Women’s leadership in academic medicine: a systematic review of extent, condition and interventions

Abstract

ObjectivesBecause culture reflects leadership, the making of diverse and inclusive medical schools begins with diversity among leaders. The inclusion of women leaders remains elusive, warranting a systematic exploration of scholarship in this area. We ask: (1) What is the extent of women’s leadership in academic medicine? (2) What factors influence women’s leadership? (3) What is the impact of leadership development programmes?DesignSystematic review.Data sourcesA systematic search of six online databases (OvidMEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library and ERIC) from the earliest date available to April 2018 was conducted. Bridging searches were conducted from April 2018 until October 2019.Eligibility criteria(1) Peer-reviewed; (2) English; (3) Quantitative studies (prospective and retrospective cohort, cross-sectional and preintervention/postintervention); evaluating (4) The extent of women’s leadership at departmental, college and graduate programme levels; (5) Factors influencing women’s leadership; (6) Leadership development programmes. Quantitative studies that explored women’s leadership in journal editorial boards and professional societies and qualitative study designs were excluded.Data extraction and synthesisTwo reviewers screened retrieved data of abstracts and full-texts for eligibility, assessment and extracted study-level data independently. The included studies were objectively appraised using the Medical Education Research Quality Study Instrument with an inter-rater reliability of (κ=0.93).ResultsOf 4024 records retrieved, 40 studies met the inclusion criteria. The extent of women’s leadership was determined through gender distribution of leadership positions. Women’s leadership emergence was hindered by institutional requirements such as research productivity and educational credentials, while women’s enactment of leadership was hindered by lack of policy implementation. Leadership development programmes had a positive influence on women’s individual enactment of leadership and on medical schools’ cultures.ConclusionsScholarship on women’s leadership inadvertently produced institute-centric rather than women-centric research. More robust contextualised scholarship is needed to provide practical-recommendations; drawing on existing conceptual frameworks and using more rigorous research methods.

Scientific medical conferences can be easily modified to improve female inclusion: a prospective study

“…8 Organisational changes that support women to achieve their career goals are as important as encouraging women to self-promote. 9 To the best of our knowledge, this is the first study of audience participation at a UK medical conference, and suggests an interventional effect to improve female inclusion. These findings should be considered in the future planning of academic conferences.…”

The impact of preferences for clinical and managerial leadership roles on the willingness to apply for a medical leadership position: Analysis of gender differences among a sample of German senior physicians

“…They have to cope with disrespect and discrimination in their career paths. 7 Further, pregnancy risk and part-time work due to motherhood result in lower availability in the hospital and subsequently fewer career opportunities. 8 However, to date, only a few studies have focused on explanations regarding gender-specific differences in the career aspirations of physicians and the underlying motives of women to apply for leadership positions.…”

“…8 However, to date, only a few studies have focused on explanations regarding gender-specific differences in the career aspirations of physicians and the underlying motives of women to apply for leadership positions. 7,9,10 A confidence gap between men and women has been considered as one explanation. 11 Moreover, a lack of leadership training and mentoring programs has been mentioned.…”

“…12 Currently in Germany, two-thirds of medical graduates are women; however, only approximately 10% of physicians in MLPs are female. 7 Therefore, research on hybrid roles needs to account for gender differences in motivations, preferences and self-efficacy beliefs.…”

“…This is in line with findings from central reviews in the field of gender differences. 7,23 Therefore, we assume lower self-efficacy beliefs related to clinical leadership/managerial leadership (H 7a/b ) among female senior physicians.…”