Gender Inequity in Institutional Leadership Roles in US Academic Medical Centers: A Systematic Scoping Review

Area of Science:

• Medical Education
• Health Services Research
• Gender Studies

Background:

• Academic medical centers are increasingly focused on gender equity initiatives.
• Despite these efforts, translating them into diverse institutional leadership remains a challenge.

Purpose of the Study:

• To evaluate the current status of gender inequity in institutional leadership positions within US academic medical centers.
• Key leadership roles examined include deans, department chairs, and program directors.

Main Methods:

• A systematic scoping review was conducted using PubMed, CINAHL, and ERIC databases.
• Searched for articles published between January 1, 2019, and August 5, 2022, focusing on gender inequity in academic medical leadership.
• Studies were screened and evaluated for bias following PRISMA-ScR and Cochrane standards.

Main Results:

• Out of 8120 retrieved articles, 94 studies reported on leadership roles.
• Significant underrepresentation of women was found across leadership positions: deans (19.5%), department chairs (15.9%), division chiefs (19.7%), and program directors (21.9%).
• Gender disparities were pronounced in surgical specialties, and even in specialties with high female faculty representation, women were not equally represented in chairs and chiefs roles.

Conclusions:

• Considerable gender disparities persist in academic medical leadership despite stated goals of equity.
• Certain medical niches virtually exclude women from leadership, and even female-dominated fields show significant inequity.
• Urgent organizational and systemic changes are required to achieve equitable gender representation in academic leadership.