primary study participants did, in fact, witness GBD and identify their respective responses. The men participants openly discussed their experiences bearing witness to GBD, providing an opportunity to explore how an advantaged group (men leaders) responds to GBD toward a less advantaged group (women colleagues).…”