Is the Glass-Ceiling Higher Than We Think? Sex Disparity Trends in Physician Executive Positions and Academic Plastic Surgery

Abstract

Introduction Advanced levels of professorship and executive positions are considered markers of success in medical academia. Despite sex parity in medical school graduates, sex disparities within positions of power remain unequal. The purpose of this study was to analyze sex composition at different levels of leadership at multiple academic, highly ranked institutions. Methods Hospital executives and academic plastic surgery faculty were identified through an internet-based search of all Accreditation Council for Graduate Medical Education–accredited plastic surgery integrated and independent residency training programs. Institutions from the U.S. News 2018–19 Top 20 Best Hospitals Honor Roll and Beckers Review 2018: 100 Great Hospitals in America were also included. Information on board of directors/trustees (BOD), administrators, and plastic surgery faculty with focus on title, sex, degree, specialty, and academic rank was collected from departmental and hospital websites. Duplicate institutions were excluded. Results Data on chief executive officers (CEOs)/presidents (n = 275) and BOD members (n = 5347) from 153 medical institutions were analyzed. Physicians consisted of 40.7% (n = 112) of CEOs/presidents, of which 10.7% (n = 12) were surgeons, and 15.6% (n = 835) of the BOD membership. Female physicians in executive roles were disproportionally low, consisting of 5% (n = 14) of CEOs/presidents, reaching significance (P = 0.033). Sex representation within plastic surgery departments demonstrated similar trends. Women comprised 18.3% of the overall plastic surgery faculty (n = 1441). Significant differences between mean male and female plastic surgeons (8.2 vs 1.84, P = <0.001) were observed. In addition, female plastic surgeons represented only 26.3% of all assistant professors (P = <0.001), 18.75% of total associate professors (P = <0.001), and 7.8% of full professors (P = <0.001). Conclusions Although women are increasingly pursuing careers in medicine and surgery, the data suggest that there remains a paucity of female physicians in top leadership roles. At the departmental level, female plastic surgeons are also underrepresented. At the executive level, men make up over 88% of physician CEOs at the highest-ranked medical institutions. This study further highlights the need for the development of educational, mentorship, and career pathways to further improve female representation in positions of power within academia.

A Descriptive Analysis of Integrated Plastic Surgery Residency Program Directors in the United States

“…Between 2008 and 2018, there was a great increase in both the number of women entering plastic surgery training, as well as tremendous growth in the number of women in plastic surgery leadership positions 19 . Previous research has also shown that sex representation in plastic surgery departments favors male surgeons, and that there is a paucity of women in leadership roles 20,21 . One report analyzing the representation of women in plastic surgery, found that they were underrepresented in academic medicine and leadership roles across regional and national organizations 22 .…”

The Impact of Socioeconomic Factors on the 2022 Plastic Surgery Match

“…Workplace diversity is known to decrease among positions with increasing seniority or leadership [44][45][46] ; this is especially evident in many competitive surgical specialties, including PRS. [47][48][49][50][51] Although women make up 43.5% of all PRS residents, their proportion drops to 17.2% of practicing plastic surgeons, 13% of program directors, and only 8% of department chairs. 16,49,52 These numbers drop further for women of color, who occupy only 6.25% of PRS program leadership roles.…”

The Annual ASCFS Whitaker Lecture: Breaking Through to Bold

“…There are no female editors in chief of plastic surgery journals. 14 This lack of visible female leadership is witnessed by students, residents and even faculty creating a self-sustaining cycle of lack of representation. 13 Our proposed solution is to elect a woman as an editor in chief.…”

“…14 What began as one woman’s accidental acceptance to medical school from a practical joke, has transformed into women comprising more of the medical school class than men. 14 Women are no longer accepting previous constraints. In her book published in 1949 Simone de Beauvoir said “It is perfectly natural for the future woman to feel indignant at the limitations posed upon her by her sex.…”