Gender, Professional Experiences, and Personal Characteristics of Academic Radiation Oncology Chairs

Abstract

Understanding the pathway to leadership and challenges faced by leaders can inform efforts to promote professional diversity and equity at all levels. We sought to describe professional experiences and personal characteristics of academic Radiation Oncology (RO) Chairs and to evaluate the hypothesis that differences exist by gender. After IRB approval, surveys were distributed to 95 Chairs of academic RO departments following the 2016 annual meeting of the Society of Chairs of Academic Radiation Oncology Programs (SCAROP). The surveys included 28 closed-ended questions and the 30-statement validated Leadership Practices Inventory (LPI). The anonymous survey results were analyzed by gender using the x2 test for categorical data, and either the rank-sum or t test for continuous data based upon its distribution (significance p < 0.05). From the invited 95 Chairs, 72 responded (76% response rate): 61 males (74% response rate), 10 females (77% response rate), and 1 who declined to identify gender. There were no significant gender differences in age, academic rank, number of publications, or prior leadership positions held at the time of the first Chair appointment, but female respondents captured significantly greater total direct funding from extramural grants than their male counterparts (median [IQR]) $1.89M [0.5-5M] vs. $0.25 M [0-1.0M]; p = 0.015). At time of appointment, 50% of female respondents found it “difficult” or “very difficult” to move to a new geographic location (primarily due to age of children and spousal employment) compared to only 21% of males. Among the 58 males (95%) and 9 females (90%) who were married at the time of first Chair appointment, 25 males (43%) and no females (0%) had non-working spouses. On average, female Chairs had fewer children than males (Mean ±SD 2.1 ± 0.7 vs. 2.8 ± 1.1, p = 0.02). Once appointed Chair, males and females both found budgeting and resource allocation to be their greatest professional challenges; males also found legal and office management challenging, whereas females found staffing and external communication challenging. There were no gender differences between the LPI-identified leadership domains, with “Modeling the Way” being most common behavior. The most common professional goals were “shaping the direction or culture of the department” and “shaping the direction of research.” Although limited by sample size, this study suggests that the few female Chairs are no less qualified than their male counterparts in terms of productivity or leadership skills, but that they face unique challenges in the context of a historically gender-structured, hierarchical society. The observation of higher grant funding among women at time of Chair appointment suggests a possible need for interventions such as unconscious bias training to ensure that selection processes do not hold women to a higher bar.