Abstract
The 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. To compare how male and female EM chairs experience leadership emergence, with attention to factors associated with support of the emergence of female chairs. 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. Semistructured interviews were conducted via teleconferencing with an 11-item interview guide. Qualitative findings identifying similarities and gender differences in leadership emergence were collected. Among 20 female chairs in EM, 19 women (mean [SD] age, 56.2 [7.1] years) participated in the 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. This 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.
Highlights
Emergency medicine (EM) has experienced unprecedented growth over the last 2 decades, but gender parity of its leaders has not evolved
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 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
Summary
Emergency medicine (EM) has experienced unprecedented growth over the last 2 decades, but gender parity of its leaders has not evolved. Making up 50% of medical students,[4] comprise 37% of EM trainees[5] and 38% of EM faculty.[6]. The proportion of women holding department chair positions in EM remains between 10% (2001)[7] and 11.3% (2020).[2]. The long-standing belief that increasing the number of women in medicine would lead to more women leaders has been proven false.[8]. Women in medicine publish less,[9] are less successful in obtaining long-term federal funding,[10] and lag in faculty rank progression.[5,11]. Women faculty lack academic rank parity, and as rank increases, women’s rank parity declines.[12,13]. Women who assume leadership positions are more likely to become assistant or associate deans of education, faculty development, and diversity than department chairs.[5]. Fewer than one-third of center or institute directors and 18% of academic department chairs and medical school deans are women.[5]
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