Fixing the 'Leaky Pipeline': More Women Leaders in Medicine

Medical Students Changing Medicine

Jane Hayes; Iris Kuo

Disclosures

March 29, 2019

Here's a "fun" activity: Go to your institution's website and find the page with all of the department heads. Count the number of women and count the number of men. Now—stay with us—count the number of men with facial hair. What do your numbers look like? If the pattern at your institution resembles the trend that Wehner and colleagues found in the top 50 medical schools in the United States, just the men with facial hair might have outnumbered all of the women.

However, as medical students, when we look around at our peers, we see equal numbers of women and men. So why does the representation of women look so different at the start of the academic medicine path compared with that seen during a career? The percentage of women medical students has been higher than 40% since the 1995 to 1996 academic year. In fact, looking back to the 1988 to 1989 academic year, one third of the graduates from medical schools were women; about 30 years later, in the 2016 to 2017 academic year, only 17% of medical school department chairs and 17% of deans were women. These numbers are even lower for women of color.

The decreasing representation of women at each higher rank within academic medicine is at least partly a result of the phenomenon referred to as the "leaky pipeline." Whereas previous explanations of gender inequity focused on the lack of women going into medicine (the "pipeline problem"), the leaky pipeline model acknowledges that women have made up a significant portion of medical students for a couple of decades but are leaving academic medicine at multiple points, resulting in gender disparities, particularly in leadership.

Different Standards

One of our first introductions to this issue was through Robyn Klein, MD, PhD, during a talk in which she discussed her work in studying and combating the omission of qualified women from major academic conferences in neuroimmunology. When she surveyed conference organizers as to why women were so underrepresented, one of the reasons given was that "there was a lack of women with the appropriate expertise." Klein's research found this statement to be false.

Similarly, other studies have demonstrated that women's grant proposals may be held to higher standards than those of men, and men are more likely than women to be described with words like "pioneer" and "innovative." Women's successes, in contrast, are often attributed to their environment or effort, as opposed to their talent. Studies using CVs have found that those with a man's name are more likely to be judged favorably than those with a woman's name. Why do we tolerate different standards?

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